KATJA'S FALL

 

Dear George, 

I was sitting in the solarium reading the newspaper when I heard Katja scream for me from the kitchen. I rushed in and was startled to find her lying on the floor, limbs askew, her face pressed against the floorboards. She had been walking toward the sink, was suddenly overcome with dizziness, and had fallen flat on her face. It was a struggle trying to help her get up because her left leg was in excruciating pain. She made it to a dining room chair an inch at a time, and I went to get the walker that we’d stored in the basement from a previous hospital stay. Katja was frightened that she’d broken her leg or that she may have damaged her titanium knee implant. Thanks to our elevator, Katja made it upstairs to bed. We thought about calling 911 but decided to wait until the morning to see how things went. This was Friday, July 19. 

Katja didn’t experience pain if she kept her leg perfectly still, and she slept during the night. In the morning, though, her pain was even worse. She woke up crying, frightened that she might never walk again. We decided to call 911. The paramedics, a team of four, arrived in less than two minutes. I put our dog Iko in the den with the door closed, and the paramedics interviewed Katja — what had happened, where the pain was, her medical conditions, allergies, etc. They were very professional and competent. The University of Cincinnati Medical Center is near us and is the city’s largest hospital, but we’d had to wait over four hours last time so I suggested Good Samaritan instead. Katja, though, opted for UC because of its extensive facilities. The paramedics wrapped her in a blanket-like stretcher and carried her down the stairs from our second floor and out to the ambulance. I took Iko for his walk and drove over to Emergency an hour later. 

Contrary to our last experience, UC Emergency was relatively uncrowded, and Katja had already had X-rays by the time I arrived. The doctor said the X-rays did not show a broken bone, but that X-rays weren’t able to detect soft tissue injuries — muscles, ligaments, etc. He also wasn’t convinced that there wasn’t a fracture and had ordered a CT scan to further explore that possibility. Katja wasn’t able to bear any weight at all on her left leg. Her pain was still terrible. Because she couldn’t stand up, the doctor said she would need to stay in the hospital at least overnight. We were both relieved. 

One night in the hospital soon turned into five nights. The CT scan had detected a fracture in her left knee area. The medical team decided against surgery in favor of letting it heal naturally. A physical therapist worked with her each day. On day one Katja couldn’t move her left leg at all without experiencing unbearable pain. On day two she could raise it one inch (pain at level 9 of 10). Day three, two inches. Day four, several inches, less pain. On day five she walked down the hospital corridor and up and down five practice stairs. The hospital had been negotiating with our insurance for a two-week stay in a rehab facility, but Katja had improved enough that they canceled that. They still weren’t ready for discharge because Katja’s blood pressure was up and down, and they judged that to be the likely cause of her fall.  

The morning of day six Katja called to say she was being discharged. I drove over and waited in the Patient Discharge area till a nurse brought her down in a wheelchair. A significant moment. We drove home, and Katja was able to use her walker to get up the patio stairs and into the house. Iko was out of his mind to see his mom. Katja was feeling improved enough that she thought she might be able to go to the opera at Music Hall on Saturday evening, but that didn’t sound like a realistic possibility to me. We cancelled our plans for a trip for a summer vacation trip which we’d scheduled for the end of the week.  

Katja has been home for a week at the time I’m writing this. We’re both happy about this, but it’s had its ups and downs. Being a caretaker is a pain in the neck, as is being dependent on one’s spouse for just about everything. We’re used to each separately doing our own thing through the course of the day, but Katja is not very mobile and needs help with all sorts of physical tasks. She’s still in a lot of pain and spends a lot of time in bed, though she did cook scrambled eggs and bacon the other day and likes to get up to feed the dog. 

 I find myself very aware that we are at an age where we can be more subject to physical perils. We both worry about Katja’s injury. I find myself drinking more water (since the doctor said Katja was dehydrated) and gripping the handrail more firmly when I go up or down the stairs. The doctor said that Katja’s recovery will take about six weeks. We’re up to it, and it will probably go by fairly quickly. On the bright side, we’re lucky since the accident and injury could have been even worse. 

Love, 

Dave

BUREAUCRATIC NIGHTMARE DEPARTMENT

Dear George, 

All this medical stuff puts us at the mercy of huge impersonal bureaucracies, and it’s starting to drive me crazy. A few months ago Katja was diagnosed with a cracked wisdom tooth under her gum that needed to be extracted. While this sounded unpleasant, we were pleased that the operation would be performed by the head of the oral surgery department. He apparently was on vacation though, and the surgery was actually done by a resident. A month or two later Katja started having severe pain in the location of the surgery. An X-ray revealed a bunch of small bone fragments scattered around the now-healed area of her gum. The new doctor said he’d never seen anything like it, seeming to imply that the original operation had been badly botched. In any case, Katja needed to have another operation, more intrusive and difficult than the first. The hospital double-checked with our insurance company to make sure that the operation would be covered by insurance, and, after receiving an affirmative response, Katja underwent a second procedure. Six weeks later we got an e-mailed bill from the hospital for $13,000. Katja called the hospital, and they advised us to call our insurance company since the latter hadn’t paid the bill. When Katja called, the insurance person said they hadn’t paid the bill because the hospital had used the wrong code in sending the bill, classifying the operation as medical rather than dental. They told Katja to contact the hospital and ask them to change the code from medical to dental and resubmit the bill. Then they would pay it. Katja called, but the hospital said they were not able to change the code from medical to dental because that would involve breaking the law. (What law remains obscure.) The insurance company then said that nothing could be done and that we would need to pay the bill out of pocket. The situation, of course, seemed totally ridiculous. Katja called the hospital back, and, after some haggling, they agreed to reduce the bill if we would pay the full sum immediately. It was still many thousands of dollars, but there seemed to be no other choice. I brought up the idea of hiring a lawyer, but Katja gritted her teeth and gave the hospital our credit card number. The most positive thing I can say is that I’ve stopped losing sleep (though I have been having bad dreams). 

Love, 

Dave

What's the Scoop on the Real Seniors?

Dear George, 

I have a big birthday coming up next month. Eighty-five — the biggest number so far. Since 66% of people born in 1937 are no longer with us (1), I should appreciate being around to celebrate this event, and I do. However, it’s still a bit unnerving. Gerontologists call the “85 and over” age group the “old old” or the “oldest old”, a life stage associated with risk of degenerative disease and disability, loss of autonomy, and physical dependence upon others. I prefer to rely upon a British radio station that asked their 85 and older listeners to vote on a new name for people in their age bracket. (15) The number one choice was “Real Senior” (40%), followed by Long Lived” (26%), Wisdom Warriors (12%), and the “Very Oldies” or the “Venerables”. I googled “Real Senior”, and the first thing I got was an organization that helps people remain in their homes as long as possible. (7) Not too reassuring. Then I tried “age 85”, “85 years old”, “oldest old”, etc. Here are some of the things I found. 

 The first thing I noticed confirmed my belief that statistics lie. Most research studies and reviews use “85 and over” as an age group category. However, “85 and over” has an interesting feature. All the earlier age groups are typically in five-year increments, e.g., 40-44, 55-59, etc. “85 and over”, though, is open-ended. Like we’ll just lump all these ancient people into a single category, whether they’re 86 or 102. In one empirical study the researchers reported that members of the 85 and over category in their sample ranged between 85 and 103. That’s a big spread. Looking at census data, about 66% of 85 and overs are 85-89, 26% are 90-94, and 8% are 95 or older. Consequently. “85 and over” (hereafter 85+) is broader and less precise than other age categories and may not be particularly descriptive of persons who are 85. 

 The second thing is that researchers and reviewers tend to focus on negative attributes of the Real Old, i.e., disease, disability, death. However, there are always alternative ways of viewing any given finding. For example, one research team found that 37% of 85+ people have severe visual impairments. (9) This is, of course, an important and distressing finding. Note, however, that we can conclude with equal validity that 63% of 85+ people do not have severe visual impairments. Below I’m going to report some of the research findings I’ve run across on Real Seniors, but turning the reported results around to state them in an optimistic direction. 

*80% of 85+ people live in their own home or apartment, and only 8% live in nursing homes. (12) 

*A British study found that 59% of 85+ respondents reported feeling no more lonely than they had a decade previously. (5) 

*By age 85 80% of people show no meaningful loss of muscle mass and strength. (6) 

*About 50% of adults over age 85 do not have hearing impairments. (6) 

*82% of people 85 and over do not report clinically relevant depressive symptoms. (8) 

*About 20 out of 100,000 people 85+ commit suicide in a given year (0.000002%). (11) 

*Despite decreasing thirst perception with age, 59% of 85+ people drink sufficient liquids daily. (17) 

*According to Webmd, a study of 1,299 women 85 years and older found that 77% do not have mild cognitive impairment and 82% do not have dementia. (16) 

*47% of persons age 85+ report no difficulty performing any daily living activity. (8) 

*A U.S. survey study found that 51% of elderly persons (85+) did not have a need to be driven places, 65% did not need support in taking care of their residence or assistance in shopping, and 77% did not need assistance with housekeeping activities. (14) 

*In 2018 the percent of adults 85+ who did not need help with personal care was 79%. (2) 

*A study of 125 older adults (85+) found that, compared to younger age groups, they score as high or higher on scales measuring resilience, coherence, purpose in life, and self-transcendence. (13) 

 Here’s my way of summing this up: A majority of people in the 85 and over age bracket in the U.S. live in their own homes or apartments; do not have hearing impairments or severe visual impairments; do not show muscle loss; do not exhibit clinical symptoms of depression; have a near-zero probability of committing suicide; do not need assistance in driving, shopping, housekeeping activities, or personal care. While any given individuals might not show all of these attributes, it seems clear that a hefty number of adults 85 and over function effectively in the world, physically, mentally, and socially. So much for the negative stereotypes of the “oldest old”. The next question is how one can age successfully as a Real Senior. I hope to get back to you on that. 

Love, 

Dave 

 SOURCES: (1) 247wallst.com, “How Many People Are Still Alive From the Year You Were Born,” 7-31-21; (2) sci.gov, “2019 Profile of Older Americans,” May 2020; (3) apa.org, “A snapshot of today’s older adults,” Sept. 2021; (4) assets.aarp.org, “Chronic Conditions Among Older Americans,” undated; (5) cambridge.org, “An investigation into the patterns of loneliness and loss in the oldest old,” 10-30-15; (6) frontiersin.org, “Age-Related Disease and Clinical and Public Health Implications for the 85 Years Old and Over Population,” 12-11-17; (7) help4seniors.org, “Stay Independent at Home,” undated; (8) imaging.org, “Read how IOA views aging in American,” undated; (9) ncbi.nim.nih.gov, “Blood pressure and mortality in elderly people,” 6-13-98; (10), ncoaorg, “Get the Facts on Healthy Aging,” 1-1-21; (11) npr.org, “Isolated And Struggling, Many Seniors Are Turning To Suicide,” 7-27-19; (12) pew research.org, “Growing Old in America,” 6-29-09; (13) pubmed.ncbi.nim.nih.gov, Resilience, sense of coherence, purpose in life and self-transcendence…,” 7-9-05; (14) soa.org, “Retirement Experiences of People Age 85 and Our,” 2019; (15) the guardian.com, “Keep it ‘Real Senior’,” 12-15-14; (16) webmd.com, “Prevalence of Dementia Increases Dramatically After Age 90, Study Finds,” 5-9-11; (17) en.wikipedia.org, “Old age”, undated

BATTLING THE SLEEP DEMONS

DEAR GEORGE, Some years ago I was a Grade A sleeper. All the credit goes to my doctor who was happy to refill my Ambien prescription whenever I wanted. Ambien, in my view, is a wonder drug — like oxycodone or the polio vaccine. I would simply take a pill, fall asleep in precisely 30 minutes, sleep soundly for eight hours straight, and wake up refreshed and eager for the new day. Unfortunately that doctor retired and my new doctor was less enthusiastic about drugs. He hinted that one of his patients went out in a stupor and walked in front of a truck. Whatever the case, when I turned eighty he told me that federal guidelines prohibited him from refilling my Ambien prescription. I think that was a fib because my wife’s doctor didn’t seem subject to such guidelines. Nonetheless, my Ambien supply came to an abrupt end. And so did my good sleep. I tried all of the over-the-counter sleep aids, but none of them seemed to work. Now I often take two or three hours to fall asleep or I wake up at 3 a.m. and stay awake till sunrise. Such a drag.

I’ve been asking Google about sleep problems, and there’s a lot of info. One thing I learned is that rich people sleep better than poor people. If the world were just, this should be the reverse, but it’s not. Explanations for low-income insomnia include occupational hazards, off-hour shifts, lack of healthcare services, neighborhood stressors (e.g., noise, pollution), and daily stress. Sleep inequality in turn contributes to decreased cognitive performance, mental health issues, disease (e.g., diabetes, heart disease, stroke), weight gain, and up to a 30% greater risk of death.

Another unpleasant fact is that sleep problems increase with age. Older people often have more trouble falling asleep, sleep less deeply, wake up more often during the night, wake earlier in the morning, and wake up feeling tired. (This sounds familiar to me.) Many different factors enter into these aging-related changes: less production of hormones that promote sleep, more sensitivity to environmental stimuli, medical issues (e.g., arthritis, heart or lung disease), side effects of medications. In addition, low exercise, frequent naps, and drinking more alcohol or caffeine can contribute to sleep difficulties. Older adults with poor nighttime sleep are more likely to be depressed, experience more attention and memory problems, fall more in the night, and have a poorer quality of life. On the other hand, bad sleep is not an inevitable product of aging. Many healthy older adults report few or no sleep problems.

There are many standard sleep tips: don’t use cell phones, iPads, or TV in the bedroom; do aerobic exercise during the day (before 2 p.m.); avoid caffeine, alcohol, sugary foods, exercise, and smoking before bedtime; reduce light and noise in the bedroom; keep the same sleep schedule every day; check side effects of medications; keep a journal, listen to calming music, or read a relaxing book to reduce mental stress. I find that it sometimes helps to go to sleep if I slowly count backwards in my mind from 99 to 0, or progressively relax my muscles from my toes up to my nose, or visualize pleasant landscapes like the Menominee River. When I wake up bright-eyed at 2 or 3 a.m. I often play a game or two of computer solitaire. Winning the game seems to clear my mind and provides closure, such that I go to sleep quickly when returning to bed.

Two things bother me most about my erratic sleep. First, I don’t know why this is happening. My life isn’t that stressful, and I stay up till midnight so I ought to be tired. Second, it’s frustrating that I’m not in control of my own mind and body. I whisper to myself, “Go to sleep…go to sleep…go to sleep” fifty or more times, but my body pays no attention. Getting to sleep is, however, an interesting challenge, and I sort of look forward to it each night. I think I will eventually be successful. LOVE, DAVE

SOURCES: health.clevelandclinic.org, “22 Facts About Sleep That Will Surprise You”; healthline.com, “People with Lower Incomes Have More Sleep Issues…”; helpguide.org, “Sleep Tips for Older Adults”; sbm.org, “Insomnia in Older Adults”;sleepeduction.org, “Sleeping and Growing Older”; tuck.com, “The Inequality of Sleep”

The Outing

DEAR GEORGE: Katja and I have enjoyed Sunday brunches at the Broadway Cafe for at least thirty years. We bring along the Sunday Enquirer, and Katja does the Jumble while I scan the TV Week and read the sports pages. The Broadway chefs are breakfast masters. Perfect fried eggs or French toast, delicious hash browns, crispy bacon. A delightful end of the week for families and retired folk.

All this, of course, came to an abrupt halt with the arrival of the pandemic. The Broadway closed its doors to indoor dining, and we stopped going to restaurants altogether. We finally got vaccinated this past March, and we’ve been thinking about going out for breakfast ever since. It took a while, but we made the big decision this past weekend.

We arrived about eleven a.m. There were fewer cars in the parking lot than I remembered, and we found a spot in the front row. The front lobby was empty, and we stood by the hostess’ stand for a few minutes. Restaurant staff flitted by. Finally a masked waitress came out of the kitchen. I couldn’t tell if we knew her or not. She handed us a couple of disposable paper menus (clearly intended for one use only) and asked for our drink orders. Katja said water and black coffee, and I said the same. She pointed toward the dining area and said we could sit anywhere we wanted. There was one couple seated on the north wall and a family of five in the opposite corner. Most of the booths and tables were walled off with cellophane tape and had “Closed” signs. We found a booth far away from the other diners.

As we sat down I noticed a QR code on the wall just above our tabletop (one of those square bar codes with lots of squiggly black lines and white spaces). A small sign just below it said “You can place your order and pay your bill here.” I pushed on the bar code two times with my thumb, but it didn’t do anything. When the waitress came I asked her how to order with the bar code. She said I could take a picture of it with my smart phone, then follow the prompts and email my information to the kitchen. “But,” she added, “I can take your order in person.” Katja ordered two eggs over lightly, whole wheat toast with butter on the side, and bacon. I ordered the same except for link sausage. Normally the waitress would bring a little tray with a variety of jams and jellies, but instead she asked if we wanted grape or strawberry. Apparently offering a tray that other customers had used meant danger. Katja chose strawberry, and I chose grape.

Fifteen minutes later the waitress returned with our order, just as Katja was finishing the Jumble. She gave each of us a cellophane wrapped package containing black plastic silverware and one napkin. The silverware wasn’t the more expensive sturdy grade that we get at the Party Source but small-ish bendable utensils that might come with a McDonald’s Fun Meal. There were no salt and pepper shakers on the table (also to avoid contamination), and the waitress brought little packets at Katja’s request. The food tasted as good as we remembered it, and we ate it up more quickly than usual. Katja complained that the coffee was horrible, but I reminded her that it’s always been horrible. The waitress didn’t return to ask how we were doing but she did finally bring the check. As we left the dining room was empty.

We waited quite a while at the cash register. I joked that we could just walk out without paying, and my evil self wanted to do so. Finally a kitchen worker came out. The bill was $18.50, about three dollars higher than it used to be. The kitchen guy didn’t ask how our meal was, but he did say, “Have a nice day.” To commemorate this historic event, I took a selfie of us standing outside the front door. We had taken the big step of re-entering the world. Unfortunately the world wasn’t quite ready. LOVE, DAVE

What I've Learned From The Pandemic

DEAR GEORGE, Our lives have been significantly altered for over a year because of the coronavirus pandemic. With growing hope that we might return to normal in the foreseeable future, I find myself trying to figure out what it has all meant to me. Here are my thoughts so far. LOVE, DAVE.

(1) The pandemic is like prison. The pandemic means different things to different people. One of my acquaintances loves working at home and dreads returning to the office. Another is mourning the loss of both of his parents to the virus. For Katja and myself it’s been mostly a matter of home imprisonment — confined to the house, cut off from contact with friends, most of our normal world inaccessible. Life’s pleasures typically involve going places and doing things, and fourteen months of restrictiveness have resulted in a felt loss of control and bouts of boredom and hopelessness. (2) My wife is a pretty good cell-mate. Despite divorce filings rising 34% during the pandemic, I’d say that we fellow prisoners have actually been more mutually supportive than we normally are. Together in the same boat, we’ve managed to share a few laughs every day. (3) The pandemic is a major test. In the most dire circumstances the pandemic has meant coping with the death of loved ones, job losses, business failures, neighborhood decay. In my own case it’s been more a question of resourcefulness — how to restructure my life in meaningful ways, given the loss of so many options. (4) My grade is a C-. A year ago I made a list of things I could do more of. Start a new home exercise program, read more books, do an art project, study Spanish, write more poetry. As with my New Year’s resolutions, I failed at all of these. Personal change is difficult to bring about. My only significant adjustment has been to watch more TV. That’s o.k. — I enjoy watching TV and it’s entertaining. But it’s also lazy and nonproductive. (5) Others are alien beings (and so are we). Out on the street most of us wear masks, concealing our faces, smiles, and nonverbal expressions. When passing on the sidewalk people move as far apart as possible, sometimes stepping into the gutter or onto an adjacent lawn. We now live in a world where everyone else is a potential threat to one’s well-being (and we ourselves are threats to others). How alienated can the populace be? (6) The pandemic is politicized. One might think the pandemic to be a public health matter, but, thanks to an unnamed former president, it’s a political monstrosity as well. Half the country (the other half) is the enemy. I feel angry when I see people in indoor spaces who refuse to wear masks; resent the millions who choose not to be vaccinated; and, with the exception of Gov. Dewine, am generally disgusted with the actions of red-state governors. It’s amazing that we can’t find more common ground since everyone faces the same global disaster. (7) Social isolation isn’t all bad. Some people have prospered during the pandemic. The takeout restaurant down the street is doing a whopping business. For myself I find that my faulty hearing has been largely “cured” during the pandemic (thanks to TV closed captions and lack of conversations). I also suffer much less from social anxiety (given minimal social contact). Much of the time I feel more at peace than I did before the pandemic. (8) One solution is a sense of mission. After months of stagnation, I rediscovered a major task that I’d put off for years and years. We have an upstairs room that I regard as my “junk room”. It’s filled with stuff that I’ve accumulated over forty plus years — treasures from yard sales, antique stores, flea markets, etc. The piles of stuff grew out of control a decade or two ago, and I’ve long been thinking about cleaning it up. With so much new free time, it seemed like my chance had come. The job took about a month, but I was totally engrossed and managed to create order out of chaos. This was my most satisfying accomplishment during the past year. (9) Family is the bulwark. We would have had a much harder time, were it not for the support of our sweet family in New Orleans. J, K, and the kids flew up last month, and, with all of the adults vaccinated, we did a lot of activities that we’d foregone for a year: the zoo, out to eat at a fancy restaurant, multiple thrift shops, Findlay Market and Jungle Jim’s, three-ways at Skyline Chili. They gave us concrete hope that our lives were changing for the better. (10) Dogs help too. Dogs don’t worry at all about the pandemic. If anything, they appreciate getting petted and walked more. My son J. drove up from New Orleans in March 2020 on his way to California and left their miniature schnauzer, Iko, with us. Having this furry bundle of energy in the house has made our lives much more lively and enjoyable. (11) Returning to “normal” is a challenge. With the exception of our recent family visit, Katja and I continue to pretty much shelter in place. Keeping isolated seems to have become our fixed pattern, and sometimes I worry it will go on forever. We need to take some more baby steps to break free.

BAD HEARING FOLLIES

DEAR GEORGE, As you know, my hearing isn’t a hundred percent. Actually it’s improved a lot during the pandemic (since I rarely talk to anyone), but it’s still shaky enough that it can leave me muddling through public situations. For the most part, these are harmless but amusing encounters. I try to keep track of examples in my daily diary. Here are a few. LOVE, DAVE

HELPING OUT A STRANGER. Sometimes I’ll ask people to repeat what they said when I don’t get it. Other times, when it’s less important, I just fake it. The other day, for example, I was taking photos of the flowering trees on Ludlow Ave. A middle-aged man approached me on the sidewalk and said something like,“Is grat houch dooling arn the narket?” “Yes,” I said confidently. “I knew it,” he said, shaking his head vigorously. Then, double-checking, he asked, “That one?” and pointed to the house directly in front of us.“No,” I said cluelessly, “that one down there”, and I pointed in the general direction of the house next door. Suddenly it dawned on me that he’d asked me if the house we were in front of was going on the market. Too embarrassed to correct my misinformation, I sped up my walking pace, leaving my innocent victim in a state of befuddlement.

MY ERRONEOUS MEDICAL RECORD. When I went in recently for a medical checkup, the nurse went over my recent history, going through her list to see whether I’d been experiencing various symptoms (e.g., unexpected weight gain, chest pains, dizziness, medication allergies, etc.). As she read through the list, I said “no” for most of them. Sometimes, though, I didn’t quite hear what she said, so I just said “no” to those too. Later I decided that that might not be the best way of going about it since incorrect information could affect my treatment. I have survived so far though.

MYSTERY LUNCH. Returning from the dentist, I came upon a Long John Silver’s. I looked over the drive-through menu and decided on the two-piece fish lunch. The woman over the staticky loudspeaker said, “Would you like to try a kkrccash mnintrop vrvv? It’s $5.99.” She had a high-pitched voice which always gives me trouble, so I asked her to repeat it. She said, “Would you like to try a ppraavckr menffllk fibber? Only $5.99.” So I said, “Yes, that’s what I want.” She asked if I would like some Krrmlkfszces with that, and I said no thank you. It only took a minute or two to get my order, and I pulled into a space in their parking lot to eat. I was curious about my mystery lunch. Actually it turned out well: one piece of fish, one crabcake, four fried shrimp, French fries, and coleslaw. I’d order it again next time but I don’t know what to ask for.

MY FAVORITE SUPPER. The other night Katja brought in a delicious meal to the table. “What’s this?” I asked. “Chicken pot pie,” I heard her say. “Oh great, my favorite, chicken pot pie.” “No,” Katja replied, “chicken pot pie.” “Yes, chicken pot pie — my favorite,” I said. She spoke slowly and articulated carefully, “Chicken Pad Thai.” “Oh, Chicken Pad Thai, I didn’t think this looked like chicken pot pie.” In any case, it was tasty. The next day I sat down and Katja brought in another plate. “Chicken pot pie,” she said. “Oh, Chicken Pad Thai,” I replied. “No, chicken pot pie,” she said. “Are you saying Chicken Pad Thai?” I asked. As it turned out it actually was chicken pot pie this time. I gave up trying to get it right.

The Biggest Day

DEAR GEORGE: Around noon today we watched Joe Biden take the oath of office and deliver a stirring inauguration speech. Then an hour later we drove over to the UC Med Center and got our first Moderna vaccinations. Two life-changing events in the course of an hour. I can’t remember such a time in my life. Watching the inauguration I felt my whole body suddenly relax, and I realized I’ve probably been in a constant state of muscle tension for the last four years. My main aim has been to live long enough to see the end of the Trump presidency, and I can’t express how satisfying that was (though I know that many have the exact same feeling). I realize that the damage that Trump caused will last for years and even decades, but there’s that reassuring sense that the country’s course as been righted, at least to the extent that that’s possible. I also think it’s remarkable that we got our anti-Covid vaccine on the same day as the inauguration. That’s also a great relief and a concrete sign of hope for the future. Frankly, I was amazed that it came as quickly as it did. For me it means a return to the fitness center and my aerobic exercise classes by early March and many more public events that I’ve been missing by the autumn. Like Trump, the country’s recovery from the pandemic will likely take years, but the growing availability of the vaccine is an occasion for optimism and rejoicing. I think we’ll just sit back and enjoy this happy time. LOVE, DAVE

Death Stats and Factoids

Dear George,

Death is on my mind a lot these days.  It’s because of the pandemic.  I wind up thinking, ‘Every day is going to be the same, and then I will die.”  So I’ve been looking into death lately.  It’s definitely more interesting than I thought.  Though I’m still not enthusiastic, I can see it is one of life’s really big events.

Love,

Dave  

How many people born in Sweden in 1875 (my grandfather’s year of birth) went on to die?

There were 135,558 births in Sweden in 1875, and 135,558 of those Swedes are now dead.  No slippage.  (17) 

Altogether how many people have died in human history?

Roughly 100 billion deaths since Homo Sapiens appeared over 200,000 years ago.  (9) 

Nowadays how many people die each year?

According to the Population Reference Bureau, about 8 out of every 1,000 people die each year.  (4)   Globally that’s about 150,000 per day.  (24) 

What are the main causes of death in the U.S.?  

2,839,205 people died in the U.S. in 2018 (the most recent year for which data is available).  About 74% of these deaths occurred as a result of 10 causes (which have remained fairly constant in recent years).

1.  Heart disease: 655,381 (23.1%)

2. Cancer: 599,274 (21.1%)

3. Accidents: 167,5.9%)

4. Chronic low respiratory disease (lung diseases): 159,486 (5.6%)

5. Stroke and cerebrovascular diseases: 147,810 (5.2%)

6. Alzheimer’s disease: 122,019 (4.3%)

7. Diabetes: 84,946 (3%) 

8. Influenza and pneumonia: 59,120 (2.1%) 

9. Kidney disease: 51,386 (1.8%)

10. Suicide: 48,344 (1.7%)   (14) 

What is the worst way to die?

According to ranker.com, one of the worst ways is being trapped in a falling elevator.  Because your internal organs tend to keep moving upon impact, they can tear out from the bottom of your body.  Your head, however, remains farthest away from the point of impact, meaning you may survive long enough to see your insides make their way outside.  (16)

What are the most common methods of suicide?

Worldwide, the most common methods are hanging, poisoning by pesticides, and firearms.  Other common methods are jumping from a height, drug overdoses, and drowning.  (25) 

How painful is death typically?

Thanks to palliative care, pain and other symptoms (e.g., fatigue, insomnia, breathing issues) actually improve as people move closer to death.  Over 85% of palliative care patients have no severe symptoms by the time that they die.  (20)  

Can doctors help one to die?

Assisted suicide is legal in Washington, Oregon, California, Vermont, and Montana.   (9)

How many people die because of medical errors?

About 440,000 people die every years from preventable medical mistakes.  (15) 

What is your life expectancy if you are 70 years old?  80 years old?

Life expectancy in the U.S. at age 70 in 14.4 years for males and 16.6 years for females. At age 80, life expectancy is 8.3 years for males and 9.7 years for females.  (19)  

Will I live longer because I am left-handed?  

Left handed people die 3 years earlier than right handed people.  (18)   

How many people live to age 116?

About one out of every two billion people live to 116 or older.  (8) 

How has the lifespan changed in the U.S.?

In 1900 people lived to an average of 47 years; this increased to age 68 by 1950 and 77 in 2000.  (24) 

What is the strangest death of a famous historical figure?

The ancient Greek philosopher Chrysippus died in a fit of laughter when he saw a drunken donkey try to eat some figs.  (3) 

How many people die from smoking?

According to the CDC, cigarette smoking kills over 480,000 Americans each year.  (5)

How many people die from drug overdoses? 

Overdose death rates in the U.S. have steadily increased from 38,329 in 2010 to 67,367 in 2018.  (7) 

How many Americans die from dog bites?

There are about 4.7 million dog bite victims annually in the U.S.; about 365,000 are treated in emergency rooms; and 34 die, most of them children who were bitten in the face.  (13) 

How many people die from falling out of bed?

About 600 Americans die each year from falling out of bed.  (6) 

Are icicles dangerous?

About 100 Russians are killed each year when sharp icicles fall from rooftops and land on pedestrians.  (13) 

Does texting while driving kill people?

About 6,000 Americans die each year in accidents in which they are texting while driving.  (13) 

How many Americans die from lightning strikes?

An average of 49 people die from lightening each year in the U.S.  (23) 

How many  die from shark attacks?

On average twelve people die worldwide from a shark attack each year.  (By way of comparison, humans kill about 100 million sharks and rays each year, mostly through commercial fishing).  (22) 

How many people are killed by hippopotamuses?

Hippos, who are aggressive and unpredictable creatures, kill 2,900 people per year in Africa.  (13) 

What about roller coasters?

Americans take about 900 million rides a year.  About 4 people die annually.  (13) 

What is the deadliest war battle in history?

1,971,000 casualties occurred in the Battle of Stalingrad (1942-43) between Nazi Germany and the Soviet Union.  (92)  

Are there dead bodies on Mount Everest?

There are over 200 corpses of failed climbers frozen on Mount Everest.  (12) 

How many people go to Heaven after they die? 

89% of women and 69% of men think they will go to Heaven.  (2)  However, based on clues in the Bible, the website 88c.com estimates that only 2.5% of deceased people will go to Heaven, while 97.5% will go somewhere else.  (1)

Are there any living organisms that are immortal?

There is a type of jellyfish (turritopsis nutricula) that lives forever by reverting back to the polyp stage after reaching maturity.  (11) 

SOURCES: 

(1)  888c.com, “How Many Will Be in Heaven?”; 

(2) abcnews.com,  “Poll: Elbow Room No Problem in Heaven”; 

(3) allthatsinteresting.com, “The strange deaths of 16 historic and famous figures”; 

(4) buzzfeed.com, “31 Strange and Disturbing Facts About Death”; 

(5) cdc.gov, “Burden of Cigarette Use in the U.S.”; 

(6) content.time.com, “How Americans are Living Dangerously”; 

(7) drugabuse.gov, “Overdose Death Rates”; 

(8) dyingmatters.org, “Interesting facts about dying”; 

(9) fact slides.com, “Death Facts”; 

(10) factretriever.com, “61 Grave Death Facts”; 

(11) guff.com, “45 Insane Facts About Death”; 

(12) mentalfloss.com, “30 Astonishig Facts About Death”; 

(13) odd.com, “10 Incredibly Bizarre Death Statistics”; 

(14) MDlinx.com, “Top 10 causes of death in the US” in 2020;

(15) msn.com, “The most interesting facts about death”; 

(16) ranker.com, “Science Has Finally Determined The Most Gruesome Ways to Die”; 

(17) scb.se, “Population and Population Changes 1749-2019); 

(18) scoop whoop.com, “15 Srange &n scary Facts About Death”; 

(19)  ssa.com, “Actuarial Life Table”; 

(20)  theconversation.com, “No, most people aren’t in severe pain when they die”; 

(21) usafacts.org, “Number of Deaths in the United States between February 1 and September 19;  

(22) usatoday.com, “Shark attacks 2019”; 

(23) weather.gov, “Lightning Victims”; 

(24) wikipedia.org, “Death”; 

(25) wikipedia.org, “Suicide methods”;

 

A Coronavirus I Ching Reading

Dear George, 

Having drifted into a state of total lethargy,  I haven’t checked the I Ching even once since the pandemic began.  That’s ridiculous.  The I Ching, of course, is the ancient Chinese Book of Changes.  Drawing from Confucianism and Buddhism, it provides guidance for moral decision-making and action.  One typically consults the I Ching by asking a question and then tossing three coins six times in a row.  The pattern of heads and tails for each coin toss results in either a solid or broken line (see citations at the end for details), and the six lines are arranged vertically in a stacked hexagram as in this example:   

Hexagram 43: Kuai - Breakthrough (Resoluteness)

Each possible hexagram, subdivided into an upper trigram and a lower trigram, represents a  specific life situation.  With six coin tosses, there are 8 trigrams possible and 64 (8 x 8) hexagrams possible.  The 8 trigrams represent heaven, lake, fire, thunder, wind, water, mountain, and earth.  The I Ching provides an interpretation for each of the 64 hexagrams.  Each interpretation includes an Image (the state of mind a superior man would adapt under the circumstances) and a Judgement (the best strategy for action under the circumstances). 

I asked the I Ching, “How can I best cope with the pandemic?”  Like Michelle Obama, I find myself increasingly experiencing “low-grade depression”.   Most of our major pleasures in life have been closed off, and I wake each morning with a sense of dread and an expectation that there is nothing to look forward to.  I tossed the coins six times and recorded each solid and broken line.  My hexagram (shown above) is titled Kuai (Breakthrough [Resoluteness]).  The upper trigram is Tui (The Joyous, The Lake), and the lower trigram is Ch’ien (The Creative, Heaven).  The hexagram suggests that the lake has evaporated and ascended to the sky where it will discharge itself as a cloudburst, hence the imagery of a breakthrough.    

Richard Wilhelm’s commentary.  In the most highly regarded rendition of the I Ching, translator Richard Wilhelm writes:  “This hexagram signifies on the one hand a break-through after a long accumulation of tension, as a swollen river breaks through its dikes, or in the manner of a cloudburst. On the other hand, applied to human conditions, it refers to the time when inferior people gradually begin to disappear. Their influence is on the wane; as a result of resolute action, a change in conditions occurs, a break-through. The hexagram is linked with the third month (April-May).”

My comments.   As usual, the I Ching is uncannily on target.  April-May, of course, is when the coronavirus’s major surge began in the U.S., including a sharp increase in hospitalizations and  deaths, shelter in place mandates, the prohibition of large public gatherings, and the closing of restaurants, bars, and many retail establishments.  Like most people, I’ve experienced more and more tension since that time, and my mode of coping, frankly, has been that of an “inferior person”.  Morose, passive, self-pitying, hopeless. 

How can one break through the paralyzing funk that the pandemic produces?  First, it’s helpful to recognize that there are wide differences in how people respond to the situation and that depression isn’t an inevitable alternative.  Many people, of course, experience catastrophic personal losses — of loved ones, of jobs and income, of their businesses or families.  People in our age group are likely to feel particularly vulnerable to the virus and may fear the prospect of an imminent death.  At the opposite extreme, some regard the pandemic as a complete hoax and adopt a far more cavalier attitude.  Or persons may not let themselves be overwhelmed by the situation.  In occasional instances, the pandemic provides a desirable opportunity for financial profit (e.g., pharmaceutical companies).  Likewise, there are divergent ways of viewing the pandemic.  Probably a majority dwell on the fact that 1 of 60 Americans have been infected by the virus, while others are reassured that 59 of 60 haven’t been.  Experts estimate that 1% or fewer of infected persons are likely to die (though, on the other hand, 99% or more will not).  

It seems to me that two things are required for a breakthrough.  The first is to adopt a less exaggerated and more realistic view of the pandemic.  I spend endless hours soaking in frightening information from the media (which concentrates almost entirely on death rates and largely ignores rates of recovery).  In looking at relevant statistics, our odds, in fact, are pretty good.  Second, I think a breakthrough occurs which one engages in meaningful, rewarding activities that provide a renewed sense of mission.  Something beyond watching Netflix and taking naps.   A lot of my own gloomy state is linked to the loss of so many activities in our community.  I have lost my poetry classes, but I can still write tons of poems.  The gym has been shut down, but I can do a challenging exercise program at home.  The same for blogging, reading, art, music, photography, and playing cards and Trivial Pursuit with Katja.  I’ve been a slug-a-bed for much too long.  Hopefully finishing this blog post will be the first step in a personal breakthrough.  Time will tell. 

Love,

Dave 

SOURCES: 

Wilhelm, Richard.  (1950). The I Ching or Book of Changes. Cary Baynes, trans. Bollingen Series 19. Introduction by Carl G. Jung. New York: Pantheon Books. 3rd edition (1967), Princeton: Princeton University Press.

mindsports.ni, “Interpreting the I Ching” 

taopage.org, “Content of the I-ching” 

the-iching.com, “43. Parting (guài). Breakthrough”

 

Skipping the Fourth

Dear George,

Thanks to the coronavirus, this may be the most un-Fourth of July since 1776.  No fireworks extravaganza on the riverfront, no band concerts or parades or community-wide picnics.  You don’t even see that many flags.  Just a lot of firecrackers that have been going off late at night for the past two weeks and terrifying neighborhood dogs.  It’s just as well.  Between Trump, the country’s failure to control the pandemic, George Floyd, the uproar over monuments to white supremacy, and economic collapse, it’s hard to dredge up any feeling of patriotism.  Here is my optimistic, if somewhat delusional thought.  Six months from now we’ll be inaugurating a new president, they’ll be distributing a vaccine to hundreds of millions, police reforms will be in place in many U.S. cities, racist monuments removed, and an increasingly successful reopening of business and industry worldwide.  Probably too much to hope for, but some of it could actually happen.

This is pretty much a lost year so far since virtually everything pleasurable has been put on hold.  On top of it all, I woke up on June first with every muscle in my body aching.  Thinking it due to the statin I take for high cholesterol, I emailed my doctor’s office and asked if I could stop the statin.  During these perilous times it’s difficult to see or talk to a doctor, so the nurse-practitioner said by return email it was o.k. though she thought it more likely to be arthritis.  My son and daughter-in-law, the two doctors in our family, tentatively diagnosed my condition as Polymyalgia Rheumatica, a mysterious but not uncommon ailment apparently linked to being older than one should be.  I relayed this to the nurse-practitioner, and she started me on a low dose of steroids (prednisone).  That helped quite a bit for the first two days, then seemed to reach a plateau.  The pain is tolerable, gets better in the course of the day, and I’m patiently waiting for it to go away altogether during my three-month steroid treatment.  

The other painful thing is that my close friend Jennifer and her partner Brian moved this week from Cincinnati to Virginia where she’s taken a high level position in the state university system.  Jennifer came here twenty years ago, and, because she lived right down the street, we walked home from work together practically every day.  That’s a lot of walks and talks, maybe 3 or 4 thousand.  This is the second time in a couple of years that one of my closest friends has moved away, and these are losses that are pretty much impossible to overcome. 

A bright spot is that our son J and grandkids V and L will be coming to visit in about a week, and they’ll stay with us for two weeks, the longest get-together we’ve ever had.  I think it’s a great opportunity.  I worried that with so many things shut down it will be hard to keep the kids entertained, but J reassured me that they are very content to spend the whole day playing video games.  I myself have never played a video game, so I’m going to ask them to give me some lessons.  At the end of their stay they’ll drive back to New Orleans, taking one or both of their dogs with them.  J asked if we might want to keep Iko in Cincinnati.  Katja’s been wishing for that for some time, but then she changed her mind, thinking back to a childhood trauma when her veterinarian dad said she couldn’t keep the new puppy he gave her because its original family wanted it back.  Dog arrangements will work out one way or the other.   This three and a half month visit from Iko and Lil Paws has been a great treat and has reminded us how much we are dog people.  

Katja sent me off to Clifton Market yesterday with a grocery list that included some challenging items, e.g., unsweetened cocoanut, cider vinegar, two avocados.  A staff person stocking shelves found the cocoanut for me, and I actually found the vinegar myself, though I had to call home to see if apple cider vinegar was correct.  Another staff person pointed to the end of the aisle where the avocados were, but unfortunately the labels were missing from the various fruit and vegetable boxes.  I picked up two dark green lumpy items shaped like small footballs and took them back to the staffer, asking her if these were avocados.  She looked at me strangely and nodded yes.  Then she asked if I would like her help in picking out which avocados would be best to choose.  I declined but sincerely thanked her for her offer.    

So we are muddling along.  Cincinnati is one of the worst places in Ohio for spread of the virus right now, so we’re trying to be as careful as possible.  Take care, wash frequently. 

Love,

Dave