Vagaries

You may notice the post’s title has changed from the one in the email you were sent. That’s because I
made an alteration and then published the post without changing the name. Mea culpa.

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One of the least often used glands in my body is the one responsible for careful planning. I even forget its name. In thinking about what to serve to our upcoming guests, we decided to have beef fondue on Christmas Eve. It’s a nice way for four people to have a leisurely meal and conversation. We’ve done it many times.

So we went looking for our fondue pot and came up empty-handed. Ditto the plates and specialized forks used in the cooking process. It turned out that both of us had forgotten that we donated our fondue set to the Salvation Army Store a couple of years ago as something we used too seldom to keep around.

Of course, now I want to have that fondue dinner more than anything. It takes all of my will power not to sit down at the computer and order gear to replace what we gave away. So why do I resist the impulse? Because there is no certainty that we would not be repeating history in another year or two, imagining once again that we need the space.

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Old age isn’t a battle: old age is a massacre.

Philip Roth

I love this quotation of Philip Roth’s. Who knows what got him up that day in such a rueful mood, but there is certainly an underlying truth in it. Let’s face it, our bodies were never meant to endure as long as they do now.

Experts keep telling us that we begin our physical decline well before we are thirty. The good thing is that most of us are unaware of this fact until later on, when we find that our body seems to be trying to set new limits. When we find one day that that ankle sprain now takes f.o.r.e.v.e.r to heal.

So while becoming an octogenarian may not be exactly a crime against nature, I accept that it is distinctly unnatural … perhaps a misdemeanor.

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Colorado passed a law regarding single-use plastic bags. There is an outright ban scheduled to take effect on Jan. 1, 2024. Between that date and Jan 1, 2023 there will be a 10 cent charge per bag charged to the customer.

Some local businesses are going right to implementing the full ban, and skipping the annoyances associated with collecting all those dimes. Some are not. Either way it’s a step in the right direction. Those who make the bags have had plenty of warning that laws like this one were on their way to the books eventually.

Perhaps one day we’ll look back fondly on the good old days when roadside ditches looked like this and rural fence lines were the last stopping place for legions of dangling sacks.

I can see possible conflicts arising at the grocery store during the dime per bag phase. Some packers at our local City Market don’t put many items in each sack, and now shoppers will be watching that more closely to cut costs. On the other hand, put too many pieces in and you risk bursting.

Customer: Here there, what are you doing? You can get more in that sack.

Employee: But do you want the bag to bust open on the way out of the store?

Customer: Then double bag it.

Employee: You know that in that case there will be twenty cents added to your bill?

Customer: (Turning to cashier) Is that right?

Cashier: That’s right.

Packer: Just let us do our job, if you would, kind sir.

Customer: But this is larceny! Where is the manager?

Packer: In his office, with a terrible headache.

Customer: Migraine?

Cashier: Bag complaints.

Of course we could avoid all this drama by bringing reusable sacks with us. As we might have done without needing to be legislated into it.

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I just finished a book that I should have read during my pediatric residency. It’s called “Being Mortal,” and is written by Atul Gawande MD. Perhaps I would have taken the time to read it, but the problem is that it wasn’t published until 2014. And you wouldn’t think a pediatrician would need a book that is described in the following way.

Being Mortal is a meditation on how people can better live with age-related frailty, serious illness, and approaching death. Gawande calls for a change in the way that medical professionals treat patients approaching their ends. He recommends that instead of focusing on survival, practitioners should work to improve quality of life and enable well-being. Gawande shares personal stories of his patients’ and his own relatives’ experiences, the realities of old age which involve broken hips and dementia, overwhelmed families and expensive geriatric care, and loneliness and loss of independence.

Wikipedia: Being Mortal

So why should I have read it? Because I was for the longest time such an admirer of the technology of medicine that “going for the gold” in most cases wasn’t seriously questioned. I could have stated my motto in this way: Is there more we could do? Well, then, let’s do it! My attitudes changed after seeing that the technology, the shiny hospital stuff, and the brand new drug or technique led to unhappy endings too often for me to be so cavalier. And it also led to the patient’s increasing dependence on us, the providers, as well as the frustration and anger of family members when things didn’t go as planned, as nearly always happened in complex illnesses.

Through the years, I began to clearly see the flaws in the practice of “doing everything,” all the time. That it was important to press the pause button periodically. My own difficulty was that now I was facing a new motto: If I don’t do everything … then what do I do?

These days I am not applying what the book has to teach us to my clinical practice, but to my life. Because the author isn’t talking about kids, but about doctors and geezers and the trouble we get ourselves into just by keeping on breathing, one day after another.

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Seems to me that reading these stories would be helpful to everyone who knows (and/or loves) someone who is scheduled to flutter or limp off this mortal coil one day. Wait … that means just about everyone, doesn’t it?

(To be continued)

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Saturday afternoon the sun shone, the wind did not blow, so I layered up and took a bicycle ride out into the rural. This is what I saw.

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While making a short run across town yesterday, while Robin was captive in the passenger seat of the Outback, I was pontificating about the changing location of gear shifters in cars over the years. On the floor, on the steering wheel shaft, and on the dashboard as both pushbuttons and levers.

Our present car has the shifter on the center console which is only possible because front bench seats are so out of vogue. When I was a breathless adolescent, nearly all of the sedans had bench seats, which allowed one’s date to slide over and be oh-so-close during the trip to the movie or wherever. It also allowed the driver to assess how the date was going by the position of his passenger’s body.

When your date was right next to you, that was delightful and confidence-building. If she placed a foot or two between your posterior and hers, perhaps you had some work to do on the relationship. But if she was all the way over to the right side, had her window down, and was hanging her head out the opening and shouting “WHY ME?” to an uncaring universe, you might as well take her home because things were not going well at all.

The Indifference of Heaven, by Warren Zevon

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