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 their 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