The Youngest Son

As her sons start to come apart (inexorably, with no let-up), the father, who internalizes everything, and never talks about the disintegration of the family, suffers a stroke and is hospitalized for six months. At this time, the mother has her youngest son, Peter, committed. He was in hockey camp and started to act out. He was sent to Brady Hospital, “a private psychiatric hospital in Colorado Springs.” (How long, self wonders, did it take for Robert Kolker to collect these masses of material? Because the research is incredible, the kind of thing that she can easily see someone spending 20 years compiling.)

  • In early September, Mimi finally visited and saw Peter wearing only underpants, strapped to a bed with no sheets on it. The whole room reeked of urine …

The mother pulled him out immediately (During all this travail, her husband was still in the hospital: he was “paralyzed on the right side of his body”). She puts Peter in the University of Colorado Hospital in Denver. Doctor’s note: when patient became “more provocative” (whatever that means), his “family thought that was his normal level of functioning.”

p. 134: When boy # 6, Joe, visits boy # 10, Peter, he was “able to tell the patient’s therapist that at times in the past he has had symptomatology similar to Peter’s.”

At this point, five boys have shown signs of personality disturbance. Self knows from the reviews that there’s one more boy who gets diagnosed schizophrenic. Which one? This shell game is agonizing for self, imagine the feelings of the parents (well, the feelings of the mother, because the father was pretty much out of it after his stroke).

So, drugs. There were a lot of drugs around. Four boys “into LSD” and one “into black beauties and other uppers.” The youngest child “smoked pot at age five.” The mother was deeply, observantly Catholic. She cared. Nevertheless, this is what happened to her. And on p. 135, a panel of doctors sat down and told Mimi that in their findings, she was the cause of her son’s disintegration. (Maybe she was, who knows. The jury’s still  out. But she was cut off from her own parents, and her grandparents, though concerned, felt helpless)

Stay safe, dear blog readers.

Your Emergency Response Team of the Day: Mercedes-AMG

from The Economist, 4 April 2020:

The seven Formula-1 teams in Britain have high-tech engineering centres stuffed with the latest production equipment. And they employ hundreds of staff with the talent to use this gear to design, test and manufacture parts rapidly, in the days between races. With the season suspended, they have been collaborating on ways to help produce ventilators, which are needed urgently to treat patients suffering from covid-19. This week, one team, Mercedes-AMG, obtained approval for a device which it can quickly manufacture by the thousands.

The first 100 devices have now been delivered to University College Hospital and other London hospitals for clinical trials.

Stay tuned, dear blog readers. Stay tuned.

Donald McNeil, New York Times Health Reporter

“If it were possible to wave a magic wand and make all Americans freeze in place for 14 days while sitting six feet apart, epidemiologists say, the whole epidemic would sputter to a halt.”

The Wall Street Journal, Friday, 13 March 2020

p. A4: CRISIS TESTS PRESIDENT’S AD-LIB STYLE

Does self care? She means, about the testing of the President’s “ad-lib style”? No, not really.

President Trump’s rare prime-time speech Wednesday was designed to reassure the nation about his administration’s response to a quickly spreading coronavirus.

Instead, Mr. Trump’s scripted speech included errors about health-insurance payments and European travel restrictions, people involved in the speechwriting said Thursday. He also inserted his own mistakes as he spoke, the people said.

During the 10-minute speech — with its one stray word suggesting that the U.S. would ban cargo from Europe — stock futures fell sharply, and the global market rout that followed led to U.S. stocks’ worst drop since 1987 on Thursday.

The Telegraph: Boost Your Immune System Now!

Here’s the link The Telegraph sent out: Anna Magee’s Guide to Boosting Your Immune System.

Ignore POTUS speeches also. You’ll just end up more confused.

Look at flowers. Think Peace. Feel Love.

DSCN0443

Backyard, Redwood City, 7 a.m.

Stay tuned.

Sunday Morning Reading: WSJ Weekend Edition, 15-16 February 2020

20200216_092330

2400 passengers

Health workers in masks and body suits

“I can’t wrap my head around the fact that I could die from this cruise.” — Gay Courter, 75, American novelist

Global Fund for Women: Statement

NOTE: Lest you confuse this with Ivanka’s Global Women’s Initiative WHICH DOES NOTHING, the Global Fund for Women has existed in Menlo Park for decades, and provided small grants to women establishing their own businesses, from small villages in India and Africa, to women’s clinics, all over the world.

22 October 2019

No politician should come between a patient and their doctor, no matter what country they live in — but that’s exactly what the Trump administration has done. This is about health and rights — which transcend partisanship and borders.

One of Trump’s first actions as President was to reinstate the devastating global gag rule, which denies funding to international organizations working on global health if they provide abortion service or even referrals. This means that 26 million women and families worldwide are denied access to contraception, cancer screenings, STI treatment, and safe abortion services. And just last month, the same laws were expanded to the United States under Title X, which will prevent millions of women from being able to access affordable reproductive healthcare.

Global Fund for Women supports women’s rights organizations that are expanding legal and safe abortion access for women and girls, and funds feminist organizations that are documenting the impact of the global gag rule.

You can read more about this excellent organization, here.

Still Reading Stephen Westaby

Summer continues. The days are long. Self’s favorite time of day is after dinner, when the heat is dissipating. Around 8 p.m. It’s still light.

Self’s reading has slowed with the warm weather. Today she’s on Chapter Nine of Open Heart: A Cardiac Surgeon’s Stories of Life and Death on the Operating Table: Westaby is doing a heart transplant on a 10-year-old boy named Stefan. The doctors begin surgery when they get word that “the donor heart had left Harefield” and “would arrive in Oxford in thirty minutes.”

It arrives. The assisting doctor, Marc, “started to trim the donor heart,” which was “from a live person with a normal brain.”

(In parts, this book reads like a horror story — Westaby seems to have a taste for the gruesome detail)

It was time to cut out Stefan’s own sad heart and make ready for the new one. Out it came. The empty pericardium was a curious sight. No heart. It must have been scary when Barnard did it for the first time. Like a car without an engine under the hood.

Then, the implantation:

Any donor heart is slippery and wet. Not easy to hold in position.

My treacherous imagination takes over.

Stay tuned, dear blog readers. Stay tuned.

“The Dreaming Spires”

Self is still on Ch. 7 of Stephen Westaby’s Open Heart. It’s a very gripping chapter. Everything unfolds in Oxford, hence “the dreaming spires” (repeated twice in this chapter, the editor must have really liked the expression).

DSCN0034

  • It was almost 8:00 a.m. The summer sun shone brightly on the dreaming spires. I left Katsumata to close the chest and went to warn the ICU about the impending arrival. Something different. For the next twelve hours, Julie’s critical period, she would have no pulse.

As Westaby explains in the previous paragraph, pulse “was much less important than blood flow . . . it didn’t matter whether the blood had pulse or no pulse in it. Flow was the key.”

Further on Julie’s condition:

  • Her kidneys had quit. She would need dialysis for a few days. And she was a little yellow. The liver was suffering as well. By most criteria, she had been dead. But we hoped she would live now. Good or what?

Self would say Julie just won the Lotto. Because Westaby was paged, and because he was willing to come in despite not being on call.

He goes to the patient’s anxious family and they can read his expression: despite “mask dangling down and blood on my theater shoes, I looked pleased.”

Whew! What an event! Like a real battle, and the outcome: “Julie was still alive.” The doctor’s not sure about brain damage, though.

Stay tuned, dear blog readers. Stay tuned.

 

The AB-180, 1997 Prototype

From reading Sheryl Recinos’s harrowing memoir of surviving on the streets as an under-age runaway, to Stephen Westaby’s memoir of his most wrenching heart cases.

Sheryl Recinos ended up a doctor (amazing), but that part is not in her memoir, Hindsight: Coming of Age on the Streets of Hollywood. (Maybe there will be a sequel? Self hopes so)

Stephen Westaby’s memoir, on the other hand, describes his work as a member of the team that produces the first artificial heart.

Ch. 7, Open Heart: A Cardiac Surgeon’s Stories of Life and Death on the Operating Table

It took the team five years to produce a spinning blood pump the size of a bicycle bell, weighing just half a pound . . . First called the AB-180, it was intended to support the circulation for up to six months . . . It was so simple that one of the technicians attached a prototype pump to his garden hose and drained his fish pond with it.

The first English “guinea pig” for the AB-180 was a 21-year-old woman who had contracted “viral myocarditis, a viral illness like a cold, but when it involves the heart, it can be fatal . . . a desperate situation for a vivacious young woman who had been normal the week before.”

As self told Dearest Mum many years ago: Dying has nothing to do with age.

Look at self’s older sister, dead of streptococcal pneumonia at 34.

Look at Dearly Departed Sister-in-Law Ying, who died at 38 of leukemia which had been diagnosed less than a year before.

In Westaby’s memoir, Julie’s “leg was already blue — pouring out lactic acid.”

Self was the person who received her sister’s autopsy from Lenox Hill Hospital. Her parents couldn’t bear to read it, so self did. It listed her sister’s cause of death as sepsis. Blood poisoning. 11 days earlier she had presented at Lenox Hill’s emergency room, complaining of a bad cough.

As Westaby writes, “most patients with viral myocarditis get over it.”

As most patients with streptococcal pneumonia, what self’s sister contracted, probably do.

Self can tell you she never, ever expected her sister to die that year. That it happened so close to Christmas made all subsequent Christmases into depressing occasions. In fact, a Christmas present her sister had mailed from New York arrived in California three days after she had passed.

11 days. That’s all it took to move a healthy young woman, a mother of three, to illness and then death. That was time enough, though, for self to fly to New York. Time enough for her parents to fly in from the Philippines.

In Westaby’s book, “the doctors scrubbed with haste. What was more important now? Survival or sterility?” He grabs a scalpel and runs the blade “straight through, hard onto the bone.” He runs “the saw up the sternum.” As Julie’s “heart was stopping, I kept moving . . . ” He gathers Julie’s “flickering little ventricles” into his fist and hand-pumps.

Stay tuned, dear blog readers. Stay tuned.

 

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