"The Joy of X"

here

Speaking of joy, I finally got back to my ALEKS geometry course,^* which I abandoned last August after my mother fell.

My mother is continuing to improve, by the way. Which means the four death talks -- four -- that various doctors initiated with me and my siblings were premature.

Actually, the four death talks appear to have been not only premature but wrong in every respect. Take, for instance, the observation, made by my mom's intensivist in ICU, that: "Your mother has tiny little lungs and an enormously enlarged heart. Her only hope of survival would be a heart-lung transplant."

That appears to be codswallop, according to my mom's new cardiologist. "Heart function is good." "Heart muscle is strong." "Ejection fraction is normal." "Pulmonary hypertension has resolved." And so on.

Also, the diagnosis of congestive heart failure: wrong, it seems. My mom tells me she was given a brochure on congestive heart failure sometime after her heart attack 5 years ago, which informed her that a person in her situation had 5 years to live, max. Also wrong. Unless, of course, she doesn't have congestive heart failure (confusion reigns amongst us family members), in which case the brochure is possibly right but irrelevant.

Meanwhile, the physicians associated with the nursing home where my mom is recuperating have been operating under the assumption that my mother's diagnosis is congestive heart failure so they are now trying to nail that down. Congestive heart failure: yes or no? That is the question. The nephrologist (my mother does have kidney failure; of that we are sure) says she is going to read the entire history.

oh, man

My life goal: vegan my way to a healthy old age and die in my sleep. By then I will have spent a good 30 years dealing with the public schools; I don't want to spend the last 20 wrangling with hospital intensivists and hospice-touting PCPs. Noooooooooo.

That said, I will also point out that modern medicine is a miracle. Wow. My mom is alive and recovering because emergency rooms do what they do and dialysis machines & nephrologists do what they do and a good nursing home does what it does - because they all do what they do. Modern medicine keeps desperately sick and dying people alive and then some.

true story: in February I flew back to Chicago and went with my mom to an appointment with her new cardiologist. We're sitting together in his tiny office, my mother is back from the grave and getting around by wheelchair and medi-van...... and the doctor tells her to "lose weight and exercise." In 6 months we have gone from "tiny little lungs and an enormously enlarged heart" to "lose weight and exercise."

Alright, then!

Seriously, though, I don't know what to make of our experience thus far, and I have made a conscious decision not to delve into the literature on US medicine. (Also banned: the literature on US food industry.) I've read just enough to see that some of the institutional problems besetting health care are similar to institutional problems besetting public education, and that is helpful and intellectually stimulating to know. But that's enough. If I start finding out what goes on in your basic American hospital, my head will explode. Ditto for factory farming and the USDA.

The one tentative conclusion I hold at the moment: doctors aren't particularly expert at making predictions about an individual patient's immediate future. That's fine with me. I want doctors to save my mother's life, not ship her off to hospice because things look bad. And save her life is what they did.

My advice, which I realize is not original but bears repeating: when you're dealing with major medical, keep your wits about you and take things with a grain of salt.

And: if different doctors are telling you different things, pay attention to that fact. In our case, we were getting so much bad news about our mother, doctors were so insistent the jig was up, that we discounted the observations of doctors who weren't telling us that death was imminent. Not long after the intensivist told us my mom's only hope was a heart-lung transplant, another doctor told us, "She's doing well. This is what we do in ICU. We support a patient's organs and bodily systems while the patient recovers to the point that they can function on their own."

Hearing this, my sister and I thought, in so many words: this guy is nuts.

Then, during my mom's third hospitalization, when I received two hospice-promoting telephone calls from two of her PCPs, the hospital cardiologist told my sister that my mom's heart was strong and we weren't anywhere near hospice decisions. The nurse said the same thing. Another glaring contradiction.

That go-round we reached the reductio ad absurdum of having the hospital social worker apparently develop a suspicion that we children were trying to usher our mother out the door, seeing as how we kept bringing up hospice. The social worker actually interviewed my mother on the subject. What is your relationship with your children, she asked.

Hah!

Next time, Ms. Hospital Social Worker, try asking: What is your relationship with your PCP and why does he keep calling your kids up long-distance to bend their ear about how their mother can have a "peaceful, quiet death" if they talk her into going to hospice sooner rather than later?

My other provisional conclusion: more specialists. Fewer PCPs. (Just kidding.)

In any event, my siblings and I needed to attend to the fact that we were getting wildly different opinions from different physicians, and we needed to find out why that was happening and insist that everyone get on the same page if possible. Instead, we assumed the worst and we grieved. Grieving before the fact clouds your reasoning. I don't think there's any way not to grieve before the fact, but from now on I am going to know that's what I'm doing and try to reason my way around it.

But back to ALEKS. I've got 3 more topics to master, then I return to Algebra 1, which I was working on before I decided to sign up for geometry last June because I was forcing C. to sign up for geometry. During the 9 months I've been away, ALEKS Algebra 1 seems to have grown from 288 topics to 333. Oy. When I switched to Geometry last June, ALEKS erased my Algebra 1 records, but my screen grab says I had mastered 270 topics.

Will I ever get to calculus?




^* Now I just have to get back to Fluenz Spanish and life will be good.