In Memoriam

by Dennis Green

More Americans died in the Civil War than in any other, because, of course, Americans were fighting each other from both sides of the conflict. In 1886, Memorial Day was established to honor those many thousands of dead, and it’s good to remember that as we fire up the barbecue or go shopping.

There will be two ceremonies today in Alameda — one on the carrier U.S.S. Hornet, which fought in World War II, carrying Jimmy Doolittle and his raiders into their famous raid over Tokyo early in the war, giving a tremendous boost to morale back home — and the other near our house at the flagpole and memorial plaques at the entrance to the community of Harbor Bay.

I won’t be tottering over there on my cane, but Diane will drive me to a couple of stores for some necessary supplies, including food for my aquatic turtles and tropical fish. I’m gradually resuming my household chores and hope to do a little gardening this week, prying some invasive daisies out of the lawn and weeding around one rose bush which has just come back from the dead with a glorious burst of red blossoms.

On this day, I remember those I knew who fought in combat, including one who died in the Battle of the Bulge, my cousin Stanley. My uncle Bob, who fought all across the Pacific in the U.S. Navy; my professor and mentor Marvin Mudrick who fought across those Pacific Islands as well, in the Army; another professor and friend, Ed Loomis, who led a machine gun squad across Europe; and a third professor of mine, Douwe Stuurman, in Army Intelligence, who was among the first forward troops into Berlin, ahead of the Soviets.

And there’s my dear friend Larry Settles, who fought five tours of duty as an Airborne Ranger in Vietnam, and died years later of neurological injuries he received there. And of course, Paul Fossum, Navy SEAL with a Navy Cross and a warrior of the first rank who visited Alameda recently and regaled us with stories of his life.

For several years, Diane and I, as “Lazzari & Green Advertising,” worked for client Mountain View Cemetery in Oakland. We produced a big, in-depth brochure about its history, designed by Frederick Law Olmsted, great American landscape architect who also designed New York City’s Central Park, the Stanford University Campus, and consulted on the design of Yosemite National Park and of San Francisco’s Golden Gate Park. A champion of the move to naturalism, Olmsted blended the manmade with the natural landscape and his visions continue to amaze.

Every year for Mountain View, we produced a Memorial Day Service, complete with speeches by local civic leaders, and a memorial ritual including a Scottish bagpipe marching band. The mournful tunes they played brought a hush over the gathered crowd. And those moments transcended ritual and ceremony, becoming positively spiritual.

Struggling as I am with the renal failure this year, Memorial Day takes on yet another new meaning, and the solemnity I feel is lightened by great joy that I am still among the living.

©2010 Dennis Green

Absolute Certainty

By Dennis Green

Yud Resh Ayin! “By using this name, I fill my head with certainty! Certitude! Conviction! Sureness! Trust!” I needed to be broken before I could be strong! And I get just the strength I need from the “Weekly Kabbalah Tune-up,” from Yahuda Berg. Maybe I’m not as lapsed a Jew as I thought!

Or I share a spiritual curiosity about myself, with my chum the incisive art photographer Nate Bennett, who loaned me the book, The Seventy-Two Names of God, and sent me the link to the Kabbalah Centre.

As they say, “What does not kill me makes me stronger!” Much stronger. In all my many broken places, in fact, I have grown a knot of character around each break that serves me well. Come join me in a state of absolute certainty!

It’s better than sureness, or the sneaking suspicion that you might be right about something, (for a change). It compares to confidence the same way the peace that passeth understanding compares to relaxation. And I think they must be related, for I feel the same softness and absence of tension throughout not only my body, my extremities, my fingertips, but also throughout my psyche, my mind, my soul, my heat.

I believe that both these states of mind and being come from a state of Grace, and I‘ve lauded that miraculous gift quite enough. So let’s move on. Does absolute certainty have any practical application in everyday life? That’s more interesting and compelling than abstract philosophies, after all.

Absolute certainty can serve one well in community and political life, let me assure you! When certain issues arise, if you’re well-read and informed, and have a modicum of sense when it comes to evaluating both sides, you can come down on one side or the other with absolute certainty. You may lose, as I often have, but so what? If you were on the right side, it counts in your karma account.

So where do we go now? What do we do next? I’ve started a new story, which may be a novel, a long short story, or a novella, An Independent Man, which explores that question, on my own behalf in some respects, but also as a question for YOU, and for the entire American culture, and the Zeitgeist itself. What’s next?

Well, I suspect it will have a lot to do with new technologies, since we now have a broader spectrum of the types of devices available to us for the purpose of communication, creativity and also entertainment. The iPad resets the notch of excellence of ease of use among digital producers. Like all advances in civilization, the “Third Wave,” as Alvin Toffler called it, has changed our lives. Digital cameras changed Kodak; digital picture frames changes display; online music sharing changed that industry forever.

E-books are changing the publishing industry; streaming video, (and 3-D) are changing movies; and TV is next, with HD, ultra-thin screens and now 3-D in televisions as well, along with online “broadcasting, is changing TV forever.

Networks beware. Of that I have absolute certainty.

©2010 Dennis Green

Hell's Angels

by Dennis Green

The good news is that one more session of hemodialysis, on Saturday, tomorrow, will probably be my last. I start peritoneal dialysis training next week, which I’ve done before, and which is much less hellish than hemo. There is really no bad news. But after six weeks, and on my way out, I suddenly realized today how much adjusting I’ve done at the hemo clinic.

There is a real community of like souls there, in spite of our many differences, and even though it’s definitely the Ninth Circle of Hell. Today, a Hawaiian gentleman all puffed up by water retention helped me in the door, and was very friendly. And Nurse Irene has a crush on me. I tease her about bringing in some port wine next time to relax a bit. “A big canteen of the stuff!” I laugh. She does too.

Tuesday, Thursday, Saturday afternoons the same patients come for dialysis, and most of the same attendants. They were a little underhanded yesterday, and Irene was a’hoppin’ and a’jumpin’ and even a little stressed out. At the end of my three hours, though, my blood pressure was a little high, so she made me sit until it come down under a hundred.

So I pondered it in my heart today while in hemo…how we humans adapt, bond and share whatever it is we have in common. That applies to writers in a writing group who share a love of words as much as the audience at a Grateful Dead Concert who share a love of the music. But in medical or therapeutic situations, the bond is often based on mutual disabilities or illnesses.

I took a T’ai Chi class at Alameda Hospital for three years, and became very tight with my classmates, many of whom had also suffered heart attacks, or even, as I had, bypass surgery. There was one older Chinese gentleman in his Nineties, whose wife and daughter came with him just to make sure he didn’t fall during some of our more strenuous stretching poses. The bond was quiet but powerful there.

When I worked at Children’s Hospital Oakland, I observed the bonding that took place between parents of, say, kids with cystic fibrosis, who sometimes took classes together in such techniques as clearing the lungs of their kids with some vigorous thumps to the chest, or the parents of diabetic kids who had to learn how to test blood sugar levels, keep the sick kids to a special diet, and know what to do in case of a diabetic coma.

These medical groups tend to be very practical, but also have about them, over time, a spiritual dimension. Any stress that reinforces one’s sense of mortality will do that. And for me, over the past six weeks, the prayers and blessings and just plain positive, affectionate thoughts from my Chums has made a huge difference in my regaining my will to live. Quite honestly, I was within days of calling off all treatment and just letting myself go to that last big sleep.

Now, at this point, I will endure almost anything to have a few more decades with Diane. If I do, I’ll no doubt outlive my darling dog Lucca, but if I can be there for her in her final days and hours, love and comfort her, make sure she’s not in pain, I will be thankful.

I see people at the hemo clinic who are on their last legs, who have strokes during their therapy, or go into shock. Anyone over 65 knows as well that they are very unlikely candidates for transplant. Anyone over 50 has to agree to accept the kidney of a donor who is also over 50, or even older. It’s quite an exclusive little club!

And we feel sorry for each other, rather than feeling sorry for ourselves.

©2010 Dennis Green

SilverSmiths

by Dennis Green

Today, I felt like regaling myself with some of my Navajo, Zuñi and Yurok silver jewelry — two inlaid bracelets by Yurok silversmith and artist David Ipeña, a huge silver “Sunburst” Navajo bracelet, signed “DTH,” and a big oval silver Zuñi sunburst belt buckle with a turquoise stone in its middle, unsigned. The magic of silver is the same as that which resides in the clear flowing water of a mountain stream, so I am made new.

And I’m wearing my $500 Marc Nason boots, hand made in Italy of exotic black scuffed leather, with the Gothic crosses on the sides repeated in two tiny silver pulls on the zippers. An indulgence I’m probably still paying for, these boots, but wot the hell… Because I had an appointment with my surgeon today, and she stabbed a long needle into my belly without any anesthesia, I figured I would need some Gothic armor.

The peritoneal catheter, though, is healing nicely, except for the hard knot of fluid under the last incision, and Dr. O’Neill tells me I’ll be able to start peritoneal dialysis training next week. That means six more sessions of hemo, but now that I’ve established a major flirtation with my nurse, Irene, (“Good night, Irene, Irene/I’ll see you in my dreams!”), I can bear it. The iPad certainly helps.

It’s interesting how the material world and the spiritual/emotional world intersect. Makes me suspect the two aren’t as separate, or different as we thought, after all.

It was 40 years ago, when I was still teaching at UCSB, that it started. One of my students opened a store in Santa Barbara, “Ya-Ta-Hey,” dedicated to the study and promotion of Southwest Native American tribal art and jewelry. That’s where I bought the Sunburst Navajo turquoise bracelet. I paid several hundred dollars for it, a huge sum for me at the time, but I was a goner. And today, it’s worth several thousand.

The day I met Diane, we were both wearing Zuñi inlay bracelets, by chance, but it sparked some wonderful connection. She has been collecting tribal art and jewelry longer than I have, and has many more excellent pieces to show for it. Our house is like a New Mexico & Tlingit Museum!

And I know full well the magic contained in these works of art. In the tribes, the artist, the silversmith, the dream worker is one of the most highly regarded members of the tribe. They bring the Next World into this one, and what they create is Power.

I am part Lakota, descended from Crazy Horse, the Sioux chief who led his warriors into battle at the Little Big Horn, and may have personally taken Custer’s scalp. From the Great Spirit, I got my Lakota name, “Lone Wolf,” when I was only nine years old, in a vision in Blue Lake, California. I have been fascinated by Native American lore ever since.

David Ipeña was the only artist working in paintings and silver jewelry in his tribe. Their traditional craft was basket weaving. I have three signed silver pieces by Ipeña, and an ink line drawing. While I was having bypass surgery, Diane found a silver Yurok warrior pendant by Ipeña, in 1996, which I wear to this day. That same month, the artist died of a heart attack while hiking on Mt. Tam, and if that’s not magic, I don’t know what is!

©2010 Dennis Green

Sins of the Drug Wars

by Dennis Green

How very liberal and enlightened! In America, in most parts of the country anyway, the possession or use of marijuana is a minor offense, often punishable by a small fine, rarely by imprisonment. But the sale or cultivation of marijuana — unless protected by legalization for medical purposes — is a felony punishable by imprisonment. Consequently, many thousands of Americans languish in prison, costing the taxpayers on average $100,000 per year each, for doing something most of us acknowledge is harmless to the user, or even beneficial. Doh!

But the real harm — the terrible harm — being done by the U.S. drug war is in Mexico, where approximately 100,000 people have died in a bloody battle between the drug cartels and the Mexican army and police. Fully 60% of the revenue going to the Mexican drug cartels is from marijuana, and most of that weed is exported to the U.S. Without that revenue, the cartels would shrivel, or even die.

While our own DEA pressures Mexico to wage that war on its own soil, knowing full well that a simple change in our laws would drastically reduce, or even eliminate the problem, a stalemate between the two countries continues. But the legalization of marijuana would also mean a huge reduction in the DEA law enforcement budget, and in the budgets of state and local law enforcement agencies, and prison systems, all across America! Mercy me.

The Second Great Depression may yet be avoided, but the Second Prohibition is still with us, started by president Richard Nixon and promoted heavily by First Lady Nancy and President Ronald Reagan, and it’s not working any better than the first Prohibition did. As a tactic of the conservative counter-revolution, it was a smashing success, but as a prevention program, the War on Drugs, specifically marijuana, has been and continues to be an abject failure.

The epidemic of medical marijuana dispensaries in Los Angles is a proof in point. If allowed to increase, there would be more marijuana dispensaries than bars.

We know it’s harmless, less harmful at least than alcohol, tobacco and even caffeine, and yet we tolerate a prohibition that makes only top criminals and cops rich, and we also perpetuate enforcement strategies that focus on the inner city rather than college campuses or senior centers, where abusers of prescription drugs are legion.

But a national hypocrisy so huge and damaging that it kills thousands of people and imprisons thousands more is not just an amusing aberration in the collective psyche, but a mortal sin. And it’s so Middle Class, so pathetic an attempt to give the polite nod to conformity and sobriety, that it’s a massive national embarrassment.

We have an opportunity in California this November for redemption, with Prop 14, by making the recreational use of marijuana as legal as the medical use. But the outcome will be very close, determined probably by the demographics of voter turnout. If older voters predominate, legalization is likely to fail.

They may call it the “Tea Party,” but they probably don’t smoke tea. Unless people under 30 vote in big numbers, (and why should they, without an Obama to support?), pot is doomed to go on killing people in Mexico and the ghettos, and not by second-hand smoke.

©2010 Dennis Green

Writerly Reflections

by Dennis Green

I’ve always thought of myself as a writer, even as a very young boy, but I’ve never thought much about my writing. Until now. How I write, what I write, how I go about it.

From this side of the eyeballs, I’m just a story teller. I simply sit down to tell a story. “Once upon a time…” In a sense, I’m re-telling a story, maybe something I heard in my sleep, a story I like well enough that I think you will too.

But I listen to Scott Turow talk about his writing, as Charlie Rose asks him some questions, such as, “Why do you write so much dialogue?” And that gets me thinking about it. Scott answers, “Oh, I just write down what I hear. I hear these people talking, and I just write it down.”

And that’s about how dialogue comes to me. But there’s more. “I write,” he then says, “for the same reason that all writers do, because it’s a matter of survival, it’s the only way I have of making peace with myself.” A supremely confident man, I find his manner almost off-putting, until I recognize where I have encountered it before. In myself.

A chum, Els, also a writer, tells me that she enjoys writing description, dialogue, “scenes,” far more than she does writing narrative. And she is rather amazed, or amused, that I use narrative so much, not even as a device, but just as my natural voice. Els says she likes the experience in the writing of “being in the here and now” which writing description and dialogue does for her, and that sense of immediacy doesn’t hold any special pleasure for me.

It may also be that I prefer the god-like perspective of the ÜberVoice.

And I usually start a story with an idea, one which can be summed up, or pointed at, with a simple phrase, a title. I proceed the way the ripples on the surface of water from a stone dropped thereon might proceed, in the most natural process I can imagine. If it’s an op-ed piece, I try to make a convincing argument, which is also a kind of story. “Once upon a time there was an idea…”

The Charlie Rose show comes to an end, and with the closing refrains of music, as usual, my dog Lucca sets up a howling, and a singing, and a guttural longing that is curious and amazing indeed. She then finishes up her marrow bone, comes across the room, stands in front of me and licks her lips, once, twice. Meaning: I want to go outside now.

I let the dog out the back door, and leave it closed but unlatched. She will lie on the back porch for fifteen minutes, then come back inside and flop down on the floor, where she will doze. (How’s that for immediacy?)

I have invested a good deal of my time and attention in the subject of aging, of growing old. In fact, I’ve been at it now since my mid-fifties, getting a jump on old age itself and putting an early end to those fiddling middle age years. (How’s that for narrative?)

Sometimes I take great delight in executing some sort of rhetorical flourish. It might be bringing an essay back around to its own title, even using the same phrase in a final or penultimate sentence. But when I do that, I can feel my self-conscious mind rising to the surface, making itself felt, and then known clearly by the tracks it leaves behind. And I like to let it sink back down out of sight.

These writerly reflections don’t come all that naturally to me, as I say, and so this particular bit of writing on these two pages is all of it more self-conscious than my usual writerly state. So much for humility!

©2010 Dennis Green

The Failure of American Education

by Dennis Green

Catholic schools in America have a 90% graduation rate. Public schools, by contrast, graduate only two-thirds of their students, on average. America, which spends more per pupil than any other nation, produces student outcomes in the very bottom ranks of all students worldwide. This crisis in education is finally being addressed, and by some unlikely sources.

The American Education Federation and the American Education Association — the national teachers’ unions — are the biggest and most powerful employee unions in America. They contribute huge sums of money to political campaigns, maintain extensive lobbying efforts, and exert tremendous influence with lawmakers. What is their view of education, and what it needs, how and why it is failing?

“Resources and innovation.” They say that more money is the only solution to all our woes. Yet, 93% of our local AUSD budget goes for salaries and benefits, mostly to teachers, and the rest to a few administrators, custodians, and other service and clerical personnel. Chances are that any new money going into that budget will go to raises and contracted benefits, which often mean no employee contribution, and to shortfalls that the district must make up for any losses by pension investment funds — hundreds of millions of dollars nationwide in the past few years.

But a whole new movement is underway — by those who believe that the secret to better education outcomes lies in the quality of the teaching itself — with better prepared, mentored and managed teachers. And they call for merit pay, based on a complex of student test scores, observation of teacher classroom command and presence, and extensive teacher interviews.

Reform of American Education began with President Bush’s “No Child Left Behind” program, which emphasized the importance of standardized testing and the ranking, (and financial reward or punishment), of performing and failing schools. The program also sparked the creation of charter schools, which are free of school district management and union contracts, and are open for enrollment to children from any home in the district.

Critics of this program point to many schools assuming a strategy of “teaching to the test.” They also note, especially in the humanities and arts, the inability of standardized tests to measure a student’s progress. They defend the concept of “neighborhood schools” as well, often code language for de facto segregation.

Reformers say that teachers are always taking credit for their students’ success, but don’t want to be held accountable for their failures. They say that teachers often blame parents, culture and the students themselves for poor educational outcomes, instead of assuming any responsibility for their own efforts.

President Obama’s new program, “Race to the Top,” is a contest designed to encourage and reward reform, especially toward greater teacher preparation, support and accountability. And it also encourages school choice, a lifting of the caps on charter schools, and strategies for closing achievement gaps. In Round One of the program, 48 states failed to qualify, largely because of union resistance.

Teachers’ unions’ biggest achievements are tenure and seniority — code language, respectively for lifetime job security, regardless of performance, (tenure), and highest pay and stronger job security for the oldest teachers in the face of layoffs, again, regardless of performance, (seniority). Such protectionism and lack of accountability are hardly the dreams of those early union activists fighting and dying in the streets for workers’ rights.

Obviously, the failure of American education will not be turned around so long as those at the very head of the class are never graded.

© Dennis Green

Tiny Pleasures

by Dennis Green

An extreme crisis in one’s life — medical or financial or romantic — can bring with it one unexpected benefit. Even the smallest pleasures loom very large, as the strained proportions of appreciation stretch both ways.

Proportion is a big part of this phenomenon, but in extremis, tells us that normality may be the distortion, and this magnification of pleasure may be the norm.

When you can’t leave the house, can barely walk down the hall, your world shrinks, but then suddenly expands again as minutiae take on a wholly new significance. When there is a tremor in the right hand, and two catheters penetrating your flesh, the body itself takes on a whole new aura of meaning.

But what causes me the greatest fascination these days is the iPad. and that is because it resembles in strange ways the workings of the human mind. It’s the touch screen. Quirky. Ephemeral. Capable of multi-tasking and of overload.

There are many functions that respond to simply touching the screen. Tapping it once does one thing, tapping it twice does another, and tapping it three times brings forth yet another charm. Pressing and dragging moves icons around. Squeezing the fingers together or apart can enlarge type font or another image, or shrink it, place it, move it and in Pages wrap text around it in different layouts and configurations. And with the iPad, apps are available that create a keyboard, like a piano, or the strings of a guitar, with corresponding sounds.

I have downloaded more apps than I can possibly use. One features a fish pond, complete with bird sounds in the background and carp swimming below. Touch the surface of the “water” and you will hear the sound of rippling water. Another features a wide variety of handguns. Touch the trigger of one and the iPad resonates with the sound and an approximation of the relative recoil of that particular weapon.

Many of the apps for the iPad are based on those designed originally for the iPhone, but re-designed for use on the new device. Because the screen is larger and more responsive, the touch factor can be expanded. And it doesn’t always work, multi-touch, or calls up a feature, such as the magnifier along the edge of a page in Pages, which allows you to jump to another part of the manuscript, when you didn’t intend to. Mental.

What I’ve always loved about Apple engineers has been the “intuitive” nature of their software designs. (And on the contrary, when Microsoft stole Windows from Apple, it turned it into a clunky, clumsy way to navigate the screen and applications — the very epitome of “nerd.”) But when it comes to being intuitive, the iPad, with its touch screen and simplicity — no mouse or keyboard — is even more so. Consequently, there is virtually no manual, except online, and really no need for one. Commands and functions come so naturally you just need intuition, and a little common sense, to figure them out.

The sheer genius of the size and simplicity of the iPad is what makes it so revolutionary. Large enough to fill your field of vision when it is propped up in your lap, yet small enough and close enough for the experience to be incredibly intimate — that’s what makes it such a pleasure, if a tiny one. Watching a movie or music video, reading a newspaper, magazine or book, or writing an email or a story in Pages is a sheer delight!

I’m sure this new toy coming into my life under any circumstances would have been exciting. But with the rest of my world so shrunken, this little baby opens new doors of perception, experience and enjoyment I didn’t even know existed!

©2010 Dennis Green

Letting Nature Take Its Course

by Dennis Green

Nature. The Natural World. We think of Nature as something exotic, a world apart from and parallel to this one, the world in which we live, a world of concrete and metal and constructed housing. Nature is the great outdoors, the uncivilized parts of the world.

But no…it’s right here. NATURE R US! Inside us, all around us. The workings of Nature — that’s all there is, finally. “What you can depart from is not the Process.” So where do we get our notions of “the unnatural,” our concern that the ways of Nature itself can be thwarted?

If I, and my doctors, were to just “let Nature take its course” right now, I would be dead. As it was, that first week I was hospitalized with renal failure, there was so much resistance on the part of my attending physicians and bedside nurses that I did almost die. I asked for peritoneal dialysis, and they were all reluctant, because very few dialysis patients can tolerate the regimen — only 7% of all patients on dialysis.

The first time I went on dialysis, the process was very gradual, and I worked up to it, taking training classes in the abstract, getting the peritoneal catheter inserted surgically, letting it heal and “rest” for several weeks before using it, then gradually introducing manual dialysis, at first simply overnight. Fill, sleep, drain.

So Dr. O’Neill reconstructed her original surgery about three weeks after the first effort, shaving off some of the little fatty drapery than hangs down into the cavity and was blocking the catheter from draining. She may have repositioned the catheter slightly, its intake valves, or pinned back the fleshy “drapery” that might have been blocking the draining and I know that she trimmed some of the fatty tissue away. I’m sure it ordinarily serves some useful, evolutionary function. After all, the peritoneal cavity wasn’t built as a reservoir for dialysis fluids!

Medical science, in fact, is the unnatural manipulation of natural processes in the service of life extension and health enhancement. I’m just lucky that my nephrologist, Dr. Law, identified me as a candidate for peritoneal dialysis rather than the “warehousing” of hemo. I may even be able to get off hemo after only four or five more sessions.

But I will never forget that huge room, that “warehouse” where dozens of patients lie on couches, on the nod, semi-comatose, while the machines circulate and filter their blood. A disproportionate number of Asian and African-American people, many older than 70, and it occurs to me that this is a very lucrative business. Rent a warehouse, train ten people per shift, stock thousands of gallons of dialysis fluid…get rich.

I hope to be saying my farewells to this strange world, where a state other than life carries on. It can carry on without me.

Somewhere back there in my past, life goes on undisturbed. Nature takes its course. Healthy people run and play and laugh and swim. For now, I am stranded on this little island where nothing is normal, nothing is natural, nothing is the same as it was. “On Dialysis…” I will say, and people will shrug sympathetically, without even a glimmer of awareness what this means.

Late breaking news: letting Nature take its course, yesterday my bladder finally let go of its contents on its own, without the horrible hard plastic catheter being pushed all the way up inside it, and I am feeling very optimistic. I may even get off dialysis again!

©2010 Dennis Green

The Incredible Shrinking Universe

by Dennis Green

I listen to the expert on global warming explain our planetary dilemma. “It’s already too late to stop global warming,” he says. “We’ve already added one degree to the temperature, and there’s another degree in the pipeline. Among working scientists there is no disagreement. It’s happening. It’s real. It’s irreversible, and the consequences are going to be enormous. It’s people versus physics, the fossil fuel people versus the science, but the physics doesn’t have any money to make its case, no lobbyists, no congressmen on its side…”

Melting glaciers and polar caps…rising ocean levels…the oceans one-third more acidic than they were ten years ago…the balance of nature and eco-systems disrupted, destroyed. It’s the end of the world as we know it!

Macro. Microcosm that I am, my own personal, physical, medical ecology is failing along with the planet’s. My kidney function, a month ago now, dropped from 17% of normal to 15% of normal, then suddenly to 5% of normal. Anything under 10% is fatal unless drastic and dramatic treatment is undertaken: dialysis.

And there are two methods of dialysis — hemodialysis, where a catheter is inserted into a major artery, and the body’s blood is pumped into a machine where it is filtered, the toxins and excess fluid removed, some chemicals added that would ordinarily be restored by the body itself. This is by far the more common method pursued by victims of kidney failure — fully 93% of sufferers chose hemodialysis.

The other method, chosen by only 7% of those with kidney failure, is peritoneal dialysis, where a permanent catheter is inserted into the peritoneal cavity, whereby special fluid fills the cavity and by osmosis across the peritoneal diaphragm removes toxins from the vital bodily fluids, and the resulting waste fluid is then drained via that same catheter, using gravity or by machine. Manual peritoneal dialysis requires several such fluid exchanges every day and one long overnight exchange to keep the body well.

No amount of hemodialysis can purify the bloodstream as well as peritoneal dialysis does. But not everyone can perform or endure the process, the multiple exchanges, going through the day filled with the cleansing fluid, or being hooked up to the machine all night. But for me, having experienced both, I will endure anything to avoid the agonies of hemodialysis and to experience the additional benefits of peritoneal.

On hemo, the mind is obscured as an airport might be by fog. Awareness is severely dimmed, and one lives from one session to the next, with little of interest in-between. The rest is like a state of comatose semi-consciousness. At the hemo clinic, there are literally dozens of people dozing on their couches having their bloodstreams filtered by machine.

On hemo, my universe shrinks to a very small nut-like core of dim awareness. I don’t care about world peace. I don’t care about global warming, or planet death or the end of the world as we know it. I feel fine. But I feel very little of anything. I am only dimly aware of other people, and world events are beyond my human ken. It’s the end of the world as I knew it…and I feel…

©2010 Dennis Green

My Que

by Dennis Green

Ordinarily, I function with an I.Q. around 168, where it’s been tested several times over the years. It provides me with a fanciful imagination, a feisty spirit, and a Devil-May-Care attitude toward life, especially my own. I’m so used to having those intellectual ergs at my disposal that I don’t know how to function without them.

So…recently, when renal failure and subsequent hemodialysis left me seriously impaired, mentally and physically, I was too befuddled to think straight, let alone at my usual 16-cylenders. I was in a fog unlike anything I have ever known before, and in retrospect, I think I experienced what it might be like to have a below average I.Q.

When you’re used to sparking off at 168, let me tell you, it’s impossible to imagine how other, less gifted people operate. But after being medically impaired as I was for several weeks, I have an entirely new appreciation of such a difference than I have ever had before in my 69 years. And the revelation is remarkable!

Without my usual bright lights, I would never have been able to accomplish any of the important things I’ve done — no success in college to a degree that enabled me to pass my Master’s orals with a recommendation that I remain on the PhD track, teach freshman English at the University for ten years, and stop just short of the Doctorate by choice. No position as “Senior Editor” at that same University, none of the subsequent achievements in the corporate world, owning my own business, or in journalism…

When I was first identified as “gifted,” in the fifth grade in Blue Lake, California, my teacher wanted to skip me two full grades, but my mother demurred. I’m glad she did. But I’ve also never received any other special attention or fast-track educational opportunities. Public schools devote most of their special attention and funding to low-achievers, not the gifted, we who simply have to fend for ourselves.

And we do. Our natural advantage helps us satisfy the usual requirements of scholastic achievement with a margin of success that gives us that customary edge: we go the teachers one step better, and keep them on their toes. Before long, they’ll be organizing themselves into unions to protect themselves from us. Ya think!?!?

But such a gift, like all such gifts, humbles the recipient. In this state of humility and gratitude, trust me, no ego trips are allowed, or sought. The source of the gift itself is obvious, and no assumptions about the grace surrounding that gift are possible. The gift of Grace is, like the Sign of the Cross, unbidden and undeserved.

Imagine yourself bereft of half your I.Q., left in a mental state lacking your usual perceptions and acuity. I don’t have to. I’ve been there, done that. Suffered such a state of mind, and believe me, I don’t want to go there ever again!

And that loss, that experience, has shown me how serious a state of grace it is, having this gift and grace. I will never take it for granted again. But I will also never dismiss the efforts of those who don’t enjoy the beneficence I’ve known.

©2010 Dennis Green

Nurse David

by Dennis Green

A very tall man, rangy features, broad-shouldered, tapering down to pencil thin legs. Outspoken.

“I’ll give you some swabs for those bed sores!” he exclaims. “You swab the sore, wait a few minutes and let it dry, then swab it again. Might take 15-20 minutes total. You’ll wind up with a shiny coating on the sore, and it will soon dry up. Poof! Gone!” Nurse David is brusque, and efficient, but when he warms up to you, he’ll shake your hand warmly, firmly, and even, after awhile, touch you affectionately on the shoulder.

On our fifth visit to Urology, I say to Nurse David, “So what’s the plan? When can I get rid of this Foley? I’ve had the damned thing now for more than a month!” The Foley is a “permanent” catheter that stays in my penis and drains the bladder into a small plastic bag strapped to my leg. A miserable situation.

“Well,” he looks pleased that I have finally asked. “There are several alternatives. One is ‘intermittent catheterization.’ That’s where you insert a catheter at home, on your own, four times a day, drain the bladder and take it back out. No permanent catheter, no bag strapped to your leg. And some folks on I.C. begin to urinate on their own again.”

“That sounds like a big improvement!” I enthuse.

“Another alternative is minor surgery on your prostate, shave it down just a bit so it doesn’t block your urination…” he explains.

“Is that what’s blocking mine?” I ask.

“Probably so. Not for certain, but a likely cause,” he says.

“I’d rather avoid any more surgery just now,” I say, “after all the catheters…”

“Well, Nurse David explains, “I’m just telling you some of the things you might be aware of when you meet with Dr. Cheng, your Urologist. The more information you have, the better prepared you will be when he talks to you.”

I know medical protocol well enough that Nurse David’s words make perfect sense to me. He’s not supposed to prime me for my clinical interview with Dr. Cheng, but he’s certainly free to answer my questions. Now that I’m thinking more clearly, the hemodialysis relieved by a day of peritoneal dialysis, and asking those questions, Nurse David is a wonderful source of information.

Kaiser Oakland Urology Department. One of many I have known. Not Nephrology, which deals with the kidneys, dialysis and so forth. Dr. Cheng, my Urologist, fires up the computer screen. “These are the worst kidneys I have ever seen,” he remarks. “They’re nothing but stone!” I can tell how relieved he is that the kidneys are not his turf.

And then I ask the leading questions that prompt him to order “intermittent catheterization” for me rather than the surgery. Nurse David returns, and, after removing the Foley, shows me how to do the I.C., using a thin catheter with a blue line up one side of it, how far to insert it to reach the bladder, 18 inches, 20 inches, 22 inches…when about 10cc of urine pours out. “Do that four times a day,” he tells me, and we huddle over a daytime scheduler to decide the times.

Nurse David then loads me up with enough catheters for a month, two tubes of lubricant, swabs for the bed sores and gives me the firm handshake, then walks me out to the front desk to schedule my next appointment. He puts his hand on my shoulder affectionately, and I know I’ve made the cut.

©2010 Dennis Green