Roses, wrecks and New Year’s blessings

Rose et amour....rosa y amor ....rose d'amour ...
Rose et amour….rosa y amor ….rose d’amour ..rosa de amor.. // Explore (Photo credit: photosylvia / silabox.)

It was the first day of Anna’s fifth week in intensive care. When the car flipped over and down the embankment she had emerged with a broken sternum, broken ribs on either side, a cracked femur and internal injuries; internal bleeding has been a problem since. I got this report from her husband Ned, in a phone conversation linking our homes on opposite coasts. Ned had been driving when he suffered a sneezing fit and blacked out; Anna had tried to grab the steering wheel and possibly prevented something worse from happening. The accident left him without a scratch — other than a broken heart.

Ned and I go wayy back: to the time he brought me a corsage of roses from his family farm on the occasion of my second grade piano recital. So I am sad for Anna, but in some ways sadder for Ned. He is a retired corporate executive, a take-charge type, and an incurable optimist; this may be putting a strain on his famous ebullience.

“I’m there every day,” he told me. “I give her my three rules of life: Never give up. Don’t you dare give up. And, Don’t even think about giving up.” Anna, I’m willing to bet, thinks a lot about giving up. I didn’t suggest that to Ned.

I was writing a note to Ned, following up on that conversation, when the phone rang. My youngest daughter, reporting on her holidays on the east coast, said — as a sort of throw-away aside — that there had been “an incident” the night before at the end of her 3-hour trip from North Carolina to Atlanta to visit with family. At the Claremont Avenue off-ramp from I-85 in Atlanta (a familiar piece of real estate now etched into my brain) her Toyota truck had flipped, coming to rest on its side just before crashing into the pylons below. Airbags inflated, emergency helpers immediately appeared to get her out the window and she sustained only a bruised shin. Flo, the elderly part-labrador retriever, was also lifted out unscathed, but Apple the more recent rescue dog took off for parts unknown.

“They kept wanting to take me to the ER. I said, ‘Thanks, but I’m an ER nurse, and I’m calling my brother.'” Later in the holidays she planned to visit the totaled Toyota to see if an explanation — front tire issues are suspected — for the accident might be found.

There’s no particular connection between these two accidents, and no particular reason for such a Christmastime story. Unless it would be an excuse for quoting these words from my friend Anne Lamott’s new book, Help, Thanks, Wow: The Three Essential prayers:

“We are saved by memories of love and beauty — maybe there’s more of that to come, if we keep on keeping on…”

Happy New Year!  And if you see Apple the dog, let us know.

Re eGadgets: will eReaders replace books?

In all the current talk about new eGadgets and their impact, the eBook has pretty much escaped condemnation — except for the dwindling population still committed to the printed page. And some of us hold-outs are beginning to waver.

Two old friends, Peter and Martha Klopfer, arrived from North Carolina yesterday with 60 or 70 books to get them through 10 days on the west coast. Peter, who is a Duke Professor Emeritus of biology,  and Martha, who is a thinker, runner, endurance rider and generally literate person, are prone to go off into the jungles of Madagascar or trekking in the Jordanian desert or climbing Machu Pichu. On these sorts of trips 30 or 40 books in their old-fashioned form are difficult to manage.

Enter the justifiable eReader.

There are by now enough eReaders to fill an old-fashioned 8 1/2 x 11″ piece of paper in 10-point Times Roman type. There’s the pioneering Kindle and the Kobo and the Nook and the Sony and of course the loudly heralded iPad, and there are probably a dozen others poised to debut.

But would you cuddle up with an eReader, asks Cynthia Ramnarace in an AARP Magazine blog?

Absorbing the written word isn’t what it once was. Whether you’re a new convert to e-reading or a die-hard fan of bound pages, you can’t ignore the evolution of reading. News reported by websites, e-mail and text messages is strangling printed newspapers. E-mail has replaced handwritten notes. And entire books can now be read on hand-held computers with a mere 6-inch screen.

The issue Ramnarace and others are debating is all about the reading experience. Can you be transported to another realm, as has always been true with paperbacks devoured on secluded beaches or under old trees in back yards — or under the covers with a flashlight for that matter, by a bunch of words on an eScreen? Maybe. But hard core print-book people think not.

“When books become computerized, you lose that contact with the maker,” says Cindy Bowden, director of the Robert C. Williams Paper Museum at Georgia Tech in Atlanta. “When you pick up a book, you notice the feel, the touch, the way the ink bleeds into the paper.”

If anybody thinks the paperback or its big brother hard cover will ultimately defeat the eBook onslaught, however, it is probably wise to think again. The copies you can buy in a bookstore that can’t also be bought in an eForm are getting fewer and farther between every day.

Not all books are available as e-books, but many are. Of the two industry leaders, Kindle boasts a library of 285,000 books, most for $9.99 each. The Sony Reader provides free access to 500,000 books in the public domain, including classics like Jane Austen and William Shakespeare; the Kama Sutra and the Bible; and contemporary works like Sue Grafton and Dennis Lahane, even “The DaVinci Code.” Another 100,000 are available for purchase from the Sony eBook Store.

Over time, e-readers could prove more economical than traditional books. For the price of buying 26 new hardcover books, one could also purchase the same number of e-books, plus the Kindle itself. And the devices allow readers to sample the first chapter of any book for free before purchase. Digitizing words could help elevate the medium, and in turn, boost a struggling publishing industry.

Peter and Martha are en route to the 40th annual Ride & Tie championship in Trout Lake, WA, where there is great beauty but not library and where they will celebrate their 55th anniversary in a manner somewhat more strenuous than most post-50th observances. After the race, there will be eReading.

Can You Love an Electronic Reader as Much as a Book? The Debate Is On – AARP Bulletin Today.

Aging brains can still follow the $$

day in the life: lunch money
Image by emdot via Flickr

Balancing the checkbook isn’t as easy as it used to be? You can’t remember where you put the keys? OhmyGOODness, you say, I must be getting old.

The bad news is, age happens. The good news is, it does not necessarily bring a concurrent loss in cognitive ability. Get a new calculator, maybe one with a bigger keypad. Accept the fact that you’ve been misplacing the keys, occasionally, since you started driving.  And take heart in a new study from Duke University indicating that, all things considered, age is not a determining feature in the ability to make sound economic decisions.

Just because your mother has turned 85, you shouldn’t assume you’ll have to take over her financial matters. She may be just as good or better than you at making quick, sound, money-making decisions, according to researchers at Duke University.

“It’s not age, it’s cognition that makes the difference in decision-making,” said Scott Huettel, PhD, associate professor of psychology and neuroscience and director of the Duke Center for Neuroeconomic Studies. He recently led a laboratory study in which participants could gain or lose money based on their decisions.

“Once we accounted for cognitive abilities like memory and processing speed, age had nothing to do with predicting whether an individual would make the best economic decisions on the tasks we assigned,” Huettel said.

The study was published in the Psychology and Aging journal, published by the American Psychological Association.

Working with 54 older adults between 66 and 76 years old, and 58 younger adults between 18 and 35, the Duke researchers assigned a variety of economic tasks that required different types of risky decisions, so that participants could gain or lose real money.

On a bell curve of performance, there was overlap between the younger and older groups. Many of the older subjects (aged 66 to 76) made similar decisions to many of the younger subjects (aged 18 to 35). “The stereotype of all older adults becoming more risk-averse is simply wrong,” Huettel said.

Getting to the heart — and brain — of the issue, PositScience blogger Ted Baxa says “this finding will come as no surprise to many.  Legendary investor Warren Buffett, 79, continues to outperform fund managers half his age.  The message to take from this article is that age by itself, as the saying goes, is just a number.”

When you finish with the checkbook, in other words, you might want to get busy on your brain exercises.

Cognitive Ability, Not Age, Predicts Risky Decisions – DukeHealth.org.

The Public Option Death Panel

Here’s a death panel even Sarah Palin could love — but maybe we’d better not tell her. You, however, will probably understand its value and possibly want to put it to work for your own benefit. It centers around a form called POLST, for Physician Order for Life Sustaining Treatment (in New York it’s MOLST, for Medical Orders) fast catching on across the country. The panel consists, essentially, of your doctor and yourself.

Initially developed in Oregon in 1991, POLST programs are underway in a handfull of states including Washington, California, New York and North Carolina, and are being developed in over a dozen others.

Erin Henke, POLST Program Manager for the California Coalition for Compassionate Care, outlined the program for a group of healthcare professionals this week in San Francisco, part of CCCC’s efforts to get it efficiently established across the state. The key, she emphasized, is the conversation between individual patient and medical professionals. You don’t get the form signed, in other words, unless and until patient and physician have discussed what the former wants: CPR if you’re not breathing? Feeding tube? Comfort care only, if you’re in bad shape, but you’ve got a pulse and are breathing? Or perhaps every intervention possible — tubes, wires, ventilators, the works, including transfer to a hospital intensive care unit. But the point is, you make your own decisions. Once the form is completed and signed, it follows you as part of your medical record. In California it’s printed on Pulsar Pink card stock, and not easy to overlook.

Rollout of the program, Henke explained, is an ongoing process; it will only work when it is widely known and understood not only by individual patients and physicians but also by the many other members of the profession — nurses, caregivers, ER personnel and others. CCCC’s focus right now is on skilled nursing facilities and hospitals, though Henke and the teams of POLST program advocates around the state are working toward a broad educational spectrum.

The basic POLST approach, as explained in a Journal of Palliative Medicine article by Diane E. Meier, M.D. and health care journalist Larry Beresford published earlier this year, is to provide “actionable information on how to honor the wishes of a patient with a life-threatening condition” on a variety of issues. It goes farther than an Advance Directive (though if there’s a discrepancy, the Advance Directive takes precedence) and it differs from an out-of-hospital DNR (Do Not Resusitate) form because it lets you choose treatment.

I asked Henke if the patient/doctor conversation which is necessary in order for this extraordinarily useful document to be completed is covered by most insurance companies. She says that to her knowledge there is no specific code for such a conversation, although she understands there are other codes under which physicians can bill. Let’s hope Betsy McCaughey and Sarah Palin don’t find out. Or Chuck Grassley.

Though I am only terminal just now in the same sense that all of us mortals are, I talked about the POLST form with my Kaiser primary care physician just to be sure we remain on the same page. Wouldn’t it be nice if everyone had that same opportunity.