Wednesday, March 14, 2012

The Last Four Weeks of Doctor K

Last month, the Wall Street Journal published an article called "Why Doctors Die Differently".  It begins with the story of Charles, a 68-year-old doctor who was diagnosed with cancer.  But instead of taking the damn-the-torpedoes approach to fight the illness with his knowledge and excellent access to treatment, he chose to forgo all intervention.  He spent his last months with his family.  Charles knew all too well the reality of cancer, the limits of medicine to extend life, and the decreased quality that life would have.

Here is the story of one patient I had met in a hospice where I volunteer, a former convent where terminally ill patients are admitted.  At that time last year, all the patients were elderly and bed-ridden, fading in and out of consciousness on their daily schedule of being fed and cared for by the staff.  While I was at the bedside of one patient, I saw from the corner of my eye someone walk quickly past the doorway.  It was a young-looking woman, healthy, strong, and very alive.  And in a hospital gown.  But no wheelchair, walker, or oxygen tank.  I thought I had seen a ghost.

But it wasn't an apparition, the hospice was not haunted by any former residents hanging around as younger versions of themselves.  This woman was a patient, and she was herself a physician.  I'll call her Dr. K.  

Dr. K had been diagnosed with an aggressive form of cancer which had claimed her sister the year before.  "I don't want to go through what she went through,"  she explained. "I saw it all.  It was beyond pain."  As a physician, she knew her options, she had no false hopes.  So after her diagnosis, she closed her practice, sorted out her affairs, and when the cancer reached its advanced stage, she checked herself in to the hospice.  Her plan was to stop eating and end her suffering in four weeks.  

The hospice staff was gracious beyond belief.  They enjoyed conversing with a fellow medic, listening to her story, and accommodating her every wish. Visitors flowed in and out of her room.  Between her busy visiting dates, I talked to her during the first two weeks.

She was grateful to have all the cleaning, shopping, and personal care done for her; all the more time for her to spend with loved ones.  She talked to me about her career and her family.  But, with a level head and sharp intelligence, she also talked to me about the morbid subject of starving one's self to death.  Namely, she had not been sticking strictly to her plan of only drinking ice water with a teaspoon.  She had been eating occasionally; the human need to stay alive was too strong.  In fact, she said that to do it "properly", one had to take a strong dose of valium, close the door, and lie in bed all day, every day.

I don't know how much of her decline was due to refusing food or the inevitable progression of her cancer.  The third week came and I stopped by her room.  She was no longer in any condition to talk, drastically thin and visibly weak.  I pulled up a chair to sit with her in silence.  She turned her head to me, opening her eyes halfway.  "I recognize you," she whispered, placing her boney hand on my arm.  "I'm sorry, I'm very tired.  I can't talk right now."  

It never fails to impress me that people maintain their decency and politeness at the end of life. I told her there she didn't have to apologize, we didn't have to talk.  Her eyes slowly shut and she drifted into a reverie.  But I also knew that in a hospice, there is no coming back.

The following week, I went up to her room and saw that it was vacant.  The bed was made and Dr. K's belongings had been cleaned out.  I was amazed, she had carried out her plan on time.  She had done things her own way, calmly, serenely, and with no open ends.

Thursday, March 8, 2012

The Best Underwear for Rolfing

Once in a while, a client asks me what underwear they should wear that would best for Rolfing.  And indeed, to get the most out of each session, there is in fact underwear that helps me do my job better.
Here are a few notes.

So, to summarize, in a Rolfing session, first of all, yes I do need you to undress down to your underwear.  All in the confines of my office, so no worries if you are shy (if you have questions about wearing an undershirt, drop me a note).  Then, I take about one minute for bodyreading to see how you walk and breathe before the session itself begins.  Every session is different, but it always includes important work around the neck and shoulder area.  Thus, having the base of the neck free of straps and ties makes my job much easier.  Also, when it comes to working around the hip joint, good old cotton behaves most like a second skin, much more so than a synthetic fabric.   

By the way, I recognize that I have only addressed undergarments for half of my potential readers, so for those of you who don't wear any of the items pictured above, here are two more.

Wednesday, June 22, 2011

The Party of a Lifetime and the Virus That Caused It

The photo album has been in this house for twenty-five years.  I found it stashed away in the meditation room upstairs with about fifteen other yellowed, crumbling volumes of photographs.  I'm not sure whose photo albums they are.  Some may have been taken and collected by staff over the years, others appear to be personal albums from patients who passed away, and who had no one willing to store the memories for an indefinite time.

I am upstairs at Coming Home Hospice in San Francisco's Castro, and the pictures I'm talking about are of some of the earliest victims of AIDS from 1985-87.  The photo above is titled "Hospice Prom."  Keep in mind that a hospice is an end-of-life home that serves patients who are diagnosed with six months or less to live.  The outrageously dressed people in the picture, I assume, are some of the dying patients together with staff and friends who visited them.  They are literally celebrating like there's no tomorrow. 

As I turn the pages, there is one picture after the next of young handsome men, first in their street clothes, and as illness progresses, they appear in their hospital gowns, bed-ridden.  Very noticeable are their visitors:  few family members, but lots of friends.  And wigs, sequenced dresses, platform shoes, and glitter lip gloss. 

Needless to say, they don't party like that at Coming Home Hospice anymore.  The patients I talk to once a week are mostly older, suffering from dementia, or phasing in and out of awakened states as they wait out advanced stages of cancer.  A World War II veteran, a 100-plus year old great-grandmother, a 85-year-old stroke survivor whose nephew and niece placed him in care.  But these young patients in the photographs flinging feather boas and sporting tiaras?  That was yesteryear.  Those parties are gone, because the illness that claimed them, AIDS, has nearly ceased to exist in this city.  
Meanwhile, the virus lives on.  And these images remind me of a certain grace that the first AIDS patients had as they faced not only the harrowing diagnosis of a new, incurable disease, but also the global stigma of being "punished" for being homosexual, one example of this being Pope John Paul's decision to cancel a planned visit to Coming Home Hospice during his stay in San Francisco in 1987. 

Twenty-five years later, the experience of being diagnosed HIV-positive remains devastating, yet living with the virus has drastically changed.  The disease which once grabbed headlines has long been relegated to being out-of-sight, out-of-mind, by the efforts of modern medicine that raced against the clock to stop it.  A blessing, which also made the fantabulous parties at this house history. 

Monday, June 20, 2011

Thank You for Littering

My recent trip to Mexico ended up being a lesson in impermanence.  We visited the ruins at Monte Alban, Mitla, and Teotihaucan, whose perforated historical documentations have archeologists scratching their heads as to what actually happened there.  A bulk of these civilizations' traces had been reclaimed by nature, because, for the most part, they biodegraded.  In addition to this tidbit of the transience of things, my airplane reading happened to be Cradle to Cradle by William McDonough and Michael Braungart, who recommend a paradigm shift from "being less bad" to a "production of good waste".  In other words, instead of believing that our waste must be destructive in nature, we should consider Nature's model of waste as food.  Biodegradable waste is not waste, but nutrient.

Now, back in San Francisco with McDonough and Braungart's words fresh in my head, I encountered one of those irritating little events that all business owners are familiar with:  I ran out of business cards.  But, knowing that the blitz-white, ink-jet matte card paper from Avery contains petroleum-based chemicals to give it that sleek patina, and that these chemicals may be thrown into the recycling without being made for recycling, I started thinking of another solution.  After all, the life cycle of my business card in the age of smartphones is pathetically short.  As soon as my information is entered into a Contacts list, my business card becomes trash: bent, stained, and discarded into a landfill.

The result is shown above:  my business leaf.  I gathered eucalyptus leaves from the park across from my apartment and wrote on them with Sharpie pens, which are non-toxic and contain only a fraction of a percentage of the harmful chemicals of a wet newspaper leaching onto the sidewalk.  So, if I happen to run into you and give you my leaf, then please save my email address... and thank you for littering.