Friday, April 30, 2010


Beef (Hungarian) Goulash is a favorite of mine. When I was in elementary school my mother's cousin Anna would invite me to dinner about once a month for a special treat.  She was a wonderful cook and would serve this over broad egg noodles with home made applesauce on the side.  I have adjusted her recipe a little bit but this is my homage to Anna.

2 pounds beef cubes
3 medium onions
1/3 cup flour
1 tsp. salt
1.5 tblsp. paprika [sweet/mild]
1 cup beef stock
2 tblsp. oil

Preheat oven to 330*
Put flour in a plastic or paper bag and add the meat.  I like to use chuck as it is most flavorful.  Shake to coat the meat.  Heat oil in skillet over medium-high heat.  Shake excess flour from meat and brown well in skillet.  After browning, remove meat to a casserole dish.  Add the onions to the skillet and brown lightly.  Stir in paprika and salt to coat.  Remove onions to the casserole dish and deglaze the skillet with the beef stock and pour over meat and onions along with 1/2 cup water.  Cover the casserole dish with foil and bake for 1.5 hours or until meat is fork-tender and falling apart.

Serve over buttered egg noodles or with potato pancakes.

Wednesday, April 28, 2010


"Friendship is like a prism through which the many variations of beauty are revealed in our lives."

Friendship has always been important to me.  I may be a rock but I'm not the proverbial "island". I have been blessed with wonderful friends.  At times I have been cursed with less wonderful ones.  My friends are an eclectic, mismatched bunch of very good people.  

I have a long list of acquaintances but my inner circle is a rather short list.  When I give a dinner party for that "inner circle" we fit nicely at a table for twelve.  There is no messiah and there may be no holy grail but there is surely a Mary Magdalene, a Peter and a Paul.  There is probably even a Judas.  

My dearest friends are from all walks of life from electrician to best-selling author, from mini golf partner to producer and from stay at home mom to a boozy chanteuse.  Let's not leave out the chubby gay married guys who argue like the couple from Who's Afraid of Virginia Wolf. The conversations are wild and head-spinning.  I love each of them for their individuality and strength, devotion and foibles.  

Being a full time caregiver has shaken some low-hanging fruit from my tree of friends.  I may not be as much fun as I was when I was younger and carefree. I certainly cannot be spontaneous.  My friend time has to be planned and much of it has been reduced mostly to phone calls and emails but its value certainly has not been diminished.  

I had one friend from high school with whom I shared nearly thirty years of my life.  We were so close for so long that our other friends regarded us as an old married couple.  I think we may actually have been closer than many married couples.  I saw her though her brief problem with alcohol.  We were there for one another over lost pets.  We vacationed together.  We dined together.  She was by my side through business successes and failures.  

The stresses of my life as caregiver were more than she wanted.  When I could no longer travel on a whim or dine out several nights a week, our friendship became a casualty.  To put it directly, she abandoned me.

Another of my wonderful friends has been there for me forever.  We are family.  When times are good we laugh and celebrate.  When times are bad we are one another's rock.  Lucy is the lucky recipient of my many phone calls from the emergency room.  When she got married I was the luckiest because I got a new best friend in her husband Joe.  Lucy and Joe are quick to offer help and always the first on the scene in a crisis.  Together they gave me the highest honor of being godfather to their first daughter and honorary godfather to the second.  

While some friendships waned others flourished.  One friendship blossomed and grew because we had caregiving in common.  I was well into my role when she was just beginning hers.  When she was overwhelmed with the task at hand a mutual friend suggested she give me a call.  As the local pro I am often called upon for support but this was special.  

Ms. Alice and I had met casually in the past at social or theater functions but we really didn't know one another.  Now through our common bond of caregivers we discovered how much else we had in common.  We are both from theater.  We are both artists.  We are both bitchy.  Most importantly we have the same sense of family and duty.  Not only did we become strong mutual support but most definitely members of our "mutual admiration society". No one understands the life of a caregiver better than another caregiver.

"A true friend is someone who is there for you when he'd rather be anywhere else." 
len wein

Maybe it's that I am of a certain age or maybe it is an eventuality of technology but this past year has been a year of reconnecting with friends from my past.  Somewhere in the early middle years we disconnect from some old, true, loved friends.  No arguments.  No traumatic event.  Some friendships just fade.  We get sidetracked with career choices.  We get preoccupied with building our lives and families.  We meet new friends.  We drift geographically. What doesn't change is the seminal connection we had with our friends.  The good memories are stored and cherished.  These friends were the building blocks of our lives, without whom we would not be who we are at present.  

At fifty we are mostly settled into our lives.  Friends' children are sufficiently grown.  Careers are mostly chugging along.  Few of us have much need to prove ourselves.  We have returned to our roots and our old friends.  There is comfort in old friendships.  We share commonality and secrets.  Perhaps in reconnecting with old friends we are making an effort to reconnect with ourselves.  Maybe we're trying to recapture a bit of our youth.  Maybe we're just more comfortable with ourselves.  

In the past year I reconnected strongly with a girl I went all though elementary and high school with.  We have a strong bond of common past but we also admire the people we have become.  I most recently met with my best friend from high school.  We were inseparable back then.  We shared everything. We grew into men together.  We could have been characters from Summer of 42!

Lawrence became the important doctor we always knew he would.  I found my way though antiques businesses and theater and writing as we knew I would. Twenty years had lapsed with only a brief email now and then until he re-appeared on my doorstep with his bright and lovely daughter.  He had brought her back east to hunt colleges and included a side-trip to his hometown to show her around [and to show her off].  

Twenty years were shed as quickly as anyone could imagine.  We reminisced and laughed and remembered and we were 17 again if only for a few hours.  We have such different lives in different parts of the country but none of that was perceptible.  We looked at one another and saw the kid, the best friend, the mischief-makers that we were.  

Old [good] friends are like that.  Years can pass and you fall right back into rhythms and patterns.  There is great comfort in that.  Within my small circle of friends we know that a little time or distance or even life's interruptions don't matter.  One phone call and we're there for each other.  

"Friendship consists in forgetting what one gives, and remembering what one receives."
dumas, the younger

Friday, April 23, 2010


"...the taste of chocolate is a sensual pleasure in itself, existing in the same world as sex... For myself, I can enjoy the wicked pleasure of chocolate...entirely by myself. Furtiveness makes it better."
dr. ruth westheimer 

There are many variations of this classic which is sometimes called Texas Sheet Cake or Longhorn Cake.  They're all good.  Here is my adaptation.  This confection is a retro chocolate lover's delight.  Rich chocolaty cake topped with gooey, nutty chocolate frosting!  This is a homey, unpretentious crowd pleaser.


2 sticks butter
1 cup water
4 tablespoons high quality cocoa powder*
2 cups all purpose flour
2 cups granulated sugar
1/2 teaspoon salt
1 teaspoon baking soda
2 eggs
1/2 cup sour cream

1 stick butter
4 tablespoons cocoa powder
6 tablespoons milk
1 cup chopped pecans**
1 box confectioner's sugar
1 teaspoon vanilla

Preheat oven to 375*
Grease a jelly roll pan [10.5 x 15.5 x 1]

In a 2 quart pan combine 2 sticks butter, 1 cup water and 4 tbsp. cocoa and bring to a boil.  Remove pan from heat and add 2 cups flour, 2 cups sugar and 1/2 tsp. salt.  Beat in 1 tsp. baking soda, 2 eggs and 1/2 cup sour cream.  Pour mixture into the prepared pan and bake for exactly 22 minutes.

While the cake is baking prepare the icing:

In 2 quart pan combine 1 stick butter, 4 tbsp. cocoa, 6 tbsp. milk and bring to boil.  Remove pan from heat and add 1 cup chopped pecans, 1 box confectioner's sugar and 1 tsp. vanilla.  Stir well to combine.  Spread over hot cake as soon as you remove the cake from the oven.

Cool before serving.  Do not try to remove the cake from the pan, serve from pan!

*I prefer Valhrona cocoa powder available at Dean & Deluca and many online sources.
**Many recipes call for walnuts but I prefer pecans.  Feel free to substitute your favorite nut.

Tuesday, April 20, 2010


Having been ill for so many years, a great deal of healthcare workers have come in contact with my mother.  Most of whom have been good. There has been  a range of people from the worst to the best. The ones that I want to recognize are the best of the best.  Some of whom only had the briefest of contact with us and with names I never knew.  Others who were in our lives for many years.

In the beginning there was Dr. Uppal and her staff.  When we would go for medical appointments they were so kind and understanding.  My mother was in the early stages of Alzheimer's, repetitive and forgetful.  They were very patient with her and took the time to explain things to her and make her feel relaxed and comfortable.  At this point in her disease other medical personnel would talk around her to me as though she wasn't in the room.

The first in-home care we had was when my mom had fallen and broken a couple of ribs.  She was in pain and it was difficult for her to move and she needed assistance.  I didn't know the "system" back then.  I was just being initiated into the caregiver's club.  No one told me that she would have been eligible for Visiting Nurse and an aide to help us out.  The daughter of one of my sister's friends is a nurse and worked at a local nursing home.  When Susan heard about my mother's condition, out of the kindness of her heart, she offered to help my mother bathe and check up on her.  

Not only did Susan come to help Adelaide but she brought a friend along from the nursing home to help.  Susan and Nancy were [and are] wonderful people.  They have the disposition and compassion of nurses out of old war movies.  In subsequent years Susan has returned when stitches or surgical staples needed to be removed and she found our first private aide for us.

"It is the first of all problems for a man to find out what kind of work he is to do in this universe."
thomas carlyle

Kathy was my mother's first private aide.  She was young, brash, full of spirit and just what my mother needed.  She knew just how to handle my mom and my mom loved Kathy.  Kathy was with us for about 8 years and saw Adelaide through the major part of her decline.  During Kathy's time with us Adelaide went from just needing some supervision and assistance to no longer being able to walk and barely able to speak.  

I learned most of what I know about the technical side of caregiving from Kathy. I also learned from her demeanor.  I had a good teacher. 

Then there was the Hospice period. 

"Considered to be the model for quality, compassionate care for people facing a life-limiting illness or injury, hospice and palliative care involve a team-oriented approach to expert medical care, pain management, and emotional and spiritual support expressly tailored to the person's needs."

Hospice brought us amazing care during a most difficult period in Adelaide's journey.  Most notable was Helen.  Helen is a wound care nurse of outstanding skill, loving nature and kindness.  When she arrived on the scene we were in turmoil.  My mother's health was grave and her prognosis was poor.  Helen not only took the best possible care of my mother but she also soothed and reassured me.  I learned nearly all I know about wound care from Helen.   

There were also a couple of stand-out aides provided by hospice and Visiting Nurse.  Most notable were Rosa and Maureen.  I felt comfortable having them in my house and I knew my mother was safe in their care.

When my mother first developed her sore, both the head hospice nurse and my mother's doctor [at the time] worked me into what I can only describe as a frenzy. They were tossing around words and phrases that all boiled down to impending doom.  A doctor friend of my sister's made a phone call on Adelaide's behalf and within 24 hours Doctor Swamy, a local surgeon, and his wife [an RN] were at my mother's bedside.  Yes, a surgeon was making a house-call!  Within five minutes this calm-mannered doctor had assured me that he could perform a small surgery [at home] and get my mother on the right path.  Before I knew it he had done what he needed to do, set out instructions for care and my mom was on the long road of maintenance.  I'm not sure how my mother, sister or I would have survived that weekend without Dr. Swamy.

We have another private aide who is wonderful with my mother.  They get along so well together.  My mother lights up when Niki comes to take care of her.  She sometimes even manages to get a couple of words out of Adelaide and that pretty amazing.  Niki is caring, protective and well-skilled.  She always leaves my mother looking happy and healthy.

The two of Adelaide's Angels who have been most important and contributed most to her longevity are her sister Gloria and family friend Joselle.  

Gloria and Adelaide were inseparable. They grew up together.  They lived most of their lives together.  They were best friends.  In the early years of my mother's illness Gloria was there to watch out for my mother.  She took care of their house, she saw that my mother was fed and supervised.  She was my mother's best companion and protector.  Without Gloria I would have had to become a full-time caregiver much sooner.  When Gloria passed away it was a tremendous loss for all of us.

Joselle is our behind-the-scenes angel.  Big-hearted and ever patient, Joselle is always just a phone call away and I can't express my gratitude for the comfort that gives me.  Joselle is best described as "connected" in the local medical community.  She works [runs] a local consortium of doctors.  Her knowledge, compassion and access are irreplaceable.  Joselle has arranged for doctors to make the ever- elusive home visits and more importantly I know that if I have a question or a doubt, she can reassure me or answer my questions.   For a lay caregiver faced with the onslaught of medical challenges Joselle has literally been a life-saver for both my mother and me.  

"Precious beyond price are good resolutions. Valuable beyond price are good feelings."

To all the un-named emergency room workers, EMT's,  hospital aides, hospitalists, X-ray technicians etc. who have touched our lives: your care, skill and compassion have not gone unnoticed.  Our thanks to all of you.

Friday, April 16, 2010


This is a simple and delicious coconut custard pie made even easier if you use a frozen or refrigerated prepared pie shell.  I'm not a big fan of anything with shredded coconut but it's my sister's favorite pie so I adapted this recipe especially for her.  To my surprise, I even like this pie.  This is rather sweet so if you like your pies less sweet subtract about 2 tablespoons of the sugar from the recipe.

3/4 cup granulated sugar
2 tablespoons all purpose flour
2 eggs
1/2 stick butter [melted]
1 cup whole milk
1 teaspoon vanilla
6 oz. sweet flaked coconut
1 pie shell


Place a cookie sheet on center rack of oven and preheat oven to 350*

Combine sugar and flour in a mixing bowl.  Beat in eggs, melted butter and milk.  Add vanilla and coconut and mix by hand until combined.  Pour into prepared pie crust and bake [on heated cookie sheet] for 45 minutes or until a toothpick inserted in center comes out clean.  Check occasionally to be sure crust isn't getting too dark.  If the crust is browning too quickly cover the edges with aluminum foil and continue baking.  

Carefully remove pie [on cookie sheet] and allow to cool completely before serving.

Tuesday, April 13, 2010


Monday April 12, 2010 
a day in the life of a caregiver

2:00 am   Mom woke me up with some rather loud vocalizing.  She hasn't been feeling well so I rushed to check on her.  I changed and repositioned her.  She fell back to sleep.

2:30 am   I returned to bed to try and catch some sleep.

8:30 am   I arise, take a quick peek in on mom who is still sleeping, and stumble to my morning coffee ritual.

9:00 am   The morning care for mom:  bathe, change, clothe, replace wound bandage and feed. All the while  chatting and trying to be pleasant.

9:45 am   Phone call from hospital case worker regarding my aunt Theresa who has been in the hospital  since Thursday.  I'm very tense because this is the call I've been waiting for and hoping to hear that my aunt will qualify for and be transferring to a nursing home facility.  Excellent news!  Apparently my threat of dropping my aunt off at the SPCA worked. At noon Theresa will be moved to a local facility where we know much of the staff either from other family members having been there or from my friend's mom having been there for a few years.

10:10 am  Arrange for an aide to stay with mom so my sister and I can tend to Theresa's transfer and get her settled in at the home.  

Noon:  Patricia [my sister] arrives with the aide.  I give some quick instructions to the aide because the wound care doctor is expected for his weekly visit.  This is an important visit because for the past couple of days I've been worried that the wound isn't doing well and I'm afraid it might be infected.  Also, today is the day that a new aide is going to be provided by Visiting Nurse so my private aide will have to show her "the ropes" and settle her in.  The new aide will be coming 3 times a week for a whopping 90 minutes per visit.  Still, that's a help to me in terms of laundry, bathing, etc.

A side note about wound care.
I hate it.  I never intended to become a nurse or doctor.  I'm a man of the arts not of blood and guts.  I've learned to do it and I do it well but it takes its toll on me.  I have to psyche myself up to the task every time I change the bandages which is once a day sometimes more if necessary.  Aside from the "gross factor" I'm always worried about hurting my mother or contaminating her or what I might find when I remove the old dressing.  There is nothing pleasant about this.  I'd rather do any of the other less-than-pleasant tasks that I have to do on a daily basis other than wound care. But I do it.  I have no choice.  Patricia won't even stay in the room for the changing of the wound.

1:00 pm:  We arrive at the nursing home, which I always refer to as "Shady Pines" in homage to the Golden Girls.  Perfectly appropriate because the character of Sophia could easily have been based on Theresa.  Theresa has already arrived and is settled into her new room.  We chat a little and then Patricia and I make the rounds of visiting the staff.  We want to make sure they have instructions for Theresa's care.  They're all very attentive.  Theresa will be in good hands.  Then we have a visit with the gal in charge of admissions.  We know her.  We have friends in common.  She's a lovely person who fought hard to get Theresa placed with her.  Many years ago when my mom had had a fall and before we had any help at home, this girl came to my house to bathe and help with my mom out of the kindness of her heart.  Now we owe her an even bigger "thank you".

2:30 pm:  Patricia and I finally stop at the nearby McD's for a very quick snack.  Then we go shopping to get some things for Theresa to make her more comfortable and "at home".  We get some new clothes, snacks, a clock radio and a stuffed kitty.

2: 40 pm:  While shopping, my iPhone rings and it's the wound care doctor calling from my mother's bedside. As I had feared, he suspects infection.  He prescribes medication [which means that I'll have to fetch that later] and changes her care orders. Now the wound dressing has to be changed twice a day instead of once. Great.  Why make me sick only once a day when you can do it twice!  

3:30 pm:  We schlep back to Shady Pines to give Theresa the things we bought.  She loves the kitty but of course had comments to make about everything else.  Well not the snacks.  She's happy to see those and digs right in.  "What do I need [fill in the blank] for" she asks.  This is as predictable as Christmas in December.  It's a family trait.  A very annoying family trait.  Why say "thank you" graciously when you can grumble instead?  Now I write her name in all her new clothes [so they don't get lost in laundry].  Theresa is officially installed.  We're out of there.

4:15 pm:  Home.  Meet the new aide who is just finishing up with my mom.  She seems nice enough.  She says goodbye to us, scratches the dog on the head and leaves.  Now I get the rundown from my private aide.  "She seems OK but she keeps looking at her list and only doing what's on the list".  Followed by "I had to TELL her to change the bed after she bathed Adelaide."  Our private aide loves my mother.  She's very protective.  I love that about her.  "I told the new girl that you mother knows everything that's going on so she didn't think she could get away with anything.  I told her she finds a way to tell you if anyone is mean to her."  

4:30 pm:  Patricia takes the private duty aide home.  Ah, peace and quiet!

4:35 pm:  Phone rings.  My mother's brother calling to see how things went.

4: 45 pm:  I sit on my bed to check my voicemail, etc. for a few minutes.

5:00 pm:   Phone rings.  I wake up.  Aunt calling to check on Theresa.  I know this particular aunt will call at least 10 more times tonight.  Thank God for caller ID and voicemail!

5:10 pm:  Feed the dog.  

5:20 pm:  Rush out the door to fetch the new prescription for my mother.

5:30 pm:  Stand in line behind 20 people at the drug counter, while answering calls on my mobile phone.

6:00 pm:  Feed mom.  Give her her medication.  Change and position her.  Make sure she's OK and comfortable.

6:30 pm:  Rush out to an appointment I had for myself.  I manage to grab a bit of dinner while I'm out.

8:00 pm:  HOME.  12 calls on the home voicemail and I'm going to ignore all of them. Check on mom, she's fine.  Dog is fine.  I'm fine.  Thankfully I managed to grab a double espresso while I was out.

8:15 pm:  Notice that I had TWO aides in the house today and neither of them did my mother's laundry.  So now I have to begin the laundry.  Today was bed-change and bath so there is at least two loads of laundry to be done.  The last thing I want to be doing is laundry.  I can't stand looking at it so into the machine.

9:10 pm:  Laundry in process.  Dog outside for his constitutional.  Time to change mom's bandage.  Yuck!  The doctor did a bit of surgery while he was here earlier in the day.  Now I have to deal with that.  

9:40 pm:  Bandage done.  I survived.  Dog is in for the night.  More phone calls unanswered.  First load of laundry moved from washer to dryer.  I grab a bottle of water, a glass of brandy, a couple of rice cakes and plop on my bed.  Collapse is a more accurate word.  It's "me" time.  News on the TV.  iPad on my lap.  Drink on the night stand.  

11:30 pm:  I awake from my nap!  Drinks still on night stand.  iPad sleeping on the bed between me and the dog.  

11:35 pm:  Tend to Adelaide one last time [I hope]for the day.  She's changed, had a snack and ready to sleep.  I kiss her forehead [both to say "goodnight" and to check her temperature which is a habit], turn off her TV and return to my bed.

11:45: Sip beverages.  Watch something stored on the DVR.  Catch up on emails. Drift to dreamland. 

"I was always looking outside myself for strength and confidence but it comes from within. It is there all the time."
anna freud

Saturday, April 10, 2010


"These last couple of weeks have been difficult ones. My mother's eldest sister, quickly approaching 93 years old, had a serious decline in both mental and physical ability. Long a widow and without children, Theresa depends on my sister and me. Until recently she has been amazing.

Barely four-and-a-half feet tall, Theresa has always been a dynamo. She hasn't had an easy life but she has been blessed with longevity and good health. Born at the end of World War I, the first child of young Italian immigrants, her birth mother died when Theresa was two years old. A couple of years later my grandfather remarried and there were six additional siblings. She has out-lived her husband, three of her younger siblings, nearly all of her friends and survived breast cancer. She has always handled adversity with admirable grace and dignity.

Decision time has arrived.

Theresa can no longer live on her own.  This has become obvious.  For her own safety and regardless of her desire to remain independent, we must intervene on her behalf.  Just as I demanded she give up driving after she had an auto accident in her mid-eighties, now I am charged with the task of arranging for her care.  Home care or nursing home?  Those are the choices.  Both are expensive.  Both have their appeal and detractors.  Where do you even begin?  

Because of her declining health I chose to begin with the physician.  I arranged for an appointment and a consultation.  Having been through a similar situation with another of my mother's sisters, I know that there is a Medicare provision for a period of nursing home stay following an approved three-day minimum hospital stay for a qualifying condition.  This Medicare benefit is up to a maximum of 110 days.  That is enough time to make plans, figure out finances and place her home on the market for sale.  

After an unnecessary [for me] lecture on caring for the elderly from the unpleasant doctor, he suggested I take Theresa directly to the emergency room where she could have tests and get necessary treatment after which he would check-in on her and determine a course of action.

This is where the bureaucracy begins....

Upon arrival at the local hospital emergency room, my aunt is met by the ever-competent and usually pleasant staff of nurses, physician's assistants and physicians.  This is familiar territory for me having taken my mother and her siblings here too many times over the past several years.  Everyone looks familiar to me.  Some of them ask me how my mother is doing.  They quickly begin testing, poking, prodding, ex-raying my aunt.  I begin answering questions, filling out forms, offering documents and signing, signing and signing.  I am well aware that I will be answering these same questions many more times over the course of the next few days.  It seems that information is never passed along with the patient.  It's like being in a phone chain with the local cable-TV provider and being asked repeatedly for your phone number.

After several hours of stabilizing her blood pressure, blood sugar and hydration, Theresa's ever-charming physician has arrived to review her condition and chat with us.  

"Fasten your seat belts.  It's going to be a bumpy night."
bette davis [all about eve]

"You know she can't take care of herself" he begins with the obvious. "I'm going to try to admit her but there's not enough wrong with her, the tests aren't bad and she's not going to qualify for that Medicare thing". We're having this conversation while she is receiving three different IV's and her blood pressure is near stroke numbers.  At this point I'm fairly certain mine will be too.

Theresa finally gets admitted to the hospital.  I can have a night of rest [from this obligation] knowing that she is being taken care of.  At promptly eight the next morning the hospital case worker called me.  Theresa is being discharged and she's not qualified for the nursing home.  "Oh, and she can't be left alone" I'm reminded.

"Now what" I ask aloud to the phone after the case worker has already hung up on her end.  I begin calling someone I know at one of the local facilities.    "Let me see what I can do" I"m told.  That hope held out for about an hour until I get a call saying nothing can be done except Theresa can go into the nursing home as a private pay from day one which requires two months payment in advance, roughly $24 thousand dollars.  Not a chance I'm forking over that kind of money with no notice on a Friday if at all.

Hours pass with no contact from anyone regarding Theresa.  Meanwhile I'm trying to come up with any solution.  This is a real problem now.  I certainly can't take on full charge of my aunt since I am already more than busy taking full-time care of my own mother.

Half past three arrives and my sister and I head to the hospital, still no good plan in place.  I'm thinking that I might just plain refuse to take her home.  "What are they going to do?  Put her in a cab to get herself home?  I doubt they want to risk that liability.  "Damn it, why haven't I heard from anyone?"

When we get to my aunt she is sitting in her chair with her hardly-touched lunch in front of her.  She looks terrible and she is still connected to at least three IV's.  "Oh, she's doing great" the nurse reports.  "Really?" I ask wondering if she simply means "she's 93, breathing and talking [a little]".  Then the nurse, who is really very nice and sympathetic, continues to tell us that they had to give Theresa "some insulin" and she's not walking on her own and "she's been vomiting a couple of times".

Sounds to me like she's perfectly ready to be discharged.  All I have to do is get her home, have IV's set up, learn to monitor her blood sugar and administer "some insulin".  Oh, and don't forget the vomiting!

After ninety minutes the case worker arrives to chat with us.  I express my apprehension and I think I made some sort of joke about sending Theresa to the SPCA "because if they can't find a home for her they euthanize."  Note to patient advocates:  "case workers" do not have a sense of humor and get nervous when you mention the term "euthanize".

"We would never just send a patient home without a plan" explains the CW.  "Theresa is here for the weekend but after that you have to have a plan.  Oh, and she's still not going to meet the Medicare criteria".  I explain that I'm thrilled that she will be safe for the weekend but we are still faced with the problem of what to do.  "Monday is a long time away" she explains "considering your aunt is 93 and all".  I'm told that there will be another case review on Monday and maybe "we'll be lucky and Theresa's health will have declined enough for her to qualify for care".

This is the pathetic state of our current health care system.  How can anyone say that overhaul was not needed?  We're reduced to praying that a 93 year old woman gets sicker in order to get help.

We visited Theresa this afternoon.  She's comfortable although she's not eating.  Today's nurse was very curt but did inform us that they had taken more ex-rays and an ultrasound of Theresa's abdomen since she's still vomiting.  

"Hey, maybe we'll get lucky!" I'm horrified to have repeated. 

Theresa is thoroughly ready to go to a nursing home.  I discussed her situation with her today and explained that if she goes home she will have to have a lot of care and that it would only be in the interim while other arrangements are made.  "I don't want to go home" she declared.  "At least at the nursing home there will be company and things to do I'll have a nice room".  There's the Theresa we all admire.  Ever the optimist.  Ever the pragmatist.  One more challenge that she will face with grace.  She also has the comfort of knowing that we are doing what is best for her and that we are here for her whatever life brings.

I hope we come to an easy solution on Monday but we will do whatever we must to keep her safe and comfortable to best of our ability.

"We're all stumbling towards the light with varying degrees of grace at any given moment."  
bo lozoff

Tuesday, April 6, 2010


I'm a PC.  I've been a PC since 1986.  I never understood the allure of Mac.  Yes they're dependable.  Yes the graphics and publishing are stronger than PC but still I'm a PC.  What a silly name, Apple.

I'm a late "baby boomer".  I like toys and gadgets and the magic and wonder they represent.  I can't help myself.  I'm hardwired to be drawn to gizmos.  Personal portable reel-to-reel recorder: had it.  8-track player AND recorder: mine. Personal computer: must have. Walkman: of course. CB radio: doesn't every driver need one? CD player: amazing.  CD Walkman: no brainer.  Phones you carry with you: duh.

Then it happened.  Apple launched, what I refer to as, "the attack of the gadgets".  The first time I saw a commercial for iTunes and iPod I was mesmerized.  I resisted the temptation until the second generation iPod was released. They had me where any manufacturer only dreams of having its customer.  The seamless interaction between iPod and iTunes was brilliant.  The ease of use, economy of effort and instant gratification of music which could be in your iPod and ears in moments was genius.

"I do not read advertisements. I would spend all of my time wanting things."
archbishop of canterbury

When the first talk of Apple coming out with a revolutionary phone that would combine with iPod and iTunes and connect with the internet with a real web browser my interest was certainly on alert.  Then the press releases and news stories and photos were released.  There it was with that unmistakeable touch-screen with its vivid image quality.  Well, I just had to have it.  I'm not enough of an addict to wait in lines on release day or, heaven forbid, camp out days in advance.  I can wait.  One day.  I lasted ONE day.  I walked into an Apple store, saw the iPhone on the table and it was love at first touch of the screen.  

There are two schools of gadget phone geeks.  There are the Blackberries and the iPhoners.  Each is devoted to his own personal preference.  Blackberries are good sturdy workhorses.  iPhones glisten.  

Damn, they're good!  Just when I thought I'd seen and had all the gadgets I could ever want, Apple did it again.  There were those announcements and press releases and advance buzz again.  "Now what"?  A tablet computer?  Really?  They had been tried before and never caught on.  But this is Apple!  If Steve Jobs weren't Apple he could have been a coke dealer in Studio 54.  He knows how to get people addicted.  He's the serpent from the Garden of Eden. Now I understand the name "Apple".  Evil Genius!  

The iPad looks and feels and reacts just like an oversized iPhone.  It shines and sparkles.  It's the Taylor-Burton diamond of gadgets: you don't really need it but it would sure be nice to have.  For a month I swore I could be strong enough to resist the hype.  Apple sent out tempting emails which I promptly deleted.  I have an iPhone.  I have a notebook computer.  It's like going out for a wonderful dinner, being perfectly satisfied with your entree and then they bring out the dessert cart.  You don't need dessert.  You didn't even think you  wanted dessert.  Still that creme brulle calls out like Lorelei called out to ancient mariners.  

"Man is a creation of desire, not a creation of need."
gaston bachelard

I resisted the urge to run out and buy an iPad.  I didn't hunt one down on the internet.  I waited.   TWO days.  Then I had to have it.  I needed my fix.  What was I going to do with it?  How would I use it?  I certainly didn't need it.  I just wanted it. That's not exactly true.  I knew how I was going to use it, it's just unnecessary.  I love my iPhone.  I knew I would love it's bigger, look-alike brother.  Spring is here and I like to sit on my porch or in my garden and read and listen to music.  Now you can add "surf the net" to that for one tidy, convenient, easy on the eyes package.  You certainly can't sit in the garden with your notebook computer on your lap, that's silly and awkward.  iPhone is just too small to comfortably read novels from.  There are also my frequent nice-weather visits to the riverfront, state parks and botanical gardens.  So many places have wi-fi available and if not, I can still read and listen to music.

There really are uses for the iPad.  Apple has thousands of applications ranging from games to beautifully thought out word processors and everything in-between.  There are also accessories such as a full-sized bluetooth keyboard for serious writing although I'm writing this blog on the built-in virtual keyboard to see how it does.  It's fine.  The touch is a bit sensitive and the size is slightly smaller than a netbook's.  

Basically this is a "take-with" computer.  It's big enough to be usable and small enough to not leave home without.  As a writer, it will eliminate carrying a legal pad with me or dictating voice memos on my iPhone.  I also think the iPad is a must for travelers.  

I am purposely not going into all the technical details and attributes of the iPad.You can find that info on the Apple website or in the many tech blogs and magazines.  This is just one incurable tech-a-holic's love story.