More Than 'patch,patch,patch'

      Within a two day period last week, I had appointments with my dentist, optometrist, and audiologist.  Nothing major, unless having a new molar crown counts as major.  A routine check to determine if my glasses are strong enough and to have the little 'computers' in my tiny hearing aids refurbished.  Soon it will be time to schedule my annual consultations with the PCP, cardiologist, and urologist.
Overall, I am healthy and I am grateful.  My two younger brothers --71 and soon 65--have wondered how I, the oldest at almost 75, have avoided the menu of orthopedic hardware they each 'wear'.
They are not impressed by my answer of 'clean living'.
    I'm uncertain but I think it was the venerable Art Linkletter (and if you wonder who he was, go ask someone with grey hair, or no hair) who said that after 55, everything is "patch, patch, patch". He did  say (write) that "old age is not for sissies".
    Stereotypes abound about 'old people', many of them unkind, derisive, and even mean-spirited. One is that an old person's 'best friend' is their bodily ailments and anyone within hearing distance (with or without hearing aids) can get a complete medical history and introduction to this 'friend'. As a teen, I knew not to ask Lois how she was because 15 minutes I  would still be getting the details.  [I promise never to write again about my 'doctor visits.]
   Another is that most older adults live in some type of 'nursing home' (by whatever euphemistic label).  Actually, the percentage is rather low.  Many of 'us' continue to live 'independently' and enjoy a wide range of social, professional, spiritual, mental involvement in life. (None of this is meant to disparage the reality that such a facility is a necessity for many persons; our mother was one such .)
   One of my heroes and models on how to 'age' with grace and dignity was Mr. Ralph Riddle who died a couple of years ago at 99+.  Always the epitome of kindness, alertness, engagement, good humor, courtesy, immaculate grooming (the list can go on), it was a delight to be in his presence.  He was the oldest of many siblings. His father and my maternal grand-father (also the father of many children) were good friends. Ralph loved to tell the story of how his dad had said to my grand-father: "Grover, the Bible says that we are to be fruitful and multiply and replenish the earth, but it didn't say we had to do it alone."  
      Without doubt, illness and diseases are not humorous ; nor are  they the totality nor the essence of Aging.  Not all of us are 'grumpy old men (or women)'.  [let's be honest, many are]  One ancient culture had an aphorism that "when an old person dies, it is like losing a library.'  
    One of my acquaintances said that his elderly father had friends across the age spectrum as a way of avoiding some of the loneliness potential that can come if all ones friends are in the same age cohort. I think that there is wisdom in that philosophy.
Maybe one key ingredient is mutual RESPECT.

    Satchel

MED SCHOOL MAXIMS ....for all of us

    Have you ever been searching for a particular 'something' only to have another item turn up and then mused to yourself 'Well, there it is; I had wondered where I placed it.' ?  A few days ago, I was attempting to locate something that I had deemed 'essential'...now I donot remember what it was; but I found the notes for a presentation that I made a couple of years ago.  Our counseling center is part of a major teaching hospital and I was asked to speak to the rising Fourth year class of Med Students.  The topic was 'Taking Care of Yourself as a Medical Student'.

     These Maxims or Aphorisms seem (with some slight modification of detail) to be applicable to many professions and occupations . . .and maybe to life in general.  At any rate, an abridgment of the notes:

     I have never been a Medical Student. I have been a Graduate Student in the MA program at Wake Forest University and the PhD program at UNC-Chapel Hill.

   I  did read a book once about med school life . . .which I highly recommend to you: Ferrol Sams, When All the World Was Young.
It  is volume three of his only slightly fictionalized trilogy about growing up in   rural Georgia pre-WWII.  The last volume describes his time as a med student at Emory University at the onset of the war and his service in the military.

   When I was asked to attend this orientation and to speak on the above topic, I decided on a slightly different slant.  I wanted to do a Letterman-esque "Ten things I Wish I had Known when a Fourth Year Medical Student".  So, I asked my younger brother who has been an Orthopedic Surgeon for 40 + years for his input on "Self Care".

     Now, my brother tends a tad towards 'earthy' and 'plain spoken' (which isn't the same things as 'vulgar'. So, be warned ...)  He replied: "Beats me-don't have a clue what you're referring to : self care.  Get up in the morning, brush your teeth, take a crap, shave and shower, no? Really, though I don't know what the term means to you.  Obviously more than it conveys to me. So, if I have any chance to be of any help...[being] more practical and less reflective than my two brothers, I'd need to be filled in a  bit more."

     So, I gave it to him in a different frame:  "Ten Things I Now Know That I Wish I Had Known Then About Being a Physician."

     I then read to the assembled group what my brother wrote in response to the request. Those comments (which I'll give momentarily along with some of my own commentary) prompted me to reflect: "I love book titles. Some are so descriptive that reading the book is almost a redundancy.  Here's one that my brother's email brought to mind:  If You Don't Know Where You're Going, You May Wind Up Somewhere Else.

     Perhaps there are limits to planning and goal setting, and as someone trained as an academic historian as well as  having been privy to hearing many stories in my clinical office, I know for certain that there often are a variety of possible outcomes to situations and that the way things turn out does not always mean that such was the only option.

     Consquently, I want to suggest that a part of   your 'Self Care' as a 4th year Med Student might lie within some of my brother's  reflections.  Some speak eloquently for themselves; for others, I have added some of my own comments. First, his reflections in " ".

1. "You shouldn't  ride in 'on your white horse' and think you can solve all the problems of the world because you're smarter than everyone else-you're not."
    His medical pedigree for that comment is pretty good. Undergrad and Med School at UNC-CH; Intern and  Resident at Yale; OJT at Saigon General ca. 1970.

2.  Perhaps  experience at the latter informed his second comment:
"You can't make  chicken salad out of  chicken [poop]---some things you just can't fix."

3. "All  people deserve the right to be  listened to; don't see patients with one hand on the door as if you are heading out."
     Malcolm Gladwell in The Tipping Point indicated that the doctors who are least likely to be sued are those who treat the patient with kindness, care, attention and time.  It's important to make the connection and avoid treating people like a "sack of symptoms".

4.  "Think--would you want to have the treatment you are suggesting for yourself or for your family."

5.  "Take time to enjoy your family and take time to do things with them---kids grow up in a flash and are gone."

6.  This next one brought a huge laugh from the audience: "Be collegial with your compatriots--there'll be enough money to go around, and it's not the cash that brings the best feeling of reward--it really is about helping other people."

7.  "Don't let the feeling of 'is that all there is?' get you down---and there probably will be those days."

8. "Take time each day to enjoy the world around you if you can; it relaxes you."

9.  "Have something other than medicine that you care about, because the likelihood is that at sometime, you'll not be able to continue to practice and if you don't have any other interest, you'll be a grumpy old fart."

10.  And one that I would add: "To ask for help when you cannot solve a situation yourself is not a sign of weakness.  It's a sign of intelligence."

11. Oh, yea, there was one other 'pearl' from my brother: "One of my med school profs said,'hindsight's better than foresight by a  damned sight!'  Apropos of nothing I guess."

You never know where you might hear a 'life lesson'.  This was in a "Hagar the Terrible" cartoon.  His young son asks: Dad, if you were my age, what would you do with your life?"  Hagar: "I'd always listen to my parents, develop good work habits, and I'd study hard to get a quality education that would help me in years to come."
   Then, in the second panel: "But I'd make VERY, VERY sure I had a lot of FUN along the way."

      Satchel

'KAR-RAK-TERS''

       I have lived much of my life in small Southern towns.  While small towns do not have a monopoly on 'kar-rak-ters', they have an abundance of the breed.  So, what makes someone a 'kar-rak-ter' which is not the same thing necessarily as a 'character' ?
     A dictionary definition can be at least partially helpful.  For the latter, I found this: 'the peculiar quality or set of qualities by which a person is distinguished from others'.  Helpful, but lacking.  For the former , this seems apropos: 'A unique or extraordinary individuality; a person characterized by peculiar or notable traits'.
    As I reflected on some of those unique kar-rak-ters' I have known (and know), here are some descriptions that seem to fit:
  .an original
    .eccentric
       .someone not overly concerned with public opinion
          .some degree of endearment
              .someone who 'marches to a different drummer'
                 .a non-conformist with enough self-confidence not to  care about 'what others may think'
                      .occasionally, though hardly necessarily, with limited cognitive endowment,
                   .someone with 'rough edges'; not 'homogenized'
                      .one who speaks his/her mind without  'measuring words'

      These (often) dear souls are frequently remembered long after their deaths in ways that upstanding, so-called prominent persons are not.

        Garrison Keillor's Lake Wobegone seems to be populated exclusively  by 'kar-rak-ters'. Likewise, Ferrol Sams's books and short-stories portray the antics and 'carryings-on' of not necessarily fictional folks.  'Real life' also provides them in abundance.  A local barber shop (not salon) often serves as a gathering place for these folks, as does what in local parlance is known as 'the beauty      parlor'.  Age and gender do not seem to be primary determinants, either.

      My wife remembered when as a young newcomer to this town, she was checking out of a local 'mom and pop' grocery store and the man in line in front of her left his coat on the counter as he was leaving. Coat in hand, she pursued him down the sidewalk and when she gave him the 'forgotten' item, he calmly noted, "I always leave my coat in there."  (That was later determined to be true.)
     A local businessman (whose son, 'Junior', still practices law in our town) was notorious for his reckless driving and frequent accidents.  One day he had a fender-bender with the mail carrier and immediately owned responsibility.  The mail carrier demurred, "No. It's my fault.  I knew you were out here and I drove anyway."
    Niza lived his entire life in a near-by mill village. (Like other Southern cotton mill towns, the mill and its culture have largely vanished.)  While 'cognitively challenged' , he nonetheless managed an adequate degree of functioning.  With an occasional taste for illegal whiskey, Niza also wore a long overcoat regardless of the season.  One night he went to my uncle's barbershop.  Getting a haircut was a 'Revenuer', someone responsible for tracking and destroying liquor stills and arresting those who bought and sold the product.  Someone jokingly told the agent that he should frisk Niza.  Everyone laughed and the conversation soon shifted.  When the man had left, Niza opened his coat, revealing a bottle of moonshine, and muttered to the group, "Don't you ever do that again."
      Milo died a few months ago.  The locals have begun a 'Milo Festival', showing old Grade B western movies and bringing 'cowboys' to town, as a way of remembering this gentle man of good will who regularly showed 'cowboy movies' at  his home,  as well as entertaining nursing home residents with his harmonica renditions.  Little details such as wardrobe coordination, neatness, and such niceties were not, apparently, among his priorities.
      I think 'kar-rak-ters' are not as abundant as they once were.  Maybe there are too many pressures for conformity. Whatever the reason(s) for the declining number, I think we need them...for lots of reasons.  They are 'spices' in otherwise bland foods of conventionality.  Like actual spices, though, they are best appreciated in a balanced quantity and application.  Within each one of us, there is likely a 'kar-rak-ter' wishing for his/her opportunity to live.

    (In preparing this entry, I have been immensely helped by one of the kindest, most endearing 'kar-rak-ters' I know.  However, I donot hold my wife responsible for anything written here.)

     Satchel

"PEARLS OF WISDOM"

       Reading has always been one of my pleasures...since my mom taught me to read when I was pre-school and dad gave me my first book...Bowser the Hound...in 1945.  Along the way, a line, a sentence, would seem to 'jump out' at me as something worth remembering.  In my 20's, I developed what I called my 'quote board'.  Actually, it was a 36" x 36" sheet of poster board.  The original has been long lost and now I write them in a notebook.
(These practices long before electronic storehouses.)  A couple of days ago while searching for something totally different, I happened upon some of these 'pearls of wisdom'.  There are others 'out there', waiting to be rediscovered.  For now, I pass these on as today's 'musing, meandering, and muttering'.  Seems that many of these 'sayings' could find a home within one of those categories.
Do you have some of your own favorite wisdom quotes . . .
     
     High ranking goes to Satchel Paige's inquiry (that is the source of the blog's name): "How old would you be if you didn't know how old you are?"

   He purportedly also advised,  "Don't look back; something might be gaining on you."

    ."There is something almost holy about the silence of early morning." Grumbach, Fifty Days of Solitude

    ."I ain't worth a darn first thing in the morning without a cup of coffee."  Bill Mauldin, Up Front

    ."There is a world of difference between a wise guy and a wise man."  Anon.

    "The step from knowledge to wisdom is the longest one in a person's life." George Sheehan, Going the Distance

    ."No one should be made to endure Christmas within at least one year of a personal catastrophe ." Howard Owen, Littlejohn

     ."Loneliness is the poverty of self; Solitude is the richness of self."  From May Sarton's Well

     ."Everything is different since it  changed."  Grumbach, Coming into the End Zone

     .Graffiti at the University of Michigan: "It often shows a fine command of the English language to say nothing."  cited in Grubach, Extra Innings

     ."Each age of life is new to us; no matter how old, we are still troubled by inexperience."   Ibid.

     ."I also have an aversion to sentimental displays, Mother's Day and Father's Day, and other such plastic celebrations."  Ibid.

     ." 'Dog' is 'God' spelled backwards."  Anon.

     ."Don't wish your time away, son." My dad...from the book of Life

     ."Sometimes we could all use a lesson in staying quiet."
            Kay Gibbons, A Virtuous Woman

       ."But sometimes the hardest things to see are the ones that are right up on you."   Ibid.

        ."Sometimes when something happens to us it may be  years before we know whether it was fortunate or disastrous."
       Gordon Livingston, And Never Stop Dancing

      ."When the map and the ground don't agree, then the map is wrong."  Livingston, Too Soon Old, Too Late Smart

     ."God blesses those who hustle and beg."  Anon.

     ."Not knowing the questions, it was easy for him to give the answers."  Dag Hammarskjold, Markings

     ."Inside every older person is a younger person wondering what happened."   Anon.

     ."A person at war within himself will often make casualties of those he loves."  The Rev. Dr. Fred Craddock

    ."When traveling at night, you can see only as far as the headlights shine; but you can make the entire journey that way."
        Craddock

    ."The man who views the world at 50 the same way  as he did at 20 has wasted 30 years of his life."  Muhammed Ali


   Tell me some of your own 'pearls of wisdom' if you care to add a response to today's post.
    In the meantime, 'how old would you be if you didn't know ...?"

      Satchel
    
    

STAN, THE MAN

      Though I may sound like a total cynic, in my opinion, there are people today who are called 'celebrities' whose claim to fame is that they are 'famous' ,without ever having contributed a whit to the betterment of humankind.  And, a huge category of those 'celebrities' ... Sports figures.  Beyond the inflated 'compensated packages' these folks receive (didn't say 'earn'), there are the constant exposures of 'feet of clay'.  Examples?:  For the first time in many years, no one was elected to Baseball's Hall of Fame this year, a once-venerated cyclist has 'come clean' about how he won so many races.  I know...some could point to the so-called "Black Sox Scandal" when the Chicago White Sox were bribed to lose the World Series in 1919 (?).  And the poor kid who approached his hero, 'Shoeless' Joe Jackson and plaintively begged, "Say it aint so, Joe !"
      Stan Musial died a few days ago.  By all accounts, I have ever heard or read, he was an outstanding athlete...and, more importantly, an exemplary human.  "Google" his name today and you will find eloquent tributes to him for his athletic prowess, of course, and more eloquent ones for his 'humanity'.  When President  Obama awarded him the Presidential Medal of Freedom in 2011, he called Musial the kind of person that one would want one's children to emulate.
    Well, my dad's sons did !  Dad was a huge St. Louis Cardinal's baseball fan.  When Musial came to town in 1975 for a Hot Stove League dinner, I had the pleasure of watching dad shake hands with his 'hero' who had also been my sports hero for decades.  How many of today's players could hit five (!) home runs in a single afternoon (even if double-headers were still played.)?  He did it back in the early 1950's.  Certainly made an impression of my adolescent ambition.
    ( Now, it would be very easy to seque into a fitting tribute to my father and his encouragement in my high school athleticism, but I'll save that for another post.)
     'Reality' intervened with my own sports career and I acknowledge (what you have likely surmised if you have read this far) that I seldom give much attention to athletics today. [However, if anyone asks me if I have a favorite 'professional' baseball team, I reply, 'No, I'm a Red Sox fan, though it would be difficult for me to name anyone on the roster.] Some have said that baseball is a kind of metaphor for life.  Well, let's ponder that at another time. 
    For now, RIP # 6.

          Satchel

THE SOUNDS OF SILENCE

     Have you ever had someone 'shhh !' you?  I suppose that we typically hear that as a kind of reprimand.  Simon and Garfunkle in their early song, The Sounds of Silence, warned that "silence like a cancer grows".  And, used as a weapon of retaliation, silence can put great strain on a relationship. Receiving the 'Silent Treatment' from someone important to us is usually unpleasant.
    Conversely, respite from constant and sometimes necessary sounds can create a safety zone for our beleagured ears and spirits.
My paternal grand-father wore an 'old-fashioned' hearing aid with the battery and volume control resting in his shirt pocket and a long cord extending to the earpiece.  When the noise level became too much, he would reach into his pocket and mute the sound.
    To say the obvious, hardly all sounds are unpleasant.  One of my favorite sounds is that of the pre-dawn lapping of waves on the beach. (best enjoyed with a cup of coffee).
    Silence can have its benefits.  I alert new counselees that silence can be a powerful part of our sessions and is meant as respect for them to 'listen to themselves'.  A counselee once became silent after ten minutes of conversation.  I likewise remained silent for the duration of the session.  After 40 minutes, I gently noted that our time had expired.  She said, "this has been helpful".  I guess that we often talk so much that (as my dad was fond of saying) 'we can't hear ourselves think'.
   Now, there are persons for whom the quiet is unpleasant and unsettling and they donot want to 'hear themselves think'.  Many ministers report that silent places in a worship service become distressful for their congregants after a very few seconds.  External quiet does not necessarily mute the internal cacophony...what my elders called a 'racket'.
    My  friend of many years arises EARLY  every morning to meditate and to journal.  He says that 90% of praying is "just showing up".  I admire his discipline but also know that there are additional ways of listening to our thoughts and our spirits, an innately 'worthy' endeavor as well as providing the added benefit
 of making living in the world of sound more fulfilling.  Try sitting quietly for ten or fifteen minutes and listen for what you may 'hear'.


     SHHHH !
         Satchel

"WHO LOVES YOU, BABY?"

     Wasn't it Kojak, the television detective, who often asked, "Who loves you, baby?"  I suppose that the correct response would have been, "You do." That question and its' flip side, "Who loves me?"seem to be particularly close to the heart, mind and lips of many persons.  With Valentine's Day as a constant reminder to demonstrate one's love (and the more lavishly, the better), it's little wonder that confusion abounds as to what 'love' is all about.
      Consider: "I love ice cream"; "I love pizza"; "I love my wife (husband)"; "I love God"; "I love my house"; "I love ...".  That is a lot of freight for one small, four-letter vehicle to carry.
     So, we'll confine it to humans, specifically those in a 'significant relationship'.  A popular song from some years ago claimed that "Love is a Many Splendored Thing".  No doubt that is often the fact.  For others, love seems more a "Many Splintered Thing", inflicting wounds that bring relationship damage and dismay.  Then, "who loves you, baby?" rings hollow.  What, then, do we mean when we speak that powerful word?
     Taken alone, any of the following might be a 'splinter' of love.
An immediate response for some could be called 'Romantic' or emotional, or what someone has called 'The Tingles'.  Relationship appropriate affection can be important.
    Then, there are the words.  "I love you" spoken by an important person makes for 'good listening'.  But if that is the totality, then Eliza Doolittle (in My Fair Lady) had a legitimate complaint: "Words, words,words; I'm so sick of words! Is that all you blighters  can do?"  There is some truth in the cliche that 'actions speak louder than words'.
     An accomplished 'actor' can, however, perform the apparently loving gestures and their heart 'not be in it'.  Reading motive and intent is imprecise.
     I have another nominee: Loyalty or Durability.  It derives from a healthy, balanced Self-Respect (not the same thing as Narcissism).  For persons with a religious faith perspective, such 'Self-Love' is derivative of the belief in their innate worth given by the Creator.  Even with my faults, failures, limitations I am a 'work in progress' and hardly the ultimate judge of someone else.  With that in place, I am better able to determine what are appropriate relationship behaviors.
     Love, real love, despite  all the songs, poems, and platitudes does not come easily.  Someone has correctly observed that "love is not for the faint of heart." It sometimes requires "WORK", but that does not have to be the same as "HARD LABOR".
     Do you like to read?  A couple of titles might be helpful.  The Five Love Languages by Dr. Gary Chapman has been recommended by many of my clients.  And, Dr. John Gottman's The Seven Principles for Making Marriage Work is a powerful synthesis of years of research into relationship dynamics. And, even if you are neither married nor intend to be, both these books can  stimulate insight into  that  often-spoken, less-often understood word, LOVE.

     WHO LOVES YOU, BABY?

  Satchel
  

WHOSE SHOULDERS DO YOU STAND ON?

        The world looks different at kneecap level . . .try squatting to the height of a four year old.  There is just a lot 'out there' that you will miss. The next time you attend a parade, look at the children lined up along the curb, hoping for a good view.  Fortunate is the little one who has been lifted onto the shoulders of a parent, grand-parent or other caring adult.  Now, the view is vastly different.
     In viewing the 'parade of life', we, likewise, stand upon the shoulders of others.  Without those boosts, we would be looking at our own lives from another kind of kneecap level.
It is part of the cultural lore in the U.S. that we venerate the 'Self-Made Man [Person]' and 'Rugged Individualism'.  I maintain that there is no such individual.  Self-reliance and Self-sufficiency are different matters.  It was said of a US President in the 19th Century that he was a self-made man who never ceased to praise his maker.
     In his book, The Outliers, Malcolm Gladwell builds a persuasive case (in my opinion) that numerous factors combine to make the 'successful' individual.  We can influence some of those factors; however, many can be attributed to other 'reasons' beyond our control, such as being in the 'Right place' at the Right time, where and when we were born, kinspeople, mentors, plain-old-luck, and on it goes. ( If the length of the book seems daunting, it is available in audiobook. And, if that is too great a time challenge, consider reading just the last part. And, no this is not a 'commercial for the book.)
       At whatever place you find ourself along the age spectrum, Whose Shoulders Do You Stand On?

     Satchel
      
      

Why "Satchel "

SATCHEL

     (This is 're-run' of initial post on another address which had a typo , caused by difficulties in hand-eye coordination and/or visual limitations.  Whichever, that entire matter is probably an appropriate entry unto itself.)

     As a youth, I was impressed with the achievements of Leroy "Satchel" Paige, the 'old man' who had become the 'oldest Rookie' in Major League Baseball (having played with such distinction in the segregated Negro  Leagues for many years).  The man would never tell his exact age, thereby making the curiosity even greater about how someone 'his age' could prevail in a game for 'young men'.  Satchel supposedly mused, "How old would you be if you didn't know how old you are?".
   So much for the old saw, "Act your age!" that has been used to ascribe age-appropriate behaviors, especially, perhaps for youth and elders. I learned some valuable lessons about this topic when I was 50.  A friend invited me to join him in a 15 mile run/race through the streets of Charleston, WV. My goals were to complete the course and to do it under three hours. Gratefully, I was able to do that.  The following day, the Results published in the local newspaper informed me that I finished 30 minutes behind Dr. John Pianfetti who was 81.  The following year, I was only 15 minutes behind him at the finish line.  Though I never met Dr. Pianfetti, he was one of my heroes. The experience has become a kind of metaphor for me as I accumulate the candles on the birthday cakes.
    "How old would you be if you didn't know how old you are?"
           Satchel