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Archive for the ‘Health care’ 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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In the “as if we needed to hear any more bullshit from you,” category, Donny Trump tweeted that “ObamaCare will explode and we will all get together and piece together a great healthcare plan for THE PEOPLE. Do not worry!”

This is just another indication of why Trump is not a leader, just a thin-skinned child who, when he doesn’t get his way, takes his ball and goes crying home…in this case, to his daughter, not his wife…hmm. It was the perfect opportunity to admit that ‘his’ congressional leaders were unable to develop a plan to replace the Affordable Care Act {ACA}. He could have followed it up with, “Now is the ideal time for Republican and Democratic leaders to reach across the aisle and, together, develop a plan that will replace the flaws in ObamaCare and that will ensure that all Americans receive appropriate health coverage.” That is something that a leader would have done.

Consider the number of times that Republicans attempted to repeal the ACA over the eight-year term of Barack Obama. The number, by the way, is sixty. It seems to me that rather than spending all of that time attempting to repeal a law, they could have more productively spent their time developing a plan to replace the Act. If you, as a member of Congress, felt that ObamaCare was such a terrible piece of legislation, wouldn’t you first come up with a better, stronger, more viable plan rather than behaving like a bunch of spoiled children? I’m sorry, am I being too logical here? Was it, perhaps, a case of, “We don’t want anything that the ‘foreign-born,’ n-word, SOB got past us to ever show up as part of his legacy! Oh, naw, that could never be the case…or could it? Was it that this first national health plan, for all its flaws, managed to get enacted by Congress?

You see, I’m rather a cynic when it comes to killing something just for the sake of killing it. I don’t hunt, but I used to enjoy deep sea fishing enormously. We kept the bluefish and stripers that we caught because people would eat them. If we were having a better than average day, it was catch and release. The Republican Party had seven years to put together a better health plan. They-didn’t-do-that. They-wanted-to-kill-a-program-that-had-been-legally-enacted-without-having-the-faintest-fucking-idea-of-what-to-replace-it-with. Now, I don’t know about you, but I might just have wanted to ask my Republican Congress person what he or she was doing to develop a plan to replace ObamaCare during those seven years, and if they didn’t have an answer, I might just have voted his/her ass right out of that Congressional seat. Am I being too harsh for you here?

Now, unable to come up with something to replace the Affordable Care Act, instead of uniting Congress, this idiot at 1600 Pennsylvania Avenue, the “Greatest Deal Maker of All Time,” whines and moans and blames everyone without even considering the tremendous opportunity put before him, starts his surrender talk with, “Well, no Democrats were going to vote for anything the Congress came up with.” Note that please. It wasn’t “…anything we came up with,” it was, “…anything Congress came up with.” In other words, “It wasn’t my fault; it was the fault of those assholes in Congress.” It’s this lack of leadership qualities or even understanding the qualities of leadership that terrifies me about this man. He was a little king in a small village when he had his businesses that were being run by others. He was a television celebrity who could do as he damn well pleased when he was on air. He is now in a position that requires skills and qualities that he has never and probably will never possess, but because of his celebrity status and the bombast with which he conducted his campaign, he was the chosen one.

There is a need for our nation to have a health plan. There is a need for a health plan that covers the rich, middle, poor, and elderly classes. It can be done. Mitt Romney showed that it could be done in Massachusetts. Was his plan perfect? No, it, too, was flawed, but care was taken to correct many of those flaws. No plan, whoever, drafts it, is going to ever be 100 percent guaranteed to work for everyone. We are not a one-size-fits-all nation. Hell, we weren’t even a one-size-fits-all-state. From the hills of Holland to the tip of Provincetown and from Florida to Dracut and beyond, Massachusetts residents have different needs, but by God, Romney tried and did something no other governor had done. Now is the time for Ryan and McConnell, Schumer and Pelosi to sit down, shake hands, look at one another, and simultaneously ask one another, “How do we pull ourselves out of this deep shit,” for that’s what it is. Trump and his hooligans will do everything in their power to ensure that the ACA implodes, just to get back at Obama. It’s time for the adults in the room – those from both sides of the aisle – to come together and determine what is best for the country, for all 326,474,013 members of this country. Forget ‘Hairspray’ and his band of brothers, for he will attempt to sabotage your efforts. While sub rosa may be a term we don’t care to hear, it may be the only way that the nation will be able to make health care for all a reality. Demonstrate that you are true leaders even though we don’t have one sitting in the White House.

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“From the day you’re born, you begin to die.” I have heard this so often from so many bloody pessimists, that I’m rather disturbed by the statement itself. Furthermore, nothing could be less truthful. It would be better if it was said that, “From the day you are born, your destiny is to die.” Not one of us can foretell whether or not we will be a great chemist or teacher, mathematician or bus driver, doctor or physicist, but we all know that from the moment we begin to understand life, our final destiny is death.

Obviously, I think about death. What 82-year old do you know who doesn’t consider it to some degree or other? Oh, don’t know any 82-year olds? Hell, you don’t know what you’re missing. We are, alternatively, joyful, cynical, hypocritical, positive, negative to a degree you wouldn’t understand unless you were 82, and at times, we are absolutely youthful and playful. In other words, we’re just about as screwed up as the rest of the world’s population…but we can be one whale of a lot of fun at a party…as long as it ends by 7 pm.

So no, we do not begin to die when we are born. In fact, we begin to grow. As usual, I’ve bounced around the Internet to learn when we actually do begin the process of dying. It appears that our brain, lungs, and skin are the first to go. According to a column in the London Daily Mail, and confirmed by a few others, “As we get older, the number of nerve cells – or neurons – in the brain decrease. We start with around 100 billion, but in our 20s this number starts to decline. By 40, we could be losing up to 10,000 per day, affecting memory, co-ordination and brain function.” Now, I don’t know about you, but the math would indicate that it won’t be long before I become a blithering idiot. No, of course that’s not true. Our neurons can regenerate, if only in certain portions of the brain. Hey, and guess what helps this ‘neurogenesis?’ There are a couple of things, and one of them is physical exercise. I’m not going to ask my neurologist why this is so, but I would add this: On days that I exercise really hard, I have more energy and can attack with greater success such things as crossword and jigsaw puzzles, and have more interest in taking on new challenges. In addition, I find that my attitude is more positive than on those days when I don’t make it to the gym.

Like the brain, the lungs also mature at about age 20 – 24, yep, even those that haven’t been messed up by smoking. Since I happen to be one of those jerks who didn’t heed the Surgeon General’s warnings when they first appeared in 1975, you can just imagine how bad my lungs are. Hell, I didn’t quit until 1998. I now have emphysema as well as COPD, and I can tell you firsthand, it “ain’t no fun!” If you happen to be a smoker, give quitting a chance. I know it’s a bitch, I’ve been where you are, but believe it or not, you will feel better in about three weeks.

As far as our skin is concerned, let’s face it, most of us treat our skin brutally. We’re sun freaks; we don’t ‘lotion’ up to keep the skin soft and supple, particularly men, so it really is no wonder that our skin, by the time we’re 20, is ready to rebel…can ya blame it?

Let’s talk about the heart. The heart begins to age at around 40. Referring again to the article in The Daily Mail, The heart pumps blood less effectively around the body as we get older. This is because blood vessels become less elastic, while arteries can harden or become blocked because of fatty deposits forming on the coronary arteries – caused by eating too much saturated fat. The blood supply to the heart is then reduced, which can result in painful angina. Men over 45, the time of my first heart attack, and women over 55 are at greater risk of a heart attack. What can you do to prevent becoming a victim of the number one killer in the US? This one’s going to hurt so hang on tight. The first thing you can do is to watch your diet. I didn’t, but I sure as hell do now. The second thing is exercise…yes, I know I’m beginning to sound like Bob Harper or the male equivalent of Jillian Michaels, but it’s truly impossible for me to tell you just how much better you’ll feel. Yes, it’s a pain in the ass to begin a regime of daily exercise, but it works. I didn’t begin regular workouts until four years after my first heart attack. I didn’t have the time. I didn’t want to join a gym. It was too much work. You think of the excuse and then recognize it for exactly what it is…you’re lazy. Start off by taking a walk around the block three times a week. Okay, so you have to get up half an hour earlier to do it. Your loved ones as well as your heart will thank you. Oh, by the way, before you do it, check with your Doc. After all, he’s the one who’s been telling you for years that you don’t get enough exercise.

I’m not going to go through each and every organ in the human body, but I was a bit surprised that our breakdowns occur a bit earlier in some cases and a bit later in others. Our hair begins to leave us after age 35. The eyes begin aging at 40. Men, you can expect your gut to become noticeable by 55, and ladies, sorry but the boobs begin to age at 35. All in all, while death may be our final destiny, it’s probably a good idea to take care of what we’ve got while we’ve got it. But whatever you do, enjoy life; far as I know, it’s the only one we’ve being given.

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“How’re ya doin’?”

“Terrific, thanks; how about you?”

(No answer, but…) “Well, you’re lookin’ terrific!”

What the hell is that supposed to mean? I told this person I was “terrific,” and he looked at me like I’m some kind of liar. If I was doin’ shitty, I’d tell him, “I’m doin’ shitty,” so what’s the big deal. Does he want me to say that my back hurts like a son-of-a-bitch because all of the lumbar vertebrae are self-fused and they can’t even get a bloody needle in to give me an epidural anymore? That my back is so bad that I now have to use a cane to ensure my balance? That there’s no cartilage in either of my knees and when I walk, I can hear the bones rubbing together? That the doctors tell me I wouldn’t survive the anesthesia required for knee replacements? Is that what he wants?

I’ve stopped telling people how old I am when they ask. “Old enough to know better, but still young enough to learn,” has become my standard mantra. It’s either that or “Old enough to know not to make the mistakes of my youth,” that’s another one I’ve used.

I sometimes think that people ask how old you are so they can feel better about themselves. The one that really gets my goat is some young stud or ‘studdess’ telling me they hope they can do what I do when they’re my age. Screw that; I do what I do because I’m not quite ready to kick the bucket yet, and this exercise shtick is what the doctors say will help to keep me out of the crematorium. Someone asks if I’m feeling all right and follows up with, “You look kind of pale.” I just tell them I’m feeling a bit ‘ashy.’ They never get it, but it gives me a pretty good chuckle…at their expense…you don’t have something nice to say to me, shut the f..k up; I don’t need to hear it…particularly at five in the morning.

I’ve learned that there is a singular advantage to using the cane. People hold doors for me, and even old ladies who can walk without aid will defer to me as I enter the gym. At home, I often leave the cane and walk around unaided. Then I bump into a wall or a piece of furniture and remember that the cane is used for a reason…yep, you’re right…not the brightest bulb on Broadway!

I’ve noticed, in my dotage, that I get more hugs from young women than I used to. I figure they don’t think I’m any threat to them any more. They’re right, of course, but oh lord, does it ever bring back fond memories of yesteryear. Hell, I wasn’t a threat to them even then…married at 22, father of three ten years later…I never had the time or the desire to be a threat.

You see, the way I look at things now is this: I have coronary artery disease, but I’ve survived the first four heart attacks and now have six stents in the arteries around the heart. I had an aneurysm in my abdomen that one of the doctors caught before it burst, but it was purely by accident that he discovered it…whew. I say “whew,” because abdominal aneurysms are the tenth leading cause of death in this country…yeah, I was surprised too. I smoked cigarettes for 51 years and have moderate emphysema and chronic obstructive pulmonary disease to show for it…but it could be a whole helluva lot worse. I’ve managed to get by with nearly 20 surgeries to my credit, and if it’s all the same to those who care, I’d just as soon not have to go through any more. Although I must admit that Versed, one of the anesthetics being used today, is fantastic because it blocks out your memory and is great on pain…yippee Skippy!

The latest episode in this medical autobiography is the one that I guess I’ve been dreading for years. I was recently diagnosed with glaucoma in both eyes. I don’t know how fast this disease progresses, but for someone whose two great loves are reading and writing, this comes as something akin to a good hard kick in the…backside. However, like everything else, this storm can be weathered. There are always books on tape – I can become a better listener than a reader – and my little blog is so filled with errors that it just means Juli will have to add proofreader to her already endless list of things I ask her to do on a daily basis…as I say, the blog will have a few more errors. I’m certain of this because I know exactly where she’ll tell me to go if I ask her to proofread. Since that may well be my ultimate destination, I don’t wish to encourage more people than necessary to tell me to “do it now!”

Well, that about sums it up from this side of the bar stool. Keep those comments coming. It’s always nice to hear what’s going on in the world of reality.

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All that build-up just for one stinking heart attack! Looking back, it hardly seemed worth the effort. Don’t get me wrong, I’m not complaining about what happened recently; neither do I intend to make this another po’ me, po’ me essay designed to get the “Oh you poor dear,” bullshit. We’ve been there, done that, and I gotta tell you that the T-shirt isn’t too bad.

No, this is going to be another of those goddamned lectures that we all used to cut when we were in college. This is one of those dreaded ancient professorial types who should have been named emeritus a long, long time ago and given some small administrative task that would keep him out of everyone’s hair but most importantly, keep him out of the friggin’ classroom.

You do have to admit that my qualifications to give this dull, boring, and sometimes nauseating pontification are pretty darn good. Hey, four heart attacks and made it through each one. I mean, think about it, where are you going to find qualifications like that? Oh, sure, you’ve got your double, triple, and quadruple bypass types, but they all have those long scars on their chests. Donald Trump would look at them and say, “Ah, you guys got caught. You’re no heroes to me. It’s the guys without the scars, still walking around; those are the ones I like.” It would just be his basic John McCain anti-hero speech turned upside down, inside out, and sideways.

Anyway, getting back to today’s (snore) little talk, I cannot help but wonder when this little heart attack began to build up. Yeah, that’s right, build up. Heart attacks, so I’m told, don’t just suddenly happen. “Oh my God, he had a heart attack? Died? He was so young. He used to play golf every weekend. Oh my God.” Okay, but did he walk the course or ride a cart? Was the golf course where he could smoke a few cigars and not worry about being nagged by his spouse? Did the rest of his week consist of sitting his ass behind a desk, perhaps even grabbing a quick lunch at the desk? Was he always the first one in the office and the last to leave? What were the external and internal stresses he was facing on a daily basis? How often did he see a doctor…and did he listen to what the doctor told him? Better yet, what did he tell the doctor about his life?

My last heart attack was in April 2002. After number three, I have to admit that I was pretty cautious for a number of years. Sure, I slipped up every now and again, perhaps as time went by, maybe a little more often than now and again. My weight slowly creeped up until my six foot, one inch frame was carrying over 260 pounds. During the past two years I had been told by my primary care doctor, pulmonary physician, and my cardiologist, “You have to lose weight.” I’d try…not all that hard, but I’d try. Finally, I decided – note who made the decision – that the weight wouldn’t come off no matter how much I exercised or how much I watched what I ate. Trips to the gym became a serious chore…but I went, not as often as I had been going, but I went. Walking down the hall became a task. Out of breath, I’d stumble into bed at night. All of this developed over a period of about two-and-a-half years. I’m not telling you that it takes that amount of time to build up to a heart attack. I am saying that in my own case, I would trace the beginnings of this heart attack back to 2014. Did I know I was in this position in 2014? Naw, of course not. I was almost 80 years old. At that age, everyone is short of breath; everyone has trouble walking down the hall. Everyone is exhausted every night, right? Wrong my friend, wrong, wrong, wrong! No one could see what was happening inside my body. In hindsight, I can say that plaque had begun to reach a point where it was allowing blood to be pumped through the heart, but one of the arteries was closing, not rapidly, but with every squeeze, a micron more of plaque was being added. It wasn’t until May 17th of this year that that particular artery, said, “Hey, Jack, I hate to let you down, but I gotta tell ya, I’m tired. I can’t do this stuff anymore. I’m gonna send you a message and it ain’t comin’ by snail mail.” Now, I don’t know if my arteries are as dumb as the rest of me, but this wasn’t “Hmm, pain in left side of chest, radiating down left arm, with sweating and someone pounding a sledge hammer around where the heart should be. I think I have a problem.” Uh-uh, and that’s the interesting thing about heart attacks…they are not required to send you a specific message that your heart and your life are under siege. I have yet to feel and hope that I never do feel what most think of when they speak of heart attacks.

Am I trying to terrify you with all of this? Yes and no. Yes, I’m trying to set you straight that heart attacks can affect anyone at any time. My assistant came into the office one day and announced that she’d just had her annual physical exam. “They told me I’d had a silent heart attack,” she said. Okay, it didn’t kill her and, in fact, she’d never known. But it gave her an awareness. Just be aware that your heart won’t betray you unless you betray it. Not smoking, regular exercise, and a healthy diet…every doctor and his brother will tell you these things are important. Others will say live fast, die young, and have a good looking corpse. Then there’s the middle ground: Be smart; take care of yourself as best you can; ensure that the doctors you have are people who are practical and offer practical advice.

And no heart attacks…you hear me?

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I really like my University of Michigan clothing. My son has sent me a sweatshirt and heaven only knows how many different T-shirts in maize and blue emblazoned with Michigan swimming and diving on them. In fact, it was just such a combination of sweatshirt and T-shirt that I was wearing Tuesday morning as I prepared for my morning exercise routine at Planet Fitness. The muscle ache on the right side of my chest and in my right shoulder, I attributed to lifting one too many weights.

At the gym, and before working out, I sat at one of the client tables in one of the hand-shaped chairs, feeling that this shoulder and arm pain really weren’t getting any better. “Aw, to hell with it,” I thought and headed to my car instead of to the bike awaiting me at the gym. Home I toddled, laying down beside my sleeping partner carefully in order not to rouse her from slumber. After a few minutes of restlessness, I decided that the pain might just not be the result of a muscle pull or tear. Time to get this checked out.

At 6:15 in the morning, one does not go to the local physician. Instead, I took the direct route to Newton-Wellesley Hospital. In a situation not dissimilar from going to the dentist for a toothache only to have it disappear just before you get there, the pain began to subside…and I began to feel like a damned fool. Nurses came and nurses went. Doctors came and off they went. Blood was drawn and it too disappeared into the ‘who-knows-where’ cloud of something or other.

“I’d like to run another test,” said the attending physician, who shall remain nameless to protect the innocent. This one, I knew, was to determine if there was somewhere, floating around in this magnificent 81-year old body, a nasty little thing called a blood clot. These are fine unless they happen to wind up in your brain where they can cause a stroke or in your lungs where they can cause the ultimate step.

“The scan is clear; the x-ray is clear, but the blood enzyme is borderline,” said the doctor. I was acutely aware of what he was saying, having been through three prior heart attacks. “Are you saying this is an infarction?” I asked. “No, he replied,” obviously impressed that I could use such a terrific technical term – no dummy, this kid – but the troponin level is such that I think we should do another test. I will pause here to tell you that enzyme testing is an excellent way of diagnosing whether or not what the patient is experiencing is heart related or not. The only problem is that enzyme tests have to be performed six hours apart. By now, it was getting nigh on to noon and that meant that it would be well into the evening before the results were known. Now, I don’t know about you, but I don’t care to spend any more time in a hospital than absolutely necessary. They’re filled with germs and sick people and they are real morale busters. “You want to admit me, don’t you?” I glared with steely eyes (like that?). “Yes,” he said, with a look that matched my own. After arguing the advantages and disadvantages, I had to admit that his case for staying was somewhat stronger than my own arguments for leaving, thus I was taken to a bed in the main hospital, prepared for a sleepless night. Who the hell can sleep in a hospital?

Sometime after dark, this same emergency room doctor came smiling into 543A and proudly announced that my enzyme level had risen, thus indicating a heart “concern.” Translation: You have had a heart attack and we have stabilized you. Okay, that was heart attack number four, but the first one where any semblance of pain had occurred. Heart attacks are funny things. They don’t always behave as we have been told time and time and time again. Pain is not a necessity. Radiating tingling in the left arm doesn’t have to happen. Symptoms of a heart attack are all over the place, bear witness that the muscle ache (I thought) was on the right side, not the left, and while the muscle ache extended to the shoulder, it hardly “radiated” down the right arm. Still, it was a heart attack.

The following morning, there was no pain and I was ready to get in the car. It was over and all was right with the world, right? Young doctor whozit abused me of that idea early on. “We’re sending you in town for a cardiac catheterization,” He said. For those unfamiliar with this procedure – I had been there and done that so was fully prepared (yeah, right), a needle is inserted into the femoral artery [mistake one] in the groin and is threaded up through the heart, looking for blockages. If everything is clear, so is the patient. If a blockage is found, it is cleaned out and a stent implanted. A stent is a tiny piece of wire mesh that is used to keep the offending artery open. “Piece of cake,” I thought. “No pain; everything should be clean and clear [mistake two].

Late Wednesday afternoon, I was taken by wheelchair to the “cath lab.” They prepped the groin area and when the surgeon came in, he announced, “We’re going through the wrist.” I had heard of this procedure, but the radial artery seems so much smaller than the femoral that I didn’t understand how this would be possible. In addition, having a probing needle thrust into my wrist was not something to which I was looking forward. “Don’t worry,” said one of the nurses, “you won’t feel a thing.” While I was conscious throughout this ordeal, she was right. Whatever Kickapoo joy juice I had been given put me on cloud 9 and 10 and 11…good stuff.

I have no idea how long I was on that table, but it seemed like forever. When it was all over and the lights came up, I remember asking if everything was clear. Hardly, replied some doctor from somewhere. It seems that one artery was blocked 99.9 percent and a few others needed some plaque removal. Ergo, I was one lucky sumbitch that a doctor in the emergency room at Newton-Wellesley refused to let me make a fool of myself and go home.

To Doctor Adam Lurie; to Ryan Flanagan; to Doctor Colin Hirst and his team; and to all of the wonderful people I met at both hospitals, thanks for your dedication, patience, warmth, and understanding. Nursing care at both hospital was fantastic and guess what…I even liked the meatloaf lunch I was served just before departing for home on Thursday…in my Michigan sweatshirt and T-shirt.

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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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