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Notably Quoted

It’s good for an artist to try things. It’s good for an artist to be ridiculous.
Sheila Heti in How Should a Person Be?: A Novel from Life (p. 18)


Roto-Rooter & Recovery: Part I

I had tried valiantly to avoid this operation for at least a decade. Of all the invasive procedures that can happen … I mean, wow. Not that I’d rather have brain surgery, of course, but still … here I was. The wait was over and the dreaded TURP was going to happen. This was the week I was going to show up at the hospital, point to my private parts, and say “have at it.”

The morning before the surgery, the schedule called for me to go to the hospital and pre-register … which is a smart way to do things. This appointment did exactly what was intended: to save a lot of time during the day of the operation. I answered the receptionist’s and nurse’s questions (verified that I had not been taking blood-thinning drugs, for example), signed their forms, asked my own questions (can I bring my iPhone? my Kindle? my dietary supplements? – yes, yes, yes), and received my hospital wristband (along with the warning not to take it off or I’d have to do the check-in procedure all over again tomorrow). Then, I went to the lab for the final blood work, where I had to be stuck TWO times, by TWO techs, so they could do DUPLICATE tests. Oh, well, better safe than sorry?

I did my best to keep breathing the rest of that day. The anesthesiologist called me in the evening for a short chat, and told me a little bit about the approach: we’d be using a spinal anesthetic, a technique that, when combined with the other drugs, would totally put me out, and also provide maximum benefit to the surgeon by relaxing my midsection for the work on my prostate. I wouldn’t remember a thing, he assured me.

That night I slept very fitfully and awoke early. According to instructions, I didn’t eat or drink anything. My ride was going to be here at 6:45 so I could be at the hospital by 7:00. Surgery was scheduled for 7:30.

The rest of the following two-day period (my time in the hospital) is somewhat of a blur. But I do remember parts … 

The receptionist downstairs pointed me to the elevator. I went up to the waiting area and they almost immediately called my name. I was shown to a tiny curtained-off area where I was asked to disrobe and put all my belongings into a plastic bag. (Luckily, I had also brought along a gym bag to carry things in.) I put on the hospital garb and lay down. “Could I have another blanket, please?” They brought a nice, pre-warmed one. Ahhhh.

Somebody came by and inserted an IV into my lower left arm. Poke. Ouch. The nurses were very nice, though business-like. The anesthesiologist came by and introduced himself. My urologist (the surgeon) stopped by to say hello and to let me know that we’d be underway shortly.

Soon I was rolling down the hallway toward the operating room. We entered, I looked the place over, and said something like: “hmmmm… it doesn’t look like the Grey’s Anatomy rooms.” (I guess things are always different in real life, eh?) The put me on the table and …

… almost immediately I woke up in the recovery room: in the little curtained area where I’d left my stuff. What? It’s over?!? Really?

Well, of course it wasn’t over. The surgery was rather the easy part, even if it did involve inserting a tube up my penis and carving away part of my prostate. (They don’t call it a roto-rooter job for nothing!)

[The story continues here.]

Insurance Rates

This note is to inform you that I will not be renewing my auto insurance policy with you, effective February 7, 2012.
The bill I recently received, for my six-month renewal, is $649.70. As I spent some time trying to wrap my head around this number, I did the math and discovered this is exactly 25% more than my previous bill. I did not understand at all how this could possibly be correct, so I called, and you indicated the rate increase was due to the fact that I had had a claim in 2010 and it (the consequences of the accident) had finally caught up with me. (Or words to that effect...)
Now, the claim I had in early 2010 (almost two full years ago!) was for a small fender-bender in my parking lot at work, and, yes, it was entirely my fault. However, my recollection is that this is the first claim I have ever had as a Farmers customer where the fault was mine. Yes, I have had comprehensive-coverage claims for cracked windshields and vandalized tires. And, yes, I once had a car totaled out, back in the 1980s, in the middle of the night (while I was upstairs in my house, sleeping) by a hit-and-run driver. BUT: I have not had an accident that was my fault since I’ve been insured by Farmers … and I started with you back in 1978.
Further, in all that time, I believe I have had only one moving violation: a speeding ticket in Lane County, Oregon, sometime in the late 1990s.
During our initial phone conversation about this rate increase, you offered to reduce my coverage limits so we could bring my premium payment into line with what it had been (up until now). At first, that seemed to be the way to go … but, really, I don’t WANT reduced coverage. I really desire some consideration as a long-standing Farmers customer, and to be assessed no penalty for having had one, yes one, accident in 34 years of continuous coverage (in Corvallis, Oregon; Bloomington, Indiana; Eugene, Oregon; Portland, Oregon; Roseburg, Oregon; and now, Larkspur, California).
But, after yet another consultation with you, Famers doesn’t seem to be able to offer me such consideration. I have now shopped around and AAA has written me a policy for the level of coverage I currently have with Farmers, for slightly less than I had paying with you. My new AAA policy is effective February 7 so you will not be receiving another premium payment from me for auto insurance. (My renter’s insurance will remain with Farmers, though I will be looking for other companies to ultimately fulfill that need as well.)
The question I leave you with is: am I not the kind of responsible person you WANT to be insuring?
Most respectfully yours,

Occupy Wall Street West

The Occupy Movement emerged from its state of winter hibernation in San Francisco yesterday on the second anniversary of the U.S. Supreme Court’s decision in Citizens United v. Federal Elections Commission.

(As I’m sure you know, Citizens United is the landmark case that removed limits on how much money corporations and labor unions could donate to political causes. As a result of this lunatic 5-4 decision by our high court, a new type of political action committee, the so-called “Super PAC,” is now legal. Taken together, these unregulated, large-money organizations have, so far this year, dominated the political landscapes of Iowa, New Hampshire, and South Carolina during the Republican caucuses and primaries.)

The protests here in San Fran were part of day-long, Occupy Wall Street-related demonstrations all over the country demanding that banks put an end to evictions and foreclosures.

I very much wanted to take part in this Occupy protest and to be there to document it photographically. However, I wasn’t able to get downtown as it was a busy workday for me. Of course, fair-weather protester that I am, I’m not sure I would have shown up anyway; it was a very blustery winter day here in the Bay Area.

The event was mostly a success for Occupy: the San Francisco Chronicle reported that there were several hundred demonstrators in the Financial District who took to the streets, made a lot of noise, and shut down the headquarters of Wells Fargo Bank. The thousands of protesters that had been anticipated did not materialize, though.

I will have to get downtown soon for an Occupy-related event. I want to see how it’s evolved since I began my hiatus from protesting (because of my surgery and subsequent recovery). I ferried into the city nine straight weekends during the fall (from October 7 to December 3, 2011) to photograph the people, signs, structures, marches and other happenings of #OccupySF.

(I see the Huffington Post reports that the former (former?Occupy San Francisco (#OccupySF) movement has reorganized and now calls itself Occupy Wall Street West. I didn’t know that until today.)

Waking Up … Or Not

Well, as you learned from my last post, I finally decided to have the operation I’d been putting off for years. In the modern medical age it is quite easy to engage in such avoidance; drugs designed to alleviate the most problematic enlarged-prostate symptoms have enabled men to delay surgical intervention for a long time. In my case, I was on Flomax (I’m sure you’ve seen the ads on TV) for about a decade. The ultimate reason for my decision? — the number of trips to the bathroom per unit time was getting pretty damn ridiculous. And, really, I just didn’t feel well anymore.

I’m an academic; I work on a campus. So, given that this was an elective procedure, for a non-life-threatening condition, and in trying to be a most-responsible employee, I thought I should do the operation at the end of Fall semester. Things can be sort of frantic at the end of an academic term, but after that things slow way down and campus is totally closed between Christmas and New Year’s. So, in the middle of November, I scheduled this to happen during the first week of December.

Of course, being the perpetual worrier I am, as I entered the last few days prior to the big event, I became more and more anxious. I had never had a surgery before. And, wouldn’t you know? — I watch all the doctor shows on TV, always have (from Ben Casey and Dr. Kildare, to St. Elsewhere, ER, Chicago Hope, Grey’s Anatomy and House … I’ve always been fascinated). I had good reason to worry, I thought: Murphy’s Law seems to rule. If something can go wrong, it will. Right?

Oh my god, I said to myself. Here I am, 64 years old, and I am having this first-time experience … that could all go terribly, terribly wrong. What would happen if I went under anesthesia and the knife … and then stayed under? You know, like forever! What then?

I have neither a will nor an advanced healthcare directive. Further, there’s the fact that no one is present in my life to provide advocacy for me while I’m in the hospital, no one to make decisions if I don’t wake up, no one who knows what to do in case I die. Shit! Have I really lived this long? Do I really have no one? What the heck do I do NOW?

Well, in the absence of any paperwork, or even having ever talked out any of these issues with anybody, I thought maybe the most responsible thing to do was to let someone in on this particular bout of existential angst.

As it turned out, Katrina and I had been having a brief email exchange about my situation, and in one of her notes, she had asked me about the length of my hospital stay and the anesthesia for my procedure. So I wrote her back telling her what I knew about the spinal anesthesia that would be administered, and then I said…

Speaking of anesthesia … would you consider doing me a favor?

I don’t have a will or an advanced health care directive. If for some reason I don’t wake up from this, could you use this email as evidence of my last wishes? (OK, yes, morbid, I know…)

My last wishes, as of this afternoon, as I write this from a Starbucks in Mill Valley, would be to be cremated with the ashes spread on the top of Mt. Pisgah. If that’s legal up there, that is. So just in case: would you consider communicating this message to my blood relatives — and see if you could make that happen for me?

I will rest easier tonight having said this to someone. If that's too over-the-top a request, just say so, please.


Thankfully, amazingly, she agreed.

So, yes, thanks again, Katrina. I went into all of this with some peace of mind, imaging myself, in the worst-case scenario, spending eternity on one of my favorite hiking trails in Oregon

Soundtrack Suggestion

All that I know is I’m breathing
All I can do is keep breathing
All we can do is keep breathing

(“Keep Breathing” — Ingrid Michaelson)

[The story continues here.]

A Twist in the Path

I have written before about my old-geezer struggles with benign prostatic hyperplasia (BPH, i.e., “enlarged prostate”), PSA tests, biopsies — and intense discussions with my physicians about interpreting the numbers. August 1999 was the month when a routine blood test yielded a distinctly- elevated PSA, resulting in a referral to a urologist. As it turned out, that appointment was merely the first of many over the intervening years, resulting, so far, in 29 blood tests for PSA, two prostate biopsies, a decade of taking Flomax, and a November 2009 emergency room visit for urinary retention that resulted in catheterization for six days. (Now, that was a memorable Thanksgiving!)

Over 15 years of testing, my PSA numbers have risen steadily (sometimes dramatically), my prostate gland has continued to grow, and my symptoms have become progressively worse. In the course of all those doctor visits, one fact became increasingly evident: should I be so fortunate to keep on living, I would eventually need surgical intervention for my condition.

And, so, that time finally came. During the summer and fall of last year, living with this condition became more and more problematic, and even a double-dose of my medication didn’t provide adequate relief. Reluctantly, very reluctantly, I came to acknowledge that the procedure known as a “TURP” (transurethral resection of the prostate) was imminent.

On December 6, 2011, almost six weeks ago now, I entered Marin General Hospital to have the operation. So, dear reader, be on guard. I’ll be writing more about this journey in coming posts.

[The story continues here.]

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