AFTER SURGERY, A CLEVELAND CLINIC EVALUATION

Tis the last day of January. This is just what I remember of my surgery, I may remember more later and these comments are only just what I remember.

 It has been one week since I posted my departure to Cleveland Clinic and my surgery.  I was really very apprehensive, I usually am not too worried, but this time I was going to unknown territory. I left home with my daughter and huge teaching notebook. A REALLY WELL DONE PRE OPERATIVE INSTRUCTION BOOKLET.  I am glad, however, that I read above the fifth grade level.  Most people do not and as I checked the booklet, it was written for college level.   More apprehensive each mile we drove.

First, let me tell you that, ALL WENT WELL, in terms of outcome.  No Cancer!!  My problem was a little one and my recovery was fast and good.outcoome.  I really have no reason to complain, but things were so different for me and I feel obligated to comment.

When I arrived at the Surgical Center, it was a long walk to the check in desk.  The clerk was sorta robotically efficient.  Had her spiel down pat.  My daughter was given a beeper and a piece of paper with a code.  That code allowed her to follow my progress on any of many screens.  It would tell her when the surgery started, was going on, over....etc.   We sat down and waited.  Others were scattered about waiting for news.  I was puzzled, it was a small room.  I was to find out that there must have been dozens of these little rooms, waiting rooms, with tv's , newspapers and people waiting.  The chairs were old and worn.  Upholstered and had stains.  I was concerned.   Plants were dying.   First sign of a failing organization. (as per Lelan Kaiser, PHD).

It was not long before I was called to yet another desk on yet another level.  We had been told to go to room 33.  We arrived to a hall with doors and numbers.  Not a soul around.  We knocked on the door, it opened and a nurse welcomed us into a small preparation room.   I certainly  was not the center of attention.  It was another patient who had informed another nurse of words in Yiddish and that was the center of attention.  I joined into the rather interesting discourse...but my  anxiety did not lessen.  I was thinking how routine and removed from the process they really were..  They did have the two identifier concept down.... I cannot tell you how many times I said Russelline Greenlaw, August 1.   I was prepared by putting on the usual gown and cap, adding a couple of identification bracelets, and crawled into a uncomfortable stretcher. It was not long before another nurse came in, started an iv, took a few vitals..... My daughter and I waited a little while and I was off to the operating room.  I was frightened.  I had not spent one single minute with either an anesthesiologist or nurse anestensis, except for my pre op visit.  I found this to be really strange.  Had they seen me when I didn't know it? 
.
I was taken down hall after hall to the operating room.  The man who took me was wonderful.  His conversation was easy.  He had been at the Clinic for a number of years in this same job.  Somehow the grey in his hair and the easiness of his voice helped so much.  When I arrived outside my operating room, people started coming up to me....individually then in group.  I FINALLY saw my first anesthesia person.  A seemingly competent nurse anesthetist.  He asked the right questions and seemed very competent.  The anesthesisologist showed up and didn't communicate.  I asked which agents I would get.  He slurred all his words, but laughed when he said I would get Propronal, like Michel Jackson. And he walked away.  Then there was something of a team that asked all kinds of questions.... like what i was having done, and my name and birth date,  again the concept of two identifiers and making sure of the site and surgery being done.  All this in the impersonal hallway with very impersonal people walking briskly up and down.

They rolled me into the room.  I looked around and identified all that was going on, watched the scrub nurse setting up the instruments.... and said to the anaesthetist... I am so scared and anxious I am going to jump off this table!!  He motioned  to someone, and said that he was giving me something that would help.  I said WHAT?  A little versed.... I did calm down.  I was then asked to move to the table from the stretcher... I did.  That is the last I remember for a while.  Turns out it was about four hours.

I cannot remember much about anything until I was in my room.  I do not know where the room was except on a unit of some sort.  Leah came in.  She seemed a little upset, but my pain didn't let me see her very well.  The nurse gave me something.  I went to sleep.  My memory is so bad for the events that marched past me for the next 24 hours.  People came and went. My son in law thought the recovery room nurse was superior--wish I could remember that time.  Leah was beside my bed.  I can remember sending her home.  I do remember sometime late in the evening they gave me a turkey sandwich.  My back was killing me.  Not because of the pain, it was itching off.  One wonderful nurse took a rough towel and scrubbed it...I loved her so.  Sometime during the night they brought in a patient for the other bed in my room.  A young woman who was three months pregnant and had had gall bladder surgery at a hospital west of Cleveland.  I worried all night and until I left. She had no privacy.  I was privy to all her personal history and info. 

I came home on Wednesday afternoon, a little more than forty eight hours after I arrived.  I still cannot put together the experience in any kind of sequence.  I do remember some things:

•  the five am, or so, rounds by the impersonal and efficient surgical team.  Saying wrote things to an old lady.
•  asking questions to the white backs of that small reportedly efficient group of surgeons.
• finally asking a nurse to please check my back, I hadn't moved off it for a long time. She found a cut gown  and other stuff under me.  I felt so much better when it was all gone.
• wonderful efficiency in keeping my pain under control.   one time only, a nurse came in that had never seen me before and handed me pain pills.  I had to say...Russelline Greenlaw, August 1..... She almost dropped her teeth.  We became great friends , but I don't think she will forget to identify correctly..
• being taken by wheelchair to a holding area while waiting for Justin, my son-in-law to get the car. I sat alone and wondered what would happen if I passed out... it had only been a little over forty-eight hours since I had undergone four hours of surgery under general surgery. Not a professional in sight.

I do know the systems that have been put in place are really good.  They certainly had been well thought out.  Bet not a single OLD person had input.  It was all about energy and youth. Entry and Exit from the hospital were very easy, albeit impersonal.  My communications with the surgical department was greatly enhanced by being able to access the nurse coordinator. 

I was very disappointed.  I really have had such good experiences at Duke.  I had such exceptional surgeons.  Dr. Hey, my spinal surgeon, and his team would have never showed me their back with questions unanswered.  I shall never forget his prayer with me before surgery.  God held his hands.   Dr. Proctor my general surgeon would never have not given me eye contact. My hip surgen did not give me any more minutes than the cleveland clinic doc, but it was quality time.

 I truly thought that the days of haughty, impersonal, and lack of communication skills on the part of physicians were gone.  Not so. This is only a story of the Surgical Service and of the Anesthesia Service.  My visits with my internal medicine, pain management , urology and physical therapy experiences rate way high.  I was pleased with every NURSE I met. I do understand how the local folks can question how good the Clinic really is and choose another venue..

 Maybe it is because it is so cold in Cleveland.

OFF TO SURGERY ON MONDAY....Cleveland Clinic

Cleveland Clinic Complex

Inside Surgical Center

I will be having surgery on Monday at Cleveland Clinic for my appendix.  Therefore, after I post today, I will not be posting until I get back and feel like sitting here.  Some of you may ask why am I sharing my experience so openly.  Well, it may be helpful.  Not so many people let you in their mind and since mine is so empty it will not be too complex for you to follow me.  Just joking.

I have chosen Cleveland Clinic as my provider for health care.  I am not one that cares a lot about the touchy feely of delivery.  I want the best staff I can have.  I rate the technical expertise and outcomes top on my list.  If they relate to me in some great way that is a plus, but not required.  I have researched both the clinic and my physician.

My experience at Cleveland Clinic has been so positive so far.  Maybe because it is very much, if not  identical to Duke.  I am very familiar with a hundred people asking the same questions, the multiple roles of nurses, and all the hustle and bustle.  Leah will be with me until they let me be on my own.  We are thinking that 24 hours after I have had the procedure, I will be good to go.  To back up just a little...I have been having bowel problems for quite a while, mostly controlled.  I told my primary care, Ann Tann, MD, after thanksgiving at a regular appointment.  She ordered a CAT and it showed a 2 cm, very small, lesion at the site of my appendix.  I was referred to one surgeon who chose to send me to another one who is very skilled in appendix work.  No kidding.

Dr. Chilikonda

The most critical step for me was to choose the best surgeon I could find.  I choose Sricharan Chilikonda, MD.  This may be a bit of a surprise to most of you who know I have a bias.  He is listed as Surgical Oncology, Minimally Invasive and Robotic Surgery...that is what is on his card. He is part of the Digestive Disease Institute.  His interests are: biliary and pancreatic surgery, gastrointestinal surgery, general surgery, hepatobiliary and pancreatic surgery, hepatobiliary surgery, Hepatocellular Carcinoma, laparoscopic liver surgery, laparoscopy, liver, Liver surgery, Metastatic Cancers, Surgical Oncology. I guess he has the abdomen covered. .  He will be repairing a hernia at my belly button, so as part of the Hernia Institute, guess this is also a match.  He was recruited from University of Pittsburgh.  He was on staff in the Division of Surgical Oncology at the University of Pittsburgh where he served as Director of Robotic Surgery. He is currently in the Department of Hepatobiliary and Transplant surgery and is Director of the General Surgery Robotics program at the Cleveland Clinic.  OK so I think I have it covered.  I cannot choose my anesthesiologist.  The most important thing I wanted to know was how it actually worked in the OR.  The anesthesiologist, the MD, supervises anesthetists during procedures.  In this case the supervision ratio is 1:3 with additional backup when needed.  I feel comfortable with this.  Normally, the nurse anesthetist is so skilled that he/she does not need the MD.  However, when they need them they really need them.  It is a good question to ask, although the staff will think you are a little crazy , but do not be afraid.  There are some hospitals in this country that do not have a MD on site. 

I will be having general anesthesia.  I have had it so many times in the past four years, that it is almost routine for me. Today's induction is so improved as is the recovery.














I am having moments of pure panic.  Most of the time I talk myself into knowing that this is such a little thing.  The report from the CAT scan was: DIFFUSELY DILATED APPENDIX, THIS IS MOST LIKELY MUCOCELE OF THE APPENDIX   THOUGH APPENDICEAL CARCINOMA CANNOT BE EXCLUDED.  One of the most exciting things about Duke and Cleveland Clinic is that they have a chart that is available to patients.  Everything is open and known to the patient.  This is the goal of all systems in the future.  Many times physicians will take it upon themselves to tell you what they want you to know.  These times are getting fewer.  Unfortunately, in my opinion, the most incompetent of the physicians use lack of information to avoid letting their patients know of their incompetency.  Information is not withheld in any form.  .Some of you would prefer not to know details.  I shall never forget, setting up one of the first patient education committees in the country at Barnes in St. Louis.  We brought the doctors to the table, yelling and screaming.  They wanted nothing written.  My preoperative information came in a personalized booklet of over fifty pages.  Quite an advancement.  I really hate it when patients do not take advantage of the improvements.  I am hoping that every reads every word of the things they get, researches on the Internet and talks to professional friends that they may have.

Back to being scared.  Of course I am.  My closed mouth but wonderful grandmother, would be shocked to know that I was letting even casual friends know how I am feeling.  My family will relate.  Coping with the next few days will be a challenge.  Especially since I am in a different place and have not developed any friends and am not yet active in my church.  My sister has been a constant support to me in the last twenty years, and she is no longer close by.  That saddens me so much. Leah has been with me on brief occasions, but never for the long haul.  Lots of waiting.  She will be so helpful.  My strategy is to keep busy.  Today I am cooking corned beef for the family...cleaning house, and getting my things in order.

Another thing to do, I have to make sure my health care power of attorney is in order.  In the past the person I trust most, my friend Jane, has held that. I really do not feel that close family should be put in a position of having to make the decisions.  It still reads that way but I have to rewrite it.  I know that my daughter will use her as a resource if it is needed and will listen to her sage advice. Making sure your financial and healthcare poa is in order is a must.  The other document that really needs to be in order is the DNR document.  I know that this is a real low risk procedure, but variables exist...so lets be prepared and make it easier for the people who have to make the decisions and take care of you.  So many people ignore the preparation of these documents as well as a will.
        I will re read all my instructions this afternoon.  I have to do only clear liquids on Sunday and not eat anything after midnight.  So some hearty meals are in order...but not too much.  Although they told me that there would be no bowel prep, thank goodness, I was still worried.  that prompted an additional call to the nurse practitioner in the surgeons' practice.  She said it was great I raised the question.  We all know our bodies better than anyone.  So we agreed that I would do a simple laxative, and only have clear liquids on Sunday.  I hope every patient in the world compares their body with the general knowledge and asks and asks and asks.  What if he does need to use and incision rather than the laproscope that is planned?  The cleaner the better.  If I had complete evacuation every day, this would not be a concern.  I do not.  So lets get that bowel as clean as possible.  Thank goodness it will not be a Go Lightly thing. 
I don't need to carry anything much but my documents and iPhone.  The hospital has clothing.  I am not interested in pretty, so that gown is very comfortable and utilitarian.  I will not be wearing makeup--most of you will want at least a little lipstick, but not me, just something else to keep up with.  I will have my glasses and iPhone:  they have comb and brush, dental care items so I will leave those at home. My daughter will carry a little bag for me. Forget the book, I have a regular book and a audio book ready to go on my phone.  The hospital will have stuff to support walking and other movements. No special pillow, Most hospitals will not allow this, thank goodness because of the bed bug problem and general inability to know cleanliness of individuals.  So get over personal preferences.  No jewelry, lock it up.  Prepare to amuse yourself with people watching, resting, and whatever TV might be available.  And my iPhone.  I will have another bag, if a longer stay is required, but still will take very little.

The most important thing to me, is to have an open and inclusive conversation with my daughter.  This is above all the most important thing.  Now, this conversation is assuming that this is a simple 12 hour procedure.  But, it must  include all alternatives.  This will be so hard for me, but harder for her.  Taking enough time to take care of this business is worrying me more than anything.  Talking to my other family and friends is important, even critical.... although this is a minor major surgical thing. 

Well you are in my mind.  I know that there are so many other things to say, but for now this is enough.  I will be back with you when my experience is over.  Love my Blogging and will be back soon

Til next time.....

BEFORE I KICK THE BUCKET

Have you made your bucket list?  I don't care how old you are.  If you are young, with a good bucket list your life will have more direction and you will have many many great experiences.  If you are older, like me, you have to keep the list going.  The orgin of BUCKET LIST from Wikipedia.:

"The Bucket List is a 2007 comedy-drama film directed by Rob Reiner, written by Justin Zackham, and starring .....Jack Nicholson and Morgan Freeman. The main plot follows two terminally ill men (portrayed by Nicholson and Freeman) on their road trip with a wish list of things to do before they "kick the bucket." I really thought it was an older orgin.  I am sure the idea has been out there in many forms, but the idea really took off as a result of this movie.  Well worth your time if you haven't seen it. I wrote mine shortly after seeing the movie.  Many of my items remain the same and some drop off because I have lost interest or because my goals or thoughts change.  Most people equate their bucket list to travel.  No No.  Anything that is something you want to do.  It is not a to-do list for day to day stuff we are afraid we will forget.  It is not a list of world peace issues or things that you cant really participate in.   It comes from your heart.  For the list, do not hold yourself back.  You don't have to order it, life doesn't order itself very well so why should your list. 

I would love to hear from you and what your lists are.  Maybe I could even pair up a couple of you who have the same item on your list....and need someone else to do it with.   Lots of time we coincide in strange and wonderful ways. Maybe there is someone reading the blog that can help someone else meet their list items.  Who knows.

This year is really the first year, believe it or not, that I am still thinking in the future but one that predictably has a end point.  We all may not be here tomorrow, but carefully hide that fact from ourselves.  My health has kept me back from doing some things.  Getting too far from my support system makes me nervous.  But soon, I am going to kick that idea to the curb.  My physical limitations keep me from doing some things, but I keep that on the list hoping that there is a crane somewhere that can life me there.  Sometimes items costs too much.  But they should stay on the list.  Who knows when you will win the lottery.  Bucket Lists help us focus on getting things done that we want to do.

My Bucket List:

• 
  Volunteer at Yellowstone or another Park for a summer
• Ralph and I spent a few days here in the late 80's.  It is so beautiful.  I would love to spend some months just absorbing the beauty and meeting people from all over the world.

• Volunteer as a Church Secretary
• Mostly this is a high expense for the church, I think it would be exciting to help people by being the one who answers the phone and assists connections
• Attend the Icon workshop at Kanuaga.
• The Episcopal retreat in the NC mountains, Kanuaga,

• 
  Cruise the north eastern shore of us, Russia,Norway, Finland, Poland
• I love cruising and this area of the world is one I have not visited.  I have been to Gdansk by land. The Baltic was so beautiful  I even found a small piece of amber in the sand at Hel.

• 
  Go on a Freighter cruise.
• I think leaving a port and not knowing where or when would be so exhilarating.  Accommodations are few and quite adequate, I have heard.  Lots of time for just reading, sitting in the sun and talking to friends.
• Design and teach a class on Nursing History--the last fifty years.
• I have shared these years and would like to give nurses an appreciation of where they were and where they are now, helping them become leaders that will guide nurses to the future.

• 
  Spend some time with my niece's and nephew alone so I get to know them and they get to know me uncensored.
•  Susan.,and  Nancy and Sean and families, and Jim and Mary.   I adore my nieces and nephews.  I am not sure they know how proud I am of them.  I would like to know them better.  I get to see Jeff more when I visit my sister.  We always interact in a huge group or alone for short times.

• 

  This is
  All it used to be.

  Spend a week at Smithsonian, just slowly
• I have been to all the museums, but it has all been with others.  I want to go and rent a mobile wheelchair and spend as much time as I want looking at each item, painting, movie, etc.

• South American cruise around the perimeter.
• This is high tone thinking.  I would love to start on the East Coast of this country and arrive on the West Coast and taking a train home.  Or come or go through the Panama Canal.
•  Cross the Atlantic on cruise ship.
• My husband, Ralph, crossed the Atlantic in the thirties as he went to study in France.  The stories could not be replicated, but the experience would be just as wonderful.
• 
  Sit on the beach and watch the sunset.
• With mobility issues, little simple pleasures are so hard.
• Go fishing on a quiet lake in a boat.
• Growing up, my Grandfather and I would fish for hours. Everyday.  The lake was next to my house.  This is really what it looked like.  Such peace. 
• 
  
  
   
  
  
   
  
  
   
  
  
   
  
  
   
  
  
   
  
  
   
  
  
   
  
  
   
  y
  

  

  Celtic Sisters Knot

  Go on vacation with my sister, just she and me, at least once a year when she retires.  Cheap and basic...better for sharing

This is the start, but I will be adding as time goes on......

                                                                              JIM, this one if for you

MY GRANDSON GOES TO COLLEGE

My grandson starts college tomorrow.  There is such an exciting time.  I want to go with him and hold his hand....wouldn't that be a funny sight.  He is entering Tri-C.Cuyahoga Community College.There are three campuses plus some.  He will be taking his classes at this time on the Parma or Western campus.  His classes fall into two categories:  must and fun.  He is taking History and English in the must category.  Rock and Roll is in the fun category.  This should be a great class in that the Rock and Roll Hall of Fame is here.  I suspect there will be field trips.  He has his car and Justin helps him keep it up and is teaching him how to change oil and do all that stuff.  His books and a Kindle will start him out.  Getting a good start is so important and this Community College has a very high rating.

    Sterling is such a wonderful human being.  I have talked to him at length about his assault.  They have not yet found or can charge the men that did it.  He has forgiven them.  He is such a better person than I.  I cannot forgive this terrible act.  I pray often that God will let me let it go, but it is so hard.  I have dreamed over and over of being left in the cold to die and freeze on concrete.  He has some plastic issues left to be fixed.  But I am so grateful that life threatening brain injury was avoided.  God held him in his hand. He can go to college, how close it was that he wouldn't be there.

    He does things that show such understanding.  On  New Year's Eve It was his first time out alone on this kind of holiday for the night.  I was worried out of my mind.  I am sure his mother didn't give it a second thought, nor did his Dad, nor did his Step Dad, nor did his Step Mother.... but this Grandmother did.  Others think I am crazy, but old as I be, I know what is out there. It is impossible to put him into a nice glass bubble so he will never be hurt.  That was proved in November. On New Years' Eve, I was watching whatever on TV.... i heard my back door being opened.... My grandson came to the door to say I am in, and HAPPY NEW YEAR.  That was so wonderful.  His sensitivity. This will take him far in choosing what he will do with his life.

My grandson make me proud all of the time.  He always has.  I know that from time to time there has been setbacks, maybe more than a few....but I have always known that he would think through the issue and come to a good conclusion. 

    One of the most positive things about him is his concern and sensitivity to those who are weaker than he is. He has a loving tenderness for animals.  Although the routine details of care is sometimes an issue, he touches them with compassion and caring.   He shows consideration to me when he takes out my trash, gives me his arm when the walking is hard, and when he brings me little goodies. This will take him far.

• I know his heart.  It is bigger than most.
• I know some of his struggles.  With words and not with words, Peer pressure is overwhelming.
• I watch him getting half of things right, and counting it as all right. 
• I watch him getting things half wrong and counting it as all wrong.
• I watch when people disappoint him.  The sadness and pain.
• I know his grief when for reason, he looses faith in friends and family. 
• I see the hurt in his eyes when someone hurts his self esteem.
• I know he will grow to be a wonderful man and make a family of substance.
• I watch him fulfill his job responsibilities with consistency and pride.
• I see him defend his friends, despite their actions toward him or society.
• I watch him trying to figure out which road to take and hope that he will take the right fork in the road.
• I do what I can to make his life better and wish it could be more.

Sterling, As you start College:

• Take every opportunity that is offered to you to grow. 
• Open every door and see what is behind that door. 
• Get to know your professors. 
• Choose your role  models well. 
• Study hard. 
• Play when it wont hurt your bigger goals. 

The only things a college guy has to be concerned about is getting good grades, his health and his reputation.

MENTAL ILLNESS, TALK, AND POLITICS

     I am sure that  this particular post will anger some, make some uncomfortable, and maybe it will prompt some to action. 

THESE STATEMENTS HAVE ONLY TO DO WITH MY OPINIONS, OBSERVATIONS AND CONCLUSIONS AND DOES IN NO WAY REFLECT THE POSITION THE STATES MENTIONED,  OF JCAHO OR MENTAL HEALTH PROFESSIONALS ANYWHERE.

     First, I want to tell you that I am sure I do not have all or even some of the answers.  But I know there are wonderful professionals out there that do have the answers.  I just want to share with you some experiences that are anecdotal.  I agree with Gloria Steinem who said in a speech at NC State ...that antidotes are the only way we can fully understand the human condition. I have always gotten quite angry in meetings when people would say well we don't deal in personal experiences, where is the data.  Well data depends on  who collects it, how it is set up, and on and on...Data has taken this country down the tubes more than once.  Personal experience stories have as well.  We need to consider both carefully. In the area of mental health is certainly one of these areas.

     I worked for Joint Commission in the early 90's and as luck would have it I was just married to Ralph.  I told the scheduling department that I had a traveling buddy and if they wanted to assign me to doing alone surveys that I would be up to it.  I was assigned to doing those surveys that must be done when the. organization doesn't meet requirements at their regular survey.  I had been cross trained to do hospital, medical staff, environment, mental health and ambulatory surveys (one of the first and few nurses that could survey medical staff), so I was a good pick to do these surveys. 

     Ralph and I were excited about our time together and traveling .  We started out from Raleigh and moved up the coast through Virginia, Maryland, Delaware, New ,Jersey, New York, Mass., and back across northern New York, to Ohio, Indiana, Kentucky, and home through Tennessee.  This took an entire year.  We were visiting primarily three kinds of organizations: Mental Health Hospitals, Prison Hospitals(forensic care) and more rarely, small isolated hospitals and clinics.

     By the time I got to Hyde Park, NY, I was in quite a state.  On this particular day I arrived at a Psychiatric Hospital where  the offices were in a beautiful old turn of the century building, on a hill, with many additional modern dormitories and workshops.  The grounds were beautiful, although a little unkempt.  The beautiful area was like a ghost town.  Only and occasional person would walk by. The state was closing this facility. The issue was: Psychiatric patients had been mainstreamed by law.  The new drugs had proven that many symptoms could be subdued and controlled and that people who had been institutionalized could be treated with drugs.  So many hundreds of thousands of patients were discharged, funds cut, and admissions cut down as patients were seen on outpatient basis.  Only one big problem.  Left to their own, many mental health patients will not take their drugs.  So they would get back into destructive behaviors with no way for readmission.  Where do they end up?

     The rest of the story is equally interesting.  My next stop was in Fishkill, NY at a prison.  They were madly building beds for patients.  The very same patients who had enjoyed the beautiful grounds, the work in the sheltered workshops, the manufacture of simple products and the self esteem that comes from those programs.... were now in prisons.  They had been discharged.  Many had become homeless.  Those in prison had committed crimes that brought them there.  Now they were in rooms with a small window. little outside activity, and the terrible impact of self esteem.  I talked with a number of these people.  They could articulate this cycle with heartbreaking detail.  Not enough food, no where to be when it was so bitterly cold, very unsafe conditions and inability to trust anyone.  Some ended up in Attica, and as I visited there, the same stories but the offenses were more severe.  Since the 90's I have watched this continue with no intervention to change the outcomes for the mentally ill.  I have only watched funds cut year after year because of the words mentally ill.  We would never consider cutting funds in the same percentage for premature babies and other programs.

     There is no doubt that many people had in good faith supported the rights of these individuals, believing that it was in the best interest.  The vision was lacking.  How could a country that took care of their people so well be so unfeeling, thinking that they were feeling?  My grandfather who had a third grade education in his limited language used to say to me,"  Rusti, a country or a family that does not take care of their babies, old people, sick people and crazy people will not survive.  That is why we pay tax.  That and making sure our army is in good shape." He was obviously not politically correct.

     What does this have to do with TALK.  Any mental health worker who has had experience with a certain population of patients will tell you that what is heard is often misinterpreted.  For example, airplanes flying over, cars braking, and things on TV.  With that misinterpretation comes action.  Sometimes these actions require staff in hospitals to subdue patients because of their reaction.  If anyone argues that talk radio, news programs, crime programs, etc... do not influence the thinking is grossly ignorant.   Therefore, yes the vitriolic voices win or loose depending on what you are trying to do. 

If you are winning, you are getting more people to listen, higher ratings, promotions and more money.  Because I periodically listen to Rush and others, doesn't mean that I agree and has nothing to do with ratings..  I just need to know what they are saying.  I was shocked when Ms. Palin talked of putting individuals in the cross hairs.  But I wrote that off to ignorance, and in the back of my mind I wondered how it had affected the impressionable and the delusional.  I do not think that individuals who do voice anger and hate really expect that their words have such a negative effect.

   Why cant we as a country step back just a few years and learn to argue effectively.  In my sophomore year at Duke I had a wonderful Sociology professor. His words were something like this.... "As you study here and as you go about your life, take a vow to expose and oppose ignorance.  Get your facts right.  Argue them well. Understand that others have a right to their opinions and do not be afraid to let  oppositional arguments  become your own, if the facts are better than yours. If it is an issue of importance, do not be afraid to take action.Because you are educated and  action is a requirement."  This is certainly paraphrased because I cannot remember the exact words some fifty years later.  This idea was repeated over and over throughout my four years at Duke. What has happened to us is that we cannot debate issues using civility and come to a compromise.  We must be careful not to criticize compromise it is how we can survive as individuals and as a nation.

Again, I want to leave you my most important quote:

Dante once said that the hottest places in hell are reserved for those who in a period of moral crisis maintain their neutrality”

ARABIA AND ARAMCO INTERESTING PRACTICES AND EXPERIENCES

Consulate Dhahran

Today I am watching a History program with my grandson.  In our discussion we were talking about things that are prohibited in places around the globe.  I was in Arabia from March 1983 until October of 1986.  My friends tell me some things have improved and some are the same and some have gotten worse.  I think it changes frequently, so my comments are just about my limited experiences.  I will just touch on some of the things that were limited or forbidden. 

The first thing that comes to mind is the biggest, religion.  Only mosques exist.  Buildings cannot have architectural design that includes a cross.  this includes windows.  This does not mean that church was not held.  The Roman Catholic Church, and the Episcopal Church met in living accommodations occupied by an employee that held the services. The General Protestants met regularly in a large gym on the compound.  No printed matter stayed behind.  We rarely had anything to go by, but when we did there was someone at the door making sure it was shredded.  I shall never forget.  We had a visiting Presbyterian minister who was the father of an employee who was standing in for the regular minister.  It was Easter.  He was speaking about the physiological effects of crucifixion.  He had made a mock-up of Christ on a cross.  Of course, it was too large to get all the way into the car so across campus he drove with Christ hanging out the window.  It was quite a job getting rid of all the parts before leaving the service. He scared his daughter so bad.



Booze Making Stuff



Booze was another forbidden thing.  That is not to say that there was not a lot of it there.  The first night I was there, I was taken by my boss to dinner at a private home.  We had very good Brit beer.  The guys from the UK did a great job of making and especially drinking.  Everyone had their "friend" who supplied it for them.  We usually got in at least one severe burn a year.Up until the fifties, every male that came into the company was issued a booze making apparatus.   I made my own wine.  Take a grape juice bottle that came with a enamel top, remove the rubber stopper, put a few grains of yeast , some sugar, in the bottle and let it go to work. I could never let mine age.  After about a week, it was wonderful but had almost no alcohol build up. 

Pork was another thing that was not allowed.  Well, ARAMCO had a pork store where the infidels could buy bacon and other  pork products.  I think that has gone away since the Gulf War. Upon arriving to the airport, one family was bringing their guinea pig. They would not let the pet into the country because pigs were not allowed.  Honest!

Going out to eat was a treat.  However, there was a regular place to sit and a family area.  Women could only sit in the back, usually less desirable area.  When Dairy Queen opened, I went with a family from the base into Al Kobar.  The man in the group asked what I wished, and my order was a Peanut Parfait.  I sat down.  I had forgotten that I was to go  to the back.  In just a few seconds every dark brown male eye was staring me down.  I realized I was in the very wrong place.

Of course western clothing for women was frowned upon.  We generally did not have to wear traditional gear if we were only in Al Kobar if we had our neck, wrists and ankles covered.   But if not on the bus going from one base to the other, it was expected that we  wear the clothing.  I frequently would ride with an administrator who was Arab from one hospital or clinic to another.  I wore my abaya and veil.

The one thing that was the absolute worst was the public whippings, and amputations of hands or fingers.  When shopping, we were summoned to the main courtyard in the town.  The buses stopped, and the stores and restaurants closed and we were herded to see the punishment.  I found this picture and it is very much like one of the three of such occurrences that I remember.

Prayer time is always respected.  If you had not eaten,you could not get into a restaurant.  However, if you were eating, the shades would be drawn and you would be allowed to stay inside and continue eating until it was over.  The sound of call to prayer is so pronounced that I can close my eyes and hear it.

More at a later time.

MY LAST DAUGHTER POST...HAPPY DAUGHTER'S WEEK



Leah's Glamor Shot



     We are still in Arabia. 

Leah visited more often than most. We were able to negotiate visa's.  I was able to come home every six months which was unusual.  Her last visit was on her 21st birthday.  We had a large and impressive party for her.  Gifts (as is the ARAMCO custom) were expensive by my standards and many.   Receiving a telephone call was a big deal in the eighties in Arabia.  Her father called right in the middle of the party.   He was able to tell Leah Happy 21st.  She was given a beautiful large aquamarine ring.  It is her favorite.  I have tried over the years to get her to  let me wear it, since she doesn't,  very often.  I keep trying without luck.

    It was on this visit that the photographer friend of mine made what now is called glamor shots of us.  The photographs were so good.   

    As a birthday present, I handed in my resignation on August 20th and started to make preparations to come home.  Tuition was paid through her college year's.  I was on my way home.  I didn't  leave until October as it takes a long time to get out of country.  Not the usual thirty day resignation. The Saudi government held my passport and my exit. was dependent on what they wanted to do.  We both wanted me home quicker. 

     By Christmas, I had a small condo in Durham, NC.  We put things carefully in to each place.  Came time to get a Tree.  Since we were late getting decorated, the day before Christmas we started out to find our tree.  The living room had a 20 foot ceiling.  We pulled into a nursery that looked like it had a tall tree.  We bought a huge tree for almost nothing.  I was in a panic to figure out how I was going to get it up.  Well, Leah had no trouble in talking the young man at the nursery into coming and putting it up for us.  This story reminds me of another tree story.  When were were in St. Louis and moved from our house to an apartment, we had a fun tree experience..  Christmas came and we went to the tree farm and picked out our special tree.  The put the netting over it so when we got home it went up the elevator and into the apartment with no trouble.  We took off the net and let it spread its beautiful limbs.  It was beautiful.  Well Christmas was over and the tree was needing to go.  Turns out it was so big that we couldn't get it through a single door.   Not to be one to give up, we cut each limb using bandage scissors (the only think I could find).  It took a long time to trim down the limbs, fill the black bags.  Then we were able to get the tree through our french doors to the balcony and lower it with a rope down to the ground....and to the trash. Whewwww that was a hard job. 

The next few months found  me looking for a job and Leah doing the same.  She decided to go to Pinehurst and look.  She was so lucky in that she found a job with a builder that taught her so much.  She found a beginner apartment and made it look like a palace.  We both went on our way to our new adventures .  She was indeed a woman and a wonderful one.  This was the beginning of her adulthood and on to marriage and parenthood. 

Leah, thanks for being my daughter. 

Thanks for welcoming me into your life, all of your life, but especially as I grow older. 

Thanks for sharing with me my grandson. You were happy for me to share my values, my thoughts, and my time him. All grandparents are not as lucky.

Thanks for yelling at me when I am not doing for myself what I can. You do it with love.

Thanks for making your education worth all the time and money.Especially because you love what you do.

Thanks for the meals you bring to me and I don't expect.  Sharing your special preparations.

Thanks for sharing excitement about little things.  Birds, Iris, and a shared lunch on the beach.

Thanks for your positiveness.  You bring a wonderful sense of possibility to the entire family.

Thanks for having enough faith in me to encourage me in my life. I want to live up to your belief in me.

Thanks for the cards and little books you give me telling me you care. So simple, but so important.

Thanks for understanding who I was, I am and who I may become.

Thanks for just being you!

NORTH CAROLINA AND ARABIA

THE HOTEL

MOORE REGIONAL

I had not anticipated leaving Barnes or St. Louis.  However, I went to a American Hospital Association meeting in Philadelphia.  I met and talked to the hospital administrator for Moore Regional Hospital in Pinehurst, NC.  My first response was to turn down the job.  H, e said, "Just come down and visit!"  I thought that couldn't hurt, so off I flew to Pinehurst.  I was entertained in a beautiful room at the Pinehurst Hotel, flowers and all.  I fell in love with the area and with the idea that my daughter would be able to get some North Carolina values and culture.  So, I accepted, mostly because I thought Leah and I would survive better in a gentler environment.  She finished high school in December of 1980 with all her credits in great order.  We sold the house on Woods Mill Road in Ballwin and headed for Pinehurst.

CEDAR STEPS ARE DANGEROUS

Our first residence was supplied by the hospital until I could find a place to live.  It was a condo on Pinehurst #1.  Quite nice.  It was not built for winter weather.  We nearly froze to death.  One snow and icy day, I had been picked up and in order to get down the cedar stairs that was filled with ice, I went down on my behind..  I left Leah behind.  Shortly, after I was at work she called and told me the heat was off.  I was able to send for her, but only after all the staff got in.  She had taken a box of matches and struck them one by one to keep warm, to little avail.  My little match girl.  I was so glad to see her and feed her when she got to the hospital. We put her to work carrying water as many people did not make it in to work.

We soon found a condo in Whispering Pines, NC.  It was on the golf course there.  It was beautiful.  Leah settled in and began taking classes at Sandhills Community College.  She began to understand a lot about southern culture. 

Time soon came for her to go to College and we choose to visit Mars Hill near Asheville, NC.  As I indicated, she sang beautifully.  When we arrived, during her interview, she sang without accompaniment, and was accepted on the spot!!  Just about that time, I received an offer for a job in Saudia Arabia for ARAMCO.  The money was great and after a too brief three years, I resigned and began the search for money and adventure.  I spent three years in Arabia, while Leah finished her education at Mars Hill. 

DHARAN

TYPICAL DESERT

Leah was able to come to Arabia three times.  The first time she came I searched the the compound for a younger man for her to date. Someone, I am not sure who, suggested a young up and comer who was just back from college and worked in the engineering department.  It was set up so that Leah and I would go to a performance at the theatre and he would find us.  Later, I found out that he did this, so that if she was really bad he could run.  Well it did not work out that way.  They spent hours and days together.  He is still one of her close friends and never forgets her birthday.  Fred retired at around 28, lives in Florida and is quite successful just moving money around. I would love to adopt him .  

GOLD SOUQ



   I shall never forget the first time I took her to the souk ...the marketplace.  We had a jumpy bus ride into Al Kobar and had a bit of breakfast.  We started walking,, and as we turned a corner, there was a store with hundreds of bangles of 18k gold, breast pieces all hung in the windows.  Inside there were thousands of rings and earrings.  She hyperventilated, thought I was going to loose her. 



She was able to go to the desert, swim in Half Moon Bay, and travel about.  I was not dating anyone and did not get to ride about outside the commune and was so glad Fred could show her around..  It worried me to death that she was going to get lost.  Of course, there was the danger of someone stealing her.  On one occasion I had to send her from our house to another part of the base by cab.  The cab driver came and took her to the appropriate place.  He came back to me with an offer of $100,000 american for her and he needed to talk to her father.  After a very long explanation the offer went up to 300,000.  I do not think he ever understood why I would turn him down.  I quickly called Leah and made sure she was safe.  Abduction was a real possibility.  It did no good to tell the compound cops, they were Arab and would be on the cabbie's side. Female people can be bought and sold to this day.

More about Arabia and Leah later....

GROWING UP.. Philadelphia and St. Louis

We moved from Fayetteville, NC to New Jersey.  I failed to mention that the Elementary School that Leah spent her first year of real school, was desegregated the year she went.  The area was in chaos.  This was really not a good thing for Leah.  She was verbal, pretty, and smart.  She got to do what she wanted while her first grade teacher praised her and tried to take care of kids who needed her more.  Again, the quality of her education suffered. 

From Cherry Hill to Philly the Ben Franklin Bridge

We moved north.  Joe was the Director of STD program in Philadelphia.  We first looked for a place in Philly and places west.  But ended up BUYING a little dream house in Cherry Hill, New Jersey.  It stood on the corner, three bedrooms and two bathrooms.  Everyone in the neighborhood walked to school and came home for lunch.  That was a challenge for me.  My next door neighbor was Hilda and she adopted Leah.  She had to deal with five kids and one more was no trouble. She went over to their house in the morning, to school, back to their house for lunch, and to their house to do homework and wait for us to come back from downtown Philly.  Arthur, Hilda's husband worked in and Ad Agency in NYC.  He had a terrific way with the kids and made killer martini's.  I started to work in the VA in Philly, but couldn't stand being that far away, so I took a job in Camden.  I could attend all the school functions. 

The school in Cherry Hill was full of great teachers and resources.  Leah began to do things that she loved.  The swimming team at the local pool was one of her favorite activities.  Between the school and Hilda, she thrived. We had such opportunity for the brief time we were in the area.  Leah was introduced to real music performances.  She loved them.     It was at this house that she decided to run away.  She was a small eight year old.  She was going to live elsewhere because she didn't get her way.  She started packing.... I asked her what she was doing.  Packing ... I told her OH NO, you cannot take the things that we paid for with you.  Just your clothes you have.  She left, walked around to the side of the house and started on her journey.  With me watching carefully, in ten minutes she was running back to the front door.   I cried and she cried and we settled whatever issue it was. 
But alas it was time to move again. 

We crossed the Delaware River and headed west. When we crossed the Mississippi we knew we were in the right place...St. Louis.  It took us a month to find a house.  Joe's mother came to help us look.  I have no idea why.  We ended up in a suburb west of the city, Ballwin.  West county was the place to be,  Parkway West school system was rated one of the top five in the entire country.  I dug my heels in to make sure we got in the right place.  She stayed in this system until she finished High School. 
    I could spend many chapters of a book, discussing this part of her life.  There are a couple of things that stand out.  In middle school, she wanted to sign up for Shop.  This was traditionally  a place for boys and she was told just that.  She came home and told me that she had been denied entry.   Remember this is the seventies.  I paraded down to the school, and when the dust settled, she was in.  This  was really the beginning of her career because she learned drafting.  I still have a pair of bookends she made.
     Worth many words was her accomplishment in music.  Her voice is a wonderful gift..  She sang with all of the groups in the school including the top small group.  I was able to give her some private voice lessons.  I would lay on the bed in my room and listen to her beautiful sounds during these lessons. Her performances were so commanding.
     Our house was on the top of a hill and she had friends all around us.  Margie at the bottom of the hill, Lisa to the left, Seth next door, and Sue over in the condos.  She was always in and out of the house. We lived right across the street from a horse barn and pasture.  She wanted a horse with all her heart.  We said OK, but first you must go to camp for a month and learn all about horses.  When she came home, she had decided that having a horse wasn't all that important.  That summer she learned how to muck stables and clean feet.  I think maybe she wasn't wanting to spend her time doing that.
    She began dating and creating a lot of angst as with most parents.  I have spent more hours than she will ever understand worrying about her.  Most mothers would say this.. Seems that she really had the attributes that the boys thought were great.  She was truly physically beautiful, but understanding what was in her heart made her more beautiful inside. The tenderness she gave our animals including when our calico cat had kittens in the hall closet., showed her compassion. She played a twelve string guitar, very well 
    All the kids were latchkey-- seems like all the mothers with a few exceptions worked.  It was a safer and kinder world.  It scares me to think that there might be one child doing that today.  Her grandmother came to live with us for a few years, I felt she had more attention.  She left, not wishing to be in St. Louis or with us....never really knew why.
One of my friends, Cathy stayed home and she kept a keen eye on the neighborhood..  She saved Leah's life, I believe.  A tornado hit our house, about four pm, and this would have been the time that Leah would be watching TV in our den.  Cathy had seen the deep dark sky, yellow tones and had gathered kids in her house to wait out the story.  When I got home men were on the roof putting up a tarp and the chimney was in the middle of the den.  As in many times in my marriage, I tried to quit work and stay home.  There was always a promise that this would be good, after the next promotion.  That never happened.

Our Apartment

Parkway West High

In 1980 Leah and I left the house and moved into a beautiful apartment on the top floor of a building right near her school.  The year was calm.  We were both happy and relaxed.  We spent hours together in the pool, just recuperating from a really bad few years.  I really got to know my daughter that year.  One memory of her bringing pot seeds home, and me growing them, leads the list.  The plant grew nicely.  One day when my friend Carol came over, she asked why I was growing pot,  I swear I didnt know what I was growing.  
     We spent a year in the apartment.  Leah was dating Andrew who brought her the most unbelievable pastries for Christmas.  He was so in love with her. We moved back into the house after all the legal stuff was done.  It was not long before we headed back to North Carolina carrying with us her musical skills and looking forward to college and a new future.