To Have (or maybe not) a Stroke

Heart attack

“You’re not leaving here with your blood pressure that high,” the doctor said. It was 189 over something equally ridiculous. It was not interested in coming down. Finally she said, “Okay, pick up this prescription on your way out and take it the minute you get home.”

Vividly running through my head were images of my mother, who suffered a series of strokes that eventually killed her in her 70th year. Plus images of assorted aunts and others who suffered debilitating strokes and often early deaths.

“But . . . but,” I said to the doctor, as I have repeatedly said since my carefree youth; “I don’t have high blood pressure. My three older sisters? They all had high blood pressure. They also all had beautiful auburn curls, while I got the utterly straight, dishwater blond hair. So, shortly into our adulthood, I took to saying, ‘OK, keep your gorgeous curly hair, I’ve got the good blood pressure.’ It seemed like a pretty fair trade.” My physician said, not unsympathetically, “Those genes may have caught up with you.” And just like that, I joined the ranks of the hypertensive. That great mass of humanity waiting apprehensively for the stroke or heart attack that might swoop in and end it all.

By the time I got home I was visualizing an immediate demise.

Unlike my mother’s generation, though, today’s hypertensives have internet encyclopedias worth of information and an arsenal of drugs bewildering enough to induce a small stroke if you really try to figure them all out. Beta blockers. Diuretics. Angiotensin II receptor blockers. Vasodilators. A good doctor, whose advice you can follow, at least on which meds to take, is a great boon. french fries

The rest of the try-not-to-have-a-stroke business is fairly straightforward. Quit with the nicotine, and moderate the booze (or quit that too.) Watch the weight – extra poundage, especially around the midsection, can increase your stroke probability rather dramatically. Walk for at least 30 minutes a day, increasing the distance as you can. (Swim, bike, exercise.) Salt can do you in fast; if you’re trying to stay within the recommended 1,000 to 2,000 mg per day, a large order of fries (350 mg) might not be a wise choice.

This writer is good with most of the above – excepting an occasional uncontrollable urge for a small order of fries. Plus whatever that was I picked up from the Kaiser pharmacy definitely worked. One tiny little pill, and the next day my blood pressure was 114 over 85.

Maybe I’ll stick around for a while.

Women, Abortion Rights & Willie Parker

Dr. Willie Parker

Dr. Willie Parker

Noted physician/activist Willie Parker was in San Francisco recently explaining why he does what he does.

What Willie Parker does is regularly put his life on the line in behalf of poor women and their reproductive health. Why does he do it? “It’s the right thing to do.” Among other things Parker does is to fly regularly into Jackson, MS to provide abortions at the one remaining clinic where Mississippi women without power or resources can go for this constitutionally-protected health service.

His belief that it would be morally wrong not to help the women who come to him, Parker once told this writer, was rooted partially in a sermon Martin Luther King, Jr. preached on the good Samaritan (who stopped to help a stranger after others had passed him by.) “What made the good Samaritan ‘good’ was that instead of thinking about what might happen if he stopped to help the traveler, he thought about what would happen to the traveler if he didn’t stop. I couldn’t stop to weigh the life of a pre-viable or a lethally flawed fetus against the life of the woman sitting across from me.”

Parker headlined an event celebrating the 43rd anniversary of Roe v Wade that was organized by Carol Joffe, PhD, of the University of California San Francisco’s Bixby Center for Global Reproductive Health – and which quickly sold out.

“Most (abortion) providers keep a low profile,” Joffe said in her introductory remarks; “but Willie has chosen to be very public. (Despite his multiple degrees and honors, everybody seems to call Dr. Parker ‘Willie.’) He is building bridges to the past and to the future.” Joffe went on to speak of Parker’s connections to progressive causes, faith communities and, most recently to the Black Lives Matter movement. “What he is doing,” she said, “helps all women to live lives of dignity.”

Parker, who treats the issue of personal danger as not worth his time to worry about, calls the anti-abortion efforts “domestic terrorism,” especially with the murder of providers. The incessant efforts to overturn Roe, and passage of more and more unnecessary state laws making abortion inaccessible for women without power or resources are, he maintains, in the same “domestic terrorism” category.

The author with the doctor

The author with the doctor

So in return Parker says he tries to “radicalize” every young woman he sees in Mississippi. Since the state mandates he spend time with her, unnecessarily and repeatedly, before allowing her to have the abortion which is her constitutional right, Parker considers it only fair to put that time to best use. “I tell her, ‘these people who are trying to close this clinic – they don’t think you’re smart enough to make your own decisions.’ And I explain change will only happen if she fights for it. Then I tell her to go vote.”

All of which helps explain why Willie Parker does what he does. This writer is among the uncounted others, women and men believing in humanity and justice, who give thanks.

 

 

A Memorable MLK Day Celebration

MLK on darkness

Dr. King would, I think, have approved.

One celebration of his legacy involved a collaboration between members of a fairly mainline Presbyterian church in an affluent area of San Francisco and members of a soul-spirited Pentecostal church in the city’s Bayview community, where crime and poverty run rampant. The partnership – and friendship – between the two unlikely groups has been growing ever since its beginning in response to the mass shootings at Charleston’s Emanuel African American Methodist Episcopal Church in June of 2015.

For openers, the African American Pentecostal pastor preached (only minimally more reserved and shorter than is his custom) to the mostly white Presbyterians. His message was primarily about the Biblical admonition to welcome the alien and show hospitality to strangers. He also had a few words about justice rolling down like a river, and about Martin Luther King Jr’s assertion that love will overcome racism, materialism and militarism.

MLK Day cable car

After the service some fifty or so Presbyterians boarded motorized cable cars and sang their way across town to the Pentecostal church. There the white pastor preached to the now-multicolor congregation about the Biblical suggestion that nothing much is required of believers other than to do justice, love mercy and walk humbly with the Creator. He also had a few words about some of the ads he had noticed on the trip over. Dr. King, he suggested, probably didn’t live, work and die primarily so there would be three-day mattress sales, or a 25% MLK Weekend discount on leather jackets.

During the second service, which another minister termed Presbycostal, there was a generous amount of rousing hallelujah music led by the hosts and several gospel pieces from the visitors, whose choir director and trumpet-playing musician in residence made the trip.

MLK Day Dave & choir

After the second service the hosts surprised their guests with lunch in the adjacent social hall: homemade salads, chips and dips and plates of fried chicken. A dozen or so small children, varying shades of white, brown and black, snagged their fried chicken early and set to entertaining themselves by jumping up and down a stairway below a banner that read “The Audacity to Believe.”

One of the visitors remarked to one of the hostesses, as everyone dispersed, “I think we had a lot more fun than anybody at the weekend sales.”

MLK Day lunch

 

Dying On Your Own Terms

Mileva Lewis with the author

Mileva Lewis with the author

Do Not Resuscitate? Allow Natural Death? Do everything to keep me alive? Whatever happens, I don’t want tubes down my throat! Keep me out of Intensive Care Units!

End-of-life decision-making gets tougher every day.

Dying – that straightforward, universal human experience – now often involves a bewildering assortment of choices and decisions. And most of us are poorly prepared. We have core values (and usually more than a few fears and family histories) that come into play in making end-of –life choices, but too many of us are caught unawares.

At a recent Commonwealth Club of California event Mileva Saulo Lewis, EdD, RN, used a “values history” approach to explain how these difficult decisions are made, and to help audience members walk through the process. “Values history” translates: What matters to you? Why? It was developed at the Center for Medical Ethics and Mediation in San Diego.

“Values,” Lewis explains, “are the criteria by which you make decisions.” They might be rooted in your home and family, your faith community, college or university, workplace or elsewhere, but one’s values underlie all decision-making. And the reason all this matters today, especially with end-of-life decisions, is that medicine and technology have made seismic shifts over the past half century.

Lewis spoke of how the patient/physician relationship, one of these shifts, has moved from the paternalistic, “father knows best” model to what is now often termed “patient-centered” care – shared decision-making. This new model requires patients not only to be well informed, but also to be proactive and to make their values known.

The goals of medicine, Lewis explains, include curing disease, relieving symptoms and suffering, and preventing untimely death. The patient’s part is to make sure the healthcare provider explains and counsels adequately, and respects the patient’s expressed wishes. Ideally, decisions will be made in concert.

Lewis outlined some of the factors to consider in end-of-life decision-making such as how important to you is independence, being able to communicate with others, being pain-free and other end-of-life circumstances that have been frequently discussed in this space. She suggested one tool that has not been mentioned here, and is an excellent aid: the Ottawa Personal Decision Guide. However you make (and record) your personal choices, she stresses the importance of thinking through your values, writing down your wishes and – most important of all – talking it all over with friends, family members and your healthcare provider.

“Know yourself,” Mileva Lewis says. “Communicate. Trust yourself, and your healthcare provider. And be proactive.”

Heeding Lewis’ advice can help protect your values, and insure that your end-of-life wishes are respected.

A Poetic Happy New Year to Us All

Dawn

The dawn of a new year brings the best and the worst: promise of new beginnings, anguish over old endings.  Great new ideas to nurture, bad old ideas to quash. The new year’s plans, the old year’s mistakes. And, then of course, there are those pesky resolutions.

How about — as opposed to New Year’s resolutions — a little irresolution for 2016? The talented singer/songwriter Michelle Krell apparently turns to poetry from time to time. This rumination on life and time was enclosed with her holiday letter. It is presented below, with her permission, as a New Year’s gift to readers: the procrastinators, the disorganized, the well-intentioned, God bless us every one.

THE BACKLOG

Youth has no unfinished projects

No half-written melodies

No scribbled first lines of a musical comedy starring somebody famous

No first pencil sketch for a rolling 19th century landscape in oils

No first brushstrokes for a portrait, you know, a masterpiece like the Mona Lisa

No evenly-spaced staff lines mapped out with hundreds of tiny sixteenth-notes in pencil, some crossed out

No shoeboxes with unsorted glass beads on broken strings

No velvet bag of unrepaired, unmatched earrings, some plastic, from the 1970s

No shelves of unread books

No socks needing to be matched with mates missing for 9 years or more

No basket of mending from when your aunt was alive, you got it when you cleared out her house

No collection of spools of thread from the ‘30s from the same aunt, the thread permanently, hopelessly tangled

No boxes of unsorted photos from decades of family reunions

No garden that has had no improvements since you bought the house 20 years ago

No roses that are far past their lifetime and needed to be dug up long ago

No battered and faded curtains that would dissolve if washed; and why are they still up?

No seed of a book of poetry in which poems have been re-written until they stopped breathing

No undated lists of good intentions on wide-ruled binder paper

No itemized plans for rearranging small possessions that can now not be found

No single favorite patent leather shoe that knows the mystery of its lost mate, but will not tell

No collection of old toothbrushes that have a use which will reveal itself someday

No half-begun intricate stencil decoration across the upper wall of the baby’s room; he now has a family and lives in Toledo

No splintered and rusted garden shed that would look like Sunset Magazine, or could perhaps…

No pile of gravel overcome with weeds—the beginnings of an elaborate walkway through what are now rusted garden benches next to a ghost of a trellis for grapevines that never climbed anywhere

There are no grapes and no hint of a garden path

But—there could be…

Presidential Politics & P. J. O’Rourke

O'Rourke at CClub

P. J. O’Rourke

Journalist/satirist P.J. O’Rourke breezed through San Francisco on a recent book tour for his weighty new book (640-page Thrown Under the Omnibus) and left no presidential candidate un-skewered.

O’Rourke opened with a list of candidates – “Clinton, Bush, Fiorina, Sanders, Rubio, Cruz, Christie, O’Malley, and Trump. That’s not a list of presidential candidates. That’s the worst law firm in the world.” And from that summary he plunged into a commentary on the candidates themselves:

Hillary Clinton “retains her iron grip on second place. Whoever’s in first place is so far out we don’t know who it is yet. Hillary carries more baggage than the Boeing she used as Secretary of State to visit every country that later blew up in her face. On the upside, she’s familiar with the White House. She knows where the extra toilet paper is stored and where the spare key to the nuke-missile launch briefcase is hidden.”

Bernie Sanders? “Bernie is a socialist. He says so himself. Let me give you the dictionary definition of ‘socialist.’ A socialist is somebody who will take your flat-screen TV and give it to a family of meth addicts in the backwoods of Vermont. Bernie says he wants to make America more like Europe. Great idea. Europe has had a swell track record for 100 years now. Make America more like Europe? Where can we even go to get all the Nazis and Commies and 90 million dead people that it would take to make America more like Europe?

Carly Fiorina – “If she runs America like she ran Hewlett-Packard, it’d be great as long as you shorted the stock. H-P stock fell 65% between July, 1999 and February, 2005. I can forgive Carly, but my Keogh Plan never will.

Jeb Bush has everything. He’s young (for a Republican), a Phi Beta Kappa, a successful businessman, and a two-term governor of Florida – where balloting incompetence and corruption are vital to the GOP. Jeb Bush has just one problem, the name problem. But don’t worry, Jeb is all set to legally change his name to George Herbert Walker Bush. Everybody likes him… and he only served one term, so he’s constitutionally eligible to run again.”

Ben Carson is “doing okay unless you’re one of the fact-checkers. He’s a genius brain surgeon. I’m saying please quit running for president and get back to work because we need you. Maybe he could fix George W and Jeb Bush’s conjoined heads.”

Rand Paul? “Rand thinks the government should go by the rule ‘Mind your own business and keep your hands to yourself.’ I call it the Hillary and Bill Clinton principle: ‘Hillary, mind your own business; and Bill, keep your hands to yourself.’ But Rand Paul isn’t a Republican, he’s a Libertarian. His libertarianism appeals to those who consider themselves ‘fiscal conservatives and social liberals.’ This means they want to get high and have sex while saving money; and who doesn’t? But what candidate’s going to admit that in public?

Marco Rubio’s “got kids; I love kids. But he’s got to stop it with the abortion stuff. Really, Republicans, don’t make it illegal, make it retroactive. A kid gets to be 25 – zap.”

Personally, O’Rourke says he supports Donald Trump, because of something the great political satirist H.L. Mencken once said, “Democracy is the theory that the common people know what they want, and deserve to get it good and hard.”

Trump’s “chief goal is to be on TV,” O’Rourke says. “As president he can be on TV 24/7. Plus, he can yell ‘You’re fired!’ all he wants. Trump will grow the American economy the way he grew his own, with bad debt, bad debt and more bad debt. Trump has ‘restructured’ $3.5 billion in business debt and $900 million in personal debt; ‘restructured’ means he didn’t pay it. We Americans know a leader when we see one. Trump’s foreign policy will be to build hundreds of Trump casinos, Trump hotels and Trump resorts in Moscow, Beijing, Tehran, Raqqa, Kandahar and the Gaza Strip. Then all of them will go bankrupt the way Trump Taj Mahal, Trump Plaza Hotel and Trump Entertainment Resorts did. Hell, it might just work.”

O'Rourke & Caen

O’Rourke with Melissa Caen

O’Rourke delivered these – and other – political opinions at a Commonwealth Club of California event moderated by Melissa Caen. Caen, a lawyer best known as an astute but light-hearted columnist and TV commentator, said by way of introduction that she couldn’t believe her luck in being asked to interview O’Rourke. In her writing, she said, she had for years “shamelessly stolen” from his satiric observations. Writers today will find it easier to do that, with the release of Thrown Under the Omnibus, a nearly three-pound anthology of O’Rourke’s “funniest, most outrageous, most controversial and most loved pieces.” Copies were selling briskly after the Commonwealth Club talk.

Do Lives Matter? Or just guns?

Vigil with Chiu

California Assemblymember David Chiu, whose district includes The Bayview, speaks to Vigil participants

Candles lit, holding signs that read SPREAD LOVE, NOT VIOLENCE or COMMUNITIES AGAINST GUN VIOLENCE the group stood waiting to start. But nearly half of those expected were missing. It seems there had been a shooting several blocks away. One dead. A lot of police involved, traffic blocked.

 

The vigil to protest gun violence, delayed by gun violence, eventually got underway.

This was on a recent wintry night in San Francisco, when a group from Grace Tabernacle Community Church in the city’s Bayview-Hunter’s Point neighborhood gathered for one of the regular vigils they have long held in memory of those killed by gunfire. It is a long list. The Bayview holds the unenviable record of having the most deaths and injuries from gun violence – by a large margin – of any area of San Francisco. It would be almost impossible to find anyone in the community who has not lost a family member, friend or acquaintance to gunfire; yet it is still home to generations of good people who continue to work for a better, even gun-free future.

Joining the Grace Tabernacle vigil group were a number of friends from Calvary Presbyterian church in the city’s Pacific Heights neighborhood, an affluent community which holds the unenviable record of having the city’s highest suicide rate. Some by gunshot.

Once the latecomers made it past the scene of the latest shooting, the group walked candles-aloft to a nearby corner where a young man had been killed not long ago. A collection of burned-out candles in colorful holders, some now broken, surrounded the parking meter at the spotVigil memorial.1 where he had fallen; the police had given up on it and let the site remain as a memorial. His name was Otis. No one knows who shot him; possibly he was just in the wrong place at the wrong time. Grace Tabernacle’s Bishop Jackson said a prayer and the group slowly moved on.

Occasionally they sang. (This Little Light of Mine . . . We Shall Overcome.) The wind repeatedly blew out candles, but there always seemed to be a flame somewhere. One candle-holder said to another, as she re-lit her candle by his, “I was shot in the shoulder on that corner a block away.”

The day after the vigil, Liberty University president Jerry Falwell, Jr., presumably confident that no troubled person would ever be a student at Liberty, urged his students to arm themselves.

Also on that day the Senate once again failed to pass gun control measures, including Sen. Dianne Feinstein’s bill that would have prevented people on terrorist watch lists from being able to buy guns with which to commit terror.

Several days later, some who had attended the vigil heard John Weems, at Calvary Presbyterian, address the issue of gun violence. Weems had been part of the vigil, and made a biblically appropriate metaphor of the candles being blown out by the wind, but constantly re-ignited. Darkness, he said, cannot overcome the light.

At the end of his sermon Weems lifted a stack of 8 x 10 sheets about three inches thick, and a few helpers distributed them among the congregation. There were 353 sheets listing the date, location and number of people killed or wounded in each of the mass shootings (four or more killed or wounded) in the U.S. this year according to the only-in-America website shootingtracker.com. Another 45 sheets bore the names of the known 2015 victims of gun violence in San Francisco, the city named for a compassionate saint.

Gun collage

It would be impossible to know how many firearms are in private hands in this country, but it’s safe to say at least a few hundred million. Some of them – “assault weapons,” “semi-automatic rifles,” “sporting guns” by whatever name you choose – can kill more people faster than others; any of them can kill or maim. A wide range of weapons were used for the 353 mass shootings of 2015; all of them succeeded in wounding or killing human beings. The three sheets left to this distributor read:

DURHAM, N.C.; 8/21/2015. WOUNDED: 8. DEAD: 0

ROSWELL, N.M.; 8/21/2015. WOUNDED: 1. DEAD: 3

CINCINNATI, OH; 8/21/2015. WOUNDED: 5. DEAD: 2

It’s hard not to think about how much darkness might be prevented by having a few less guns in the U.S. Those who know that darkness best continue to light candles . . . and hope.

candles

 

 

 

Follow

Get every new post delivered to your Inbox.

Join 296 other followers