Archive for the ‘Addiction’ Category

My life has been saved by doctors. “Okay,” you say, “so what?” Stop and think about what I just said…my life has been save by doctors. On at least three occasions, I was in my primary care’s office, and he noticed something that had I allowed it to continue, would have taken my life. In only one of those cases had I gone to the doctor because I thought something was wrong. In the other two cases, he noticed something unusual and got me to the emergency room in one big fat hurry. Why am I telling you this? Well, on each occasion, I paid that doctor ten bucks. Sure, he was further reimbursed by my health insurance, but for how much? How much is a human life worth these days? In all three cases, I had a wife and three children to care for plus the usual debts that we all incur during our working years.

There was a time when doctors were thought to be the crème de la crème in terms of income, and at one time I suppose that might have had a ring of truth…not in the 21st Century. And many doctors will tell you it hasn’t been true for the better part of the last Century either. No, today, the big income boys – and girls, if you’re interested – are the health insurance executives, pharmaceutical CEOs, and the hospital administrators. Doctors are just the working stiffs who don’t do anything but save lives. Are they living below the poverty level? Come-on, of course not. Neither are they making the kind of money that you would think for the kind of work they perform. If you consider medical care as an industry, which it is, as wage earner doctors are about in the middle of the pack in the industry.

According to a 2014 article in The New York Times, “The base pay of insurance executives, hospital executives and even hospital administrators often far outstrips doctors’ salaries, according to an analysis performed for The New York Times by Compdata Surveys: $584,000 on average for an insurance chief executive officer, $386,000 for a hospital C.E.O. and $237,000 for a hospital administrator, compared with $306,000 for a surgeon and $185,000 for a general doctor. “ Now that income is nothing to sneeze at, but think of the comparison. The CEO of a hospital is making damn near twice as much as a general practitioner.

In a Boston Globe article last year, Elizabeth G. Nabel, President of Brigham and Women’s Hospital, received total compensation of $5.4 million in 2014, the latest figures that are available. Another board chair of a major health care organization noted, “We must provide competitive wages and benefits in order to attract and retain the best individuals at a time when health care is undergoing sweeping change. The competition for excellent managers and leaders is especially strong at this time.” I’m sorry but the compensation for excellent managers and leaders has been strong since the beginning of the Industrial Revolution. I come back to that 300:1 ratio, where the top dog is making 300 times as much as the worker drone, in this case, doctors, nurses, and other health care professionals who are putting in on the line every time a patient comes in. Let me give you just one example: I go into the hospital with chest pain. The on-call emergency room doctor orders blood tests to check my enzyme levels – if they are elevated, the doctor understands that I should be watched and another blood test administered in four hours. Now let us assume that the lab tech who is doing the testing is getting close to the end of his or her shift. S/he is exhausted because in order to make ends meet, s/he has a second job. S/he doesn’t read the lab results correctly and doesn’t pass them on correctly, thus showing that my enzymes are normal…oops, I am, quite possibly, having a heart attack. The doctor comes to me; tells me the test is fine, and discharges me. Driving home, the chest pains come back so severely that I actually die at the wheel, crash into several other cars, killing several other people, and all because some underpaid lab tech was so exhausted that the lab tests were misread. When there is an investigation who do you think is going to get nailed to the cross? It sure as the devil is not going to be that well-paid hospital CEO. More likely, it will be the lab technician and the emergency room doctor who relied on the test results and sent me home.

I have had the pleasure of working for some pretty fine people in my life. To the best of my knowledge, only one of them was a millionaire, and he didn’t make his fortune in higher education…although today, there are some multi-millionaire salaries being paid at some colleges and universities.

If you believe that hospital CEO’s make big bucks, take a hard look at what some of the big pharmaceutical heads wrap their greedy little fists around. In 2015, Johnson & Johnson paid Alex Gorsky $21.3 million. Ken Frazier of Merck & Company received $19.89 million. John C. Lechleiter of Eli Lilly was paid a paltry $15.6 million, and the list goes on and on. Health insurance chief executive officer of Cigna David Cordani drew down $17.3 million in 2015, Aetna CEO Mark Bertolini, $17.3 million, and Humana CEO, Bruce Broussard, $10.3 million. Meanwhile, your insurance rates and mine continue to jump beyond the inflation rate. It’s not going to doctors, nurses, or others right on the firing line. It’s going to so-called “excellent managers and leaders,” and that my friends is a bunch of baloney.

American health care is in a lot of trouble. Doctors are being told by their insurance plan companies just how many patients they need to see in a day to maintain their coverage by the plan. They are being dictated to by hospitals regarding how much they can charge for procedures. And if you want to blame one single group for the opioid crisis in this country, look to the big pharmaceuticals who, in 1986, went on an all-out marketing campaign to convince doctors that “their” opioids were not, repeat not, addictive. Man, are we in trouble or what?

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Ninety-one people in the United States die every single day from an opioid overdose. According to ‘Riding the Beast,’ whatever the hell that web site is, “There are 91 similar solar systems to ours which turn around the great central sun. The mass of this great central sun is 91 thousands of times larger than the mass combined with all the 91 other solar systems. Moreover, the galaxy of the 91 universes of which the earth belongs is included in another larger galaxy including also 91 galaxies turning around a central core or sun of which the mass is 91 times higher than the previous. This formula is reproduced almost indefinitely by being multiplied each time by 91.” Now that you’ve read that bit of bullshit, drop me a line and let me know if it made sense to you. I was under the impression that science was constantly unearthing [like that one?] new galaxies and new solar systems, but then, what the hell do I know?

Be all that as it may, it still doesn’t answer the question of why the hell 91 people in America die each day from an opioid overdose. I mean I can understand those who die from a heroin overdose – heroin, of course, being an opioid – and it’s perfectly understandable that people can die from a ‘hot shot’ or just getting a bad ‘bag’ or whatever, but heroin, while a problem, is not what calls the majority of ‘the 91.’ Oxycodone, OxyContin, fentanyl, methadone, Percodan, Percocet, and other synthetic opioids are among the other pain killers on which people are overdosing. Why? Who is to blame? Is it the patients who don’t know how to use these drugs? Is it the doctors who continue to prescribe the drugs long after the patient should have finished using them? Is it the pharmaceutical companies who, back in 1986, unleased a marketing program proclaiming the safety of these drugs without having all of the facts in hand about their dangerousness? How about an answer that says “…all of the above and more to boot.” There are only two of these drugs that I haven’t tried, fentanyl and methadone. I’ve used every other one of these synthetic opioids and I have yet to overdose or even come close to overdosing on any one of the damned things. Do they kill pain? Absolutely. Can you get high on these? Well, hell, I haven’t a clue…I never did. Can they constipate you to the point where you want to shove a stick of dynamite up your ass? You’d better believe it, and if you think a bowel blockage is fun, you’re not of the humanoid species. In addition to being hind-bound, these drugs have some other interesting side effects, such as nausea, vomiting, sleepiness and dizziness, confusion, depression, itching and sweating, and – get this one guys – low levels of testosterone that can lower your sex drive, energy, and strength.

According to the Centers for Disease Control (CDC), “During 2015, drug overdoses accounted for 52,404 U.S. deaths, including 33,091 (63.1%) that involved an opioid.” Have we become more sensitive to pain in this country? I rather doubt it. My own take on this is that the pharmaceutical companies have over-marketed the prescription pain killers to physicians and that they have blatantly lied about the addictiveness of their product. In turn, doctors have been too eager and willing to continue prescribing these synthetic opioids to their patients who are too goddamned stupid to understand that getting off these prescriptions is a hell of a lot better than staying on them.

What can be done about this public health menace? Again, I turn to the CDC which states, “There is an urgent need for a multifaceted, collaborative public health and law enforcement approach to the opioid epidemic.” The CDD has established guidelines for prescribing opioids for chronic pain. These are very clear but I question if medical practitioners are following them or, if they are, if patients are actually listening to them. Whatever the case, whenever I hear that a fire department, police department or EMTs have administered Narcan to someone suffering an opioid overdose, it irritates the daylights out of me. Perhaps, rather than Secretary of State Bill Galvin spending money trying to get rid of the $2.4 billion in people’s names, the Commonwealth of Massachusetts should spend some money on an educational program to let viewers and listeners understand that Massachusetts is one of five states where the opioid epidemic is not decreasing but is on the increase. Administering Narcan to someone who has overdosed is merely inviting them to overdose again. You overdose and your life is saved, you belong in a detox facility where you can be cleansed and educated. If you OD once more, sorry, it was your choice to disregard what you were taught. Yes, your friends and family will be distraught that you’re gone. Sorry, we did what we could, but you elected not to listen…bye bye.

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When I asked about one of my high school classmates recently, I was told, “Aw, he drank himself to death some time ago.” I thought to myself, “Well, that makes two from our class that I know of.” It’s not a pretty picture. How many others, I wonder, abused alcohol? We had less than 80 people in our senior class, and while two out of eighty might not sound so bad, you go ahead and do the math as it may concern the teenage and adult population in the United States. Let me save you some trouble…there are more than 12 million alcoholics in the United States.

Hindsight is a truly wonderful thing. As the cliché goes, it’s 20/20. Looking back to my days at Northeastern and at Babson, I can now recall people I knew who always had alcohol on their breath and who would act confused at times. Naïve little me, I guess. Today, I can honestly say that I was really too damned dumb to notice erratic behavior. Perhaps that’s because there were more than a few mornings when I was nursing a hangover. Thankfully, Joan and I came to our senses before things went too far.

Looking at the statistics on alcoholism, I find that three-fourths of all adults drink alcohol, and 6% of them are alcoholics. That’s really a staggering number – no pun intended – of people who abuse alcohol. Americans spend $197 million each day on alcohol…and that’s not even counting moonshine. In the United States, a person is killed in an alcohol-related car accident every 30 minutes. Perhaps this explains why, even on my early morning drive to the gym or whenever Juli and I are out in the car, my eyes are always shifting to what’s going on in the oncoming lane. Sure, I’m going to die, but I’m not eager to have it be at the hands of some drunk I don’t even know! Two other facts that were somewhat surprising…people with a higher education are more likely to drink, and the same is true for people who are considered to be wealthy. I’m not certain what the correlation is, but it seems that if you’re well educated and rich, you’re more likely to be a drunk…for some reason, that just doesn’t compute, but it’s out there.

A friend of mine recently went to his first Alcoholics Anonymous meeting. He told me that he’d finally had enough and that it wanted to quit drinking. His feeling was that he couldn’t do so without help. He indicated that he was shocked when he went to his first meeting because he knew every other person in the room. As I’ve learned over the years, alcoholics are very well versed in how to hide the disease from others. Yes, alcoholism is a disease. It’s not a choice that most people make. It consumes the mind and body of the alcoholic, but it also affects those around him or her. While there are 12 million alcoholics as I’ve said, there are another 50 – 60 million friends and family members who are affected by this debilitating disease.

At this point, time has elapsed since the last paragraph was written. I became angry while writing it, and that’s when objectivity leaves, ergo I’m better off walking away and coming back when I’ve cooled down. My anger stemmed from the fact that I can remember, during my drinking days, of how my family was affected by my drinking. I didn’t like who I was or what I did, but thankfully, those days are long past and there don’t appear to be any residual effects.

Just because you or I may live in a ‘dry’ town doesn’t mean that alcohol isn’t easily accessible. There seem to be more “Town Line” liquor stores abutting the dry town lines than there are restaurants or any other type of establishment. No, liquor is a very easy thing to get one’s hands on. Drinking is one of society’s more widespread and accepted forms of addiction, so how do we spot the alcoholic? ‘We’ don’t have to spot someone with an alcohol dependency. Alcoholics know who they are. It’s one of the few self-diagnosable diseases there are. Asking one’s self a few simple questions can provide answers. Do you drink to relax or feel better? Do you hide your drinking or bottles of liquor? Do you drink to the point of blacking out? How often do you drink to this point? Are you unable to stop once you start drinking? Do you drink in dangerous situations, e.g., when you may have to get behind the wheel of your car? Is your tolerance to alcohol increasing? Do you find that you are neglecting things at home, work, or school? Have you tried to quit but find that you are unable to do so? These are just a few of the signs or symptoms that alcohol is no longer your friend but has become your master. I had a boss who, when we went out to lunch, had to have at least two drinks to get him through the afternoon. In addition, he would become upset if I didn’t drink with him. It made for a few awkward situations.

Why am I writing about all of this…again? It’s been done to death, and no one needs to be reminded about the dangers of alcohol. Well, maybe that’s wrong. Maybe we all need to be reminded of it. God only knows we see enough of the results of it on television…cars wrapped around trees or driving the wrong way and killing others just trying to get home. Yeah, we do need to be reminded of it…and on a fairly regular basis. Alcohol dependency is one of those things that for which we do have treatment centers and programs. Let’s make it personal…I used to drink to the point where I wasn’t very pleasant to be around. I used to drink and drive, but I got away with it. I no longer drink and I’m better off because of it. Every so often one friend or another will tell me that they are going to meetings or that they’ve been sober for so many days, weeks, or months. I understand that. I will always understand that. And I will always help anyone who seeks my help to quit. None of us wish to become one of the 100,000 who die each year from alcohol-related accidents.

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“Well, then, why don’t you write a travel piece?”

“A what?” I asked.

“Oh, you know, a piece about where you’ve been and what you’ve seen; the fascinating sights, restaurants, museums, and so forth?”

“You talkin’ to me?” I queried.

“Well…sure…” he replied, now growing a bit hesitant.

“The places I’ve been; the fascinating sights, restaurants, museums, and so forth?” I said, looking quizzically at this person I thought I had known for over 50 years…and actually turning around to see if he might be speaking to a complete stranger behind me.

“I DON’T TRAVEL,” I screamed as though speaking with a dolt, adding, “WHAT THE HELL ARE YOU THINKING ABOUT?”

That brought the conversation and companionship to a rather rapid close as he stormed off, waving his hands in the air in an “I give up; what the hell’s the use,” fashion. This, by the by, is not the first, nor will it, in all probability, be the last time one of our conversations has ended in such a manner, ie, with one of us throwing our hands in the air – why do we do that, anyway – and trudging away.

So, here I am, stuck with a blank page on the computer, still in a quandary over with what to fill this clean white sheet of screen. “Why write anything?” you ask.

“Well, writing is what keeps my sanity intact, what remains of it that is.” I enjoy writing. Actually, I enjoy writing pieces that make people think…one way or the other. They agree or disagree with my postulations, and it doesn’t matter a damn to me which way they go. As a matter of fact, I prefer it when people violently disagree with me – well, not violently perhaps, but you know what I mean – and they respond with their own clearly stated – most of the time – positions.

My options are limited. To write about any of the five presidential wannabee’s merely gets my blood boiling since there’s not one who is worthy of the highest office in the land. Seriously, think about it: Trump wants to build walls, allow his cronies to do anything they damn well please, up to and including criminal behavior. He wants to make abortion a crime and he hasn’t a clue about foreign policy. Ted Cruz wants to carpet-bomb the Middle East and tough tomatoes for anyone in the way. The way he’s talking, all Muslims would wind up in WWII-like ghettos. John Kasich and Bernie Sanders would each get eaten alive by Congressional foes, and that brings us to Hillary. Sooner or later, she will be indicted for something. I liken Hillary to John Gotti…she’s the Teflon pol to whom nothing seems to stick; Whitewater didn’t stick; Benghazi didn’t stick; e-mail messages aren’t sticking so far. Not a damned thing seems to stick. Ergo, who is going to run the country? As Felix the Cat (for those who remember) might say, eeeeeeeeek!

So politics is out. Perhaps I should write about Senate Bill 524…it’s a pisser! It’s called the “Comprehensive Addiction and Recovery Act of 2016,” and its purpose is to “authorize the Attorney General to award grants to address the national epidemics of prescription opioid abuse and heroin use.” What, we’re now making the Attorney General find a new way to fight the drug war. I guess we’ve given up trying to fight the cocaine war. It appears that Congress, in its investigative role, has found that, “The abuse of heroin and prescription opioid painkillers is having a devastating effect on public health and safety in communities across the United States. According to the Centers for Disease Control and Prevention, drug overdose deaths now surpass traffic accidents in the number of deaths caused by injury in the United States. In 2014, an average of more than 120 people in the United States died from drug overdoses every day.” My reaction to this is that it’s a great way to reduce the gene pool! Who are these 120 people who have chosen to die by drug overdose?  The circle of Kumbaya singing, well-meaning-but-wearing-rose-colored-glasses crowd will call me harsh, but that’s okay, because these 120 will not breed and they will not vote. Let them die and then let’s go after the doctors who prescribed a 20 or 30 day prescription for Percocet, oxycodone, OxyContin, or hydrocodone. I have had nearly 20 surgeries in my life, and I believe I’ve taken one Percocet pill. Did the surgeries hurt? You bet your butt they did? Were they as painful as some others might be? No! However, if doctors don’t warn patients about the addictiveness of these pills, the docs aren’t doing their job. Why did some of these addicts turn to heroin? Because (a) it can be cheaper than some of the prescription medication; (b) they couldn’t find another doctor who would authorize the pills; and (c) heroin worked better and faster. As a consequence of all this, Congress now wants to play nursemaid to people who don’t have the intelligence or desire not to become drug addicts. Sorry, that’s not where I want my tax dollars spent.

But, Congress responds, “According to the National Institute on Drug Abuse (“NIDA”), the number of prescriptions for opioids increased from approximately 76,000,000 in 1991 to nearly 207,000,000 in 2013, and the United States is the biggest consumer of opioids globally, accounting for almost 100 percent of the world total for hydrocodone and 81 percent for oxycodone.” And “Opioid pain relievers are the most widely misused or abused controlled prescription drugs (CPD) and are involved in most CPD-related overdose incidents. According to the Drug Abuse Warning Network (“DAWN”), the estimated number of emergency department visits involving nonmedical use of prescription opiates or opioids increased by 112 percent between 2006 and 2010, from 84,671 to 179,787.

Feel free to give me reason after reason for drug addiction in this country, but don’t tell me; please don’t tell me that I have to be part of a legally-adopted payment plan to help junkies rid themselves of an addiction.

Perhaps I should have written that travel piece after all…here goes. I’ve driven and flown from Massachusetts to LA and to Florida. I’ve driven the northern route which is New York State through Indiana, Illinois, Ohio, etc., and I came back the southern route through Arizona, Nevada, New Mexico, Texas, etc. Our son was married in a hillside chapel in Tennessee, so I’ve been to Gatlinburg, and driven over the Smokey Mountains into North Carolina. My travel has been limited to the United States, parts of Canada, and four unforgettable trips to Bermuda. Unlike many other people, I have not been to Europe or any exotic locales. I’d like to have seen the pyramids, but I have a thing about suicide bombers or kneeling in an orange robe and a drugged stupor while some jerk removes my head from the rest of me. Could I be more expansive about my travels? Certainly, but this little essay is now approaching 1,200 words – go ahead and count, ya damned fool – and my fingers are getting tired. Hope you enjoyed the tirade and that you’ll return again soon.

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Friend of mine returned to the gym after about a week and a half away. Since it was too short a time for a vacation, I asked where he’d been. He said that he had some minor day surgery, but it was enough to keep him away from the gym for a while. Then his face took on a funny look, and he asked, “You know what those bastards gave me.” Any number of things came to mind but not wanting to appear any more stupid that I already am, I answered no. “They gave me a prescription for 20 oxycodone pills.” It didn’t surprise me that Pete was upset since I’ve had similar experiences.

According to the Substance Abuse and Mental Health Services Administration (ASAM), drug overdose is the number one cause of accidental deaths in America. There were 47,055 lethal drug overdoses in 2014 and that number is continuing to grow. Of those deaths, nearly 19,000 were related to prescription pain relievers. To give you an idea of how fast this epidemic is growing, “…the overdose death rate in 2008 was nearly four times the 1999 rate; sales of prescription pain relievers in 2010 was four times those in 1999; and the substance use disorder treatment admission rate in 2009 was six times the 1999 rate. In 2014, 467,000 adolescents – those 12 to 17 years old – were current nonmedical users of pain reliever with 168,000 having an addiction to prescription pain relievers.” 1

When you are recovering from surgery, and you know this as well as I, there is often pain involved. That wonderful ‘kickipoo joy juice’ they give you to knock you out is great stuff, and if you’re having what I call “laundry service surgery,” that is, in by nine and out before five, the drugs in your system are probably still dulling the pain. Once the Versed and whatever else is in your system wears off, you hurt. How much you hurt depends a great deal (a) on what was done, and (b) your tolerance for pain. In all probability, you will receive, with your discharge directions, a prescription for some kind of pain relief. All too often, that prescription drug will be an opioid. “Opioids are a class of drugs that include the illicit heroin as well as the licit prescription pain relievers, oxycodone, hydrocodone, codeine, morphine, fentanyl, and others.”1

In an article by Dr. Celine Grounder, a public health specialist and a medical journalist, she asks the question, “How did doctors, who pledge to do no harm, let the use of prescription narcotics get so out of hand?” Would that there were some simple answers. One reason is because an article that was written for Pain and a letter sent to The New England Journal of Medicine. In both cases it was suggested that opioids/narcotics could be safely used to treat non-cancer patients on what seems to be a longer term basis with little concern for addictive behavior. That opened the flood gates for pharmaceutical manufacturers of these narcotics to market their products aggressively for other kinds of pain. In other words, it became open season to create a new group of drug addicts…and it was all legal.

In doing some research for this essay, I came across one article which indicated that “A recent review of medical studies showed that addiction to narcotic pain medications exists, but is not too common. On average, only about 4.5% of patients using narcotic pain relievers developed an addiction to narcotic pain medication!” I really wanted to ask the author to which medical studies he was referring and also to ask what rock he’s been living under for the past decade. Every day, about 60 people die from opioid overdose; 44 of those are from painkillers and 16 are from heroin.

Why do I keep mentioning heroin? We all know it’s an illegal drug, but as I said above, it is one short step away from many of the legal pain relievers prescribed by physicians. In a 2014 survey of people in treatment for opioid addiction, ninety-four percent said they chose to use heroin because prescription opioid prescriptions were ‘far more expensive and harder to obtain.’”2 Dr. Andrew Kolodny, executive director of Physicians for Responsible Opioid Prescribing (PROP) maintains that the pharmaceutical industry misled the medical community about the safety of opioids beginning around 1996. He believes that this led to a tremendous overprescribing of oxycodone and hydrocodone. In a speech given last September, he told the audience, “These two chemical alterations of opium are so similar to heroin they should be called ‘heroin pills.’”

Pete’s wife filled his prescription. He told me that because he has young kids and didn’t want that $**t around, he took them to the police station. I have to admit that my bottle is still in a cabinet but we don’t have callers so I’m not too concerned.

There’s no question that we have an opioid epidemic in this country. It will continue to result in more and more overdoses until such time as pharmaceutical companies are forced by law to chemically alter their “heroin pills” to reduce potential addiction. In addition, doctors should consider the patient and the potential consequences before so easily prescribing opioids. However, the most important person here is the patient. Yes, there are times when surgical pain can be tough and require medication, but does it really require something that could hook and then kill you?


  1. Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. (2015). Behavioral health trends in the United States: Results from the 2014 National Survey on Drug Use and Health. Rockville, MD: Substance Abuse and Mental Health Services Administration.
  2. Cicero TJ, Ellis MS, Surratt HL, Kurtz SP. The changing face of heroin use in the United States: a retrospective analysis of the past 50 years. JAMA Psychiatry. 2014:71(7):821-i826

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Chronic Obstructive Pulmonary Disease (COPD) is a bitch!

Fifteen years ago I walked/ran the 7.2 mile Falmouth Road Race. Today, walking the thirty feet from the family room to the bathroom leaves me breathless. Don’t get me wrong; I still go to the gym and I can ride the recumbent bicycle for 45 minutes at a resistance of seven; take a pause, and ride a 10-minute warm down with no great appreciative effort. However, getting off the bike, putting on my hat and coat, and walking to the front of the gym leaves me so exhausted that I have to sit for five or ten minutes before going to the car. Ain’t life funny?

Ah, the sins of our youth. We think nothing while we commit them, but they do come back to haunt us. For example, are you aware that only three out of ten people who smoke will suffer a tobacco-related disease? My pulmonary specialist told me that shortly after my wife had died of cancer. He told me about the study that had reached this conclusion. I didn’t believe him then; can’t say as I believe him now, but he seemed convinced. Of course, he’s never used tobacco…whatever that has to do with the price of tea in China.

Like so many other diseases that are terminal, COPD works slowly. It robs you, at a snailish pace, of that very necessary habit we all have called breathing. One day you feel a shortness of breath. It’s no big deal; doesn’t seem all that impairing. You happen to mention it the next time you see the doc. He listens to your lungs, asks how long it’s been since your last chest x-ray and sends you along to get one. The results come back and the next time you see him/her, you’re informed that you have this COPD thing. “What is it,” you ask. Simply put, it’s a disease of the lungs. You’re well aware that when you inhale, your lungs expand; hell, you can watch your lungs expand, and in men, make them look to have more of a chest than is really true. With COPD, the lungs don’t expand your chest as much because you aren’t taking in as much air. Your lungs and everything within them, lose the elasticity that helps to expand your lungs (and your chest0.

COPD is the third leading cause of death of death in the United States; yep, right behind heart disease and cancer. Rather makes it something you might like to ignore, eh? Right now, yours truly happens to be batting two for three, and they’re still examining a spot on my lung which could bring my batting average up to 1.000.

Okay, why am I telling you all this? Well, it’s quite simple; if you’re a smoker, invite someone to give you a good smack upside the head. Quitting isn’t easy; you have to want to quit. No one can scare you into stopping. You could look at blackened, shriveled lungs until hell freezes over, but that was someone else, and besides, ya gotta die somehow, right?  If you’ve ever watched someone die of lung cancer; I mean spent 24/7 with them while they wasted away, that might, er, just might convince you that you would prefer another form of death and to throw the ciggies away. It depends on you.

I’ve already told you that COPD is a progressive disease. It’s also devilish and sneaky. What you could do yesterday, you find much more difficult today; by the end of the week, you have to admit that it’s something you no longer feel very comfortable doing. Today, I watched Juli go out the back door – which she had just taken an hour getting open – and break icicles that were handing from the roof. She was wearing layers of clothing, her dorky hat, boots with steel cleats attached…while I sat on the couch and watched through the floor to ceiling windows. How do you think I felt watching her? First, I was afraid for her safety. You can get hurt by icicles that big should they decide to fall the wrong way.. Second, I was embarrassed… because that’s my job. I’m not being macho; it’s just something I’ve always done, but I can’t do it anymore thanks to COPD, and it hurt to watch someone else doing my job.

There is one thing that does help COPD beyond the medicines that help in a small way. At least it works for me, and that’s exercise. However, with all the snow we’ve had the past couple of weeks, I’ve had trouble getting to the gym.  Oh, well, time marches on, and so shall I. As for you, take an old man’s advice…there really is a great deal to live for; don’t do anything so goddamn stupid as smoking to kill yourself quicker. Someone recently compared life to a roll of toilet paper…the closer you are to the end of the roll, the faster it goes.

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I am what you might call a T-shirt fanatic. If I see a T-shirt with a clever saying on it, I buy it, period, end of report. Shortly after my partner moved in I told her, “I’ve got to clean out the T-shirts I no longer wear.” I had shelves lined with T-shirts. They covered years of the Falmouth Road Race, the James Joyce Ramble road race, the Boston Marathon, Red Cross donor shirts, and over twelve years of Pan-Mass Challenge T-shirts that ranged from “volunteer” to “staff” to “crew” to whatever else might have been available at the time. Every holiday is represented by at least ten shirts including some that are wearable only around the house. I had one with a cartoon frog – sort of like the Geico gecko sitting on top of a school desk, looking mopey and with on hand holding up its chin.. Beneath the cartoon were the words, “I’m so happy I could just shit.”  That had to have come from my younger and wilder days. The storage bag into which the T-shirts were packed; you know the ones from which you can vacuum the air when you’ve finished; well, that was so heavy it took the two of us to move it into a spare bedroom. I’m told that someday its content, along with the new ones, will become a quilt. When that happens, Hell will have frozen over and people will be living on Mars…growing their own vegetables…outside!

My girlfriend loves squirrels. I’ve bought her the full-faced squirrel T; the “I can’t talk. The squirrels are watching me T; the “The squirrels are mocking me T; and several more squirrel – and chipmunk – T-shirts and hoodies. Recently I purchased one for me that says “With Age comes Oldness.” Whenever we travel – not often for me, but plenty for her – I receive a T-shirt or sweatshirt. I have them from Block Island, Martha’s Vineyard, Rockport, Gloucester, Portland, Maine, Leonardtown, Maryland, and soon I will be receiving one…or two…or three…from Nantucket. She’s taking her camera, hoping to find the man from Nantucket.

I want you to know that my T-shirts do not just ‘ride the shelf’ in my closet. Oh, no, my T-shirt are working shirts. I wear a different one to the gym each time I go there….other than the “I’m so happy I could just shit” shirt which is in the storage bag. When I wore the one that below a picture of the Capitol read, “Never underestimate the stupidity of people in large groups,” The Republican gym members all gave me dirty looks, while the Democrats laughed. I really don’t know why the Democrats laughed; hell, they’re as much at fault as the guys and gals on the other side of the aisle.

Am I trying to draw attention to myself by wearing outlandish T-shirts? Frankly, no, I’m not; I just happen to be a T-shirt junkie. However, I’m not going to buy them and not wear them. I almost wore one to the dinner last Friday; it says “Vetustior Humo,” that is “older than dirt,” but since I was one of the younger ones there, it probably wouldn’t have been appropriate; besides, the invitation said, “business dress.” The humorous part of that is that with very few exceptions, everyone there was retired. What’s business dress to one might be read as “retired casual” to others…you know retired casual; it’s an old T-shirt, torn shorts, no underwear, and a pair of sandals. Every time you put your feet up on something, children cry and women run screaming from the room!

Along with the squirrel T-shirts that just arrived were a couple of catalogs. I’ve already found some great T-shirts on which I can spend my children’s inheritance. The first one I intend to order says, “Anything unrelated to elephants is Irrelephanti, below which is a drawing of the magnificent beast. Another that I may order says “Sweet dreams are made of cheese. Who am I to diss a brie?” Think about it; I have the rest of this catalog and the other one through which to read. UPS loves me. I’ve gotten to know drivers by their first names!

Thankfully, my partner keeps me somewhat in line; otherwise I might appear on television as one of those hoarders who dies in his own house, smothered by a mountain of T-shirts…or from an invasion of squirrels who are really pissed about the number of shirts that are critical of them.

See, I keep telling you, “You have to get a hobby!”

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