Well, it’s about more than that, but it starts in junior high.
The photograph is of the “Ninth Grade Honor Society” at Rincon Valley Junior High in…oh, I don’t know… probably the Fall of 1971. The guy in the front with the attitude…the one I want to smack upside his head…that’s me. The one in the back who looks maybe a little miffed? That’s Cathy.
She wasn’t mad at me…at least I don’t think she was… but I wouldn’t blame her if she was. I was not strong on humility.
Those of you who know us know our views on religion differ slightly. My faith in faith has been…well…unfaithful. If you pull up “Belief-O-Matic” and answer their 20-question quiz (you should try it; it’s fun), I hover somewhere between a “Born Again Pagan” and a “Devout Agnostic
This is sometimes frustrating to Cathy who, though equally skeptical of organized religion, is open to spirituality. Not “Capital-S Spirituality” like crystal healing, numerology and astral projection, but “Lower Case-s” spirituality. Cathy believes, like Einstein, that there is an order in our universe that transcends random coincidence. An order, we humans, stuck in the junior high phase of our evolutionary development, are as yet incapable of understanding.
Not me.
The one exception to my conviction that there is no “Big-G-God, no “Little-g-gods”, and no sign of a grand design in the Golden Ratio or the Fibonacci Sequence, is the occasional allowance I make for the possibility that, if there is a God, he’s pissed at me.
And rightly so.
I harken back to the Greeks who saw their gods as thin-skinned deities who easily took offence at human hubris. You know…like…I don’t know…say…self-important adolescents who somehow manage to find their way to the front of the photo, but then cop an attitude like they’re pained to be there.
I wish I could go back in time and talk to that arrogant kid. If I could, I’d tell him that God has a long memory and a wicked sense of humor. He likes good irony. Good word play. Poetic justice. Better to dial back the ‘tude, dude. Hang out in the back row with Cathy, lest the big guy send you a little late-in-life-pharma-karma.
How to put this?
The trouble with running around like you’ve got a stick up your ass is that God…well…he might just fit you for a stick just to show a “Stuck-Up” kid what “Stuck Up” really means.
Young Rob? Listen to old Rob. He knows.
He knows that old age is a series of carefully tailored indignities designed to teach the slow to learn self-important that they’re not at all important and to maybe, just maybe, think about someone other than themselves.
In the past four months, I’ve had a catheter pushed up and pulled out of my poor Mr. Happy more times than I can count. I’ve had two cystoscopies where my Santa Rosa urologist ran a scope up the aforesaid…and now just more sad…Mr. Happy. One colonoscopy where my Petaluma gastro-team, not to be outdone, ran a scope in from the California side hoping to meet my Santa Rosa uro-team at Promontory Summit. And one fun cross-it-off-your-bucket-list experience called a prostate artery embolization where, having run out of the usual orifices…orrifi?… my Oakland interventional radiologist ran a pee shooter up my right femoral artery and blasted the capillaries feeding my tennis ball sized prostate with enough microspheric buck shot to bring down a good size mallard.
I get it God. It’s not hard to pick up your “Stick-it-Up-Your [fill in the blank]” theme.
“One more,” you say.
“That’s really not necessary,” I say. “I’ve learned my lesson.”
“No,” you say. “I’m not sure you have.”
“Well,” I say. “I’d love to accommodate you, but I think we’ve run out of portals to stick stuff in to drive home your point.”
“For a head-case like you, Rob,” you say tapping my head. “We’ll make a new one.”
“Really,” I say. “It’s not…”
“Right about here,” you say, thumping harder on the top of my head. “Should sink in if we can just get behind that thick skull I fitted you with when you were born.”
When Cathy and I eloped to Northern Ireland, we went for a hike along a stream in the Tollymore Forest west of Newcastle. It was a magical walk with ancient yew trees, and arched 18th century stone footbridges spanning the fast-moving water flowing from the Mourne Mountains to the Irish Sea.
We stopped for a picnic and, being the hopeless romantic that I am, I thought it would be…as the Irish put it… “brilliant” …to set up my nifty iPhone tripod and take a photo from behind while we gazed at Foley’s Bridge in the distance.
Nice metaphor, don’t you think. Two days before our wedding. The river. The passage of time. I even thought of a caption, “Watching Time Go By.”
I know what you’re thinking. It’s okay. You can say it.
Cheesy.
All of it.
The menu? The photo? The caption? All cheesy. We’re talking smelly level cheesy. Roquefort, maybe Limburger.
Spontaneity? Hell, it took me 20 minutes to set the shot up, walking back and forth trying to catch us without obscuring the bridge.
“Just a sec, Cath; I’ve almost got it. Could you scooch just a little to your left?”
Finally, after exhausting Cathy’s patience, I plopped down beside her and activated the countdown on the remote-control shutter release on my iWatch.
5…4…3…2…1…CHEESE!
“Nice framing” I said to Cathy after retrieving my phone. “Look, I even captured the dandelions in the foreground.” She rolled her eyes.
We’re talking Gorgonzola level cheesiness.
I wonder if the Greeks had a god of cheese. Let’s look it up.
Yep. Apparently a buff fella named Aristeaus. Says here that he was the son of Apollo and Cyrene and that he was in charge of cheesemaking, beekeeping, sheep herding and olive oil production.
Diversified, yes, but otherwise we don’t know much about him. Not a lot of press. Quiet guy. Kept to himself.
Now the Catholics…they knew how to fill in a back story. This is Santa Lucio, Patron Saint of Cheesemakers.
So the story goes, ol’ Lucio was stabbed by the farmer he worked for because he pilfered too much provolone to give to the poor.
Stabbed to death? For that?
Seem’s a bit harsh, don’t you think? How about a reprimand? A note in his personnel file? Maybe dock his paycheck a few liras for every wheel of Parmigiano-Reggiano he gave away gratis.
Poor guy is probably running around heaven with a charcutier board pissed that his reward was to spend eternity looking out for cheesemakers and pointing out to the other gods and goddesses that the prosciutto wrapped melon and mozzarella is “particularly good this year.” Not exactly a corner office for a patron saint.
Here’s how I see it.
Either Olive Oil Ari or Lucky Ten Fingers Lucio, maybe both, didn’t care for my bit of unlicensed cheesemaking and decided to have a bit of feta fun. Not a lightning bolt. Nothing flashy. Just the ol’ post-it note prank.
A pink post-it note.
I didn’t see it at first. It wasn’t until the flight home, as Cathy slept beside me and I was looking through our photos that I noticed it.
Uhh, Rob…see the bridge?
Yeah.
See Cathy?
Yeah.
You?
Yeah?
YOU!!
Yeah, so wha…?
Good god, Jackson.
You’re getting a bald spot.
Ditch the L.L. Bean and throw on a smock and you’re a dead ringer for a fat friar at one of the nearby abbeys.
When the hell did that happen? Why wasn’t I told? You mean to tell me I’ve been walking around like this, probably for years, and no one said a word?
Talk about a cover-up.
My own wife? My stylist. The one who cuts my hair. The one who teases me to hold still while she takes scissors to my unruly eyebrows.
She’s known. For years, she’s known. Yet all this time she’s never said a thing about the Friar-Tuck-look growing…I mean not growing…on the back of my head.
How about a little “heads up” honey? A hint? Maybe, a passing comment? (“You might want to wear a hat.”) An innocent question? (Was your dad bald?) You didn’t have to be harsh like “You’re going bald old man.” You could have been subtle and said, “You might want to use a little sunscreen up there.”
Up where?
There!
Awkward self portrait with hand above the head.
I only mention this because the good folks at Kaiser have declined my fitting for an ultrasound colander and propose instead to bore a hole in my head roughly where my bald spot is.
Lucky Lucio and Oily Ari were way out in front, paving the way, marking just the right spot for a cranial skylight. One of those tubular models to let a little light in a dark place.
I’m all for enlightenment, but…
You know the expression, “I need that like I need a hole in my head?”
Well, apparently, I do.
I mean the hole.
In my head.
I need one.
Let me backtrack.
After the off-med ordeal…you remember that? My night of living hell…Dr. Nandipati told us she would make a presentation to a high fallutin Kaiser committee in Redwood City to get the green light on the colander treatment. This is no small committee. We’re talking a whole lot of brainiacs who know their brain shit. Brain surgeons. Movement disorder neurologists. Neuropsychiatrists. Physical, occupational and speech therapists. Engineers.
Engineers?
The plan was to show them videos of me scribbling, shaking and wobbling. My psych test results. My history. My meds. My CT and MRI’s. She told us she would give it her best shot, but the decision was not hers to make. It was the committee’s and, as soon as she knew, she would write.
Sure enough, that afternoon I opened my email to find a letter from her.
Hi Rob, We had a helpful review of your case today…it turns out…
“Helpful”, huh?
That doesn’t sound good.
I’m no Belgian, but I know a waffle when I see one.
Brace for impact, Berto.
“Turns out” that for a variety of reasons…good reasons, caring reasons, persuasive reasons…the brain folks at Kaiser (and the colander gurus at both Kaiser and UCSF) think deep brain stimulation is a better option for me. After consulting with Cathy and the fam, I’ve decided to give it a try.
Hell, why not. We’ve been to Kaiser Santa Rosa, Kaiser Petaluma, Kaiser San Rafael, Kaiser Walnut Creek, and Kaiser Oakland. Why not Redwood City?
Forget the ultrasound colander; fire up the Makita.
We know the spot. Those jokesters Oily Ari and Lucky Lucio were just clearing the way.
Sometime this summer, we’re going in.
Be good for the place… let’s let in some light and spruce up the place.
Three Blind Mice? Three Little Pigs? The Three Musketeers? The Three Stooges? Peter, Paul & Mary? Crosby, Stills and Nash? (Okay, Neil Young might have something to say about that one; you’re right.) The Bee Gees (that is, before Andy)?
Threesomes? Never appealed to me, but I’ll admit you’ve got your good ones…
Your bad ones…
And your…hard to explain…ones
Scientists will tell you the belief that things come in threes is something called apophenia. That’s our human tendency to perceive meaningful patterns in random events as a means to cope with fear and uncertainty.
I don’t know about that. I’m pretty certain there’s something to it.
Take this trio
No, that’s not Three Dog Night. But good guess.
These fun boys are Jean Martin Charcot, Pierre Marie, and Howard Henry Tooth. Two Frogs and a Brit. Back in 1886 they lent their names to a genetic disease that was all the rage. They called it Charcot-Marie-Tooth or CMT.
Catchy? No. Imaginative? No. Descriptive? No.
CMT has nothing to do with your teeth. “CMT” is a nervous system disorder in which some lucky contestants, gradually over time, lose feeling, first in their feet, then their ankles and then their calves. It’s genetic, gradually gets worse and there are no drugs to treat it.
You can spot CMT club members by their club feet. Look for high arches and “hammer toes.” Here’s a good example.
“We’re not a gang; we’re a club.”
See the arches? The balls of the feet. The heels. We’re talking precious little surface area to serve as the foundation for an overweight high-rise. This, combined with decreasing sensation, rules out the cha-cha and makes staying upright a tad dicey.
Now normally you would think a loss of sensation might come in handy. (Footsy?). But it turns out that’s bad. Pain is apparently your friend. Your body’s way of signaling “Don’t bend your ankle that way, bozo.” If you don’t have pain signaling boundaries, you hurt yourself without knowing it. Not good.
So, there’s that. I’ve got that little co-morbidity going for me.
What other nervous system malfunction have you got for our contestant, God? I’m guessing there’s another acronym up that celestial sleeve, or we wouldn’t be talking threesomes.
“Just to keep this poor wretched nonbeliever miserable, we’ve thrown in a bonus nervous system torment. Some call it WED (Willis-Ekbom); some call it RLS (Restless Leg Syndrome) For this clown, we thought sleep deprivation might be just the ticket, so we’ve added an old favorite, PLMD or Periodic Leg Movement Disorder.”
Not familiar? Here’s the skinny.
Every day, starting typically around 4:00 in the afternoon, one or both of my legs jerk. It’s not painful. It’s not the “creepy/crawly” sensation often associated with RLS. It’s not a muscle spasm. Not a cramp. (Although those are often in the mix.)
How to describe it?
You remember those bathtub motorboats we made in Cub Scouts. The ones propelled with a rubber band.
It’s like someone has turned my motorboat paddle end-over-end, tightening the nerves in my legs, tighter and tighter until they can’t twist further. When the tension is too much, they jerk. It looks and feels like a reflex. You know the one where they hit you with the little triangular hammer and your lower leg kicks. This “build and burst/burst and build” loop happens every 15 to 30 seconds. You can almost set your watch to it.
Sometimes it’s minor. Sometimes it is explosive. If I am standing on the affected leg when it’s bad, I will collapse to the floor.
The insidious thing about my PLMD friend is …it knows.
I mean…she…knows.
She knows when I’m tired. She knows when I need a nap. She knows when I climb into bed at night. At the very moment I can’t keep my eyes open, she says,
“NOT SO FAST, JACKSON. GET UP AND WALK.”
Only two things can stop her. Standing up and walking.
Or drugs.
“That’s easy,” you say. “Take the friggin drugs, Rob.”
I do. Believe you me, I’m no hero. I always say, “Better living through chemistry!”
So…what’s the problem?
[Whispering] She turns on you.
“Who turns on you, Rob?”
“The PLMD drug.”
The go-to drug used for PLMD is Requip. It’s what’s known as a dopaminergic drug. Works dandy for a while, but with prolonged use, something called “augmentation” occurs.
Augmentation is bad.
The drug actually begins to make things worse. The symptoms start earlier in the day and grow more severe. The more pills you take, the worse the PLMD gets. And…just for laughs… the worse the PD tremors get.
Okay, you say, what’s the big whoop? Deploy the chutes. All engines stop. Bring her about, captain. Stop the damn drug and find another one.
I would, but…
But what, Rob?
“[Whispering]…She knows.”
“Who knows, Rob?”
“The drug knows”
“Knows what Rob?”
“You’re trying to leave her.”
Requip is like Glenn Close prepping the bunny burn. She knows when you’re trying to dump her.
Doctors say going off Requip…cold turkey…is worse than withdrawal from heroin. We’re talking sleeplessness, sweating, nausea, intense abdominal pain. And the leg thrashing and Parkinson’s tremors go into overdrive. Sometimes doctors resort to Methadone, oxycodone, tramadol or clonazepam or some really heavy opiates to get you through it.
The trick is to taper. Slowly cut back. Slip out the back Jack before Glenn Close knows you’re making new plans, Stan.
Back in the day, I took as much as 4 mg of Requip a day. Now I’m down to 1.5. Next step 1.0, then a half, and then I’m free.
“Free at last, free at last, thank God Almighty I’m free at last.”
Well…not quite.
You remember the three pebbles?
The tests you must pass before you get the green light for Focused Ultrasound or Deep Brain Stimulation?
Right?
The first was the Psyche Test.
Check.
The second is what the neuros blithely call “an off-med examination.” Basically, the docs want you to come in having not taken your meds so they can size you up with and without your meds. Normally, this would mean a night without my Parky med, Sinemet. Big deal, so I have tremors all night. No fun, but no biggie.
But… a night without Requip?
Gulp.
Which brings me kicking and screaming to February 23, 2026. The Night of the Living Dead. The Night They Put Ol’ Robbo Down. The longest twelve hours of my life.
Quick side note before I continue. I’ve not experienced childbirth. I’ve seen two of them up-close-and-personal and could barely deliver the ice chips without feinting. So, I hear many of you mothers out there saying, “Welcome to the Big Leagues, Berto.”
I get it. Fair point. I admit it: Put me down for a whining wuss. I don’t blame you moms if you’re not moved by my story. I suspect my night from hell was child’s play (pardon the expression) compared to what you have endured.
But…
But…
Can I just say…
IT WAS AWFUL!!!
From 7:30 p.m to 7:30 a.m. I stood, then walked a few paces, then stood, then walked. Clutching the edge of the countertop, doubled over in gut pain hovering somewhere between food poisoning and the bends.
Think…one of those inflatable tube men you see at auto dealerships, but without the smile. That was me.
Legs jerking. Hands trembling. Trying desperately to remember Lamaze class and the shallow breathing technique I was taught to model.
Time stood still. Accent on the “stood.” Not so much on the “still.”
I think I watched every minute…all 720 of them… pass on my phone. 11:25…11:26…11:27. Every passing minute was a godsend. Every pending minute agony.
There’s a reason sleep deprivation is a violation of the Geneva Convention. It’s torture. Amnesty International, the United Nations, they all say forcing a person to go with less than 6 hours of continuous sleep for more than three days is a human rights violation.
Hell, I average 4.5 hours on a good night. The night from hell was zip. Nada. The big goose egg.
Poor Cathy awoke at 7:00 to find a shell of a man cowering in the corner of the family room. Like when Scout saw Boo Radley behind the door at the end of To Kill a Mockingbird.
Hey Boo.
Add to that the final 40-minute ride from Petaluma to Terra Linda, during which there was no way to stand-up, no way to walk it off, no way to stop the torture, and …well…
Let me put it this way.
I’ve been tired and hurting before. I’ve completed four solo double-century bike rides…that’s 200 miles, 17 hours in the saddle, 5:00 a.m. to 10:00 pm. I have a pretty high threshold for fatigue and agony.
At least I used to.
Now?
I just don’t know.
I’m tired. I’m seeing things, not in double, but in triple. And I can’t close my eyes to rest.
Want some whiskey in your water?
Sugar in your tea?
What's all these crazy questions they're asking me?
This is the craziest party there could ever be
Don't turn on the lights 'cause I don't want to see.
Mama told me not to come,
Mama told me not to come,
That ain't the way to have fun, No.
Your California Class B and C Driver’s License exams, both written and behind the wheel of my folks’ 67 Plymouth Fury Station Wagon and an old UC Davis Unitrans bus.
Your FAA Airman Knowledge Exam.
I know. Don’t ask. It was a short-lived dream. My pilot aspirations never got off the ground.
What else?
The trifecta of scholastic aptitude tests: your PSAT, SAT, and LSAT. I’m guessing 35 undergrad and 20 law school final exams. The Professional Responsibility Exam to prove to the State Bar I was ethical, and the mother of them all, the 3-day California Bar Exam.
Passed them all.
Well, except one.
I’m pretty sure I failed a Medieval History exam where the professor…a short arrogant nitwit who spoke with a fake English accent and looked like Sebastian Cabot … strode into the lecture hall, scribbled “The Plague?” on the chalkboard and walked out. My mistake was misreading his tell. I took from the length of the question and the manner in which he delivered it that he was looking for brevity in the answer.
I was apparently mistaken in this assumption.
My dad used to tell the story, now legendary in the Jackson clan, of the time, while at Purdue University, he didn’t know the answer to a test question. Out of time and looking for a laugh, he wrote, “…God only knows.” He got the laugh. When he got the test back, the professor had written, “God gets an “A” Mr. Jackson…you get an “F.”
You had to know my dad. He took great pride in that grade.
Looking back, I’m convinced that I passed all of these tests, not through dint of preparation nor command of the material, but because of good ol’ fashioned dumb luck and a good-luck ritual I invoked each time I sat down.
You see, I would bring to each exam a roll of Wintergreen Lifesavers and place it on the desk in front of me. When the proctor said “Begin”, I would slowly, methodically unwrap my Lifesavers, pop one into my mouth, savor it, look around, and only then take pen to paper. Worked every time.
Fast forward fifty years.
Before a Kaiser Parkinson’s patient can undergo deep brain stimulation or focused ultrasound, he must pass three tests. Kinda like snatching pebbles from the hand of a Shaolin Master.
Pebble No. 1…a psychiatric exam.
Pebble No. 2…a neurological exam after a night without your medication, and
Pebble No. 3…a CT scan of your noggin to make sure your skull isn’t too thick.
Sounds easy enough.
Off to Walnut Creek we go. We find the place. Cathy sits in for the preliminaries and confirms, as we rehearsed, that I’m a happy guy and that she feels safe at home. The shrink asks her to step out. She gives me a kiss on the forehead and a wink of encouragement.
I’m on my own.
The Questionnaire and Interview
First up? A routine questionnaire. Uh huh…uh huh. I get it. Save your breath doc, I know a good CYA when I see it. I’ve covered more legal asses than this place has bedpans. I get the picture.
Basically, you won’t fit me for my Colander or a Brain Pacemaker if I don’t have a proper “cognitive baseline.”
Seems a bit oxymoronic to me, don’t you think. A Catch-22 actually. I mean…how can you be of the right mind when no one in his right mind would let some stranger take a Makita to his head or shoot moonbeams into his cranium with some ray gun?
Oh, well. Where do I sign?.
Three hours later I’m done. Three weeks later I search through my online Kaiser records and there it is.
My report card.
Hmph…so there is a chart on me. I knew it.
Confidential? Nah, screw it. My readers are my friends.
Qualified? What the hell! Who’s better qualified than I. Me? I’m pretty sure it’s “I.”
Let’s look…
Current medical conditions?… “Too long to list.”
Current medications?… “Even longer.”
Chief complaint?… “How much time you got?”
Behavioral observations?…
”Patient arrived on time”…(I’ve always said, ‘Better to be at the courthouse early than run into the courtroom late and piss off the judge.” Good advice to you youngsters.)
“Hygiene appeared good and appropriately dressed”… (I brushed my teeth, shaved and used some deodorant)
“Mood euthymic and affect congruent”…(Uh oh; what the hell does that mean?)
“Speech in casual conversation was
“fluent”…I should hope so
“prosodic”…that doesn’t sound good
“without paraphasic errors”…better look that one up
“Thought processes linear and goal directed.” (That’s good, right? It sounds good; don’t you think?”)
Gulp.
On to the exam questions. I remember these.
No. 1:
The Digit Span Test
“So, you want me to repeat a list of numbers. First forward. Then backward. We’ll start with three numbers, then four, then five. Up to twelve numbers.”
1-7-3
5-8-2-6
7-2-8-9-3
4-1-7-9-3-8-6
5-8-1-9-2-6-4-7
2-7-5-8-6-2-5-8-4
5-8-2-4-7-9-1-3-2-2
9-9-1-5-8-4-1-3-5-7-9-2
Score?
Nailed it. Perfect score. Off the chart. Strong working memory.
This stuff is easy.
No. 2
The Trail Making Test
Hmmm…visual attention?
I’m listening.
“You want me to draw lines between randomly arranged numbers and letters. Start at 1, then find A, then to 2, then find B, then to 3 then find C. And you’re going to time me?”
GO!
Score?
Below average?
What?
BELOW AVERAGE.
So, I had to backtrack and erase a couple of times. Big deal. I’ll give myself a C–. Nothing wrong with a “C”, Rob.
No. 3
Naming
“You’re going to give me 31 color photographs and you want me to tell you what’s in each picture?”
Okay, sounds right in my wheelhouse. I’m good with language.
GO!
Score?
Average.
Average?
Yes, average. As in 69th percentile?
BUT THAT WASN’T A RADISH. A RADISH IS ROUND AND RED.
No. 4
Reasoning
Complete the pattern.
Uhhhh…what pattern?
No. 5
Orientation
Match the lines to the numbered lines below?
3 and 10? No.…5 and 7? Put me down for a 4 and 8…no 9…no 8.
No. 6
Complex Figure Copy
You’re going to show me a picture. I’m to study it. And then draw it from memory. Then draw it again 3 minutes later. And again, 30 minutes later.
Okay…let’s take a look.
Ohhhh boy,
Let’s see. A spaceship with a man driving it. There’s a railroad track. No, maybe those are stitches. That’s a kite. A flag…A couple of crosses.
Times up?
Sheeez.
Immediate recall? 90th percentile. Excellent.
Three minutes later? I dropped to 69%?
Thirty minutes later? Uh…42%.
Good thing they didn’t ask me after an hour.
No. 7
Similarities
Okay, last one. Need to finish strong Rob.
“You’re going to give me two words and I’m to tell you in what way they are alike?”
Okay?
GO.
APPLE & BANANA?
Easy.
Fruit.
SHIRT & HAT
Uhh…they both end in a “t”
No?
I’m just having fun with you doc,
Things you wear.
PIANO & DRUM?
Percussion instruments
SALT & WATER?
My first thought is prerequisites for pasta,
But I’m gonna go with chemical compounds.
LIGHT & SOUND?
Uhh…
That’s a tough one
Both have 5 letters?
EXIT & ENTRY?
Trick question; they’re opposites.
FREEDOM & TRUTH?
Illusions in current society?
REALITY & DREAM?
Uhh…
THEOLOGY & EUCLIDIAN GEOMETRY?
Constructs to explain a universe which,
in the final analysis,
is unfathomable.
Too much?
SOMETHING & NOTHING?
Hmmm…got me on that one, doc.
I got nothing.
Conclusion?
Let’s see…gulp.
“The patient’s premorbid abilities were probably within the superior range.”
That’s good, isn’t it, Cath? Sounds good. Don’t you think?
I mean, I don’t like the morbid part. If there was a “pre” morbid, there must be a morbid and I must be in it now. Never thought of myself as morbid.
That’s depressing.
And…?
“There’s more?”
“The patient’s recall was at best low average and memory, while not impaired, was “lower than expected in someone who is quite bright.”
Hmmm.
So, I’m forgetful.
I suppose that’s true. I mean, I do remember ” The Plague question.” Sebastian Cabot. And I remember my bus driver test. And ground school. Lift, drag, thrust…Bernoulli’s principle.
So, I do remember some stuff.
But I suppose you’re right. I am forgetful.
After all, I forgot my Wintergreen LifeSavers.
God knows… the premorbid Rob would never have forgotten his lifesavers.
When my kids were in grade school, whether at a school talent show, the Cub Scout Pinewood Derby, or a PTA meeting, a group of people …usually the same group of people…stayed after most had left to put away the folding chairs.
You know who I’m talking about.
Yes, you do.
You were one of them; weren’t you?
I knew it.
I call these folks “The Folding-Chair People.”
It’s a term of respect.
It’s my shorthand for those who, usually without being asked, step forward to take on a job all should share but most decline.
They don’t do so for any reason other than it’s just “…what you do.” If I had to guess, their parents used phrases like “For Goodness Sakes” or “Thank Goodness.” Or…hmmm…there’s another phrase…you know…we used to say it all the time…damn it…it’s right on the tip of my tongue…
Oh well, it will come to me.
Anyway, see these folks?
These are “Folding-Chair People.”
I took this screenshot last Wednesday when, by the miracle of Zoom and at their very kind but foolish invitation, I was given a chance to tell them a little about this goofy writing project you are now misguided enough to be reading. I thought I might use it as a means to remember names and faces.
These folks (together with many not on screen) run the Parkinson’s Support Group of Sonoma County.
Their mission is a simple one. Find ways to help Parkies, and those who care for Parkies, to just get through a day. They put on presentations by neurologists like Dr. Nandipati. They foster support groups. They educate folks dealing with Parkinson’s, often alone, on resources available to them. Many of them, I hazard to guess, most of them, have a friend, an uncle, an old workmate or spouse with the damn stuff. Some have lost love-ones to it.
As often happens with the “Folding-Chair People”, they’re content to continue to fold the chairs. But they could use a hand. Some have been folding for a long time.
I ain’t asking. They’re not asking. Folding-Chair People usually don’t.
You young folks? Thanks, but save it. You tend to your busy lives. Making a living. Pinewood Derbies, Talent Shows. PTA kerfuffles. There’s little enough time to do that.
But if you’re an old fart, maybe on the leeward side of retirement, maybe know someone wrestling with Parkinson’s, and have been looking for an opportunity to fold chairs like you used to, write them and see if there might be a way to help. You can reach them at
Those of you who know me know I have …well, let’s be honest…a big head.
Some of you are nodding. Some with your hands up. That’s okay. I have it coming. My head is big.
In several ways.
First, there is my inflated ego.
This dates back to elementary school. It was the Spring Parent Pageant of 1962 and our first-grade teacher Mrs. Durling decided our class contribution would be a May Pole.
Kinda like this one but…class size being a perennial problem…with more like 25 kids.
The pole consisted of what must have been an eight-foot-long dowel on top of which was nailed a tin pie plate. Crepe paper streamers, attached to the pie plate, stretched out to each member of the class who, pacing themselves carefully so as not to trip over the student in front of them, walked in a circle to some …I don’t know…jaunty, “Spring-like” melody. Probably “Teddy Bears’ Picnic”
Unfortunately, the May Pole had a structural flaw which went undetected in Mrs. Durling’s careful construction of the prototype. If the pie plate did not spin on the nail attached to the top of the pole, the crepe paper streamers would begin to wrap around the pole as my classmates…still focused on the heels of the kid in front of them…continued to circle.
Centrifugal force, being what it is, the kids out at the end of the streamers would either have to pay attention, slow and adjust…this was just too much to ask… or the class would gradually be drawn closer and closer to the pole as their crepe paper leashes grew shorter and shorter. This happened repeatedly in rehearsals, prompting Mrs. Durling to throw up her hands in despair and cast about for an answer.
The solution was obvious.
She needed Chuck Yaeger. A steely eyed test pilot to hold the pole.
The kid holding the pole must have “situational awareness.” He or she must have the wherewithal, uncommon in the First Grade, and especially uncommon in front of a crowd, to look up, monitor the status of the pie tin and crepe paper, and if the design flaw manifested itself, adjust, improvise, rotate his body at just the right speed, so as not to send the pole, the pageant and Mrs. Durling into a tailspin.
To this day, I remember the head-inflating exhilaration of the moment when, after another failed rehearsal, I saw Mrs. Durling’s eyes first squint in consternation and concentration, then widen as the solution dawned on her and then…scanning the class searching for the kid capable of such a tall order…her gaze settled with a look of relief…
On me.
“Rob? You think you could do this?”
“Yes ma’am… [taking the pole]…I got this.”
Thus, was born an inflated ego.
But ego is not the only measure of my big head. Anatomically, I have a big head.
In this day and age of adjustable ball caps, we’ve lost the need of hat sizing. But when a fitted hat is required, it is good to remember that a small hat size is 6 ¾ to 6 7/8 A medium is 7 to 7 1/8. Large is 7 ¼ to 7 3/8. And extra-large is 7 ½ to 7 5/8.
Put me down for an XL. Something in the Lord Big Helmet size.
Let’s see…Ego? Check. Circumference? Check. How about thickness? The general consensus among those who have studied me, in the wild and in captivity, is that I have a thick skull. This seems to be based on deductive conclusions drawn from observed behavior rather than actual measurement.
Which begs the question…where are you going with this Herr Big Brain?
Well…hopefully…here.
What I call “The Colander Treatment.”
If you want to cut down on the shakes and the good ol’ yabba dabba medicine isn’t dabba-doing the trick anymore, you have two options. The first is called Deep Brain Stimulation or DBS.
DBS is brain surgery. The docs shave your head, bore a hole in your skull the size of a dime, insert wires that travel from deep in your brain to a “pacemaker” installed beneath the skin in your chest. These devices can later be “tuned” to KFRC, probably Dr. Donald D. Rose, and programmed over time to maximize the benefits. This requires follow up visits to change the batteries and fine tune the gizmo. And the surgery runs the risk of a nasty thing called brain bleeds. And…oh yeah… it can further screw up your balance.
Another alternative is called Focused Ultrasound. Here’s how the folks at UCSF describe it.
“During this outpatient procedure, high-intensity sound waves, guided by MRI, are focused on [a tiny spot]. These sound waves pass painlessly and safely through skin, bone and brain to reach their target. Much as a magnifying glass can focus sunlight to burn a hole in paper, the focused ultrasound generates enough heat to burn cells in [the spot] without harming surrounding tissue. Recovery time is short, and the treatment can significantly reduce tremor, improving the ability to perform daily activities, such as eating, drinking and writing. “
It’s an outpatient procedure. And I do mean OUT patient. You’re awake during the whole thing. You actually help by responding to “tasks.” My grandsons Jackson and Finn love tasks. A task might be something like “Count how many letter “Ts” you can see from where we are sitting in the bleachers here in the Rincon Valley Little League Park” or “Turn around, look at that family in the pizza parlor; study everything about them; now turn back toward me and tell me…what color eyes does the dad have?”
Check this out…this is one of the tasks I’m told you are given while in the machine:
I call it the Spirograph Test.
“With your right hand, Rob; I want you to draw as smooth a line as you can inside the channel from the center to the outside. Now draw a straight horizontal line…keep it smooth and straight…from left to right. Now do the same thing again with your left hand.”
Kids, try this experiment at home.
Here’s what happens when I do it now…
So I am told…so I hope…once shaved, strapped into the water cooled colander and clamped onto the sliding table, I will be given this “task” and my line will…by the miracle of modern medical magic…be as smooth as a baby’s butt. And when it’s over, I will sit up and walk away.
It has its pros and cons.
You must get your head shaved, just as with DBS…I think I’ll go for the Yul Brenner rather than the Telly Savalas…but they don’t have to drill a hole in your head. It’s not as precise as DBS. It is a “one-and-done” procedure and doesn’t always work. You can’t adjust later and tune into KFRC, but you also don’t have to pack a transistor radio around in your chest. There is the chance for side effects (apparently the most common being a “softened” voice which, curiously, Cathy seems to think is an acceptable risk). And, if I do it, we can rule out the remote possibility of joining in a stem cell trial in San Diego.
One thing is certain. It might not work and it sure as hell is not a cure.
It will not stop the progression of my Parkys. It won’t bring back my sense of smell, restore my balance, correct my swallowing problem, stop all the autonomic shit that is gradually shutting down and making other parts of my life like peeing and pooping, emptying my stomach and my bladder difficult. It won’t make my icy cold and dead-to-the-touch ankles and feet feel warm again. It won’t stop this fucking Restless Legs Syndrome which every night, just when I might hope to find some comfort in sleep, kicks in…I mean KICKS in… and permits more rest for me standing up and walking than lying down and sleeping.
There’s a boatload of tests I’ve had to pass to qualify. An MRI of my head. A psych evaluation by a shrink in Walnut Creek. An off-med night from hell. (More about those to come).
But I should know soon if I’m a candidate and there might be a chance…I’m not getting my hopes up…okay, I am getting my hopes up…that maybe, just maybe the hand tremors will ease. And maybe, just maybe, I might play some golf without embarrassing myself entirely or make some sawdust without hurting myself terminally.
Look at this picture. That’s Kentucky Street in downtown Petaluma. See a parking space?
I don’t either.
I generally subscribe to the “expect the worst…and it will be worse, much…much worse” outlook on life. It’s a step beyond the ol’ “…expect the worst and be pleasantly surprised” … nonsense which, if you think about it, is just chicken shit equivocation.
If you want to hedge your bets, I can’t stop you. The world is full of Ara Parseghians. (Ara was the Notre Dame football coach who, in the 1966 national championship game between his No. 1 Fighting Irish and No. 2 Michigan State’s Spartans, on his own 31-yard-line with 1:30 left, chose to run out the clock to preserve the “tie” rather than risk a turnover going for the win.)
Man up Ara.
Commit. Be a pessimist and expect the fumble. Or be an optimist and march for the field goal. But either way, own it. Embrace it. Screw the tie, march down the field, and go for it.
Me? I expect the worst. It’s safer. None of that pesky disappointment.
Now, Cathy. She take’s optimism to a Jedi Knight level. She believes in manifestation.
I look at the parking on Kentucky Street and think “Skip the bookstore; I’ll order on Amazon.” Cathy says, “We’re damn well going to Copperfields and after I buy a Santa Barbara Magazine I’m ordering guacamole and a Diet Pepsi at Mi Pueblo El Centro.” Then she closes her eyes, visualizes white reverse lights and, like Moses parting the Red Sea, a parking space appears. She is the Uri Geller of auto transmissions. Doesn’t matter if it’s manual, on the column, on the floor, or automatic. She can shift your car from park into reverse with just her mind from 31 yards away.
Which brings me to last Friday and this headline:
Apparently, the good folks at Sumitomo Pharma in Osaka have been given the green light from Japan’s health ministry for the manufacture and sale of Amchepry, a stem cell treatment for Parkies. It rolls out this summer. Here’s the skinny:
Back in 2012, this man shared the Nobel Prize for Medicine.
His name is Shinya Yamanaka. He is a sixty-three-year-old research doctor and professor who currently is the Director Emeritus of something called the Center for IPS Research and Application (aka CIRA) at Kyoto University, and a Senior Investigator at Gladstone Institutes.
Yamanaka pioneered the science of “induced pluripotent stem cells”, now referred to as IPS cells. Here is one now…
Stem cells are cells in the embryo which haven’t yet been given an assignment on what to do. They might grow up to be brain cells, lung cells, heart cells. They’re like a kid on the sideline of a pick-up basketball game waiting to be chosen, not sure if he will be a shirt or a skin.
In your cellular world, this is what you call “pluri-potential.”
IPS cells are not taken from the embryo with all the messy ethical cloning issues that entails. They are grown-up, already assigned cells, usually skin or blood, that have been reverse engineered into an unassigned player. These little guys don’t have to be skin or blood cells but can grow up to be whatever they…maybe I should say Shinya and his team…want them to be. Hence the name, “pluripotent.”
Ka-Plu-eee Potential, baby! Think cloning without all the messy ethical issues.
So, the Sumitomo folks get together with Shinya and say, “Hey, it just so happens that there’s 10 million folks in the world where the dopamine producing cells in their brains have died. They could use some new ones. Let’s use IPS cells to grow up to be dopamine producers.
Voila…Amchepry Cell Therapy. We take assigned blood or skin cells, convert them into dopaminergic neuron progenitor cells, surgically implant them into the striatum in the basal ganglia deep in the brain, and hope the little suckers will grow.
And…god willing and the creek don’t rise…it seems to work.
That’s Japan. What about here?
Well, it turns out the same treatment is now undergoing a Phase 1 / 2 Trial at U.C. San Diego by Professor Joseph Ciacci. Seven lucky contestants will participate. It is expected to be completed in 2028.
I know. I called them. Very nice people.
And they’re interested. I fit the age bracket. My Parkys’ became symptomatic over five years ago. My restless leg and Charcot Marie Tooth co-morbidities don’t preclude me, and the application period is open throughout this year. Plenty of time for me to ponder my options.
That’s the good news.
The bad news is that…well…you’re a lawyer Rob. What’s the “Consent Form” say?
Hmmm, to start off: a lot of screening assessments. An “off med” day. (I’ve been through one of those; worst night of my life.) Pulmonary function testing. No problem; I have the heart and lungs of Secretariat. Pysch testing. Been through that. Marginal grades, but I passed. Gotta keep a symptoms diary. Histories, blood tests (127 to 136 teaspoons), blood collection for storage for future testing, urine tests, EKG’s, head and chest CT’s, head MRIs, MRI and angiogram of the arteries. And that’s just to see if you qualify.
Then there’s the “baseline period” when they repeat all of that, plus a PET scan.
And then if you are selected, you start on an immunosuppressant to stop your body from rejecting your cells, which you continue to take for 15 months;
And then, on the big day, more blood tests, an MRI and CT, then they shave your head, then drill (I think it’s a Makita) two 3.5cm holes in each side of your skull, and then inject 7 million stem cells in your brain on each side;
And then you spend three delightful days at the Jacobs Medical Center at La Jolla…fat, dumb and bald.
But wait, there’s more…
Follow up visits at weeks 1, 4, 8, 12 and 16 , followed by more visits at 6, 8, 10, 12, 16, 18, 20, 22 and 24 months. And lab work done between each of those visits. During which time the immunosuppressant will make you susceptible to every damn bug in Sonoma and San Diego Counties and the ones commuting with you on the airline rides there and back.
And…then? Then?
Well…it may not work.
In Japan the seven subjects enjoyed a 20% improvement on test scores when measured off medication and 36% improvement when measured during on periods.
Interesting thought problem, isn’t it?
Would you go through all that for an uncertain result? Would you up and move, rent a place in San Diego for two to three years, a large part of which will be in a doctor’s office, some of which in very unpleasant circumstances, and miss a lot of grandchildren birthdays and Little League games if there was only a 50% chance it might work and, if it does work, only reduce, without eliminating, all of the symptoms?
Or would you say, “Thanks but no thanks” and seven years from now, watching your granddaughter blowing the twelve candles out on her birthday cake, regret that you declined to participate in trials of a treatment then deemed a cure, approved by the FDA, but available only to gazillionaires who can afford it?
Whenever I leave for class, Cathy likes to tease me about my wardrobe. It’s good natured of course.
“Really?” she asks, sizing me up.
“You don’t understand,” I say. “I need to look the part if I’m going to ‘Part the Wild Horse’s Mane’ or ‘Grasp the Bird’s Tail.’”
She rolls her eyes and, giving me a big hug and pat on the back says, “Eye of the tiger, babe. Eye of the tiger.”
***
When I was first diagnosed with Parky’s, my neurologist, a movement disorder specialist, suggested that I work out as much as possible. Yeah, my Peloton was good for cardio and, yeah, my weights were good for strength, but what I really needed was to work on my movement.
Movement? Okaaaaay…like?
Like, say, boxing.
I know. I had the same reaction.
“As tempting as it is doc, I’m not sure punching people is the answer. “
There was a good reason for my reluctance.
You see, the last time I boxed was in the 10th grade when Cue Ball Carr…the wrestling coach who bore a striking resemblance to Mr. Clean (without the earring) …gave me a poor grade because I opted to dance away from, rather than go toe-to-pugilistic-toe with Bruce Wallace, a guy who lettered in wrestling and had biceps bigger than my thighs. I figured with my cross country conditioning I might outlast Bruce and score a surprise late round TKO when he collapsed in exhaustion trying to chase me down around the wrestling mat. Cue Ball was having none of that, and demanded I mix it up.
It didn’t go well.
Rock Steady Boxing is a nationwide organization created to help folks “fight back” against Parkinson’s. The local chapter operates out of this dojo on Petaluma Blvd.
The idea behind the program is that, if we can teach folks to land a punch on a speed bag, much like Bruce landed on me, we can build the kind of balance and focused movement that we Parkies need if we are to offset what’s coming. It won’t cure the damn affliction but, studies show, it slows it down.
It’s a wonderful program run by dedicated instructors who give of their time so Parkies, some barely able to stand or lift their arms, many brought by caregivers who watch from the wings, can gamely duke it out with the infuriatingly indifferent inevitability of Parky degeneration.
The pugilists and their coaches are remarkable people. They are truly inspiring.
So? I know what you want to ask…
“What’s it like, Rob?”
I don’t know. I haven’t tried it.
Why not?
It’s not something I’m proud to admit but, if I am honest, I’m scared.
Why?
Well, I suppose it’s just too real a glimpse of my future. Not tomorrow, not the day after, the month after or the year after, but it’s coming. The future is coming for me like a Bruce Wallace I can’t dance away from and will not likely summon the courage to confront.
The future scares me.
***
“WARDROBE!”
“Wdya think, Cath? This one or that one?
Blue or the beige?
Too much?
“Yeah, probably.
“What about study materials? You know my motto, “Why actually do something when you can put it off by reading about it?”
“Too much?“
“Yeah, probably.“
***
I started tai chi about a year ago. We meet in the the back room of the dojo where the lighting is dim, the HVAC can be a tad light on the H, and where a poster of Chuck Norris in his pre Walker-Texas-Ranger days greets you as you enter.
The class size ranges from three to…oh, I don’t know…maybe four. We are a clandestine wing of Rock Steady. There is Peter and Jo and Eddie, the veterans who pioneered the class and have kindly taken me under their wing.
The fella on the left is our teacher, Bob Klein.
Bob is a kind, patient and soft spoken instructor…the opposite of Cue Ball Carr… who has studied tai chi for over thirty years.
Peter, Jo and Eddie have become my friends. We are learning what is known as the Yang style long form. It is a series of 102 movements. Each movement is precisely choreographed. Some invoke images like “White Crain Spreads Its Wings” or “Tiger Returns to Mountain” or “High Pat on Horse” or “Step Back and Repulse the Monkey.”‘
I’ve been away for a few weeks while battling old age shit other than Parky’s…what the docs affectionately refer to by the pleasant name “co-morbidities”…, but when last I was in class, I was studying Form No. 61.
***
“Cath? Have you seen my earbuds?”
When I practice in the back yard, I listen to the soundtracks to The Karate Kid …you know, the haunting pipe music when Danial-San peers down the beach and sees Mr. Myagi standing on one foot atop an old pier… or to The Last Samurai, when Tom Cruise walks through the cherry blossoms contemplating the meaning of life before he goes off and kicks ass.
I’m not very good. I don’t bend my knees enough, my kicks are short lived and spastic, and when a movement calls for one or the other foot to land softly on the mat, mine tend to land with a loud thunk.
Bob says I need to work on my thunks. Thunks are apparently not what we’re after in Tai Chi.
Quick word of advice to aspiring students following in my thunks…Before you can study Tai chi movements, you must first learn to stand and then how to walk. Neither is easy.
Here is a cheat sheet for how to stand. See what I mean?
And here is a cheat sheet for how to walk.
I could spend an hour a day for the next six months and not master the Tai Chi walk. It requires weighting and unweighting of your feet, balance, and fluid motion, all of which is damn near impossible on my size seven and a half super arched hammertoed neuropathy ridden feet with weight bearing surface areas of maybe four square inches per foot.
Care to try it? Check out this website. It’ll give you some idea.
“Hey Cathy, did you see this piece in the New York Times last week? They should have interviewed me.”
“You know…’off the record.’ Maybe… ‘on background.’ I could have been one of those ‘inside sources’ you always read about who are ‘…granted immunity to talk freely for fear of retaliation.'”
“Apparently ‘proprioception’ is the ‘sense of where you are in space.'”
Pro…pree…oh? Prop…I…Oh… Hell, I can’t pronounce it, but I gotta get me some of that.
My prioception is prehistoric. It sure isn’t pro level. It’s not even amateur level. I’m Daniel-san before Mr. Myagi teaches him to wax-on, wax-off, sand-the-floor, or paint-the-fence.
I don’t know where the hell I am and this damn Parky’s is my own personal “Show-no-mercy-Cobra Kai Johnny.” I can’t get my feet under me because the asshole in the black pajamas keeps sweeping my legs. I need Mr. Myagi to do that thing where he claps his hands together, rubs them vigorously like he was starting a fire, and lays his hot hands on me.
That’s what I need.
***
My favorite part of tai chi classes is when Coach Bob begins and ends with the “gōngshǒu lǐ.” That means “cupped hand greeting.” It is a salute, of sorts.
Here is a Powerpoint slide I made. (I know…it’s a compulsion; at last count my Tai Chi PP presentation now has 95 pages and is growing.) On the right is a description of how to do the salute. On the left, what the salute means.
The salute is the sun and the moon. The Ying and the Yang. It says, “Yes, I will fight when I must, but I choose respect and control, modesty and humility, refinement and nobility.”
I like that.
Bruce Lee knew tai chi. He encouraged folks struggling with adversity to…
“Be like water.”
Empty your mind of fear and rigidity. Keep moving. Be formless. Be shapeless. Adapt as water does to the container. Yield, shift your weight, balance. Find, as water does, its own level.
When you can’t seem to find yourself, when fear bears down like a dark sleeper wave, and all seems too much to bear, remember Bruce…Lee, not Wallace…and the fear litany from one of my favorite books, Frank Herbert’s Dune…
I will face my fear. I will permit it to pass over me and through me. And when it has gone past, I will turn the inner eye to see its path. Where the fear has gone there will be nothing. Only I will remain.”
“When you’re experiencing a low…when the medication isn’t working, Rob…what does it feel like?” Dr. Nandipati asked.
“That’s a tough one doc. It’s hard to describe.”
“Try.”
“Well…it’s like …it’s like…Electric Football.”
I could tell from the sympathetic smile on her face that my description as apt and, dare I say…poetic… as it was, required a working knowledge of boyhood in the 1960’s. Apparently…I’m not sure why…that was not included in the 21st century pre-med curriculum at Cornell or post-med residency at Mt. Sinai.
Ivy League, schmivy league.
I blame Mrs. Hogan.
Not for my neurologist’s poor education on baby boomer boys…as troubling at that was…but for a tendency when, struggling to get these damn words to work , to rely on all those things in 8th grade English the other kids hated and sensibly forgot.
You know…similes, metaphors, analogies, symbolism, alliteration and the elusive onomatopoeia.
Mrs. Hogan was a no-nonsense 8th grade English teacher at Rincon Valley Junior High. (“Home of the Mighty Falcons”). Here she is. The gal with her right hand on her shoulder giving me the stank eye.
I got that a lot.
The young lady in the center of the photograph some of you will recognize as a reader of this blog.
Quick Sherman. Into the way back machine. Set the destination to October of 1969. First period. Let’s make it a Monday.”
Rob: “Okay, Mrs. H, I think I got this. A simile can be a metaphor but a metaphor need not be a simile. Right?”
Mrs. H: “That’s right.”
Rob: [scribbling notes]”And a simile always starts with a ‘like’ or ‘as’.” Right?”
Mrs. H: “Not always.”
Rob: “Like?”
Mrs. H: “Yes”
Rob: “No, like when?
Mrs. H “Like when, what?”
Rob: “Like when does a simile not start with “like” or “as.”
Mrs. H: “It might start with a ‘than’.”
Rob: [erasing his notes] “So…’like’…’as’… or… ‘than.”
Mrs. H: “No, not ‘so.'”
Rob: [More erasing] “Not ‘so’, got it.”
Mrs. H: “When King Lear said, ‘sharper than a serpent’s tooth’, that’s a simile, even though there is no “as” or “like.”
Rob: “Or ‘so.'”
Mrs. H: “Forget ‘so’, Rob.'”
Rob: “Riiiight…so…I mean…when he wrote As You Like It, Shakespeare was using a double simile.”
Mrs. H: “No.”
Rob: ” A single simile?”
Mrs. H: “No.”
Rob: “But it is a metaphor.”
Mrs. H: “No.”
Rob: “Riiiight [tearing up notes]…I got it.”
That’s when I would usually get the stank eye.
Where was I?
Oh yeah…Electric Football.
Let me explain.
Electric Football was a game when I was a kid. It would seem primitive by today’s standards. What you did was carefully place a bunch of tiny toy football players in formation on a thin green metal sheet resembling a football field.
When you threw the switch, the metal sheet would vibrate. The players would then bounce around on the metal field, not so much a coordinated football play as a communal epileptic seizure, skittering in every direction but seldom toward the goal line.
On my “Electric Football” days, I have to sit in place, wrap my arms around my shoulders, and try as best I can to ride it out until my brain turns the electricity off, the field no longer bounces, the players stop, and I can regroup .
I go deep.
It doesn’t hurt. I’m not in pain. It usually happens in the evening. Sometimes it passes; sometimes it doesn’t. Those are long nights.
Cathy knows. It’s frustrating for her. She wants to help. To get me something. A cup of tea? She sits nearby. Patient.
I know what you’re thinking.
Yeah, yeah, yeah Rob. Cry me a river. There are fellas out there dealing with real pain, chronic pain who would give their left nut to dial back their daylong misery to my internal nocturnal frenzy. Folks in the throws of chemo therapy, folks with MS, or ALS who would say, “That’s all you got, Jackson? That’s it?”
“Hold my beer.”
And there are folks in later stage Parky’s who would say, “You just wait, Berto.”
I know.
I get it.
When Electric Football nights come, I try to remind myself. Jackson, you live in the land of the fortunate. In a time better than any before. In the best state. In the best county in that state. The best weather in the world. No mosquitoes. No humidity. Cool nights and warm days. Hell, you can walk down the street and have anything you want to eat. At what time in history was that ever possible?
You’ve got Cathy. You’ve got John and Linda and Sue. Craig, Patti, Bob and Mimi.
You’ve got Kate and Matt, Sam and Hil, Nick and Gabby and eight squirrels: Jack, Finn, Avery, Grady, Olly, Rhyse, Bowie and Cole. You’ve got Lisa and Stella. You’ve got the best friends a fella might have in Mark, Ian and Bow. A book club with fellas you’ve known for twenty years.
And you’ve got your words. Words with which to play. Words with which to torment your doctors. Words with which to amuse yourself and maybe others. What more could a man want?
Ever wonder why we use the expression, “The good doctor…?”
You know, in the movies, whenever someone refers to a doctor, they often will insert the adjective, “good.” Like Sherlock Holmes, when referring to Watson, might say “…the good doctor is correct in his observation, if flawed in his reasoning…”
Shakespeare used it in MacBeth. End of Act V Scene 1, when the woman and the physician spot Lady MacBeth walking in her sleep in her jammies screaming, “Out, damn’d spot, out” and the woman says to the doc “Good night, good doctor.”
Maybe, that’s it?
Maybe it’s just a linguistic tic dating back to a time when everybody was ticking off honorifics like Pez from a Pez container. You know… “Good day, good sir.” Or “Me good wife doest love me, doth she not?”
We in the legal biz would call that question “compound.” Think about it. It’s two questions wrapped in one. Does the witness answer “yes she doth” or “no she doth not?” Or “yes, she doth not” or “no, she doth?”
Aye, that is the question.
Hmm, funny thing. I don’t exactly remember the Bard handing out token “goods” when we legal beagles were discussed. Those Elizabethans might say, “Good King Wenceslas:” or “the good Robin of Loxley” But I don’t remember anyone ever referring to an attorney as, “the good lawyer Jackson…” Sure as hell wasn’t Shakespeare! He said, “first thing we do is kill all the lawyers.”
Not that I’m bitter.
I know what you are thinking. “Where…pray tell…or is it forsooth? … are you going with this, Rob?”
That my friend is a fair question. Let me tell you.
Should you ever have the misfortune to become a Parky, I wish you the good fortune to have a doctor like Dr. Sirisha Nandipati as your neurologist.
I could tell you about her high fallutin credentials, Cornell undergrad. Her two years studying and treating Alzheimer’s at Mt. Sinai before she became a doctor, her med school and residency at Mt. Sinai, her fellowship in movement disorders at U.C. San Diego. Her membership in the American Academy of Neurology and the International Parkinson and Movement Disorder Society (No body parties like the boys and girls in the Movement Disorder Society.).
I could point you to her presentation to the Parkinson’s Support Group of Sonoma County. (Well, maybe they do?)
This was a gig she volunteered for and for which she was not paid.
I could point to a lot of those certificate-on-the-wall and cheesy acrylic trophy type accomplishments. But, not to get too legalistic, those things don’t do her justice.
Seems to me that good doctors too often take the rap for a healthcare system that is…what’s the word I’m looking for?…bad. They are given patient quotas to see each day and then blamed that they don’t seem to spend time with us. They must answer to insurance or government bozo bean counters who would dictate the needs of their patients. They must see patients all day whose lousy habits and unhealthy lifestyle cause their condition, but then blame a doctor who might have the temerity to suggest maybe they might want to stop smoking or drinking or eating themselves to a fast-food death. They can seem short on judgment and long on diagnostic tests as a substitute, not to aid in a diagnosis, but to delay or avoid the very exercise of judgment we seek.
They don’t seem to listen.
They don’t seem to care.
Me? I’m a physician-full-employment-act into…or is it onto?… myself. I keep my GP Dr. Sangster, my urologist Dr. Bellinger, my gastroenterologist Dr. Spears, my interventional radiologist Dr. Kim, my neurological pharmaceutical specialist Dr. Ray… all of them… busy night and day. And to a one, they are everything you might hope for in a doctor.
Dr. Nandipati? She is special. I knew the first time Cathy and I met her.
I came armed with cutting edge questions regarding a recent study just published in the world-wide-web. (“Let’s see how she handles my fast ball.”)
There’s the wind up. There’s the pitch.
Gulp.
Cutting edge?
You know those guys at Beni Ha Ha who slice and dice vegetables in mid-air before they even land on the sizzler? I think it was when she opened with…”That’s not quite right Mr. Jackson…I was involved in that study and …” that it occurred to me I might have been wise to keep my grilling to my own hibachi.
“Yes, well…that’s what I thought too. Good to see the good doctor agrees with me, isn’t it honey?”
I felt like the DA in My Cousin Vinny after he was foolish enough to test Marisa Tomei on the timing of a 1955 Bel Air Chevrolet with a 327 engine and a four-barrel carb.
“We’ll stipulate she’s an expert, your honor.”
I am a lucky man.
I have a wonderful wife who I know, no matter how compound your question might be and how foolish her husband will always be, loves me. The question need never have been asked.
And I have a good doctor. Not just because she knows her stuff, but because she listens, cares and, despite all the pressures which must come with our health care system, never lets those show and always shows me nothing but kindness.
For that good fortune, this old lawyer is eternally grateful.
Can't Hold Still 