“If there are no dogs in heaven, then when I die, I want to go where they went.” – Will Rogers
Around eight years ago, Sheridan and I made an over-three-hour drive to far- southeastern Oklahoma, deep into the boondocks, to visit a Border Collie puppy to hopefully make part of our family. Sheridan had seen a picture of him, and in her heart, she instinctively knew he was going to be our next dog.
Some time beforehand, our beloved lab-mix, Inky, died peaceably in the backyard, and we felt the moment was right for our other dog, Karma, to have a canine companion. At the time, we believed Karma to be part Border Collie, and it seemed a good idea to find another of her breed with whom to play. When we did genetic testing on Karma some years later, much to our surprise, we discovered she didn’t have a trace of Border Collie. I chuckle as I think about it.
After no small amount of difficulty, we finally discovered the remote farm where the puppy lived. How cute he was!
In no time at all, Sheridan fell in love with him, but I wasn’t certain, and I told Sheridan we should take our time and think about it for a few days. Not to be deterred, Sheridan stood her ground, and I trusted her intuition. So, we loaded our soon-to-be-named Buddy in the car, and Sheridan sat in the back seat with him as we made the long journey home. He didn’t whimper or whine at all, for even as a little puppy, he knew his home was with us.
Thus, we began our lives with Buddy, and before too long, he entered his awkward-puppy phase, and I loved it when one ear stood up and the other drooped down. In spite of what you see here, Buddy was invariably cheerful, and his smile would light up wherever he happened to be.
As an adult dog, if any one word could be used to describe Buddy, it would be enthusiasm. In nearly everything he participated in, Buddy exhibited what the French called, joie de vivre, a cheerful enjoyment of life, an exultation of the spirit. It truly didn’t matter where that was, whether it be playing water sports with me by the pool, taking neighborhood walks with Karma, Sheridan and me, prancing as he awaited his share of Chicken Grillers or Chicken Jerky, simply going into the backyard, or chasing the most hated creature in his world, squirrels. I don’t believe Buddy ever caught one, but he loved trying and scaring the living daylights out of them. When Sheridan and I would sit to watch a show on TV, he would invariably sidle up to her to be petted. He had the most incredibly soft fur, and we jokingly referred to him as the “cashmere dog.”
Even when he slept, Buddy was entertaining. I’ve never seen a dog that could relax as fully as he could, lying on his back with his legs up. It was hard not to laugh when I saw him in his sleeping position, this time with his squeaky-pig toy, which he had tucked under his chin.
Buddy was an integral part of our family for over eight years, but one horrific morning we woke to find him unable to move his back legs. We rushed him to an emergency clinic in south Oklahoma City, only to discover he had a herniated disc in his lower back, compressing his spinal cord. Arrangements were made for us to take him to Stillwater, where he had emergency surgery that same day. Post-op, the veterinary surgeon said Buddy had an 80% chance of recovery.
The next six weeks can only be described as an agonizing, ongoing hell. Not only did he have persistent paralysis, he had fecal and urinary incontinence, and aside from sleeping, Sheridan devoted herself totally to Buddy’s care. She patiently helped him urinate by expressing his bladder, cleaned up mess after mess, gave him prescribed medications, and prepared his meals. My role was that of a gopher, scurrying around ordering box after box of absorbent pads, keeping up with the necessary baby wipes and gloves, and making sure we had adequate supplies of dog food and medications.
Of all of us, Buddy suffered the most. Beforehand, he always had excellent control of his bowels and bladder, and I’m certain it didn’t feel good to him to lose it. He was mostly limited to a dog cage to protect him, as he could easily motor away just by using his front two legs, dragging his bottom, putting him at risk for injury. No longer could he chase squirrels, play by the pool, have free range of the home, or just enjoy day-to-day activities. That said, his attitude was generally great, and he savored the pleasant moments, such as gnawing on the marrow bones we bought him.
With this particular problem, most dogs regain the ability to walk after two to three weeks, but unfortunately, Buddy didn’t demonstrate any improvement, even after six weeks. By this time, it was clear he was suffering. Even with assistance, he became unable to go up and down steps without pain, and there were moments when he seemed depressed and lethargic. As his caregivers and family, Sheridan and I felt we couldn’t wait any longer and made the agonizing decision to end his life. So, we summoned Dr. Angela Dwyer, a home vet with Lap of Love Veterinary Hospice, who compassionately put him to sleep in an oak-tree-shaded area in our front lawn.
Our suffering after the end of Buddy’s life has been nearly unbearable, and the tears have flowed seemingly nonstop. That being said, it appears clear, even in retrospect, that we made the right decision to let him go. As I think deeply, I am certain Buddy was a personification of pure, unadulterated love, and he passionately cared for his family with every ounce of his being. I’ll never get over his death, though I’ll try to find a way to keep going, knowing that because of him, my life was made richer, fuller, more joyful, and I’m a better person than I was before Buddy came into our lives.
There will never be another Buddy in the world, though I feel confident when my time comes to go across the Great Divide, he’ll be there, wagging his tail, barking his distinctive high-pitched bark, and beaming his beautiful, healing Buddy smile. I love you, Buddy, and always will.
By the way, if there happen to be any squirrels in heaven, they’d better keep their eyes peeled. After all, their most feared enemy is now in their midst.
Just today, this composition authored by me was published online in The Oklahoman. While I don’t expect all of you to agree, I felt it was important to express how I believed. A wide range of varying opinions were conveyed in the article, and I invite you to peruse it yourself. One of the great freedoms we have in our country is the ability to say how we feel, and I value all of your thoughts and feelings, no matter that they may differ from mine.
To date, what has Donald Trump accomplished? 1) Through his tariffs, he has created economic chaos and alienated our allies. Warren Buffett once said, ““Tariffs are actually . . . an act of war, to some degree,” and what used to be our friends have now become our enemies. Alliances are important in maintaining order in the world, and Trump’s tariff policies are isolating us and making us a pariah. 2) He has created a constitutional crisis, basically ignoring the order of the Supreme Court to expedite the release of Kilmar Abrego Garcia, mistakenly abducted and imprisoned in El Salvador. Whatever happened to due process? 3) He performed a mass pardoning of those convicted in the Trump-incited January 6, 2021 insurrection at the United States Capitol. Law and order? Who are you kidding? 4) What about the unconditional support for our Ukrainian friends who valiantly fight against Russian aggression? 5) He has appointed a cabinet of the biased, those willing to do whatever Trump desires, no matter the right or wrong of it. 6) He has threatened to make Canada a 51st state and to take over Greenland. Trump certainly knows how to make friends, doesn’t he? 7) He is attacking our universities, wishing to bend them to his will, whatever that might be. Here’s to Harvard for standing up to him. 8) He has dismantled USAID, which functioned to end global poverty and promote democratic societies. Why? 9) He has created a climate of fear for those who happen to disagree with him. Remember the old Buffalo Springfield song, “For What It’s Worth,” with the lyrics, “Step out of line, the men come and take you away.” 10) Trump wants to gut Medicaid, dramatically decreasing health care to those who need it the most. 11) He deported three children to Honduras who are US citizens, one a four-year-old with cancer who was sent away without medications. 12) While decreasing governmental waste is an admirable idea, Trump’s DOGE will not only cut away fat, but also muscle and bone. As has been suggested by various publications, in this situation a scalpel is more appropriate than a chainsaw.
I could go on and on, but I’ll stop here. I think you get the picture. Because of Trump’s blatantly fascist tendencies as well as all of the above, I am afraid for the future of our country. I suspect that many others feel the same way, given his 100-day approval rating is the lowest of any president over the past seventy years.His grade is no better than an F-.
Of all the numerous issues the elderly face, one of the most challenging and potentially life-altering is falling. When I practiced emergency medicine, I treated many with this very problem, and on occasion these events led to permanent disability or even death.
The causes of falls are too voluminous to list, but in general, they can be placed in three different categories: First, environmental hazards can be a culprit, such as throw rugs, uneven steps, or floor clutter. Second, age-related changes, typified by balance and vision issues or muscle weakness, can be implicated. Finally, falls can be caused as a side effect of certain medications, such as diuretics, sedatives and antidepressants. Add to this extensive list other issues such as anemia, which can cause low blood pressure, neurological concerns like diabetic neuropathy, multiple sclerosis, etc., and healthcare providers can have quite a diagnostic dilemma on their hands. Remember, the list doesn’t include syncope – passing out – a whole other ball of wax.
I personally encountered a number of family-member falls, as both of my parents experienced this problem a handful of times, which sadly enough, were a harbinger for their eventual deaths. In my emergency career, I had learned the occurrence of falling was mostly a concern of the elderly, as after all, Mom died at 84 and Dad at 92. Somehow, I never really pictured myself as what I actually was, an aging senior citizen.
Imagine my surprise, dismay, and astonishment when I recently took a fall. I was walking down the stairs from my home office, when I lost my balance and went flying down the remaining steps onto a wooden floor, landing with a thud on my hands and knees. Sheridan was nearby, but the fall happened too quickly for her to try and help.
A quick assessment revealed a bloody scrape on my right forearm, some aching pain in my knees and left hip, and so, bewildered and embarrassed, I quickly sprang to my feet. After all, I was too young for this sort of thing. Wasn’t I?
For me, in the aftermath, the first misconception to deal with was that this episode was the beginning of the end. In other words, because I was now falling – like my parents and a number of others I had seen as patients – the deterioration associated with old age was rapidly approaching and there was little I could do to prevent it.
In my mind’s eye, I saw myself over time become bedbound in a nursing home, arms and legs in restraints, complete with a feeding tube, foley catheter in my bladder, garbled speech, foul-smelling decubitus ulcers on my hips, and not recognizing anyone who braved seeing the shell of the man I used to be. In my confused state, I was certain I saw the Angel of Death in his prototypical long black robe, scythe in hand, hovering ominously at the bedside. As I miserably lay there, I somehow realized that this outcome was not what hospice and palliative care physician, Dr. Ira Byock, had in mind when he penned the classic text, “Dying Well.”
As you can see, an active imagination coupled with medical knowledge can be a powerful, double-edged sword.
Moving past my unpleasant fantasy and looking deeply at my fall, I believe there were two main issues. First, I have chronic numbness and weakness to my right leg, a problem which has puzzled my neurologist, and secondary to that, my balance is not good. Second, when I went down the stairs, I was not being mindful, and not only was I not focusing on safely getting down, I chose not to use the handrail for support. What was I thinking?
While this accident was a terrible mistake on several levels, I have learned from my experience, making such a fall in the future far less likely. As a matter of fact, I feel greatly blessed not to have sustained more severe injuries. As Oprah Winfrey so wisely said, “Mistakes are the stepping stones to wisdom,” and I couldn’t agree more.
In the meantime, I now view this episode as a gentle nudge from God to be more attentive, and I hope to minimize any further falling episodes. As opposed to my initial fear of being at the beginning of a death spiral, I plan to have a long, healthy life. With a little common sense mixed with a generous amount of mindfulness, I’ll do everything in my power not to potentially short circuit a rich, joyous, elderly existence.
In wintertime, my hands are oftentimes ice cold, but the problem seems to be at its worst when I prepare for bed. I am reminded of the old Indian fable, “The Scorpion and the Frog.”
∞ ∞ ∞
A frog was peacefully meditating alongside a gently-rippling, blue-green river, when she was approached by a large, menacing black scorpion. The scorpion said, “I need to cross the water, and I was hoping you would carry me to the other side on your back.”
The frightened frog edged backward and stammered, “But – you might – sting me – and I would – drown.”
The scorpion sighed. “Think about what you’ve just said. If I sting and kill you, I would also drown. Why would I do that?”
The frog pondered those words for a few moments and said, “You’re right; I understand now. Hop on my back, and I’ll carry you across the river.”
About halfway to the other shore, the frog felt a sharp sting in the middle of her back, and just before she submerged, she gasped out, “Why?”
The scorpion answered, “I couldn’t help myself. It’s my nature.”
Like the ancient fable, whatever the time of day, it’s my nature to have cold hands.
∞ ∞ ∞
Back to the problem at hand, after crawling under the covers, for years I decided the best solution was to put my bitterly-cold hands in my toasty-warm armpits. That said, the shock of what felt like jagged icicles imported from a winter storm in Antarctica was nearly unbearable, but after some time, my hands and armpits would warm up and all would be kosher again.
Recently, though, I began to wonder if I was approaching the problem in the wrong way. I realized that instead of focusing on the misery of the cold, I should have been thinking of how comforting my body heat was to my frigid hands. It was time for a shift of perspective, so from that point on, I directed my mind to just pay attention to the nurturing warmth.
In my way of thinking, the results of this simple experiment were quite remarkable. As the old saying goes, rather than seeing my cup as half empty, I now saw it as half full. I realized how happy I was to have the ability to warm my hands, putting aside and compartmentalizing the disagreeable sensation of the nearly-unbearable cold. Miraculously enough, the visualization worked far better than I could have imagined, and now, when I go the bed, my cold hands are barely noticeable as compared to the warmth which encompasses them.
While this is only a miniscule example, the implications of how we view challenging events in our lives and how we react to them can be powerful. While certainly not true all the time, dark, taxing situations nearly always have some kind of associated blessing, a proverbial silver lining, and in this case, pleasantly warm hands.
So, the obvious next question is: “If I have cold hands, does that mean I also have a warm heart?” Your guess is as good as mine, but one thing I’m certain of, and that is if I focus on the positivity of warmth – whether represented by joy, goodness, love, kindness, peace, etc., as opposed to the negativity of cold – such as sadness, suffering, despair, and so on – by necessity, the discomfort of the cold must fade, eventually losing its power over me.
What vitamin or mineral should I take to help with my brittle, soft nails?
Anne
Hi Anne,
While it’s not a vitamin or mineral, the best supplement for your nails is the essential fatty acid, gamma linolenic acid (GLA). Dietary sources are limited, but GLA can be found in a variety of plant seed oils, including borage (22-25% GLA), black current (15% GLA), and evening primrose (8-10% GLA). Spirulina, a type of blue-green algae rich in GLA, has been recommended by some, but unfortunately there exists the possibility of neurotoxins and/or contamination with heavy metals, and I don’t consider it safe under any circumstance.
Potential issues: 1) If you take antiplatelet or anticoagulant drugs, such as aspirin, Plavix, coumadin, or Eliquis, GLA supplements may increase the risk of bleeding. 2) Borage oil can contain amabiline, which is a pyrrolizidine alkaloid (PA) toxic to the liver. If you choose borage oil as a GLA source, find one that is PA free. 3) The side effects of GLA supplementation are generally mild and may include belching, upset stomach, nausea and diarrhea.
Besides helping with nails, GLA can promote healthy hair and skin. Because it has significant anti-inflammatory activity, GLA can potentially benefit arthritis, PMS, and autoimmune diseases. Like many natural remedies, don’t expect overnight improvement, rather, be patient and give supplementation a trial of at least six to eight weeks.
The medical/health information is provided for general educational and informational purposes only, and is not a substitute for personal, professional advice. Accordingly, before taking any recommendations based on the information here, please consult with your primary care provider and/or appropriate professionals.
What do you believe to be the most important mineral to incorporate into my supplement regimen?
Dawn
Hi Dawn,
First of all, I recommend a daily multivitamin/multimineral to fill in your dietary gaps. In this way, you are less likely to develop deficiencies of any one particular nutrient. While all minerals are important in maintaining wellness, magnesium is especially critical and unfortunately deficient in the diet of up to 50% of Americans.
So, why is magnesium such a big deal? According to the National Institute of Health, magnesium is important for many bodily processes, including regulating muscle and nerve function, blood sugar levels, and blood pressure, as well as synthesizing protein, bone, and DNA.
Realizing its significance, what are the best sources of dietary magnesium? While the list is voluminous, in general, nuts and seeds are excellent choices, as well as legumes, fish (especially salmon and halibut), avocados, whole grains, tofu, bananas, leafy green vegetables (particularly spinach), and raisins. In other words, there exist plenty of delicious, wholesome, magnesium-rich foods available in our American diet, but we oftentimes make dietary selections that are not the healthiest.
When I worked in emergency medicine, I precepted a number of family practice residents, and some of my favorite questions for them were about magnesium. After all, every good emergency physician worth his/her salt loved magnesium, as its therapeutic uses were many, including, but not limited to asthma, pre-eclampsia (a serious hypertensive disorder of pregnancy), migraines, and the the rare, but life-threatening cardiac dysrhythmia, torsades de pointes, first described by French physician François Dessertenne in 1966. What’s not to love about magnesium? Many a life has been saved by its emergent use.
With this in mind, I often quizzed the fledgling physicians with queries such as, “What conditions predispose your patients to hypomagnesemia?” Invariably, I was met with blank stares, and perhaps some futile, stammering attempts to answer. This lack of knowledge certainly wasn’t their fault, though, as sadly enough, medical students and residents are generally taught very little about nutrition. It’s safe to say that the ideas presented in the classic text by Dr. Henry Bieler, “Food is Your Best Medicine,” was not part of their medical repertoire.
“First of all,” I would explain with a knowing look, “if your patients are on diuretics, they will have a tendency to have elevated urinary excretion of magnesium, and thus secondary deficiency. Second, any condition that causes chronic diarrhea, such as Crohn’s disease or ulcerative colitis, can cause stool losses of magnesium. Chronic alcoholics can have hypomagnesemia simply due to poor nutrition. Certain drugs and pancreatitis can also be causative, and finally, diabetics are notoriously deficient in magnesium and other trace minerals because spilling sugar in their urine osmotically depletes them .” I would invariably smile when I answered, as I greatly enjoyed teaching young training doctors, knowing someday the information I gave them might make a difference.
Okay, let’s suppose you have a risk factor for hypomagnesemia, or perhaps your diet is not as nutritious as it should be, and you want to begin a magnesium supplement. If not included in your multivitamin/multimineral, which one should you select? A number of different options are available. Remember that whatever form of magnesium you choose, the possibility exists of a laxative effect, and if such occurs, consider taking a small dose of calcium to counteract it. My preferred magnesium supplement is magnesium glycinate, usually well absorbed and well tolerated, with a close second being magnesium citrate. I would avoid magnesium oxide, one of the most popular varieties, as well as magnesium sulfate (Epsom salts) because of their poor bioavailability and increased likelihood for GI side effects such as diarrhea.
Finally, remember the wise words of Benjamin Franklin: “An ounce of prevention is worth a pound of cure.” The benefits of taking supplemental magnesium far outweigh the risks, and I believe in this situation we should all follow Ben’s advice.
The medical/health information is provided for general educational and informational purposes only, and is not a substitute for personal, professional advice. Accordingly, before taking any recommendations based on the information here, please consult with your primary care provider and/or appropriate professionals.
I have chronic pain in some of my joints, which my doctor says is due to osteoarthritis. I’ve been taking ibuprofen with some improvement, but I’ve been wondering if you could recommend any other remedies? I appreciate any help you might be able to give.
Hillary
Hi Hillary,
Osteoarthritis is the degeneration of joint cartilage and underlying bone, usually from middle age upward. Prior overuse and/or injury can be precipitating factors. The most common treatment utilizes nonsteroidal anti-inflammatory drugs (NSAIDS), which work by inhibiting production of prostaglandins, thus reducing inflammation and pain. Taking such medications, which include aspirin, ibuprofen, naproxen, among others, is generally considered to be safe if taken episodically, but chronic dosing, especially in older patients, has the potential for serious side-effects, including life-threatening gastrointestinal bleeding from peptic ulcer disease, acute renal failure, and a litany of other problems. A general rule of thumb is that NSAIDS should be used at the lowest effective dose for the shortest period of time.
So, what should you do after taking a limited course of NSAIDS? Do you have to give up and accept suffering? Consider joint replacement surgery? Not to worry, other options are available. One excellent choice is turmeric. This bright-yellow spice from India often used in curries has been shown to have significant anti-inflammatory activity, and in an Italian study, demonstrated greatly decreased osteoarthritis pain as well as reduced need for NSAIDS. I recommend culinary use and/or supplements fortified with the active ingredient of turmeric, curcumin, to get the maximal effect. Another anti-inflammatory spice worth considering is ginger, taken either as a supplement or included in your diet. Also, think about adding evening primrose oil (EPO) to your regimen, which has beneficial anti-inflammatory activity. Other supplements to ponder include glucosamine sulfate, with or without chondroitin sulfate, realizing it can take up to two months to see results, and SAMe, which seems to be as effective as NSAIDS, but requires about a month of treatment before you might notice improvement.
Of course, it goes without saying that if you are overweight, weight loss can substantially improve osteoarthritis pain. Exercise can be beneficial, though if your symptoms are worse in your lower extremities, I would consider swimming, water aerobics, or stationary cycling to minimize further joint trauma. As a footnote, acupuncture has shown promise in the treatment of osteoarthritis. In one trial, one-fourth of arthritis patients who had been scheduled for knee surgery cancelled their operations because of improvement with acupuncture, and now some rheumatologists recommend acupuncture as an adjunctive therapy along with conventional medication.
Since information exists that suggests osteoarthritis is likely an inflammatory process, please consider a diet that is anti-inflammatory, rich in omega-3 fatty acids (wild-caught salmon, walnuts, freshly ground flaxseed, algal oil, etc.), along with plenty of different colored fresh fruits and vegetables. Likewise, you should avoid foods which are proinflammatory in nature, such as partially hydrogenated oils (margarine and vegetable shortening), and polyunsaturated vegetable oils.
In closing, I can personally attest to the benefit of an integrative approach to osteoarthritis. If you have read Oklahoma Is Where I Live, you know that some decades ago, I was told that due to osteoarthritis, I would need bilateral hip replacements. I resisted the notion and found that by simply doing Iyengar yoga, my symptoms were much improved. Years later, when my hips started once again with that gnawing, aching discomfort, sometimes waking me up at night, in addition to yoga I added a regimen that included fortified turmeric, EPO, and algal oil, along with my usual anti-inflammatory diet. This resulted in remarkable improvement, and while someday I may have to consider hip replacement, currently my symptoms are much improved, and for that, I am most grateful.
The medical/health information is provided for general educational and informational purposes only, and is not a substitute for personal, professional advice. Accordingly, before taking any recommendations based on the information here, please consult with your primary care provider and/or appropriate professionals.
Many of my family are troubled by seasonal allergies, with sneezing, runny nose, cough, and nasal congestion, which seems to be worse in spring and fall. While antihistamines seem to help, I don’t like the side effects associated with them. Can you recommend any natural alternatives? Thanks!
Connie
Hi Connie,
Given the fact that your symptoms are exacerbated in spring and fall, chances are good that they’re due to mold sensitivity, though other allergens could be involved. As one who has been troubled by the annoying aspects of allergic rhinitis in the past, I am very sympathetic to the misery you and your family are experiencing, and I would like to offer some simple solutions, ones I hope will provide some benefit.
Besides antihistamines, other conventional options such as steroid and cromolyn sodium nasal sprays, as well as decongestants, can give symptomatic relief. For a more natural approach, though, I would consider freeze-dried nettle, a herb with known antihistaminic effects, 300 mg capsules, one-two every four hours as needed. Children under twelve should not take more than one capsule a day. Also, try quercetin, a flavonoid that inhibits the release of histamine from mast cells, 400 mg/daily, starting a least two weeks before allergy season. Nasal douching with saline to open the sinus cavities can provide symptomatic relief, and I recommend HEPA air filters in the main living areas and bedroom to remove the offending allergens. Try to decrease or eliminate milk and dairy products, which can irritate the immune system and may contribute to the intensity of symptoms. On a personal note, stopping milk resulted in a profound decrease in the frequency and severity of allergic rhinitis after only a few months. One can consider allergy injections, but remember they don’t work for everyone and may take years to become effective.
In conclusion, please remember the concept of biochemical individuality, the main precept being that everyone responds to healing modalities in their own unique way. What is a godsend for some may offer no benefit whatsoever to others, and vice versa. Experiment with some of the ideas I have given and discover what works best for you, conventional or non-conventional. I am confident if you look hard enough, the symptoms of allergic rhinitis can, at the least, be satisfactorily controlled, or hopefully, even eliminated.
The medical/health information is provided for general educational and informational purposes only, and is not a substitute for personal, professional advice. Accordingly, before taking any recommendations based on the information here, please consult with your primary care provider and/or appropriate professionals.
Sometime back in the mid-1980s, I was attending a metaphysical workshop, an activity I enjoyed at that point in my life. While I don’t recall what the topic of the conference was, I do remember meeting Ann Smith. How could I not? She was friendly, exuberant, optimistic, and a sparkling bundle of spiritual energy. I liked her immediately, and we struck up a friendship.
Sharing an occasional lunch, I gradually learned more about her. She was deeply interested in the spiritual kingdom, believing that each angel and saint were there to guide humankind in their own unique way. Generally, Ann loved anything and everything that involved the occult, and that included auras, psychics, astrology, crystals, tarot cards, and continued connections with friends who had passed on before her. And talk about someone who loved good food! One of Ann’s great passions was fabulous eateries, and to describe her as a ardent and enthusiastic foodie would be a gross understatement. Will Rogers might have said, “Ann never met a restaurant she didn’t like.”
Looking back to the early 90s, when I realized my marriage was in trouble, I clearly recall the phone call I made to Ann. I was emotionally barely hanging on, and when she answered the phone, I haltingly mumbled, “Ann . . .” before I burst into uncontrollable tears. Trying to regain my composure, I said, “I’m so sorry . . .” before I began weeping again. She softly replied, “Keep crying,” and I did, until I had no more tears left. Ann knew tears were healing, and she allowed me to cry for as long as I needed. I would have never guessed how many years it would take me to heal from my divorce, but Ann was with me every step of the way, and for that, I will always be grateful.
I could go on and on about what a wonderful friend she was, but instead I’d like to share just a few highlights. Ann was delighted beyond words when I met and eventually married Sheridan, believing that the suffering I experienced with my divorce all those years ago was necessary not only for my spiritual growth, but also to give me the opportunity for a loving, new beginning. When I began writing books in 2008, starting with The Lhasa Trilogy, she was an enthusiastic supporter, and all of her friends simply had to have copies of each of my books. I could have not had a better promoter than the exuberant, energetic, bubbly Ann Smith. She was also known as “Auntie Ann” to our dogs, Karma and Buddy, and she lavished attention and care on them when Sheridan and I traveled to faraway places.
When Ann was diagnosed with colon cancer at eighty-four years of age, I knew her prognosis was poor, yet she maintained an upbeat attitude. She had experienced a full and rich life, and she was not afraid of dying. With time, our restaurant visits declined, a sure sign Ann was not doing well, and she eventually entered hospice care.
Before she died, Sheridan and I paid her a visit. I was surprised at how much weight she had lost. She was pale, her blood pressure was extremely low, yet she continued to be at peace with her approaching death. The three of us held each other’s hands, and after we expressed our love for each other, I asked her what she thought was the most important thing she had learned over her eighty-five years. She paused for a moment, smiled and said with a twinkle in her eyes, “Know when to say no.” Ann was a strong woman, always willing to speak her mind, not a shrinking violet by any stretch of the imagination, and I’ll remember her dying words for the rest of my life. Ann peaceably passed away two days later.
It’s impossible to describe in words what a loss Ann Smith’s death is not only to me personally, but also to the world. Her radiant, effervescent optimism was completely infectious, and without fail, she made the darkest times better. For me, I have lost a dear friend, a counselor, a lunch buddy, and someone I could always count on, no matter the circumstances. While I feel a profound sense of loss, I don’t feel sad, rather, I’m happy God has blessed me to have known Ann for over thirty-five years, and I feel joyous knowing that her journey will continue in the spiritual realms, her true and everlasting home. After all, hanging around with angels, saints and sages of all religions, her beloved passed friends, combined with a gourmet meal every now and then, well, that’s Ann’s idea of heaven. I can think of no one who deserves it more, and I have no doubt God has already prepared a lavish table for her.
The world will miss you greatly, Ann. You are a shining, scintillating beacon of light. I know, because I know you.
Today, March 26th, 2023, is the one year anniversary of my last shift in the emergency department (ED), after having worked there for over forty-three years. As I look at this picture, I see faces of not only gifted healthcare providers, but also of dear friends, some with whom I labored for decades. While the photo gives me some sense of nostalgia, even more so, I’m happy to have moved on to a calmer, more peaceful existence. I have no desire to turn back the clock. It’s high time to enjoy the fruits of my labor, and I am grateful to God that I still have good health and the opportunity to enjoy my life. It seems impossible that I am seventy-years-old. Where has the time gone?
Thinking back, I recall when I first walked through the doors of the ED. Nothing in my training could have prepared me for the chaos and seeming insanity I would come to face. Yet, mixed with these sometimes overwhelming challenges were many beautiful, transformative, and yes, spiritual moments, ones I will never forget. All emergency medicine personnel are regularly faced with such wild swings, frighteningly-steep ups and downs, yet much like the yin and yang of Taoism, one can’t occur without the other.
It seems a good time to express a word of thanks to my beloved colleague and friend, Dr. Mary Puntenney, my parent’s internist in days past, who later became an emergency physician. Because of her recommendation, I landed at the hospital where she worked, a place I would stay for my entire career. I am also appreciative of Dr. J. D. McKean, who as the physician director, was willing to offer me a position. Deserving special mention is Dr. John Clemons, an emergency physician and my racquetball buddy, a man deeply loved by his fellow healthcare providers and patients alike. He died at far too early an age from complications of Parkinson’s Disease, and I will always miss his contagious smile and upbeat personality.
I will forever be grateful to all of the experienced nursing staff in my early years who helped show me the ropes. Nurses are the true backbone of medicine, and the whole system would collapse like a house of cards without them. Thanks to each and every one of you, from early in my career to years later. Because of you, I was able to complete my life’s work.
Before I close, I have a few thoughts I’d like to share. One thing I am most proud of is the fact that no one in my ED was ever turned away because of inability to pay. In my opinion, healthcare is a right, not an earned privilege, and I’m happy to report that while in the ED, the medical safety net for the poorest of the poor remained intact.
The devastation that those in medicine faced in dealing with Covid-19 cannot be overstated, and I well recall the period of time before immunizations were available. Our lives were placed at risk simply by performing out duties, and the heroism of those who provided healthcare in spite of this danger stands out to me as the ultimate in courage and bravery, which has never been surpassed during my career. I applaud all of those – and there were many – who put the wellbeing of others before their own, sometimes at great cost.
In my book, The Pit, I have described at length my thoughts as I approached retirement, and I feel no need to repeat them here. I will conclude by saying while emergency medicine has presented challenges to me on many different levels, if I had my life to live over, I would do it again in a heartbeat. I may have scars from all those years in the ED, but I am wiser and better for it.
Gary D. Conrad
