Go For It, Hillary!

Well, it was history, all right, but what sort of history?

Bernie Sanders supporters—and do I have to tell that I’m right there among them?—will certainly agree that history was made. After all, has there ever been a primary process that was so utterly and conveniently skewed to assure Clinton a victory?

I wanted to like her. I almost did in 2008. True, there was always something a little entitled about her: was it Farrakhan who said something like, “she just couldn’t believe that a black man would come out of nowhere…?” Think so, but the internet just drifted out the door….

Well, well—it’s the old story: divide and conquer. Stir up the muck, get the minorities and oppressed groups hating each, and bam! Donald Trump—or whoever the jerk of the moment may be—gets off scot-free.

It was fishy for months, and like fish, it didn’t smell any prettier as time went on. There was the huge disconnect of reading The New York Times—Everyone Including Nosferatu Agrees: Clinton WILL Be Nominee, read one headline—and then seeing footage of lines extending from San Francisco to Los Angeles, all just to hear Sanders speak. (Full disclosure—I made all of that up, but you know what I mean….)

Yes, it was all a little bogus, wasn’t it? Even when Sanders won, as he did in Wisconsin, he still seemed to get shafted. I mean, what in the world do you make of this picture?

Right—I checked, and 56% of 86 delegates is indeed 48. So all is on the up and up, right? I can lay aside this particular conspiracy and go back to worrying about the illuminati, can’t I?

Well, no, because here is the Washington Times, weighing in on the super delegates:

If the superdelegates in Wisconsin would do that, Sanders would leave Wisconsin with 12 more delegates than Clinton. As it stands now, the best Sanders can hope for is an eight delegate advantage, but it could be as slim as just two.

So how did it all work out? Did Sanders supporters get the super delegates to agree to be bound to the candidate who won the election? Who knows—and that was exactly the point. Because it was dizzying, this primary season: no sooner did you get done seeing the YouTube clips of Arizona than you were busy worrying about the 100,000 or so missing democrats in the Bronx, and then….

They learned—the best way to get away with anything is to be brazen. Then, when confronted, they could charge that the Sanders people were being “ridiculous,” as some comedian put it on Monday or Tuesday.

In fact, I am very frequently ridiculous. But there are also some rules of the game: if some of the Sanders supporters were at times poor losers, weren’t some of the Clinton people rather poor winners? And really, no matter how much you believe that Clinton was the right candidate, can anyone also not believe that the process was flawed?

The tragedy here is that it never had to happen: running elections is not rocket science. You only need to do three or four things. First, you take every voting machine and sell it for scrap. Second, you print paper ballots. Third, you hold elections on Sundays, when most people don’t have to work. Then, you count each vote by hand, in the presence of representative of all the candidates. I would add, by the way, that you could crowd source the whole thing by use of cameras and the internet: I promise to stay glued to the computer as my precinct’s votes are tabulated.

Right—got that taken care of!

Of course, if you really needed help—I mean, I’m just a blogger, after all—you could call in…now what was his name? Oh yes, Jimmy Carter, since when he hasn’t been building houses, he’s been supervising elections. Or monitoring them. Or doing what he does, but anyway, at 90 plus, isn’t the elder statesman around here?

Oh, and didn’t he have some tart words to say recently about the primaries? Damn, wish the internet were here….

Would I vote for Clinton, if I could vote at all? Honey, I’d vote for Clinton as many times as anybody would let me—but not with a smile on my face. That’s what I told my sister-in-law, who is furious with the Sanders people.

“Do they REALLY want Trump to be elected!” she demanded.

I decided to tell her the truth: I’m one of those people….

But I did sweeten the affair by telling her this (note, drop voice to a baritone, and also intone): At no time in the history of our great nation have we required the strength of character, the wisdom, the leadership, the compassion, the vision, of a patriot who has the proven capacity to…

…steal an election.

  

In The Maws of Mania

It may have been the most interesting moment in a long, and not very distinguished, nursing career.

That, of course, depends on how you define it: certainly when I was working on B6 / 5, I could legitimately call myself a nurse. But what about that month or so in which I helped my mother die? In that period, I drifted back and forth from being a son to being a nurse, and if I had had the experience a few decades earlier, I might still be a nurse, now.

There’s something special about it. Doctors make more money and earn more respect, but nurses are, I think, more loved and trusted. They’re there when doctors are not: in the middle of the night, in the middle of a crisis, and also—just as importantly—in those moments of triumph.

A friend in the ICU told me the following story. She had been shopping at the grocery store, and all was normal. Suddenly, however, a man rushed up to speak to her.

“Who are you,” he demanded. “How do I know you?”

She had no idea who he was, and was a little frightened by the intensity with which the man spoke.

“I know I know you,” said the man. “I heard your voice, talking to your child, and I told my wife: I know that woman! I know her voice! Who are you? What do you do? How do I know you?”

My friend—guardedly—told him her first name. Then she told him she was a nurse.

“What hospital?”

“UW,” she said, since everybody in Madison, Wisconsin, knows that UW is the university teaching hospital.

And also the tertiary medical center, which means that the worst, the most mysterious, the most intractable cases end up there.

“Where in UW hospital,” asked the man.

“The trauma center,” she said.

“I was there last year,” he told her. “I spent three months there, but I don’t remember a thing about it. I think I blocked it out, but all I can remember is the other ward that they transferred me to. So I don’t think I know you from there. But damn, I know I know you!”

His wife had now joined him, and my friend felt more safe. And just then, the two women stared at each other: my friend had no idea who the man was, but the woman certainly looked familiar.

“Good God, you’re not Joan, are you?” the wife asked.

“Yes.”

“And you work the PM shift?”

“Yes.”

“You took care of Bill for two months, do you remember that?”

“Bill!”

Joan looked at the face, which she had last seen puffy, ashen, and filled with tubes. And then she remembered.

“Bill!”

And then they were hugging, right there in the frozen food aisle, and she was telling him that she remembered: she had nursed him for two months, each day keeping up a running monologue with him.

“I used to tell you, ‘Hey, Bill, don’t give up on me now! You got a beautiful wife and gorgeous kids, and they need you, Bill. Bill? I know you’re in there….’”

Bill stabilized. The doctors made the decision: it was time to try to wean Bill off the respirator. It was successful, and it was becoming clearer: Bill was very likely going to make it. That’s when Joan, my friend, went on a two-week vacation.

She came back: Bill was gone. He had been transferred to another unit.

The point?

Bill had never spoken a word in his life to Joan. Much of the time, he probably couldn’t even see her. His brain was twisted with pain and drugs. His only connection to Joan had been her voice. And hearing it again, after a year’s time, had sent him on a frantic search to find her, to reconnect.

“I will never, ever, ever not speak to a patient again,” Joan told me. “It was one of the most powerful moments of my life. We just stood there holding each other, and looking into each other’s eye, and we didn’t want to say goodbye. So we traded numbers, and we never called, but that didn’t matter. Somehow, knowing that we had each other’s number was all the connection we needed…..”

Nurses have that.

Doctors?

Not so much….

I tell you this because I am checking Facebook, to find out how an old, old friend is doing. She’s a nurse, but also a patient, since she has bipolar 2-hypomania. And she is also, she tells me, rapid cycling, and I know, if not first-hand maybe first-and-a-half hand about rapid cycling. And I knew because of a very difficult patient on the psychiatry unit, B6 / 5.

She was a patient of Dr. James Jefferson, which almost guaranteed that she would be difficult. Because Jefferson had quite literally wrote the book on lithium: he was the heaviest gun on the faculty, and he did not take patients.

Generally….

Jefferson was either consulting or giving keynote speeches or appear on Oprah or just being Jefferson. But Jefferson had long since done anything so mundane as see a patient. So the fact that he was seeing this patient meant two things: she was interesting clinically, and she had the social / financial clout to get the best.

Probably the last nurse to be of high social status was Florence Nightingale: we are not, generally, pulled from the top drawer. And so this patient was somewhat disliked, since it was hard, somehow, to read that her ski trip in Gstaad had had to be curtailed due to a manic episode. Or that she had called Bill Clinton, at a White House dinner, a polecat….

And she was a rapid-cycler. And so she had gone off her lithium, and gone manic, and then been hospitalized. Then, she had stabilized, which everybody but she appreciated.

Anybody who has taken the moving sidewalks at O’Hare airport has had a glimpse of what hypomanic feels like. Because there you are, sprinting past everybody else trudging along, and you are spending just as much energy and getting there twice as fast. Whee! Life is good!

Indeed it is—everybody would love to be hypomanic. But this woman went way past hypomanic into full-blown mania, which was not so fun.

“There are people with knives just behind me,” she whispered to me, after she returned from her 48-hour pass. “So we have to keep moving! Quick, and whatever you do, don’t look back….”

She had been completely normal when she left. She had stopped her lithium. Two days later, she was hallucinating and delusion.

Well, I gave her her lithium. I called the great Dr. Jefferson. And then, we started walking the halls. I began to orient her: pulling her back to reality. It was simple, really: if she was on a distant planet, I would point out the guard rails of the hospital. If she was flying a magic carpet, I would make her look at her feet. We walked, we walked, and then, forty-five minutes later, she began to clear.

In two hours, she was speaking calmly, brushing her teeth, thanking me for taking care of her, and getting ready for bed.

Perhaps you know—manics don’t sleep….

So now, via Facebook, my old friend tells me: she is rapid cycling. And she never has before. Oh, and the last major breakdown was ten years ago. And so I am messaging her, and tell her to call me, and now—having spent an hour and a half writing this—the communication has gone cold.

Or rather, it’s not. She’s just written to say that she has never rapid cycled from depression to mania as has in the last two days. So she’s at home, since she’s too anxious to work. Oh, and also can’t focus.

It’s odd, how nothing much seems to have changed. There’s still stigma, there’s still shame. I read it behind her words: an old friend of ours is in Madison from out of town, but she isn’t sure she can see him. She might, she worries, just break down and cry.

It would be the best thing, of course. But welcome to the worst facet of mental illness: at that moment when you most need human contact, when you really, really, should break down and cry in an old friend’s arms, what happens?

You withdraw.

Or so you think.

I know now. You didn’t withdraw: the disease has isolated you.

        

      

Nursing Home Blues

They had been married sixty years, though the question remains: aren’t they still married? Because they are both alive, and were never divorced: the marriage remains, right?

Ummm…not so much.

Or maybe it does, because the wife has learned, well in her 80’s, to use a tablet computer. And given that she never learned to drive, that’s quite an achievement for an aged lady. But she did it, because even though the nursing home is supposed to be excellent, and is definitely expensive, well, who knows if they are treating her husband right? So she lies awake most nights, and looks at the tablet that is showing her the live feed of her husband. He’s in the nursing home, and sleeping: she’s at home, and monitoring his care.

Nothing about old age is easy, but this particular scenario is especially heartbreaking. Twenty years ago, there would have been no way to know what the night shift was up to in the nursing home, and that might have been a good thing. But now, the elderly wife—who is only technically not a widow—is calling the nursing in the middle of the night, to say that it’s been several hours since her husband has been turned in bed.

I had assumed, by the way, that the nursing home business is booming: happily, I am wrong. According to an article in the Huffington Post, the nursing home industry is projected to decline by 20% by the year 2021. Why? Well, the Baby Boomers haven’t quite gotten to needing nursing homes, and the federal government has gotten the message: it can be cheaper to keep people in their homes.

In fact, 90% of nursing home revenues come from Medicare and other government programs. So what about the other 10%? Surely it has to come from the pockets of the elderly residents, right?

Well, yes, generally speaking, but the question is how. Because consider this quote, from The New York Times:

In a random, anonymized sample of 700 guardianship cases filed in Manhattan over a decade, Hunter College researchers found more than 12 percent were brought by nursing homes.

The human interest in the Time’s article concerns an Italian-American man who was locked into a dispute with the nursing home in which his wife lives. The man, Palermo, had been dealing with Medicare, which was dragging its feet. In the meantime, the bill for his wife’s care kept rising, and eventually reached $10,000. That’s when, on one of his daily visits to the home, he saw a six-page legal document on his wife’s bed. The nursing home was asking the court, in the name of a Carmelite nun, to be appointed legal guardian of Palermo’s wife’s assets.

The court may or may not go along, but that’s hardly the point. Palermo is 82 years old, and has never been sued in his life. And now, all of a sudden, he had to find a lawyer, supervise a legal strategy, and fend off sharks, hiding behind the habit (if not the skirts) of a Carmelite nun. So even if the court says no, Palermo is being strong-armed.

In the case of my friend, monitoring her husband in the nursing home…well, she’s moderately well off. She doesn’t, however, feel well off, but then, who does? So she has strategies for saving money: she has decided, for example, that the coffee from the coffee machine at Walgreens is really much better than the espresso from the café. So she save 63 cents on her cup of coffee, or some such, and better yet, grabs a handful of napkins, since they’re right out there for the taking, and Walgreen’s doesn’t actually say how many napkins you can take. See? So she hasn’t bought napkins for several years now, and that’s a saving of about $10—maximum—per year!

This is, of course, how the rich get rich, and stay rich, and very likely get richer. But it’s also how poor people stay poor. And while the wife is liberating napkins from Walgreen’s, the nursing home is charging somebody about $7,000 a month for her husband’s care. Yes, the same care that the wife is monitoring every night via her tablet.

The daughter of the man and wife comes from overseas to see her father—and console her mother. I know how it feels: I had to visit my mother in a nursing home, but only because she was recovering from operations, and needed physical therapy. But you take a deep breath, you square your shoulders, and you tell yourself that you will leave in….wait, how can you even think that? That’s your mother in there, and you are calculating how long you must spend before you can decently leave? What kind of beast are you?

And so you stay, and it’s not so bad, especially since your mother has wrangled a private room. Well, actually, I wrangled the room, since I had called the nursing home from Puerto Rico, and my mother had been there before. So they knew her, and they liked her, and they agreed: as long as they could, they would not give my mother a roommate. But then the day came when they had to use that bed, and the roommate was a perfectly nice lady, with a perfectly nice family. And the first thing the roommate did?

Turn on the TV!

Well, you don’t want to miss your soaps, do you?

Well, in my mother’s case…yes. But she was wise in the ways of the world: she knew that if she complained to the staff, it would fall on deaf ears. Yes, I had wanted to bring in a boom box, and all of the Wagner Ring Cycle that it could play, but my mother demurred.

Yes, it was a nightmare, but as nightmares go, it wasn’t too bad. I didn’t have it as bad…

…as Mr. Palermo!  

   

Nursing Home Blues

They had been married sixty years, though the question remains: aren’t they still married? Because they are both alive, and were never divorced: the marriage remains, right?

Ummm…not so much.

Or maybe it does, because the wife has learned, well in her 80’s, to use a tablet computer. And given that she never learned to drive, that’s quite an achievement for an aged lady. But she did it, because even though the nursing home is supposed to be excellent, and is definitely expensive, well, who knows if they are treating her husband right? So she lies awake most nights, and looks at the tablet that is showing her the live feed of her husband. He’s in the nursing home, and sleeping: she’s at home, and monitoring his care.

Nothing about old age is easy, but this particular scenario is especially heartbreaking. Twenty years ago, there would have been no way to know what the night shift was up to in the nursing home, and that might have been a good thing. But now, the elderly wife—who is only technically not a widow—is calling the nursing in the middle of the night, to say that it’s been several hours since her husband has been turned in bed.

I had assumed, by the way, that the nursing home business is booming: happily, I am wrong. According to an article in the Huffington Post, the nursing home industry is projected to decline by 20% by the year 2021. Why? Well, the Baby Boomers haven’t quite gotten to needing nursing homes, and the federal government has gotten the message: it can be cheaper to keep people in their homes.

In fact, 90% of nursing home revenues come from Medicare and other government programs. So what about the other 10%? Surely it has to come from the pockets of the elderly residents, right?

Well, yes, generally speaking, but the question is how. Because consider this quote, from The New York Times:

In a random, anonymized sample of 700 guardianship cases filed in Manhattan over a decade, Hunter College researchers found more than 12 percent were brought by nursing homes.

The human interest in the Time’s article concerns an Italian-American man who was locked into a dispute with the nursing home in which his wife lives. The man, Palermo, had been dealing with Medicare, which was dragging its feet. In the meantime, the bill for his wife’s care kept rising, and eventually reached $10,000. That’s when, on one of his daily visits to the home, he saw a six-page legal document on his wife’s bed. The nursing home was asking the court, in the name of a Carmelite nun, to be appointed legal guardian of Palermo’s wife’s assets.

The court may or may not go along, but that’s hardly the point. Palermo is 82 years old, and has never been sued in his life. And now, all of a sudden, he had to find a lawyer, supervise a legal strategy, and fend off sharks, hiding behind the habit (if not the skirts) of a Carmelite nun. So even if the court says no, Palermo is being strong-armed.

In the case of my friend, monitoring her husband in the nursing home…well, she’s moderately well off. She doesn’t, however, feel well off, but then, who does? So she has strategies for saving money: she has decided, for example, that the coffee from the coffee machine at Walgreens is really much better than the espresso from the café. So she save 63 cents on her cup of coffee, or some such, and better yet, grabs a handful of napkins, since they’re right out there for the taking, and Walgreen’s doesn’t actually say how many napkins you can take. See? So she hasn’t bought napkins for several years now, and that’s a saving of about $10—maximum—per year!

This is, of course, how the rich get rich, and stay rich, and very likely get richer. But it’s also how poor people stay poor. And while the wife is liberating napkins from Walgreen’s, the nursing home is charging somebody about $7,000 a month for her husband’s care. Yes, the same care that the wife is monitoring every night via her tablet.

The daughter of the man and wife comes from overseas to see her father—and console her mother. I know how it feels: I had to visit my mother in a nursing home, but only because she was recovering from operations, and needed physical therapy. But you take a deep breath, you square your shoulders, and you tell yourself that you will leave in….wait, how can you even think that? That’s your mother in there, and you are calculating how long you must spend before you can decently leave? What kind of beast are you?

And so you stay, and it’s not so bad, especially since your mother has wrangled a private room. Well, actually, I wrangled the room, since I had called the nursing home from Puerto Rico, and my mother had been there before. So they knew her, and they liked her, and they agreed: as long as they could, they would not give my mother a roommate. But then the day came when they had to use that bed, and the roommate was a perfectly nice lady, with a perfectly nice family. And the first thing the roommate did?

Turn on the TV!

Well, you don’t want to miss your soaps, do you?

Well, in my mother’s case…yes. But she was wise in the ways of the world: she knew that if she complained to the staff, it would fall on deaf ears. Yes, I had wanted to bring in a boom box, and all of the Wagner Ring Cycle that it could play, but my mother demurred.

Yes, it was a nightmare, but as nightmares go, it wasn’t too bad. I didn’t have it as bad…

…as Mr. Palermo!