[PRCo] The Bear Returns

[Schneider Fred]

This message was written to people in my high school reunion mailing  
list.   Because I'm too lazy rewrite it for 50 different people, you  
can sort out of what you find of interest.
The tell me that normal hospital stay for a coronary bypass operation  
these days is 5 days ... longer if you are in for a repeat operation  
because the risks are higher and longer if you are older.

I was told today that being discharged on the 4th day for a man 69  
years old seldom happens.   I must have been irritating the nurses  
too much thereby forcing them to throw me out???

My first operation cardiac bypass (a triple) 13 years ago was  
miserable because of a drug interaction that put on Saturn or  
Pluto.   I could look at the chart on the wall giving the month, day  
and year and not be able to answer them when they asked me what day  
it is.   I didn't know my wife when she came in to see me.   I might  
have been in the hospital for 8 or 9 days.

This time I went in teary-eyed not really expecting to return.   They  
control the withdrawal from anesthesia so that you have no internal  
bleeding ... I think the object is to keep you under for 12 hours.    
By midnight they allowed me to awaken and pulled out the breathing  
tubes.   By 3 a.m. I wondering why PBS television changed their  
broadcast schedule to get rid of Deutsche Welle (German World), the  
German news service that used to play all night.   It eventually came  
on by 5 a.m. and by  6 a.m. I was watching the stimulating events in  
Iran on BBC television about Khomeini  demanding that the public  
accept the election of his candidate.   The mind was processing  
everything as it should.  By Wednesday evening they have out of bed  
and walking.   I thought they were nuts but I went along with the  
drill.   I've got a pinched sciatic nerve that causes all sorts of  
grief and all I needed was that pain coupled with the pain from the  
surgery.   But once they forced me to move, I found out the body was  
willing to react favorably.

More than favorably.   On the second walk at 3 a.m. Wednesday, I  
hiked the equivalent of a city block within the ICU.   They have this  
great home made walker built in their shop out of 3" polyvinyl  
chloride pipe forming a box frame ... you sit down in it, or stand up  
and roll it.   Somebody was using his brain from something more than  
hat rack.   Needs to be patented.   It was heavier than your average  
garden variety aluminum walker but then it would meet the standards  
of your suit-happy lawyer looking to make money on malpractice or  
wrongful injury (sorry Sue).

By Thursday we had figured out, in conjunction with a separate pain  
management group, how to medicate the spinal pain as well as the  
incisions and weep holes from this surgery and how to demand that  
some of the people listen to me ... "No, that's not what you are to  
be doing with my pain control ... read the instructions that Dr.  
_____ left for you at 3:15 this afternoon."     By the way, to get to  
the back side of the heart, they went in through an 11 1/4" incision  
between the rips on the left side.   Below it were two holes for 1/2  
inch diameter drain tubes.    Initially the pain was roughly  
analogous to the time I fell and broke three ribs but that has  
improved vastly.

By Friday afternoon I had finally been moved from ICU to a room on 5- 
East (the heart floor) ... the wait was so long because "there were  
no rooms at the inn."   Then I went out to explore.   I told the new  
nurses that I had not had a good walk in 12 hours and it was time ...  
needed to get the kinks out of frame.  Fifty feet down the hall from  
room, my nurses aide told me to slow down ... she was having  
difficulty keeping up with my pace.   I didn't listen well.  She  
handed me my urine bag and told me to carry it.   I carried and kept  
tramping along.   A few minutes later I looked back and she was where  
in sight.   Five minutes later later, after exploring the entire east  
end of the 5th floor, the bear came storming back dragging his walker  
behind him and triumphantly waving the cane in the air and using the  
just the two God-given legs for support.   On the room doors are  
stars with rating from 1 up to 4 depending on how safe it is to leave  
the patient alone.   The highest rating ... the star with the numeral  
4 means ... tie the bastard in bed and guard him or he's going to  
fall and cause us trouble.   They immediately changed mine to the  
lowest rating.   Because of leg pains radiating from the pinched  
sciatic nerve, I found it best to sleep in a reclining chair instead  
of a bed ... that's great too because I didn't have to argue with  
those people over putting up the safety rails on the bed.   At that  
point they gave up watching me and I was permitted to move around at  
my will.

I am thoroughly convinced that medicine is out of control when the  
(1) insurance companies are telling the hospitals and doctors what  
they are allowed to charge and (2) depending on your age, experience  
and specialization, you have to add from $3 to $10 to every patient's  
office visit just to pay for the malpractice insurance.  This leave  
you, the patient, having to be your own patient advocate.   In my  
case it is damn nice to be able to ask a dear friend, would you let  
your girl friend go this doctor?   It 's also nice have another old  
friend from my college days who is practicing medicine in Philly who  
insists on giving free second opinions.   I'm a more than a little  
concerned with where medicine is going but I have no answers.   I've  
seen our system that leaves something like 90 million people without  
health care.   I've seen national health systems all of Europe and  
Canada that let you wait three extra months for surgery or pay extra  
for upper tier benefits to get it now.   Needless to say, I have no  
good answers ... just a lot of concerns.

The greatest compliment was when my wife came in today, worrying  
about being about to take care of me at home.   The duty nurse told  
her that the patient has a remarkable ability to understand what his  
own body is telling him and he knows how listen to it.   We give him  
rules but he will do what he wants and I know he won't do anything to  
hurt himself.   Do not worry Mrs. Schneider.   What a remarkable person.

I found the hospital food to be some of the worst I have had in my  
life time and I grew up with a mom whom I thought was the worst cook  
on the planet.   Today I was watching this fabulous food travelogue  
of Tuscany on television.   They were showing a street vendor carving  
up tripe (the cow's stomach) sandwiches in Firenzia (Florence).  At  
that moment the garbage patrol came in with my lunch ... a dried out  
chicken breast bearing some resemblance to a piece of white pressed  
wallboad.    The told me we had beef one night ... could not have  
proven it by me because it would have passed an endurance test for a  
6-ply truck tire.   They also have a rule that everyone on 5-East  
(the heart wing) gets low sodium because salt might drive up the  
blood pressure    But guys, I have low blood pressure.   Another  
example of the one-size fits all rule is the surgeon trying to put me  
back on beta blockers which contain a blood pressure medication ...  
He never once questioned I was not on them before.  Reason, I get  
dizzy from the blood pressure going too low.  They did it again in  
the hospital.   In spite of that and my weaving back and forth before  
I took myself off of it, he told me on discharge, you probably won't  
take it but I'm giving a prescription for it anyway.   Huh?   Why do  
you think my family doctor and my own cardiologist took me off of  
Metroporolol?   Is this because 95% of the heart patients might die  
and sue the doctor for not doing it, so I'm going to protect myself  
anyway?   If you fall then you can't sue me because I can't prove I  
gave you the prescription?    Duh?

I met two fabulous nurses, one male and one female, both of whom gave  
me the impression that they loved their work.   In my work as a labor  
statistician I actually began to ask people at random if they loved  
their work?   Do you love to come on Monday morning?   Well in  
general, I think about 9 out 10 in the U S labor force are there for  
the pay check and 1 out of 10 truly love what they are doing.    I  
found two in the hospital who I thought loved their work.   Those are  
pretty good odds.

I also want to publicly thank a man who appeared in the hospital just  
to say hello.   This is someone I didn't even know in high school  
because he was so damned ambitious both academically and athletically  
that I never was in his league.   I didn't appreciate the value of  
learning for many years after he caught on.   I got to  gradually  
know this man as a medical practitioner and later on the class  
reunion committee.   I would have never believed that 50 years ago I  
would now be occasionally going out to lunch with John Eshleman and  
treasuring those meetings.  .   And John, thanks so much for coming  
in to my room every day to see how I was doing.   You and Patty (I  
want to thank her for coming in yesterday too) are absolutely  
wonderful friends.

And now we can schedule the back surgery! and sewing up the hernia  
and then a trip back India.

And back to the subject of people who love their work:

1)    If you live in Central Pennsylvania where you can pick up WITF  
channel 33 (Harrisburg) or 33.1 (Chambersburg).   I noticed while I  
was lying in the hospital bed an advertisement for a show at 8 pm on  
Wednesday June 24th called Sandwiches That You Will Like.   I  
immediately recognized the voice of the man narrating the show:    
Rick Seeback of station WQED, the Pittsburgh Public Television  
Station.   The first show that I can remember that Rick did was one  
titled Things That Are Not There Any More.    If you grew up there  
(like I partly did) or went to Carnegie Tech or Pitt (like some of  
our classmates did ... Julie Fatherely comes to mind), seeing it  
might have reminded you of Isaly's delis, the roller coasters at West  
View Park, the trolley cars, and many more icons that no longer  
exist.   It became a pattern that Maryland Public Television,  
Philadelphia, Harrisburg and other attempted to emulate but all of  
them fell short of Rick's quality.   I thought they fell flat on  
their video faces in comparison.  I once commented to Rick that I  
thought the big  difference was that someone instinctively understood  
how to allow person he was interviewing to lead him from topic right  
to another.   For example, he might have used used someone talking  
about going to West View Park on trolley as his way to transition  
your attention from one landmark (the park) to another (those  
ubiquitous red and cream trolleys).   He knew how to let the person  
he was talking to transition the viewer's attention and not let the  
interviewer do it.   Someone knew how to let Rick play the straight  
man and take advantage of the interviewee.   When I mentioned that to  
Rick and said, whoever does your editing does a fabulous job, he said  
"No one every told me they picked up on that before.   I do my own  
editing."  There was a sincerely look of surprise on his face that  
listener would actually pick up on the editing process.   He seemed  
very pleased.    He did an entire series of shows for WQED called the  
Pittsburgh History Series and then he branched out into other topics  
that could easily be syndicated and make money for the station ..   
one that I fondly remember was Pennsylvania Diners and Other Roadside  
Restaurants because many of his choices helped to make me fat.   I  
had eaten in 75% of them.     He also traveled the entire USA to make  
make some VCR tapes like his ice cream tape, a national amusement  
park tape, a hamburger video, and now a DVD on sandwiches.   I have  
not yet seen this one but I would commend it to you because I have  
never seen this man do a bad one.   He explained his work to me  
thusly, "Isn't it wonderful when someone is willing to pay you for  
doing something that you would do free of charge just because you  
love the work?"  I loved what I did so I could not even of  
disagreeing with him.  And in his case, he was offered a chance to  
move back to his home town to do what he loved to do.

2) Tavis Smiley has an interview show that airs late at 11:30 on WITF- 
TV in Harrisburg right after BBC news.   It has national interviews  
so I suspect it is a syndicated show and a couple of you might have  
seen this same one I saw in Lancaster General Hospital.   Tavis was  
interviewing another Rick.   This one I've never met personally  
though we crossed paths in the Dordogne Region of France in the same  
hotel.   One of his tours was there.   He came in late and I left  
early.   I left a note for him at the desk and he responded later.    
It's a person I also admired because he's doing something I would  
like to do.   Name is Rick Steeves.   Some of you may recall him from  
the Travels in Europe Series on  that originates from Oregon public  
television, locally on Saturday afternoons.

In this Tavis Smiley interview,  Rick was promoting his new book  
Travel as a Political Act.  As I listened to the interview I said,  
Damn it, I'm listening to myself.   He was describing how his  
attitudes about the world and travel within it had changed over the  
years and I just rested there thinking, that's me.   That everything  
I've been saying to people.   He talked about how he first went to  
Europe hunting the cheaper hotels.   Yes, Rick, we did that when we  
were younger.   We went through the same phases.  In the 1990s he  
impressed me because his tours (and he suggested you go on your own  
but ran guided tours for those afraid to go on their own) offered  
classes on how to be a tourist.   He would not  take a customer  
unless they signed an affidavit that they had read and agreed his  
tour instructions or listed to video and agreed with it ...  
essentially he was staying in the instructions that he expect you not  
to be a sour puss and to get along with everyone and attempt to make  
other people in other nations accept you and that you will accept  
them.   When I crossed paths with him in the Blagnac, I was astounded  
looking at his schedule for the next day that he was giving lessons  
in (1) piloting a canoe in the Dordogne River and (2) basic French so  
that you could walk in a store, and be able to smile, say hello and  
buy something on your own.  And today he was saying, "Just because  
someone in Turkey or England or Germany or France doesn't want to  
trade their passport for yours doesn't mean they don't like you.   It  
only means they are perfectly content living were they are and maybe  
it also means that they are reasonably happy with their politicians  
and not enamored with ours.   They're happy in they life and we  
should not try to change them." Amen, Rick.    I've not spent as many  
miles in Europe as he has ... suspect he has me beat 7 or 8 to 1.   I  
have over 48 months there.   But I certainly agree with his  
notions.   If you want to read what he says, here is a link to the book.

http://travelstore.ricksteves.com/catalog/index.cfm? 
fuseaction=product&theParentId=11&id=385