Pushing the Limits: Healthy Living is Difficult

Hello from Geisinger,

A 3:00 appointment has evolved into waiting for said appointment and then adding an MRI. So, three hours later I am still in the hospital and waiting for the MRI. That will be followed by another appointment with the orthopedic surgeon next week. I am not sure what all is on the horizon, but that has been how most of my life has gone. While I realize the amazingly miraculous life I have been able to live in spite of all of the complications, I must admit there are times I struggle to overcome whatever the latest complication tossed at me. A few weeks ago I was provided the incredible opportunity to speak to the medical students and faculty at the Geisinger Commonwealth School of Medicine (GCSOM) as a presenter for their Grand Medical Rounds. As I prepared for my lecture/presentation, I will admit I was a bit nervous. These are the people who have observed, examined, operated on, rearranged as well as poked, prodded, and probed every imaginable part of my GI track, or are training and learning to do it to others. They are the people to whom we give enormous power in spite of the fact they are called practicing physicians. They are the people who understand us, at least in terms of the biology and physiology, but somehow might seem to forget that we are more than a specimen; that as a patient, we are a human. In my case, I am an ostomate who have endured 11 abdominal surgeries, struggled with complications because of their surgeries, which were my only option to live at the time, and now I am 64 and struggle with hydration, disconcerting biopsies, diabetes (as a Crohn’s consequence), liver damage (as a Crohn’s consequence), episodes of Gout (as a Crohn’s consequence) and kidney issues (also as a Crohn’s consequence). Are you seeing a pattern?

Each day I live I am pushing the limits because I have been told that the reason they do not know what do to with me is that most people who have experienced my complications do not live this long. Each day I live, I know that I have been given yet another gift of 24 hours and I need to manage those time blocks as well as I can. Each day I live, I wonder how it is that I have somehow managed all of this? In the month or so, the demands of a 4 Prep/5 Section semester has taken its toll on me also. In spite of eating quite healthy, I have somehow managed to put about 10 pounds back on. This is beyond frustrating for me. I think there are some rather radical options (and yet healthy) things on the horizon. The other thing is simply getting back to my walking. I did see something on MSN this morning about how a younger person lost 50 pounds in about 8 months, and it was a sensible process. For me this is not about merely losing weight, but it is about helping my liver, my joints, and other things that have been affected by the Crohn’s, the surgeries, and the regiment of steroids and such. When I was at the gastroenterologist recently (during the fall), his response to my history with IBDs and all of the complication was telling. He noted that my body is like an upside-down jigsaw puzzle, and while they can see the pieces, they are not sure how they all fit together. This analogy did not surprise me. The more interesting part is when he noted that they reason they do not know exactly what to do with me was because most people with all of my GI maladies do not live as long as I have. I guess that is both a blessing and a sort of worrisome statement all in one. As I have noted above, there are times I struggle with what a premature birth and the lack of knowledge of IBDs when I was a child have left me, but again there is something about all of those struggles as a child that prepared me for what would come.

As I have lived longer than any of my siblings (and 5 of 9 have left this world at a younger age), I am well aware that there are no promises of a tomorrow. What all of that as done is help me realize the giftedness that I have in each day. As I sit in Starbucks in the library, I cannot help but watch the variety of students, staff, and faculty that walk past the corner table where I sit up an office on a regular basis two mornings a week. I wonder what they will be like at my age. What will the world be like? What sort of things will they try to manage or what will college be like? I am quite sure it will not be like anything we see today. What I worry about more is the quality of life many will live. Much like a shrinking middle class, there are not a lot of what I call average people. It seems like they pay particular attention to their health or they are totally oblivious. The number of 20-somethings I see that are significantly seeming out of shape or overweight is stunning. As I watch the mount of sugar they put into things, I hear diabetes screaming from every cup of coffee or latte that is sold. One of the first blogs I wrote on a previous blogging site was titled “Freezing, Fashionable, or Flummoxed.” It was after standing outside this same Starbucks 10 years ago. A young lady had mittens on, a hooded, fur-lined, parka, short-shorts, and UGGs. I remember being stunned by all of it. Again, there are times I find myself feeling old . . . what I find to be appropriate dress in classrooms or on campus, and what I see many students wearing continues to push my understanding of professionalism or appropriateness. I have, in fact, add some requirements regarding attire to my syllabi.

The pushing of limits seems to be the norm in our daily culture than the exception. This occurs in fashion, in our speech and communication, and in what we seem to allow either ethically or otherwise. During the past week plus, I have listened to the Impeachment Inquiry Hearings. I feel a bit badly for anyone being called before the committee at this point. Many of them have reiterated they are not there to predict or push for an outcome, but rather to answer the questions and the way they are pushed and pulled by both parties are incredible and disappointing. The limitations of our ability to understand how our government works is an important consideration. We have little idea of how the upper echelons of the various agencies and the classified nature of much of what happens goes way beyond the common citizen’s purview. I think all of this is related to my initial thought or purpose of this post in that I believe what we have become, and what is currently happening in Washington, D.C., pushes limits in a variety of ways that cause our country’s fabric to continue to be more frayed and tattered. I remember as a child believing that the President or serving in the United States Congress was something to aspire to becoming or doing. The other day in my three freshmen classes I asked how many of them believed such a profession was admirable or something they would hope to do and not a single student raised theirĀ  hand. In my opinion, I do believe that many of my students are wondering about all of events in the Capitol, but they are not sure what to do with it. As I listen to all of it, even as a sexagenarian, and yes, as a person who has a political preference, I am not sure how it all will transpire. What are the limits of our willingness to accept what I believe is a questionable phone call and the withholding of aid? I think the issue of former Mayor Giuliani and his involvement in an international political process is problematic. I think what will happen is both rather predictable and important. As I listen to the inquiry, it is stunning to me how each party can couch their questions that ignore the former mayor on one hand.

If indeed, the President held up Congressionally approved monies to a foreign country for investigating a company, the 2016 elections, and by extension Vice President Biden (as noted by Ambassador Volker today as an adjusted understanding), I do believe the President will be impeached by the Democratic-controlled House of Representatives. Furthermore, I do not believe the Republican-controlled Senate would convict President Trump, particularly when the benchmark for conviction is 2/3 majority. I do believe as legal commentary noted today, while there is extreme partisanship, there is still democracy. Our Constitution allows for inquiry, which is fact finding, the impeachment hearing, which I believe is a legal proceeding, and then the move to the United States Senate for a trial, which is under the administration of the Chief Justice of the Supreme Court. It is amazing what I learned way back in my 8th grade U.S. Government class. I must give credit to Mr. Flom, that amazing RHS and WHS history teacher who I believe I had for at least one class every year (and often both semesters).

As I move toward the end of another day, to be honest, I am tired. I find that the hours I used to be able to manage and the hours I can manage now are very different. Certainly, the limits have lessened. My endurance has lessened. At the beginning of this blog, I was being examined for possible hip surgery. Again, a consequence of my Crohn’s. This week I have attended four doctor’s appointments from podiatrists to neurologists. Again, my understanding of my limits, while frustrating is becoming more clear, at least in its cumulative effects. There is so much more even today to ponder. The neurologist came up with a couple of possible pathways forward, and decisions are made to try a certain regiment for the next couple of months. If that is not sufficient, there is a back-up plan. I guess the important thing for me is there have always been options. I do not always like some of them, but at least I have them. Throughout this blog I have considered the limits of the various elements of our lives. What is the best way to approach the limit or boundary? Those who know me would probably agree that I push them. I need to understand them; I need to engage with them. That is how I determine what to do with them. Limits and boundaries offer security, but they also allow an opportunity for growth. If we are unwilling to engage and see how they work, what sort of things might we have missed out upon? In my case, I think it would have been an incredible loss. My life would have missed so many experiences: from college to travel, from jobs to hobbies. I grew up hearing how I was not so many things. I grew up smaller, and at times bullied. I did not realize until lately how that would have (and has had) consequences. That will be a topic of a blog probably soon, for a variety of reasons. If I had not pushed the limits of this unique body, I am not sure I would have experienced much of what I have. With that in mind, it is time to get back to work and imagine the limits of some of my students’ writing. Here is my musical interlude that is about this season of thankfulness.

Thank you as always for reading.

Dr. Martin

Trying to Make Sense of Our Illogical World

Hello after a quick trip to Cape Charles and “Life on the Half Shell” and now weeks beyond,

It is the end of the Bloomburg Fair week and Anton has had the week off of school. He has become a fair aficionado, but I guess that is something he can always take back to Denmark. It is quite amazing to me that we have finished 5 weeks of classes already and in a day or so, Anton has been here a month. The reality and accuracy of my father’s words are once again ringing in my ears. If you think time is going faster, you have no idea of what it will be when you are my age . . . and he was about the age I currently am. He is accurate that it surely seems to go by more quickly, and what I thought being he was so old when he offered those pearls of wisdom, as he was so apt to do, does not seem so old. Anton has learned an important lesson about the conservative nature of rural Pennsylvania this past week (albeit a bit surprising in terms of the degree of cluelessness of the pettifoggers he was subjected to). While walking around the fair, some of his CC classmates decided to inquire if he were Democrat or Republican. He wisely, and accurately responded, “I am Danish.” Unfazed by such an answer, they inquired a second time, “Yes, but are you Democrat or Republican?” He again tried to help them understand,  “I am Danish, and we do not have the same political system as you have here in the states.” This mystified our budding conservative politicians, and so they once again asked, “But are you a Republican?” He noted, as he recounted the episode, that he realized as a visitor to the states he did not want to argue or create a problem so he simply tried to explain Danish politics. When he noted that Denmark is a country of Democratic Socialism, our young Central Pennsylvania Republicans decided attacking him as a socialist was the thing to do. He recounted that for the next hour they decided it was their job to convert our Danish visitor to the incredibly wonderful ideals of our current Republican party. Again, Anton noted, he did not want to create difficulties, so he listened and listened, and listened . . . and got a painful lesson in the current state of American politics. To be fair to his classmates, I am not surprised they did not understand him, I am not sure that many adults would. More importantly, I learned how astute and thoughtful, how polite and intelligent my Danish, surrogate-son-for-a-year is. Anton notes regularly that he realizes that Denmark is a small country and most people do not really understand where he is from. Part of the reason I chose Denmark as a possibility was because I have been to Denmark, because I attended Dana College, and because I have a Scandinavian heritage (Norwegian, but still Scandinavian).

Since I last blogged, which was a blog that took more than a month to complete, about half that time has passed, but it seems that my life has been consumed by school and a 16 year old. Having Anton there to keep me in line has been a busy and rewarding time. He forces me to consider something besides work, and that is not a bad thing. Another difference is that I have been required, in a way mandated, to be more efficient and effective. I know this next week will push me to see how well I have started to integrate those differences as I have a ton of grading and commenting to do, an office to move again (because of a moisture and mold issue) and simply managing all the other things that are life. My alarm now goes off at 5:45 a.m. and breakfast is on the table at 6:15 a.m. One of the unexpected side effects is that I am also eating a healthy breakfast in the morning and it seems to keep my day on track and my mornings more positive. Managing things around the house, I find myself more focused and much more organized. Some things need to happen yet this weekend, but all in all, there is a sort of two thumbs-up atmosphere around the acre. Undoubtedly, I am relearning the need to prioritize and as I write this I am finding I can do this. During the first weeks that Anton has graced my home and me with his presence, I have learned so much. Anton demonstrates an incredible intelligence and insight, but he does it with a sense of inquisitiveness and grace. His smile is affable and his willingness to help is always present. One of the things I find most enjoyable is Anton’s ability to wonder about things. He understands the world and business in ways that belie his age (of almost 17). Then there is other part of being that age and male, or so it seems in my conversations with others. I can ask things and he is so cooperative, but then he seems to completely forget there was any conversation pertaining to said issue. As I have spoken with colleagues and even the parents of his friends, I am finding he is completely normal.

I am trying to remember if I was like that. If so . . . to my parents, I am so sorry. No wonder you might have been exasperated at times. I believe it probably more true of my time than I would like to admit. I know if my grandmother wanted it I was pretty attentive, but otherwise, I was a bit remiss in my work ethic. The other night we had a conversation and I heard again the interrogative, why are you so logical about things? I do not know that I was always that way, but the more I think of it, perhaps it has always been the case. I remember as a small child trying to make sense of what it meant to be adopted and wondering why I was told some of the things I was. I remember asking more than simply why about something. I have this insatiable need to understand. I am not sure how that developed or from where it came, but it has continued even until today. I am always asking why something is not possible. I know for some of my supervisors or for some in the administration, I create some consternation from time to time. Yet, that is not my intention; rather I am trying to see how we can get things accomplished more effectively or efficiently. I am trying to understand why so many are content to not really understand the why or the possibilities. During the fall, my students have made Dickens’s Tale of Two Cities real-life for me. They are the best and the worst of times, or so it seems. I think what amazes me most is how they react to the need to put in more effort, to think more critically, or merely even to do their work and follow directions. Yesterday it was something as simple as please cut up your paper in paragraphs and put it into an envelop and bring it to class. There was a method to putting it in an envelop and not having their peers see the paper in advance, but I ended up getting 9 additional envelops for one of my sections. From time to time this semester, be it at school or in the daily news, I find myself struggling to make sense of the things that seem to happen on a regular basis. Have we become so insensitive, so narcissistic, so selfish that we cannot begin to imagine the needs or perspective of the other?

Over the last couple weeks I have been a bit obsessed with either grading or reading (and making breakfast and dinner for a 16 year old). I have four books all looking at the rhetoric of racism  . . .  or the history and the rhetoric we use to further the racial tendencies that most of us refuse to acknowledge. When I raised the possibility of white privilege the other day, the response or look from some made it hard to ignore that some believe we are in a time of what some might call reverse discrimination. What I find interesting is they are not mutually exclusive, at least in my mind. I believe there is truth to the issues of age, gender, or religious discrimination. I believe there is also white privilege at the same time. I can both benefit and be harmed by the reality of what happens in our country. What I have found as I have aged is I am much more attuned to the hardships that others face through no fault of their own. When I see a black or brown student being viewed as suspect merely because of their color in a store it hurts me. When I see a person struggle because they are an American citizen, but they are bilingual because of their background and, in spite of their hard work still struggle with their language skills, I am embarrassed that we do so little to support them in their working to achieve their own American dream. I remember my great-aunt saying her prayers in Norwegian when I was small. I remember listening to other languages from my predecessor generational relatives because they were bilingual. Perhaps I did not know they struggled, but it seemed we were much more gracious then. I know there was discrimination, but I was taught to be tolerant. And contrary to your thoughts that I might have been the product of an academic/liberal upbringing, I was a blue collar kid from NW Iowa. I grew up in one of the poorer sections of town, at least economically more depressed than some because I did not live north of 18th Street; I did not live in Morningside, the Northside, or Indian Hills as it was called. I did not live in the Country Club area, but what I know is I had stability and amazing friends. I grew up with a family where my father worked 7/12s and often 8 hours away and I saw him perhaps 36 hours very six weeks or so for three or four years. Nevertheless, I grew up working part-time jobs when I turned 16 and I was not given everything I wanted.

Perhaps what I realize again is my father was also a logical person. You did what was necessary to make it work and you treated others as you wanted to be treated. My father believed in a fair day’s work for a fair day’s pay. He told me more than once there are no free lunches in the world and he worked hard. I think I have acquired those traits from him. As I listen to the people who occupy the inner sanctum of Washington, those inside the beltway, I find myself more and more appalled by their behavior and the rancor and vitriol that seems to be the rule rather than the exception. I believe they perhaps epitomize the selfishness and narcissism I referred to earlier. There is nothing logical about the way they behave. What is logical would be our decision to throw them out with the implementation of term-limits. This is not the first time I have argued this, and it will probably not be the last. Well, I could go on, but I have worked on this post for far too long without its completion, so I will leave you with this as we are headed into Halloween, which is also the anniversary of the reformation and Luther’s posting of the 95 thesis on the castle door at Wittenburg. What if we could come together like this video? Is it logical, perhaps not, but it should be.

Thanks for reading.

Dr. Martin