Category Archives: healthcare

September 29, 2010 · 23:58

Suicide isn’t Painless: The Epidemic of Suicide in the Military

I leave the Naval Medical Center Portsmouth Virginia tomorrow and toward the end of October report as the Command Chaplain for Naval Hospital Camp LeJeune North Carolina. My last time at Camp LeJeune was as part of the Portsmouth SPRINT (Special Psychiatric Rapid Intervention Team) mission to care for Emergency Department personnel at the Naval Hospital and Base Fire/EMS responders to a particularly gruesome suicide of a young Marine who had recently served in Iraq and was preparing for another tour.

As a Chaplain and in my previous life as a Medical Service Corps officer commanding a Medical Company in Germany and Brigade Adjutant in Texas I have dealt with a lot of suicides, attempted suicides and the lives left shattered by suicide.  Likewise I have seen the results of suicide attempts as a trauma, emergency and critical care chaplain in major medical centers. I have attended the DOD Suicide Prevention Conference on a number of occasions and gotten to know many of the experts working in the field.

As I said I began my career as an officer in the Army Medical Service Corps. We had a close connection to the movie and television series M*A*S*H and the theme music to that movie is emblematic of the feelings of many combat vets who continue to deploy even after making many combat deployments. http://www.metacafe.com/watch/3444418/suicide_is_painless_johnny_mandel/

Through early morning fog I see
visions of the things to be
the pains that are withheld for me
I realize and I can see…
[chorus]:

That suicide is painless
It brings on many changes
and I can take or leave it if I please.

I try to find a way to make
all our little joys relate
without that ever-present hate
but now I know that it’s too late, and…
[Chorus]

The game of life is hard to play
I’m gonna lose it anyway
The losing card I’ll someday lay
so this is all I have to say.
[Chorus]

The only way to win is cheat
And lay it down before I’m beat
and to another give my seat
for that’s the only painless feat.
[Chorus]

The sword of time will pierce our skins
It doesn’t hurt when it begins
But as it works its way on in
The pain grows stronger…watch it grin, but…
[Chorus]

A brave man once requested me
to answer questions that are key
‘is it to be or not to be’
and I replied ‘oh why ask me?’

‘Cause suicide is painless
it brings on many changes
and I can take or leave it if I please.
…and you can do the same thing if you choose.

Last week four soldiers, one a highly decorated senior NCO and all combat veterans are believed to have committed suicide at Fort Hood Texas.  The base which has already seen more than its fair share of tragedy with 14 confirmed suicides this year is stunned that these occurred in one weekend.

Defense Secretary Robert Gates commented about the stress on the all-volunteer force: “No major war in our history has been fought with a smaller percentage of this country’s citizens in uniform full-time — roughly 2.4 million active and reserve service members out of a country of over 300 million, less than 1 percent,” as a result the wars have been fought by a small proportion of the country, for many they are “a distant and unpleasant series of news items that does not affect them personally.” While the distance grows between those that serve and the general population military families are under even more stress, with anxiety and disruption inflicted on children, increased domestic strife and a growing number of suicides. Divorce rates in the Army have doubled since the wars in Afghanistan and Iraq began.

In the years prior to about 2004-2005 the military suicide rate was almost always below civilian rates in all demographics.  This is something that we took legitimate pride in.  That began to change as the war in Iraq shifted from a “Shock and Awe” campaign to a rather nasty and intractable insurgency this began to change as the deployment tempo increased and the Army increased its “boots on ground” time from a year to 15 months with a one year dwell time between deployments. Even as Iraq calmed down and the US role shifted many troops remain and Afghanistan has become a much more difficult war than it was even a few years ago. The Marines retained a 6-7 month deployment schedule but as the war went on and personnel requirements increased many Marine units were doing 6 months in country and 6 months home.  The difficult of what was described as “dwell time” for the Army and Marines was that for all intents and purposes it wasn’t. The units would get a few weeks leave and stand down time on their return home and then begin preparing for their next deployment. These preparations out of necessity entailed much time in the field training including trips to the Fort Irwin National Training Center (NTC) or the Marine Corps Air Ground Combat Training Center at 29 Palms.  Speaking from experience before 9-11 I can say that a Marine battalion going to 29 Palms in reality makes a short but intense deployment which is taxing on the organization even as it sharpens combat skills.  The same can be said for Army units going to NTC.  Thus the time that is nominally considered time at home to recuperate is not that and instead serves to keep the pressure on already stressed units, leaders and soldiers/Marines.  In the intervening time those that present to mental health providers or chaplains are provided with care to get them back in shape for the next deployment but never really get to deal with the deeper psychological and spiritual wounds. These include “moral injury”  which often involves unresolved grief for the loss of comrades and real or imagined guilt for their own actions in war.  Such wounds ultimately create despair, loss of faith and eventually cause some service members to make attempts on their life with varying degrees of “success” in “completing” the suicide.

The result is that those who have experienced the moral injuries that come as a result of combat, seeing comrades killed and wounded, participating in actions where they are directly or indirectly involved in killing the enemy, see the “collateral damage” of civilians, including children killed and maimed go right back into to fight.  Since this war has now gone on longer than any war in US history and we are fighting it with an all volunteer force of limited numbers with many making multiple deployments, some as many as 5 or more these wounds are pushed aside.  The effect of this is a cumulative grinding down of those that serve in harm’s way. Many suffer from some form of psychological, neurological or even spiritual injury that in combination with other life stressors make them particularly vulnerable to taking their lives.  In regard to moral injury “Many of the troops kill themselves because they feel that those kinds of experiences have made them unforgivable,” said Dr. William Nash, a top PTSD researcher. “It’s a lot harder for most people to forgive themselves than to forgive others.”

Unfortunately there is a stigma attached to seeking treatment or admitting that one is suffering from depression, anxiety or any other condition associated with either seeking help on their own or being “command referred” for psychological/psychiatric help.  Since that stigma is real many war fighters don’t seek help and take “refuge” in destructive behaviors such as alcohol abuse, drug abuse (to include prescription drugs) and risky behaviors.  One wonders how many of the single vehicle accident fatalities that occur late at night to combat vets are not accidental at all but are suicides by another more “socially acceptable” means.  If a forensic psychological profile was done on every service member that dies in such events I would guess that the finding would be a lot more suicides not an accidental deaths as we would like to believe. Yes all of these deaths are tragic but it is far easier to rationalize death in an auto accident than death by gunshot, knife wounds, overdose or hanging.

I am not proposing any solutions for this problem.  I do believe that somehow the deployment tempo needs to be slowed down to allow troops to actually recover and get help.  This is one of the suggestions of the DOD Suicide Prevention Task Force.  Their report is linked here: http://www.health.mil/dhb/downloads/Suicide%20Prevention%20Task%20Force%20report%2008-21-10_V4_RLN.pdf

When I go to LeJeune I know that as a Chaplain at the Naval Hospital I will be collaborating with our mental health professionals to provide care to Marines, Sailors and their families that are living this daily.  The Marine situation is poignantly show in this article: http://www.nctimes.com/news/local/military/article_3dc03ec3-6a37-5608-8563-aca88f635271.html

I have served with the Marines almost 6 years and from what I see the Corps has changed.  It is battle hardened but less resilient than it used to be.  The Marine Corps’ suicide rate has reached 24 per 100,000, a rate that surpasses all the other services. The rate was 13 per 100,000 in 2006 when I finished my tour at Marine Security Forces. The latest available figures put the civilian suicide rate at 20 per 100,000.  The problem extends past active duty as Veterans Affairs Secretary Eric Shinseki, the former Army chief of staff, said the suicide rate for men aged 18-29 who have been discharged had gone up by 26% from 2005-07. Likewise, “of the more than 30,000 suicides in this country each year, fully 20% of them are acts by veterans.” This means as Shinseki said “on average 18 veterans commit suicide each day. Five of those veterans are under our care at VA. So losing five veterans who are in treatment every month, and then not having a shot at the other 13 who for some reason haven’t come under our care, means that we have a lot of work to do.”

There is also an effect on military health care providers of all kinds and chaplains. These individuals not only have to deal with their trauma but the trauma and hopelessness that they see in many of their patients or parishioners. These caregivers have no respite between deployments because their reason for being is to care for the Soldiers, Marines, Airmen and Sailors that present to them be they deployed or back in a military hospital or clinic.

The work will be hard and long after the last Marine, Sailor, Soldier or Airman leaves Iraq and Afghanistan we will be dealing with this for years to come.

Peace

Padre Steve+

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August 12, 2010 · 22:32

Thoughts on the Occasion of getting ready to Transfer

Two years ago I was preparing to leave EOD Group Two and getting ready to move over to Naval Medical Center Portsmouth.  At that point in my life I was falling apart. The ravages of PTSD, depression and chronic pain from shoulder, knee and ankle injuries sustained in Iraq had taken their toll. Chronic anxiety, flashbacks, night terrors, vivid and disturbing dreams of Iraq, nearly uncontrollable emotions that ranged from intense sadness complete with that girl thing of crying to intense anger and rage, especially in traffic were a daily staple of life. Fear of large crowds, noise and light sensitivity panic in airports and fear of new places brought me more isolation and pain.  I went to the new assignment with trepidation but with a desire to make an impact.

When I got to Portsmouth I did my best to cover up the affects of PTSD and everything else that I mentioned in my life for the sake of work. I threw myself into the job; especially the patient and staff care aspect of it.  I worked painfully long hours usually due to my own need to know that I was still of some use despite all that was wrong with me and I ended up getting worse and not better.  I was in therapy and most of my colleagues and my boss tried to take care of me although I’m sure that they probably wondered if I was salvageable at times. I am thankful for their support as it was needed and vital to getting me through but I still sunk down deeper into the abyss.  Nothing was getting better and I even doubted if God was even around, or if he was around if he even gave a damn about me. I was experiencing what I am now not afraid to call, not just PTSD but let me call it what it is, mental illness.  In addition I was in a full-fledged crisis of faith. During the year I had experienced the loss of a number of friends and colleagues and each one deeply affected me plunging me deeper into depression. Christmas of 2008 was the worst that I had ever experienced from a spiritual point of view. I left the Christmas Eve Mass at my wife’s church before the Mass began into the night for an hour before I got home. I looked up at the sky and cried much of the time wondering if God was there and if he was wondered if he had abandoned me.  As I got worse I stopped doing the things that I needed to do to take care of myself, good nutrition and exercise was out the door and I gained 25 pounds in 6 months and ended up on the fat boy program.  By late August I was in worse shape than I had been the previous September and it was in mind, body and spirit.

For someone like me this was almost more than I could handle and my boss, recognizing that I was not doing well pulled me kicking and screaming out of the ICU and PICU and pushed me to take care of myself and get help.  I began to do this but if you have been as down as I was you understand that recovery doesn’t happen in a day, or even a week.  It is a continuous and often painful process mixed with times where you begin to see occasional fleeting glimpses of hope.  I struggled for the next three months until a couple of weeks before Christmas I was called to the ER and in a moment of grace in the midst of my own despair I was called upon to perform Last Rites for a retired physician that was Episcopalian. As I performed the Sacrament he breathed his last, his wife and son said it was like he was waiting to receive that before he died.  Something happened that night and things began to turn around, unfortunately the young Intern physician that called me to the scene and with whom I took remedial PT tests and nutrition classes died a little over a month later.

However, Christmas of 2009 was different, for the first time since I was in Iraq I felt joy, and slowly things began to turn around.  The first part was spiritual, the next physical and psychological.  Each month I got a bit better and it was if a thick blanket of California Central Valley Thule fog was dissipating with the sun beginning to peek through.  In February I was felled by a kidney stone for a month, my physical recover was slowed but didn’t stop. Spiritually things were getting better, on the psychological side of the house my PTSD symptoms were evening out, panic attacks were going away and for the first time since before Iraq I was beginning to sleep.

In June I had three events that converged to change my life.  I was selected for promotion for Commander on June 22nd, or at least that was when the message was released.  The next day my dad who had been suffering from Alzheimer’s disease for nearly 7 years passed away and two days after his memorial service I found that I was being transferred to be the Command Chaplain of the Naval Hospital at Camp LeJeune North Carolina.

As far as promotion I am grateful to my boss because I showed up damaged and was not fully functional he chose to grade me on my potential for service on my fitness reports and made sure that what went to the promotion board was something that would help my selection.  I would guess based on my knowledge of the system that not many senior chaplains or for that matter senior officers would do the same thing.  I would have been dealt with like I was a broken piece of equipment and allowed to serve out my career but never rising to anything more than that.  This leads me into the transfer which will allow me to get my feet wet as the Command Chaplain of a decent sized hospital on a very busy base which is fully engaged in the war.  It will be challenging and I will supervise three chaplains and three enlisted religious program specialists.  Much of what I have learned recently will help me in that job and I hope to do well in it to serve the patients and staff in that hospital.  I want to be a good boss to the men and women that work in the department and hopefully am able to do some things that will knit pastoral care even more tightly into the interdisciplinary team for better care of patients, their families and hospital staff.

I have mixed feeling about leaving. I will really miss the people that I have worked with the past two years. I will not miss the perpetual staff shortages and having to be the go to guy so often, maybe even get to take some leave that is actually the kind for refreshment versus taking care of family emergencies.

My friends at Portsmouth will be that and I will miss them and keep up with as many as I can through e-mail and Facebook.  Some have been, are being or will be stationed in LeJuene and it will be great to be with them in North Carolina.

Today was a frustrating day that kept me going all day and with the exception of my PT test which I crushed with 100 sit ups, 70 pushups and just under 12 minutes for the 1.5 mile run, which I did on a stationary bike so the calorie count was converted to the run time. Not too bad for a 50 year old. I would have done the run as my ankle and knees are fully healed but I couldn’t do it until noon when the temperature was too hot.  When I get to LeJeune I will do the run. My interval training and PT program coupled with my diet is paying great dividends.  I have lost 4.5 inches around my belly since late November 2009, lost 16 pounds and 10% body fat, going from 32% body fat to 22%. I am not done as I want to lose 3 more inches around the belly and 10-12 more pounds of weight.  I’d like my body fat to be under 20% and keep it there, getting lower of I can.

I’ll have some more reflections over the next couple of weeks. My friends in the ICU are planning something for me and I am really blessed to have such great friends and colleagues. I am told that the pastoral care staff will have a good-bye as well, but that is kind of expected, the real joy for me comes from the people that I have gone through difficult times within the ICU in the high stress environment of live and death situations, ethical consults and pastoral care administering prayers, counsel and sacraments to our patients, their families and our staff, my friends.  That means more than almost anything to me as they have walked with me through the darkness.

Peace,

Padre Steve+

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June 22, 2010 · 00:53

Busy Night on Duty…Updates resume Tomorrow…wait it’s tomorrow already?

Well it has been a busy day and busy night, not even a leisurely lunch break where I could at least post a Tides update.  I’m now behind two of those, the Tides lost the last game of their series against the Mud Hens 5-1 on Sunday in Toledo, made the tip back and lost to the Lehigh Valley Iron Pigs 6-4 on a game blown by recently brought up from AA pitchers.  I have a couple of other things that I want to write but have not had time.

Tonight is very busy.  We had a 27 year old man named Kenneth pass away after a courageous battle with cancer in which he and his family were beautiful examples of grace, touch all around them despite the nature of his illness and progression of the disease.  From there I went to care for the family of a 2 year old who drowned and was resuscitated but the outlook for this young child is bleak.   Finally I spent a long time with a dear lady who after a long struggle against heart and renal failure has decided not to undergo any heroic measures and may die in the next couple of days.  I have known this women most of my tour here and I was able to make time just to sit with here and let her tell her story of faith and life, thoughts on heaven.  She is a beautiful woman that has been a blessing to me even when I was going through the depths of my crisis in faith in 2008 and 2009.

Lord knows what the rest of the night might bring but I hope to get a little shuteye soon.

Blessings

Padre Steve+

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May 12, 2010 · 00:56

Padre Steve Might be a Mad Cow Carrier and Can’t Give Blood…He’s “Mad” as Hell and isn’t going to take it anymore!

I am guilty yes guilty my friends.  I have about a one in a zillion chance of having the dreaded variant Creutzfeldt-Jakob Disease but if your believe those who promote conspiracy theories and unscientific assumptions I am probably something like Typhoid Mary just waiting to unleash death and destruction on millions of unsuspecting God fearing beef eating Americans by donating blood.  That is my alleged crime and while it is not a ‘crime’ in the truest sense of the word it might as well be as it ostracizes me and hundreds of thousands, maybe even millions of veterans and their dependants from a civic duty that many of us did before all the media hype that surrounded the decision to ban us from being able to give blood.  It is discriminatory, exclusionary and for that matter bad public policy.

Now my dear readers what is my crime and the punishment that has been inflicted on me?  I was in the military and lived in Europe in the 1980s and 1990s for a period of about four years. That my dear reader makes me ineligible to donate blood even if I am otherwise healthy and willing to give in time of need.  However the rule is rather arbitrary in nature. It specifies that living in most of Europe for 6 months or more if you are in the military is enough for a person to be a risk.  However the rules tolerate those who go on beef eating and haggis hogging binges for limited amounts of time while wearing kilts in Great Britain. It is an absurd standard to hold anyone to as the fact is simple, if you didn’t eat high risk cattle you have almost no chance of contracting or carrying the disease.

I readily admit that in that time in Europe I did eat beef. Mind you dear reader it was always well cooked and I certainly never ate Haggis.  However I am now and have been for many years treated as if I had some exotic and deadly plague like I was infected with HIV or Hepatitis B, diseases that are proven to be transmitted through contaminated blood products. I my friends am the poster child of what it is to be discriminated against based on special interest groups and media fear mongering.  That absurd fear mongering got our wonderful Food and Drug Administration and other government regulatory agencies to take draconian measures to stop something that in the scope of infectious disease is rather low on the threat scale.  I say that such action is not based on legitimate public health concerns but on a political agenda that uses fear to accomplish what it never could at the ballot box.

Now mind you Creutzfeldt-Jakob disease (CJD) or the variant Creutzfeldt-Jakob Disease (vCJD) or the real “Mad Cow” disease is no laughing matter but statistics underlying the incidence of the disease in the United States of vCJD show that if there is a threat it is very limited and that the chances of the Cubs winning the Worlds Series are better than getting this dread disease. Even statistics of a supposed “second wave” of vCJD in Great Britain estimate about 70 persons over a period of years during a “second wave” of vCJD might die, at worst case the number is 600.  In fact in Britain only one case of transmission of vCJD though blood products has been confirmed and if all people who had eaten beef lived in and eaten beef in Britain were barred from  donating blood the British would likely have to convert oil tankers to bring blood in from around the world. But they are not while people in the United States who lived in Europe, not even Great Britain are banned as a class from donating blood and the vast majority of these Americans are military members and their dependants.

I am a supporter of stringent policies on infectious diseases but if in Britain, the very epicenter of a disease that reared its ugly head in the early 1980s people can and do donate blood and the incidence of the disease is miniscule and is scientifically regarded to having more to do with genetics than eating beef.  Yet the Federal Government responding to fear mongering press reports and conspiracy theory maniacs have banned an entire class of people from donating the gift of life to those in need.  It is absurd and dishonest and plays into the hands of fear mongering power seeking special interests groups that claim the public good while discriminating against a whole class of people whose only crime was to serve their country.  Bill O’Reilly and Steven Colbert do you hear me?

Before this I was almost a religious blood donor I learned it from my dad who I think had his golden bucket from the Delta Blood Bank in Stockton. In fact he took me to donate for the first time and I continued because it was the right thing to do. I donated until I was branded with the scarlet letter of being a potential carrier of variant Creutzfeldt-Jakob Disease and have been refused ever since.  This is also true for hundreds of thousands and possibly millions of healthy military members, veterans and family members who ate a steak in Germany or some other western European country because we might have eaten a significant amount of “Bully” British Beef or perhaps a butt load of Scottish Haggis even though the chances of having these delicacies is significantly lower in good old Deutschland where people would rather eat Argentinean beef than beef from a country that they thought they should own by now and where the vast majority of the beef is well rather “brown-shirted” if you get my drift.  If the CDC or FDA has banned a whole class of patriot Americans from donating blood at least do it based on a preponderance of evidence and not speculation and paranoia.

In the United States we often run short of blood but we exclude by default one of the healthiest and giving groups of people in the world from giving. There are times in every major medical center that blood products run in short supply because of supply and demand.  Most donations centers have on hand no more than a 3 day supply for normal transfusion needs and if a major catastrophe involving vast numbers of traumatic injuries occurred, the supply would be gone in no time and people would die for the lack of blood.  Unfortunately in the world of potential mass casualties caused by terrorism or natural disaster this is a more likely occurrence than a mass outbreak of vCJD. Quite often there is more demand than supply and red blood cells have a short shelf life of 35-42 days at refrigerated temperatures and plasma can be frozen but has a shelf life of only about a year meaning that those stocks are also limited.

So rather than looking at statistics and solid data military members are banned from donating blood unless they choose to dishonor themselves by lying about it.  I have never done that as much as I wanted to give blood.  Heck we have an Armed Service Blood Center in our very hospital whose outreach director is one of my former Lieutenants from my days as a company commander in Germany.  I may be at times “mad” but my “madness” is both genetic as from a bit of PTSD, but my blood is a-okay high test 104 Octane B positive blood and I cannot donate when I want to because the debate is being driven by anti-beef eating, anti-military food Nazis who use this ‘cause’ to spread fear and increase their power relative to the rest of us.  Just take a look at their websites which are populated with hyperbole even more hyperbolous than what I spout.

I contend that I and hundreds of thousands of veterans and military members have been damaged by the zealotry of the “Mad Cow” fear mongers and their media accomplices which did its best to spread panic about this incredibly rare disease by showing infected cattle lurching around barnyards. Now it is true that this is a heinous disease but incredibly rare and for the most part has been controlled even in docile cows.

My argument is that there is a terrible need for blood products and a whole group of people are being discriminated against on the basis of media hype and pressure by special interest groups.  I know by saying this that it makes me a target and that once this post gets some hits that I will have one of these anti-beef eating, anti-military and national security ignoring bozos will post nasty things about me. So far as they don’t call me a Dodger fan I will be civil despite the fact that they won’t rest until none of us can give blood because we ate beef once in our lives.

I wish that some bold law firm would take this up as a class action suit naming the FDA, CDC and every major television network that spread the fear which drives the decision to bar an entire group of healthy people from giving blood.  This may seem callous and insensitive but I say let’s stick it to these guys and let them see the shoe is on the other foot. Let’s kick their vegan asses back to the planet Vegan where they belong. It’s late tonight but tomorrow its cheeseburger time for Padre Steve, pass the condiments please and get my stein ready.

So until the next time I say peace and may the law be with us. Maybe there is a reason that some of my classmates in seminary said that I should have gone to law school.  Maybe that’s what I’ll do with my GI Bill when I retire go to law school pass the bar and be a Priest-Lawyer, but not a Canon Lawyer, no money in that is there? So let’s go out and win a billion dollars or so from these oppressors of individual liberty and the common good.

Anyway Peace Out my brothers and sisters, have a burger or steak tonight.

Love ya,

Padre Steve+

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April 8, 2010 · 23:41

She knew that it was Time….Padre Steve’s Reflections on Pastoral Care Residency

Sometimes death comes unannounced but other times it sounds a warning.  Most of the time we think of such warnings as what our body is saying to us, maybe someone is having chest pains or that we know of a terminal condition which is getting worse and the doctors say that there is nothing else that they can do.  Other times it appears that some people almost have a sixth sense about their impending death and leave notes or say “goodbye” to loved ones in a different way than they would normally do.

When I see or hear about the sixth sense kind of incident I find that I am intrigued.  As a student of history I have read accounts where soldiers know that they will not survive a particular battle and leave things for their friends to give to loved ones.  There have been times when I have had a sixth sense about what was going to happen to someone and the feeling is like you are watching something unfold in slow motion but can do nothing to stop it.  A strange feeling that I’m sure some of my reads have experienced.

This story is a bit different and took place during an overnight as the “on call” chaplain at Parkland Memorial Hospital in Dallas during my Clinical Pastoral Education Residency. Parkland is a rather large, at the time of my residency a 940 bed county hospital and Level One Trauma center.  The “on call” chaplain after normal hours was the only chaplain in the hospital to cover all emergencies in the house.  Usually I stationed myself in the ER area as that was the “hottest” place for ministry at any given time.  I would always take a spin around our 9 ICUs but unless something was going bad on one of them would always end up back in the ER.

One night I had just finished with a situation involving a death in the ER when about 9 PM I got a page from “9 South” our General Medicine Step-Down ward.  The nurse that I talked to when I returned the page said that I needed to come up because she had a patient who was convinced that they were going to die that night.  I said that I would be right up and made my way up to the ward.

I got to the ward about 9:15 PM and met the nurse who further explained the situation to me while I reviewed the chart.  The lady was in her mid-30s and was HIV positive. She was Baptist and her husband who was also HIV positive and in a more advanced stage of the disease had just been discharged from the hospital the day before. The lady had come in for a few day stay as she had been spiking a fever but that was under control and was scheduled to be discharged in the morning.  She was not at the point of having any of the major opportunistic infections or diseases associated with full blown AIDS and her T-Cell count was good.  Clinically she was stable and expected to do well for a number of years to come.

The problem was that just after shift change the patient had told the nurse that “the Lord was going to take her home tonight.”  The nurse said that she had called the Medicine resident to come and speak with the lady but that the resident could not convince here that she was going to be okay and that she told both of them that she was going to die that evening and “go home and be with Jesus.”

Now for those who have never lived in the south “going home” is not like leaving the office at the end of the day.  Elvis “went home” wherever that was (see “Men in Black”) and if you are talking with someone raised in the south starts talking about “going home” you better stop and clarify to make sure that they are going home to watch the Braves on television and drink a beer or if they are planning on dying.  I had a grandmother who from the time that I was 5 years old kept telling that she was either “going home” or “wasn’t going to be around much longer,” of course she almost lived to be 90 and “went home” when I was 40.  But I digress.

Now patently I am generally of the mind that if the numbers say that you will live I believe the numbers.  I’m a baseball guy, God speaks to me through baseball and I play the percentages, it is the rational thing to do, which means that while I believe that God can intervene in situations I don’t bet on that happening. I read the chart, talk to the nurse, talk with the resident and I am convinced that this lady will walk out of the hospital in the morning.

Then I met the lady. She was sitting up in bed with her Bible open beside her on the mattress and she appeared to be very calm and there was a peaceful sense about her.  She was from Jamaica and very polite and when I introduced myself to her she greeted me warmly with the accent characteristic of that island nation.

“So you are the pastor?” she asked.

I replied that I was the Chaplain and a minister and that the nurse and doctor had asked me to spend some time with her.

She then said “Ah yes, they do not believe me.”  So I asked her what was going on.

She then described to me what had occurred that evening.

“You see pastor, the doctors say that I will go to my house tomorrow but I will not.” She paused and I nodded for her to go on and said “really? Tell me more.”

She continued “Pastor you see this evening Jesus came to me, he visit me and tell me that I will go and be with him tonight.”

Now I have to admit that I was skeptical but she was not acting emotional or even bothered by what she just said.  I was fascinated and asked her to tell me more.

She then went on a recitation of her faith journey from the time that she was a young girl and how she frequently would sense God’s presence and hear his voice at different points in her life, how she had gotten HIV from her husband and how much it meant for her to be right with others and God.  So I asked about the specifics of “why tonight?”

Calmly she explained. “The doctors tell me that I will be well and go home tomorrow. They tell me that I am in good condition, but that does not matter to me because Jesus told me today that he will take me home to be with him….tonight.”  Her tone was as if this was a regular every day occurrence and her face was radiant.  She continued “I love Jesus and know that he will not lie to me so I know that I will be with him tonight.” Her faith was touching and powerful in its simplicity and the amount of trust that she showed even to a message that she believed to be from Jesus that was completely different than the news of the doctors.

After our conversation which lasted about 30 minutes with me probing her faith, asking what she understood about her condition, talking about family which seemed to me for her was a conversation where she was tying up the loose ends of her life and that I was the person that she was taking the time to share them with.   As we closed she asked me if I would pray with her and give her a blessing which I did.  She thanked me, reached out and asked for a hug and she embraced me weakly let go, and thanked me again.  I was moved by this, still not convinced that Jesus would take her home, but not disbelieving her either.  When I was done I charted my visit, wrapped things up with the resident and the nurse and went back down to ER where more carnage was waiting.

About 2:30 AM my pager went off and it was 9 South calling.  I returned the call and the nurse that I had talked with earlier was on the line.

“Chaplain, please come quick, I went in to check her vitals and she is dead!”  I put on my best calm voice and said “Who is dead?”  The nurse nearly in a panic said “the lady that said that God was going to take her home, she died.”  I said okay I’ll be right up and went up as quickly as I could and got to the ward to find the nurse pacing anxiously outside the door of the patient’s room.  I asked if the nurse if she was okay, meaning her and not the now deceased patient and the nurse replied that she was upset by the death because the lady should not be dead and that she didn’t understand how the patient could calmly know that she was going to die.  Now the nurse was not a southerner unless it was the south part of the Indian Subcontinent.  Relatively new to Texas and the south she was not as attuned to some of the religious and cultural aspects of either the south or south Jamaica.  After helping the nurse calm down I met the resident who was in the room looking perplexed and as I walked in he said she shouldn’t be dead.  I just said to him “that sometimes it’s just someone’s time even if the numbers don’t say so.”  He said “Yeh, I know, but this was really freaky she told me that she was going to die tonight and she did.” I did concur that it was a bit on the unusual side but that we couldn’t discount what she believed especially since she had been correct.

As the resident went to finish up paperwork I looked at the woman. It looked like she had simply fallen asleep her Bible was on her lap and opened to Revelation around the 21st chapter and although I cannot be sure exactly what she was reading can only imagine that it was this verse “See, the home of God is among mortals. He will dwell with them as their God; they will be his peoples, and God himself will be with them; he will wipe every tear from their eyes. Death will be no more; mourning and crying and pain will be no more, for the first things have passed away.” (Revelation 21:3b-5 NRSV) This dear woman had passed away, gone home looking forward to a place where whatever tears or sorrows she had would be wiped away.

I closed her Bible, placed her hands together over it and prayed a prayer of commendation before pulling the bed sheet over her face and body. On leaving the room I spent a bit more time with the nurse who was beginning to gather herself after this unusual death.  A couple of hours later I would escort the body of this woman to our morgue accompanied by the nurse and a LVN.  As we rode the elevator down we talked a bit more and as we made the walk down the long and empty basement corridor to the morgue we did so in silence.  Once I had admitted the body and locked the door the two nurses left to head back to the 9th floor and I took the chart and other paperwork up to our office where our decedent affairs clerk would complete the death certificate.  I thought how unusual this case was as I sat for a while in the office.  I had heard of similar things but had never seen something like this before where the person in question made such a claim and was right defying the numbers that said she would walk out of the hospital.

With that I wish you a good night.

Peace,

Padre Steve+

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March 25, 2010 · 23:41

And it’s One, Two Three Wives You’re out….Memories Residency at Parkland Memorial Hospital ER

Parkland ER (Life Magazine Photo)

This is another one of those unusual incidents that I faced during my Pastoral Care Education Residency at Parkland Memorial Hospital.  I was in a mood over the weekend and wrote one that was really creepy called The “Eyes” have it; they’ve got Sammy Davis Eyes….an Experience from My Clinical Pastoral Education Residency about a day where I dealt with two unusual eye cases. That one read almost like something from “Tales from the Crypt” or “Tales from the Dark Side.”  This is less creepy and sort of ironic in a weird sort of way.

The day was one of those typical Parkland days during my residency where the abnormal was the norm and norm was not doing so well….or at least Norm (my name for this particular patient- the name has been changed because his real name was probably even more boring) wasn’t doing well.  But first let me lay a little background.

Some people live life with secrets.  Yes my friends SECRETS.  These are dirty nasty secrets that they don’t even share with people inside their “circle of trust.”  In fact I had a brother in law who was much into something called bigamy which if you ask me wasn’t very biga-him or bright of him.  We figure that he had a number of “families” and since he can’t be found in the Social Security Death index assume that he was operating under a number of names and socials….but I digress God rest his soul.

It seems that sudden and uncontrolled events sometimes bring secrets to light, in fact I think that somewhere Jesus said something about this… something like whatever is done in the dark will be seen in the light…you something like that. Sometimes these traumatic events reveal secrets that are for the individual a fate worse than a fate worse than death…which in the case of Norm was true in both ways.  Its almost like when “Death” shows up in an episode of Family Guy and I can in sense see this happening with Norm, Death deciding to visit him at work.

Norm as I call him had an accident at work….he worked in an oil refinery and since we all know from Al Gore that oil companies are all bad it was probably their fault.  However….Norm had a very bad day, in fact it could be labeled the suckiest last day of his life where indeed Death paid him a visit.  We don’t know really what happened but toward the end of the work day Norm the unfortunate either fell into a vat of hot tar at the refinery and subsequently went into cardiac arrest, or he went into cardiac arrest and fell into the vat of hot tar.  So the Dallas Fire Department EMS showed up quickly and with the assistance of the refinery rescue team extracted him from the muck, got an airway began CPR and rushed the tar covered Norm to Parkland where as usual when odd things occurred I was on call.  As they brought him in the paramedics had the pneumatic CPR machine known as “Thumper” going and were “bagging” him.  Needless to say Norm did not look too well.  He was brought into the Cardiac Resuscitation room one, a fully equipped state of the art room designed to give the treatment team on the Medicine side of the ER the best chance to save someone’s life, they were a medicine version of our Trauma rooms on the surgery side of the ER.  However the team realized very quickly that Norm had bought the farm and the code was called.

I began to work with the nursing staff to try to find out if Norm had any family but stopped when a woman identified as his wife showed up.  She was escorted into one of our three ER consult rooms by one of our Police officers.  There a young resident did his best impression of Star Trek’s Doctor McCoy “Mrs. Norm…he’s dead.” I think he expressed his condolences as well, he answered her questions the best that he could while the nursing staff and I supported and calmed her.  When he was done and death and funeral home paperwork was done we escorted Mrs. Norm to see her now departed husband and after a tearful visit to him we took her back to the consult room, gave her a chance to compose herself and ask more questions.  When she was done she departed saying that a friend was waiting for her.  With that done the nursing staff began to prepare his body for the morgue where he would briefly remain until the Dallas Country Medical Examiner staff picked him up.  I busied myself with taking care of the staff and checking the charts and paperwork since Chaplains were also the guardians of the Morgue since the Pastoral Care Department also handled Decedent care.

About 45 minutes after the wife had left the officer who had escorted her to the consult room came to me.  He said “Chaplain his wife is here.”  I looked quizzically at him and said “No she left.” With a bit of a smile the officer, a really good guy looked at me and said “No Chaplain not her, another one.”  I was floored. Another wife? This certainly couldn’t be happening.  I thought this happened only in remote parts of Utah where renegade fundamentalist splinter groups from the Mormon Church flaunted the main Church of Jesus Christ of Latter Day Saints by practicing Polygamy and we were in the heart of Dallas with big hair, big cars, big churches and the Cowboys, but not this. After gathering myself I went to the physicians and nurses to tell them the good news.  As they stared at me blankly I got the doctor who had talked with “Number One” to come and spend some time with “Number Two.” We repeated the procedure with wife number two, notification was given, pastoral care and prayer provided, a visit was paid to Norm but with the twist that the doctor asked if she knew about any other family.  Which she did not and since “Number One” had presented the appropriate identification first we let “Number Two” know that she would probably have to deal with the hitherto unknown “Number One.”  Surprisingly though the news had taken her by surprise she was sort of okay with this and left for wherever.

I went back to the doctor’s station where I was working on paperwork and talking with the incredulous staff about what had just transpired when one of the unit clerk’s came over to us.  She said that Norm’s wife was on the phone.  The doctor and I looked at each other and I asked “which one?” The clerk then said “the one in Mexico.”  Yet a third wife….the doctor and I let her know that Norm had passed away and that she needed to contact the Medical Examiner’s office for more information.  The doctor asked if Norm has any other “family” and “Number Three” said just her and her children.  Norm really got around.  The doctor and I decided not to break the fact that she was “third” to her and let the Medical Examiner’s office sort out the sordid details of this twisted evening.

So it was one, two, three wives and Norm was out at the old ball game.  I have no idea what happened later but can only imagine what it would have been to be a cockroach in the cupboard listening to the meeting of these three women who all shared the love, or maybe the lust of Norm.

Peace and stay safe and keep those relationships in order for any of us could be the next contestant on “Death pays a Visit.”

Peace my friends,

Padre Steve+

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March 20, 2010 · 12:17

The “Eyes” have it; they’ve got Sammy Davis Eyes….an Experience from My Clinical Pastoral Education Residency

Sometimes I gotta wonder about people, especially some religious people.  Of course we can all probably relate to some incident where someone with their religious beliefs led to somewhat unusual situations, even funny or tragic situations.

Of course when you work as a Trauma and Surgery Department Chaplain at a major inner city Level One Trauma Center like Parkland Memorial Hospital in Dallas, the unusual, the funny and the tragic can all be wrapped into one or maybe two two stories, sometimes on the same day.  Such an occasion occurred about halfway through my residency year at Parkland in March 1994.

About a quarter into my residency my Clinical Pastoral Care Residency Supervisor moved me from the Internal Medicine service to Trauma, Surgery and Neurosurgery service which included the Trauma and Surgery section of the Emergency Department. This several years before the hospital began their Emergency Medicine Residency and unified the ER.

We saw lots of trauma, back then we had six fully equipped trauma rooms as well as about 50 other beds of various types in the Surgery section of the ER.  The Medicine Section had three fully equipped Cardiac Resuscitation rooms, numerous telemetry beds and about 60 addition beds and rooms of various types and specialties.  When things got sporty as they often did additional beds were used in side halls for patients with minor injuries which sometimes included minor gunshot wounds.

It was often the case that every trauma and cardiac room would be full sometimes with multiple “codes” going on.  We saw about every kind of injury imaginable on the surgery side of the house and in the course of my residency year I dealt with well over 300 deaths in the hospital.  That may sound like a lot but back then Parkland was a 940 bed hospital that was usually running 90-100 percent of capacity and it had eight Intensive Care Units dealing with some of the worst trauma in the United States.  The most death calls I dealt with in one night was eight in an eight hour eleven p.m. to seven p.m  On a typical day if I left the hospital dealing with two deaths or less I considered it an easy day but I digress….I think I was talking some unusual, funny and tragic situations come together.

Well like I said about halfway through my residency I was hanging out in the Surgery ER about 10 a.m. on Saint Patrick’s day.  The morning had been busy with the usual bevy of motor vehicle accident victims from the rush hour and had died down.  It was then that the Dallas County EMS brought in a young man on a gurney who was taken to trauma room 6, the one in the back corner directly across from the “Presidential Suite” which was always cordoned off by the Secret Service when the President was in town.

The situation didn’t seem that interesting at first as I did not see the young man’s face but he appeared to be stable and since I was spending time with one of the nurses who had dealt with a patient in pretty bad shape from one of the MVA’s (Motor Vehicle Accident patients) I waited to check things out.

About 15 minutes later I wandered down to the trauma room and saw some of the Ophthalmology docs looking at the young man’s face peeking under the gauze 4×4 that covered his left eye and shaking their heads.  When I walked into the room a good number of staff looked at me, some with expressions of horror, and others amusement and still others just weirded out.  So I asked what was going on.

One of the Surgery residents answered and said that the young man had been doing crack cocaine and reading the Bible.  So I said “you mean the “if your eye offends you pluck it out” verse?” And the resident said that’s the one.  I looked at the young man and saw a large black Bible on his chest clasped in his hands. One of the Ophthalmology doctors looked at me and asked “Is that really in the Bible?”  I said “oh yeah, you want to read it?” He said yes and a number of his colleagues nodded in agreement.

Now the young man reminded me of what back in my younger days was referred to as a “stoner” kind of like Sean Penn’s character “Jeff Spicoli” in Fast Times at Ridgemont High. So not having a Bible in my hand just a small Episcopal Armed Forces Prayer Book I went up to him.  I said:

“Mr. Spicoli (the name has been changed to protect the stupid) I’m the Chaplain what happened?”  His answer was classic, “Dude sir, it was like I was reading the Bible and I saw this verse about “my eye offending me” and just knew that I had to take it out.” I said “Dude, you know that some parts of the Bible aren’t supposed to be taken too literally don’t you?” 

With his one good eye he looked up at me and said “Like I didn’t have to cut it out?”    I shook my head feeling somewhat compassionate yet amused (a feeling that many who work in ERs and trauma centers can attest to having) and said “No Jeff you didn’t….you weren’t using before you read the Bible were you?”  He then said, “Yeah, like dude, like why not?” 

I shook my head and said “Jeff my friend, God loves you and wants you to read his word but not while you’re doing crack, it tends to mess up your interpretation of it.” To which Jeff replied “Really, yeah dude you might be right.”

Now this was obviously a nice but really messed up kid so I decided not to push him any farther and commented on his Bible.

“That’s a pretty impressive Bible Jeff.”

Jeff replied “Yeah I got it like last week or something.”

I then asked him “Can I look at it with these doctors a second?”

I promised to give it right back.  When he gave me permission, I gently took the Bible from his hand and walked to the disbelieving (not in God but in what was going on) physicians with it.   Thumbing through the pages I came to Mark 9:47 and let the doctors read it themselves.  They were genuinely shocked and kept looking at Jeff as they read it.  The Ophthalmologist who had asked the initial question looked at me and said: “I guess that it wouldn’t be good to read that verse while doing crack.”  I smiled, shook my head and said “No, not a good idea.” 

With that I took the Bible back to Jeff and thanked him and he said “anytime dude.”  The docs were getting ready to transport him to surgery so I wished him well and told him that I would pray for him for which he thanked me.  I felt bad for the kid and knew that he would not be on the trauma service after the surgery and when medically ready would be hanging out in the Psych ward.  That was the last time that I saw him and I do hope that he was able to break his addiction and get his life together.

However, the day was still young and I had the overnight 7 p.m. to 7 a.m. on call duty in the evening. The rest of the day into the early evening was progressing rather uneventfully by Parkland standards, just your typical MVA’s, overdoses, cardiac arrests and shootings.

That changed when the Dallas EMS brought an African American lady who appeared to be in her thirties. Her eyes were covered with a bandage so I asked the paramedics what had happened.

One of them said, “Chaplain, you wouldn’t believe this in a million years, the lady’s sisters took her eyes out.” 

I said:  “Took her eyes out?”

The paramedic replied: “Yeah, like scooped them out, almost surgical precision. She said her sisters drove her from New Orleans to Dallas and along the way took out her eyes because they thought that she was possessed by the Devil.”

My reply was a simple, “Damn, that sucks.”

The paramedic continued “Yeah, she kept saying that her sisters said the she had “her father’s eyes” or something like that.” 

The conversation continued for a while as the paramedic vented about how idiotic and criminal what happed was and when he went to finish his paperwork and get back to his rig I went in to the trauma room where the lady was being assessed. I got a look at the eye sockets and was quite impressed.  The young man had gouged out his eye and made a mess. The lady’s eye sockets were just a little bloody and hollowed out like nothing had been there. It was rather creepy.

Since she was pretty out of it and not very coherent I backed out of the room, consult with the team and let them know what the paramedic had told me.  The story creeped them out as badly as it did me.  Later I would find out that the sisters had been arrested.  Evidently the lady was a school teacher and she and her sisters were heavily involved in hoodoo a blend of Voodoo and Catholicism. At their trial they claimed that they were “fleeing from the devil.” The victim refused to testify against her sisters but they were convicted of the crime. The link to the New York Times article and one from the UK Independent is here:

http://www.nytimes.com/1994/09/25/us/trial-in-woman-s-blinding-offers-chilling-glimpse-of-hoodoo.html?pagewanted=1

http://www.independent.co.uk/news/world/hoodoo-hex-on-interstate-20-the-blinding-of-myra-crawford-demonstrates-how-racism-and-fear-of-demons-linger-side-by-side-in-pockets-of-the-old-south-1412753.html

Never before and so far I have not seen a day where I have seen anything that unusual.  It was creepy like a really creepy horror movie.

All I can say about that day now was that “the eyes have it.” Unlike the Kim Carnes’ song, these folks don’t have “Betty Davis Eyes” but “Sammy Davis Eyes.”

With that to leave your stomach to churn I wish you a good night and pleasant dreams.

Peace,

Padre Steve+

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March 9, 2010 · 23:59

The End of Adolf the Kidney Stone…Padre Steve Muses on Surgery

Smiling again…Adolf is Dead

Well neither the Abbess nor I slept well last night as we waited for morning and the trip to the hospital.  I finally got to bed at about 0400 and was back up at 630.  We made it to the hospital in plenty of time.  I went by the office a few minutes and Chaplain Derek Ross walked us up to the APU and on the way took the time to pull aside at the small chapel near the OR to have prayer with us.

Adolf Getting Blasted By the USS Enterprise NCC-1701

Upon getting to the APU I was given pants, a smock and robe, which thankfully did not leave my tookus exposed.  Within 45 minutes I was taken back to the pre-op area and prepped for surgery getting an IV for my IV fluids and medications as well as a port for the anesthesia medicines.  I asked the Nurse Anesthetist if I would be under “General Anesthesia” for the procedure and caused him to laugh when I asked if that involved watching a video of an Army General giving an incredibly boring Power Point briefing.  The man like me has spent a good number of years in the Army and said that he would have to remember that.  The intern working with him was one I had worked with on ICU and of course the Urologist was my former battalion medical officer at 2nd Combat Engineer battalion back in 1999 at Camp LeJeune.  Once all was prepared they wheeled me to the OR where all I know was that I went under anesthesia and woke up in our post-op ward.  I was of course monitored continuously and intubated for the first time in my life, something that I knew that they would do but had no idea it happened until I tried to talk and felt the scratchiness in my throat.  I was also fitted with a stent to keep things open which I get to keep for a week. Here is a video of a Laser Lithotripsy:

http://www.miamiroboticprostatectomy.com/videos/video002.html

The surgery was successful but I was told by the Abbess that the Urologist told her that he had to do some fancy maneuvering to move Adolf into a position that he could get a good shot with the holmium  laser but that it went well with some minor injuries down there that I will have to ask him about.  After my time in recovery I was taken back to APU where I was prepped for discharge and in pretty good humor despite some discomfort especially the pain that I experience in the process of urination, which I am mandated to do to the tune of 3-4 liters a day.  Since getting home I have had to repeat this painful procedure often.  As I was wheeled to the car Monsignor Fred Elkin came down to see us off.

We went to dinner at Biersch where we were treated by some of our Stein Club friends and that was good, my first food other than two graham crackers and two saltines after surgery in the APU.  I was given a butt-load of medications for my recovery and will schedule my appoint for removal of the stent and follow up in Urology tomorrow, since I will not get it removed for a week they don’t plan on clearing me for work until the 17th.  So I have to take things easy and slowly get some light PT in at home.  I have lost two weeks of my conditioning program but should be able to get it back before time for the Physical Fitness Assessment rolls along next month.  I was hoping to do the early bird test but may have to wait a couple of weeks into the cycle.  Regardless I will do well, inshallah.

Thanks to all who encouraged, prayed and laughed with me throughout this ordeal and to those who were involved with my care.

Peace

Steve+

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March 8, 2010 · 23:52

Padre Steve Gets Adolf the Kidney Stone Removed: Musings on Laser Lithotripsy

Adolf Von Grosse Schmertzen will see his last sunrise in the morning, or whatever he can view from where he is at in the ureter.  Whatever, since he has stayed in his bunker and made my life miserable for the past two weeks he will not get to stay intact as a reward for leaving.  Instead he is going to get blasted to pieces by the latest and greatest in Kidney Stone breaker-upper technology, the Laser Lithotripsy using a holmium laser mounted in a endoscope.

This procedure is replacing the older method of extracorporeal shock wave lithotripsy as the standard of care in treating bastards like Adolf.  The older method was less invasive and used shock waves generated outside the body to break up the stone. The new method which according to the literature is “minimally invasive” involves passing the endoscope up the pee-pee thru the bladder and into the tunnel, the ureter, between the bladder and kidney where Adolf is dug into, sort of like his namesake who did the same in a Berlin Bunker back in 1945.  When the endoscope reaches Adolf the Urologist will direct a “laser” beam into Adolf “vaporizing the stone.”

Evidently there is no stone that has been able to withstand this high tech assault and the remnants of Adolf will be flushed into to sewer of history.  The success rate for this procedure is in the 90-95 percent rate according to the literature which means that for me there is a 50-50 chance of success though only a ten percent chance of that.  My assumption as to why this has replaced extracorporeal shock wave lithotripsy is that for the Urologist it is much more like imitating Luke Skywalker when he blasts the Death Star or playing the video game Asteroids.

Now I will go in tomorrow and be prepped for the procedure, I report at 815 and am told that it will be an hour or two until the procedure will begin.  Usually the preparation involves placing an IV, placing monitor equipment and asking lots of questions.  The one question I hope they ask if I have any special religious needs.  If they do I will ask if the have a live chicken, a sharp knife and an altar with candles and a shot of rum.  I am told that I will go under “General Anesthesia” which I imagine as being forced to watch a very boring Army General giving a briefing on power point to his subordinates.  Since I have slept through a few of those I image that this will be the case again.

Today I got a call from the Ambulatory Procedure Unit where I will be prepared for battle and then taken to the Operating Room, or the O.R. as medical professionals call it.  My Urologist says that the procedure could take up to three hours but that he expects that it will be done sooner than that. I do hope so because I need to wake up fast after the briefing of the boring General so that I can get home and then top off the day at Stein Club appreciation night at Gordon Biersch…yes, I know I’ve heard that you are not supposed to have alcohol after being under anesthesia but it won’t be like I will be having a beer in post-op, they don’t have any good beer there but I digress.

Today Adolf obviously sensing that his time is short has been giving me a lot of pain even with the Vicodin on board.  I cannot eat or drink anything after midnight so I’d better finish this so I can eat something to go with my last dose of Vicodin.  Providing nothing goes wrong I expect to be writing of my experiences tomorrow night, inshallah.

Of course my mind drifts to great medical films like Robin Cook’s Coma and certain episodes of House, M*A*S*H, Scrubs, the X-Files and the “Junior Mint” episode of Seinfeld which I find very comforting when facing surgery.

Pray for me a sinner,

Peace,

Padre Steve+

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March 5, 2010 · 00:00

Health Care Reform, Socialized Medicine and Adolf Von Grosse Schmertzen my Big Kidney Stone

I believe that the health care system in our country needs to be reformed.  A of my opinion comes from my days in seminary and after when the health insurance that I had was not worth the powder to blow it to hell for the most part.  My overriding concern is that people get the appropriate health care and treatment when needed and that a lot of this be preventive type care.  At the same time when the situation presents that is not a preventive medicine type situation but rather something that is dehabilitating to the point that an otherwise physically fit person cannot do their job because of pain or the effects of medication needed to keep the pain to manageable levels that treatment should be done expeditiously in order that the person would be able to resume their duties quickly.  This is especially true for those in the military who have a mission that must be done.

I am a moderate in most of life.  I understand the need for social responsibility as well as individual responsibility.  At the same time I know that even when you have a guarantee that you will have your health care taken care of that things do not always work out the way that you think that they should.

I was diagnosed with a 7mm kidney stone almost two weeks ago on a late night trip to the ER.  Despite the fact that there is almost no possibility of passing that big of stone I was given pain meds as well as medicines to help pass the stone.  I was referred to my family practice physician who was surprised that a Urology consult had not been scheduled during my late night ER visit.  He gave me a consult with Urology when I saw him and a couple of days later saw the Urologist who gave me more meds and scheduled me for a ureterorenoscopy to blast the stone and place a stint.  Since we have only so many surgery slots my surgery was scheduled for March 9th which is over 2 weeks after the initial diagnosis.  I had my pre-op appointment today and even though I am in pain even with a high dose of Vicodin my doctor is sending me back to work tomorrow with the instruction to take Extra-Strength Tylenol while I am at work only taking Vicodin if the pain gets too bad. Now with Vicodin the pain is reduced to an almost manageable level but not gone. Sleep is still problematic and just getting comfortable is difficult and between doses of Vicodin doses of 1-2 liters of beer does little to help.  I would venture to say that the pain is too bad already, but I am only a layman.

I have done everything that my doctors have told me and still there is no relief.  I have to wait until Tuesday for the surgery to blast and remove Adolf from his bunker when if the statistical probability of me being able to pass bloody Adolf would have been employed I would have had him removed within days of his discovery. Instead I have had to wait in pain unable to do the work that I need to do and all the while losing ground on my physical fitness program that I have been working so hard on getting back into optimal shape.  My Urologist has elected to send me back to work Friday and Monday with only extra strength Tylenol as a pain reliever because I cannot drive nor do much when taking Vicodin, the world goes around in a counter-clockwise direction.  So tomorrow I will go in to work and try to survive the day. However in reality I think that without my Vicodin I will be back in the doctor’s office in pain begging for relief, in fact based on the pain that I am feeling with the Vicodin I know that I will seeing my family practitioner as soon as I go in to try to get some help.  It is no fun spending two weeks in pain that does not even allow you to sleep that is only mitigated by medicine that makes your world go in a counter-clockwise direction that cannot be taken if you want to drive to work which of course means that the pain will become unbearable.  This is indeed what is in the old parlance called a dilemma and even though I like dill pickles I think that this dill-Emma will be a very sour pickle indeed.

So I shall go in to work and see what happens….

As much as I want to discuss heath care reform in general, I must say without sounding too self centered or look like I am whining that there must be health care reform and let it begin with me.  But I am whining and because I am in pain now this is somewhat self centered. For two weeks I have gone without a decent night’s sleep, been in pain and missed work and lost ground on my physical fitness program while watching my living room move in a counterclockwise direction.  This is not fun and now I’m told to not take the only thing that is keeping the pain at bay.

Now of course there are a lot of people with a lot more dire conditions than me who suffer worse than I do and I don’t dare to compare what I am going through to them, I am not so self centered to think that somehow what I am going through compares to people in long term chronic pain that cannot be mitigated especially those dying.  Thus my complaint may seem in bad form, but I am not a happy camper.  By the time the stone is out and I am done with the recovery period I will have lost three weeks of work and life in general.

Anyway, it is time for my last bit of Vicodin before I go to bed.  Pray for me a sinner and forgive me for whining.

Peace

Padre Steve+

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