Archive for Essays

A plea to tolerate the screw-up

Every day brings new opportunities to screw up.

Every day brings new opportunities to screw up.

Not long ago, Yo Yo Ma famously left his $2.5 million Stradivarius cello behind in the trunk of a taxicab. With the help of the New York police and an alert taxi driver, Ma was able to retrieve what arguably is his most prized personal possession. He was lucky. As we know, life promises nothing and the story could have had a much less happy ending.

How can a human being lose the very thing his life depends on for his personal well-being? Actually, it’s a pretty easy thing to do.

A couple of years ago, my mother gave me thirty or forty poems she had written out longhand in Yiddish. She had had a creative period about thirty-five years ago when her first grandchild was born, and for a few months, she wrote a short poem almost every day. Despite her limited education — her formal schooling ended in May 1942 when the Nazi Einsatzgruppen rolled into town and killed most of her family — my mother’s poems showed real evidence of craft. She addressed most of the poems to her granddaughter, very much as Horace wrote his satires to his patron Maecenas. Mostly, she wrote about the animals on our old chicken farm and about taking walks in the field with my father.

Whatever else my mother wrote in her European hand appears to be forever lost to me because I don’t know what I did with the poems. I have looked in my file cabinet and scoured the closets and cabinets where I have stored my graduate school notebooks and my son’s elementary and high school homework. Did I put them on my “newspaper chair,” where I keep my New Yorkers, Economists and New York Times until I carry them to the compactor room in the hallway? I am sick every time I think that I may have dumped my mother’s poems and may never see them again.

You would think that, in light of this tendency to lose what is most precious to me, I would take pains not to get sloppy in other areas of my life. But no.

Earlier this summer, I interviewed a wonderful novelist for my Backlist series. When I put my headphones on to begin our podcast recording, I heard a strong buzz in my ears. Instead of taking the time to figure out what was causing the noise, I complained that there was something wrong with the headphones. I promptly took them off and went on to do a forty-five minute interview. Not surprisingly, a buzz runs through the entire recording.

Thanks to the various noise reduction features in GarageBand, I was able to scrub some of the buzz out of my recording. But the mp3 file I created is at best like an older woman who gets plastic surgery: Despite the cuts and tucks, the face just doesn’t look good.

I e-mailed my interviewee and apologized to her. I requested that we have the conversation again by phone and focus only on the comments I used in the final mp3. I didn’t hear back from her. I suppose she will forever see me as the blithering idiot who wasted most of her morning one summer day in 2009.

I know I have just beat myself up for losing what should be preserved, and for botching the kind of interview I should be able to do in my sleep by now. But the truth is that every day brings a new opportunity to screw up. The question is, how should we respond to people who, despite training, education and common sense, simply flub it?

Oriana Falacci, the late Italian journalist, once wrote about interviewing Israel’s Golda Meir. At the time, Falacci was highly critical of Israel, yet she couldn’t help but like Meir. When Falacci got back to her hotel room, she discovered that she had lost her tape recording (or that she had nothing on tape; I can’t remember which). Mortified by her klutziness, but desperate for the interview, Falacci got back in touch with Meir and requested that they do the interview again. Meir was gracious. She invited Falacci back and the two revisited the conversation.

So, the next time somebody screws up big-time at work or in your personal life, I beg you: Be gracious. Give ’em another chance. You never know. The next big screw-up could be yours.

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My father’s stroke: 4

The siblings have a standoff.

The siblings have a standoff.

Time to air the dirty laundry.

You might not know from my previous posts that in addition to Pesha, I have an older sister and an older brother.

My brother did stay in touch with me while Papa was in the hospital, but he couldn’t find time to visit. He told me he had several competing “projects” to deal with. I didn’t probe. My brother uses evasiveness the way a cat uses a paw to swat at the mouse in its clutches: With delighted dispassion. A project could mean that he himself had a health issue. It could mean that he had to rehearse with the three community bands in which he plays trombone. It could mean he was involved in the final details of selling a house he put on the market thirteen months ago. All three turned out to be true. But how many times is your eighty-four-year-old father hospitalized after a stroke?

“I was on my way to the hospital and got lost on the road,” he said.

Until my father’s stroke, my brother has had the homing instincts of a bat.

Then there is my older sister. She is sixty-two years old, a member in good standing of her orthodox Jewish community in Atlanta, a wife, mother and grandmother. During Passover she did not offer to help cook, serve or clean up the many dishes that went into feeding my parents’ four adult children, their spouses and six adult grandchildren. At one seder, I asked my sister to pass out some napkins. She peeled off a single napkin and handed it to me. She is a feminist and firmly believes that it is her husband’s job to deal with food-related matters.

Now you get to guess what she does for a living.

If you said warden at San Quentin — wrong.

My older sister is a family therapist with a flourishing practice. A couple of days into Passover, she said, “I’m really worried about my psychotic patient. She’s out of control.”

To my parents, their oldest child is more emperor than offspring. They have seen her as a demigod for several reasons: She was the first child born to them after the murders of their own families. She interpreted America for them. She was the first person since the revelation at Mount Sinai to go to college, and then the first — and only child, as it turns out — to get a Ph.D. When Genghis Khan unified the nomadic tribes of northeast Asia, he did not do more than my sister has done to unify the torn psyches of the Georgian (U.S.) hordes.

The one thing she is not equipped to do is unify my parents’ fragmented healthcare.

I don’t remember what sparked my argument with her.  

It had something to do with watching my eighty-year-old mother transport a pot of chicken soup up from the downstairs oven while the Emperor sat on the sofa leafing through a New Yorker magazine.

It had something to do with watching her deposit her breakfast dishes in the sink and leave them for somebody else to wash.

Or with her finding the time to take a walk around the neighborhood, but not finding five minutes to say a word to my father after he had what appeared to be a stroke-like episode two days earlier.

Or with remembering how my parents used to take twenty-hour train trips to Atlanta to help with babysitting because my father was too afraid to fly.

Or with her having been in Warsaw on the same Shabbat eleven years ago as my parents and me, but telling us she was having dinner with some friends. It had something to do with her using that trip to Poland as part of a speech she gave at her daughter’s wedding, and telling the invitees that we Jews would “never again” tolerate the extermination of the Jewish people.

“Why are you so upset, sweetheart?” she asked me when I sniped out at her.

“You could take a more activist role in the care of your parents,” I said. “You could offer to wash the dishes.”

“I’ve been washing dishes all morning!” she said.

“If I had heard about Pesach from you, then I might believe you. But I’ve been here the whole time. You have let your deaf eighty-year-old mother and sick eighty-four-year-old father wait on you like a princess. You have done squat.”

“I get the feeling that you and Pesha want me to take responsibility for Mama and Papa,” she said.

“We just want to see you do something. Call them at night to say hi.”

She began to shrink into the sofa. “You’re asking me to do more than I can do,” she said.

“Call them once a week.”

“You’re getting unnecessarily upset,” she said. “You and Pesha have everything under control.”

“We don’t have anything under control. Mama and Papa are sick. They’re old. They’re physically impaired. The family is your area of expertise. You could help them.”

“I don’t live here,” she said. “I don’t know doctors in Cherry Hill.”

“Don’t you have patients coming to you with problems about their elderly parents? You must have some strategic thinking on the subject of eldercare.”

She had enough sense to stammer something incoherent.

“You have shown more concern about your so-called psychotic patient than your own parents,” I said.

“My psychotic patient has a rational husband I can talk to.”

“Your psychotic patient has healthcare insurance that covers her ‘treatment’ with you. Do you only help people who pay you?”

More incoherent stammering from somebody who always has a category to fit people into, who always had an opinion about the Iraq War, the Bush Administration, the need for change.

“If Pesha and I ‘didn’t have everything under control,’ would you step in?” I asked her.

“The way Mama and Papa live is their choice,” she said.

Therapist cliches. And people actually seek counsel from her? Cripes.

*

Even after she learned that my father was taken by ambulance to the ER, my sister did not phone. She was in Oakland with her daughter and used her as her liaison. I suspect she did not want to talk to me.

The requested once-weekly phone call to my parents has not come to pass.

My parents do not have a harsh word for her.

“She lives far away,” says my mother.

“She has a business to run,” says my father.

My sister has “doctor” before her name and my parents remain in awe.

A friend of mine believes that most Holocaust survivors not only respected doctors but feared them. “If you argue with a doctor, he might hurt you,” Leon says.

Well, I don’t know. I think my parents see themselves as lowly, uneducated immigrants with heavy accents and their “doctor” daughter is their superior.

Pesha says, “Don’t even get upset about the older sibs. They are not a factor.”

I’m good with that. But I gotta ask: What was the point of spending all those thousands of dollars on Jewish education, of hearing that we should honor our mother and father? What was the point of reading Maurice Sendak’s “Care” to the kids when they were little — and now that we’re all big, nobody cares a damn?

There is only one thing that stands between you and an indifferent world. It’s your family. And you don’t need a Ph.D. to figure that one out.

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My father’s stroke: 2

My father’s stroke: 3

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My father’s stroke: 3

Emergency Room

Emergency Room

Six days into Passover, the temperature got up to 49 degrees. It had begun raining Monday night. The downpour continued throughout Tuesday. Of all days to find my father standing outside by the passenger side of his car and hissing uncontrollably. Saliva was shooting out of his mouth like water through the spray nozzle of a garden hose. He was soaked from his newspaper boy cap down to his K-Mart sneakers.

I got the passenger-side door open and my mother and I angled him into the seat. My father has always been a wiry guy, even in his atrophying diabetic state. Combined with muscular rigidity brought on by this attack, he had a hard time ducking into the car.

“Papa, are you able to direct me home?” I asked him.

He couldn’t speak. He nodded yes and pointed me to a right-hand turn using his stiffened right arm.

My mother got into the back seat and attempted to massage whatever was happening to my father’s face into compliance. This time her efforts had no effect.

Once I got onto Haddonfield-Berlin Road, I knew the way home. I kept asking my father for directions anyway. I had to check if he was still aware of his surroundings. He was.

Kennedy Memorial, a university hospital for the University of Medicine and Dentistry of New Jersey, has a center about a half-mile from my parents’ house. “Papa, can I take you to the emergency room?” I asked.

An enraged arm motion signaled, “Absolutely not.”

I am a guilt-ridden daughter who has spent at least the last ten years actively repenting for a lifetime of obnoxiousness toward my parents. I have not argued with either of them since 1998 when the three of us traveled to Poland together. My rebellious nature has gone into eclipse and I do what my father demands: I keep driving to the house.

At home my father sat down on the sofa. The hissing and spitting didn’t stop. I sneaked into one of the back bedrooms and called my father’s DO friend on my cell phone. He and a couple other of my father’s doctor-friends had paid a get-well-call the night before and told me to phone them if I needed help. I let the phone ring seven or eight times and gave up.

Next I called my father’s nephrologist, one of the doctors who had told me to call in an emergency. I told him that my father was having some kind of episode and I didn’t know what to do.

He said, “Call 911.”

I felt like an ass. These doctors told me to call them in case of an emergency. They should have told me to call 911.

I went back into the living room to call 911 from the wall phone. Even through his seizure, my father was wildly pissed off at me. He got up from the sofa. My mother intercepted him and walked him to the bathroom. While I was describing my father’s condition to who knows who on the phone, I heard my mother start to cry.

“Di hast zikh bekakt!”

He had soiled himself. At least now I knew I was right to disregard his wishes. I never knew this to happen to him. Ever.

My mother wept as she got my father into the tub. He was still seizing when she walked him back to the living room wrapped in bath towels.

I went outside to wait for the ambulance. I was afraid EMS would have a hard time finding my parents’ house, especially in the rain.

Nothing happened. An ambulance from nearby Cinnaminson passed the house on its way to Kennedy. The two pudgy EMTs could have downed a cup of coffee and some doughnuts between the time I called and the time they finally arrived in another ambulance. Maybe they are trained to smirk so they can keep themselves calm.

They wheeled out a stretcher. “I don’t know how you’re going to get him to go with you,” I said.

My father was still spitting and hissing when they came into the house.

“Oh, he definitely should be seen,” said one of them. The two of them looked like giant Pillsbury Doughboys.

They wrapped my father up in my parents’ towels.

“You have to get him into his boxers,” I said.

“They’ll only take them off at the hospital,” said an EMT.

“You can’t take him out like this,” I said. I insisted that they pull on my father’s boxers. They sort of did and sort of didn’t, like it wasn’t really their job. Morons.

I rode to Kennedy next to the driver. I turned around to look at my father in the back of the van. He wasn’t fighting his capture anymore. The seizing didn’t stop and he reconciled himself to care by aliens.

*

The triage nurse, a pretty, fit woman with a flip-floppy ponytail, apologized to one of the chubby EMTs for her bad mood the last time she saw him. He said, “Everybody’s entitled to a bad day,” and stared at her breasts. I thought, who cares about your moods and your lust? My father is going to die in this place.

Various techs and nurses took his vital signs. Somebody put an oxygen mask on his face. The hissing and spitting wouldn’t stop.

“Is this normal for him?” a nurse asked me.

“Does he look normal to you?” I asked her.

“Some of our questions are going to sound stupid,” she said. “We have to ask them.”

The exchange was like something from “ER” on TV.

I felt bad for my father that he was now a client to be processed, a statistic concerning end-of-life care. He had tubes in his nose and his neck and an IV stuck into the back of his hand. To the young medical staff, he was an old man in the middle of some bizarre episode the likes of which nobody seemed ever to have seen before. I was in everybody’s way, but nobody yelled at me to move. Their patience made me wonder if my father was deteriorating.

A seventy-ish Iranian Jew on the other side of the curtain was having a spat with his much younger wife. He threatened to call the police if she took the house keys out of his jacket pocket.

After half an hour, in the midst of his seizure, a black tech wheeled my father away for a CT-scan. He told me he had grown up near 164th Street in the Bronx and in Spring Valley, New York. “You look so worried,” he said to me.

Don’t cry in front of the staff.

I was about to call my mother when she showed up in the ER. She had walked in the dark, in the rain, on her sciatica-weakened legs from the house to the hospital.

She started crying when the techs wheeled my father back in.

My father spoke. His speech was slurred, but still relatively clear. “It stopped,” he said.

“It stopped!” I said.

The seizing was over and he was back to himself. The medical staff hadn’t even noticed.

My father joked with the nurses and then with the cardiologist and neurologist who came by to see him. He had no rancor toward me for having called 911. In fact, I hadn’t seen him so alert in almost two years.

This is what he’s normally like,” I told the nurses.

He didn’t even object when the doctors told him he should be admitted for observation.

“Tell my wife and daughter to go home,” he said.

“Pesha’s on her way,” I said.

“She doesn’t have to come,” he said.

“You gave her an excuse not to deal with her mother-in-law.”

My father managed a crooked little smile.

Just then the shul cantor came into the ER.

“I saw your mother walk into the hospital,” he said. “I was concerned.” The cantor is a devout man with a beard. He rarely acknowledges me in shul, but in this crisis, his eyes were kind.

What with my father’s visitors, the staff and the Iranian Jew calling the police on his wife, this section of the ER was starting to take on a party atmosphere.

At some point my father would have to eat. It was Passover and he wouldn’t touch bread, let alone anything unkosher. My mother and I went home to cook. Pesha arrived a short while later. She ended up camping out in my father’s room for the next three nights. A good thing she did because, after all the fun and good times were past, a night nurse gave my father ten times his normal dose of insulin and almost killed him.

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My father’s stroke: 1

My father’s stroke: 2

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My father’s stroke: 2

Diabetes under scrutinyYou can’t always predict, you can’t always prevent, but I strongly suspect that my father’s stroke could have been avoided.

My father’s runaway diabetes has been a huge problem for the past couple of years. Early one morning in January 2008, I witnessed my father go into diabetic shock. He managed to get up out of bed, wander over to the thermostat and ask my mother where the blintzes were. My mother and I knew something was wrong. His face suddenly looked the size of a cantaloupe. His eyes gazed wonderingly at the temperature gauge as if it contained the mysteries of creation. If he were younger and it was 1968, I’d have said my father was tripping.

After this incident, my younger sister, Pesha, and I jumped up and down in front of my father’s primary care doctor, his nephrologist and the affable doctor who is also the president of my parents’ shul. “We think his medications are off,” we said.

The primary care doctor is to blame to a large degree for not keeping on top of my father’s medications and blood sugar levels. But an equally culpable actor is my father. He doesn’t keep all of his doctors informed about his various doctors’ visits. “I don’t want to insult any of them,” he says.

“You’d rather die?” we ask him.

“I’m going to live forever,” he says.

Don’t go away. The silliness has only just begun.

Around seven o’clock in the evening on March 26, my father took a fall. One of his rabbis had given him a ride home from shul, so my mother was waiting for him. When he didn’t appear, she opened the door. He was lying on his back at the bottom of the front steps. The rabbi was just about to pull out of the driveway. My mother flagged him down. The two of them roused my father, got him on his feet and walked him into the house.

If your diabetic eighty-four-year-old husband had just taken a tumble, what would you do?

Might you have told somebody? A doctor? Your children?

“I didn’t want to bother you,” my mother told me.

I said, “Do you think I call you every night so I can tell you I went to a movie?”

“You have your own life.”

I found out about the fall by chance when I visited for Shabbat. When my father mentioned it, he was almost bragging. It was one more terror he had survived.

I didn’t learn for weeks that my mother had held a cold compress to the back of his head the whole night.

Two weeks later, on the first two days of Passover, my father was more tired than usual. On Friday night he walked over to shul. I was in the kitchen when my sister Pesha came running in and began opening and closing cabinet doors.

She said, “Papa needs aspirin.”

The two of us ran down the street to the shul. When we got there — Pesha in a casual skirt, me in my inappropriate yoga pants — the right side of my father’s face was slack. One of the men, a regular at evening prayers, got my father a Dixie cup of water. The aspirin were downed, and as far as my father was concerned, he had dealt with the situation. Period. The end.

It didn’t help that another one of his DO friends said there was no cause for alarm. This doctor, a long-time family friend, insisted that he himself wouldn’t go to the emergency room in the same circumstances. “Looks like Bell’s Palsy to me,” he said.

Back at the house, our whole family was on hand for our annual Passover get-together. That’s a twisted story in itself, but I’ll get to that later. Everyone wanted my father to go to the ER. My brother-in-law Paul, a medical researcher, said he would go with him.

“You can all leave me alone,” said my father. “I’m not going anywhere.”

The voice of another esteemed doctor — my niece’s husband — voiced his opinion from a hospital in Oakland, CA. “He has the classic symptoms of stroke,” he said. “There’s a small window of opportunity for anything useful to be done. Get him to the ER immediately.”

The long-time family doctor-friend was sure that my father had Bell’s Palsy.

“I hope your malpractice insurance is up to date,” my brother-in-law muttered under his breath.

My sister Pesha sneaked a phone call out to my father’s primary care doctor. The doctor covering for him recommended that my father go to the ER. My father was furious at Pesha.

*

Over the next four days, my father had trouble chewing, swallowing and keeping his food down. He had no sensation in his lower right lip and in his jaw so he didn’t even know when food was falling out of his mouth.

Intermittently, perhaps two or three times a day, he found himself in the grip of something like a petit mal seizure. Food that had found its way into the non-feeling side of his mouth burbled out onto his lips. He started slurping involuntarily. Because he never lost consciousness, he was able to convince my mother that he still didn’t need medical attention. These episodes occurred two or three times a day and lasted no more than a minute or so.

By Monday afternoon when everyone but me had gone back to their own lives, my father’s face began twitching. Once again my father refused medical intervention. He was satisfied to let my frenzied mother hold his forehead and attempt to massage the twitches into placidity. Whatever the effect of her massage, these episodes also lasted just a minute or two.

Meanwhile, Pesha called my father’s primary care doctor and asked him to make a follow-up phone call to my father. I answered his call on Monday.

“Dr. Pearson wants you to come in for a check-up,” I told my father.

My father adores the guy, so he was willing to see him.

“We always bring him something,” my father said. “Latkes, strudel. He loves everything.”

On Tuesday morning, I drove my father to see Dr. Pearson. My mother sat in the back. I considered it a coup that my father let me drive at all, especially in a cold rain.

Dr. Pearson was a nice young man. He is a dead ringer for the slightly balding, pudding-faced doc in a ten-minute play I wrote about a guy of ordinary intelligence who put his nose to the grindstone and against all odds became a doctor. Maybe I feel I already know him because I have encountered him in fiction. Dr. Pearson kindly accepted the little brown bag of matzo meal pancakes that my mother handed him.

In the examining room, where I sat with him, my father and my mother, Dr. Pearson crouched at my father’s side and talked to him about getting a CT-scan.

“It probably is Bell’s Palsy,” he said, “but we want to rule out stroke.”

“Whatever you tell me to do, I’ll do,” says my father. My father has never spoken to his rabbi with such humility.

“We’ll set up an appointment for you this morning.”

“So soon?”

“The whole thing won’t take you ten minutes.”

We drive the twenty-two miles back to Cherry Hill, grab a bite to eat and then hit the road again for the CT-scan.

*

Don’t think that my mother is a perky little eighty-year-old caregiver. As she tells it, “I woke up one morning to a silent world.”

My mother’s deafness was not as immediate as she would like us to believe. My sister and I nagged her for a year to get her hearing tested. I wish now that I had made a doctor’s appointment for her, taken a day off from work and driven her in myself. We knew her hearing was failing incrementally and we shouldn’t have tarried.

Once I lost my job at IBM, I told my parents I would get them to their doctors’ appointments — and that included a doctor for my mother. After my father’s CT scan, it was my mother’s turn to meet with her wonderful, brilliant physician.

“He’s not Jewish himself, but he loves the Jewish people,” my father said. As far as I’m concerned, the guy could play a Praetorian guard in an antisemitic passion play every weekend and I wouldn’t care, as long as he could help restore my mother’s hearing.

My father signed my mother into the office. I noticed that he wrote out her name with great deliberation. He omitted the “in” at the end of “Finkelstein.” I noticed but didn’t think to comment.

My mother left the waiting room to take a hearing test. My father’s eyes looked glassy. He often gets that sick, blank expression. It was the same look he had when his blood sugar went too low and his face shrank to the size of a cantaloupe.

After the hearing test, my mother and I consulted with her doctor. He showed us her MRI image and said that the white dots on the brain possibly indicated that she had experienced a series of small strokes, culminating in the total deafness of her left ear. The good news was that she still had some hearing in the right ear and even a smidgin in the left. She had to see a neurologist as soon as possible and then come back to him to be fitted for a hearing aid.

A father with Bell’s Palsy and a mother with transient ischemic activity. Within a matter of a few weeks, my parents had gone from old to elderly.

We went back into the waiting room to meet my father. He wasn’t there. We checked the bathroom. Nope. We asked the staff if they had seen him. “Does he have a history of wandering around?” one of them asked. He hadn’t until now.

A patient in the waiting room told us that she had seen an older man standing by a car. My mother and I went out into the rain to search.

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My father’s stroke: 1

 

Sticking it to yourself

Sticking it to yourself

Eight days have passed since my father stroked out in a south Jersey parking lot. I am just beginning to piece together how he — and some of his doctors — contributed to this latest of his health crises.

This afternoon as my father was sitting down to eat dinner, he realized that he had run out of his Novolog insulin. He wasn’t concerned. He said he had some other insulin stored in a cardboard box with a bunch of medications he used for treating gout, high cholesterol and a low-functioning prostate. I asked him what that “other insulin” was doing in this pharma mix.

“Somebody in my doctor’s office gave it to me,” he said.

“Who?”

“He’s kind of like the doctor’s deputy,” he said.

“Where do you go to school for that?”

My father shrugged.

I asked, “Is he a doctor?”

“No.”

“So who is he?”

“He wears a suit.”

My father does not have Alzheimer’s Disease and the last thing he is is stupid. The problem is that he has a chronic case of veneratio immodicus — excessive reverence — for doctors and for the drug pushers who visit their offices.

“Did you ask your doctor if it was okay to take this 70/30 insulin combo?” I asked.

“No. Read the box and see if I can take it.”

“Do I look like a doctor to you?”

When I dialed his primary care doctor’s phone number to ask him about the insulin, my father got angry at me. Why was I bothering the doctor? A few minutes earlier he had chewed me out for talking to a family friend about a neurologist for my mother. “I don’t need favors from anybody!” he said.

Two minutes later, when we learned that the neurologist had a good reputation, my father suddenly remembered that he had met the guy in synagogue. “Such a nice man,” he said. “He gives me his hand every time he sees me.”

*

I get on the phone with the primary care doctor’s office and I ask a nurse there about my father’s insulin.

“We don’t have that information,” she said.

I am an idiot and I don’t know what to say. Why would I expect a primary care doctor to know what medications he has prescribed to his patient?

The nurse comes to my rescue. “They changed his insulin in the hospital, didn’t they?” she asks.

“He’s still using the same insulin since before the stroke,” I said.

“You’ll have to check with his endocrinologist,” she said.

As it happens, my father has an appointment with the endocrinologist this afternoon. But what if he didn’t? What if he had used up his insulin, say, yesterday, or on Shabbat when my father would refuse to use the phone to call anybody?

*

The endocrinologist is an older man with silvery coifed hair and good teeth. Straight out of the “Mad Men” era. He is delightfully rough around the edges and chews my father out for not keeping his blood sugar under control.

“Do you stick your finger regularly?” he asks him.

We are in the thick of a Clintonian moment because my father’s answer depends on what “regularly” means. He says yes. I bite my tongue.

“What’s your sugar level in the morning?” the endocrinologist asks him.

My father appears to search his memory. “Around 150,” he says.

This doctor homes in on my father’s equivocation. “Is it ever in the 200s?” he asks.

My father says yes.

“What about later in the day?”

“It can go up into the 200s.”

It routinely goes up into the 400s.

“How long have you had diabetes?”

My father gives an answer that should be shocking, but I see that it entertains him. “Thirty-five years,” he says.

Time for me to play Goneril. “My father has been checking his blood only since he had the stroke,” I say.

“When was that?” asks the doctor.

“Last Tuesday.”

Dr. Mad Men surveys my father sitting on the examining table in his bare feet. For an 84-year-old man one-week post-stroke, my father looks good. He jokes with this nuts-and-bolts gent, who keeps shooting me a look that says, “Your dad’s a real card, eh?” My father tries to tell the doctor that he can’t share his family medical history with him because everyone was killed during the Holocaust. The doctor doesn’t comprehend what that means and asks him again if anybody in his family had diabetes. 

“I was fifteen years old when they were all killed!” my father says.

“Do you remember if anyone had diabetes?” the doctor asks.

“How could I possibly remember?”

My mother wisely explains that nobody in pre-war Poland had gotten a diagnosis of diabetes.

The upshot of my parents’ remarks finally seems to register in the doctor’s brain. 

“What’s this?” he asks. He examines my father’s toenails. One of them is blackened by a fungal infection. My mother wears a mortified expression. She has tried to get my father to see a podiatrist, but he always refuses.

“Make an appointment with a podiatrist and get this taken care of,” the doctor says. Blunt.

He wants to know why my father won’t let anybody get his blood sugars under control.

“You are not going to experience any further old age if you don’t take your diabetes seriously,” the doctor says.

Up until my father’s stroke, I have had a prejudice against osteopathic doctors. But this crusty coot is knowledgeable in a way that doesn’t waste anybody’s time. He has none of that condescending happiness I have encountered in some of my own interactions with MDs. I am starting to think that for a disease like diabetes, you do not have to be a brilliant. You just need to pay attention to the matter at hand. You just need to be good at your job.

“In one week from today, you will fax me your blood sugar levels,” the doctor said. “Without knowing what they are, I can only guess at the amount of insulin you need. And guessing will never get it right.”

Why hadn’t my father’s primary care doctor insisted on seeing a record of his blood sugar?

“Am I going to get that from you?” Dr. DO-right asks my father.

My father nods in agreement.

Meanwhile, I tell the doctor, my father doesn’t have any more insulin. The doctor thinks he has some in his office and leaves the examining room to retrieve it. Nobody, including me, talks about a prescription renewal. I am just as bad as my father. As soon as the immediate problem is solved, I don’t think farther out into the future.

At home, I remind my father that he has agreed to check his blood sugar four times a day.

“Three times is enough,” he says.

NEXT: My father’s stroke: 2

Wordle image

 

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The death of the job

Jobs are a thing of the past.

If you write me off as unduly pessimistic, I can only echo Robert Lowell when he said that the light at the end of the tunnel is usually the light of an oncoming train.

I caught a glimmer of that train in the early 1990s when I took a freelance job with a now defunct pharmaceutical company called Ciba-Geigy. The company’s department of internal communications had hired me to write stories for a newsletter that touted the virtues of Total Quality Management. The TQM premise is that everyone in an organization — from new hire to executive manager — should do whatever it takes to “delight the customer.” TQM was especially popular in post-war Japan. Its biggest proponent, W. Edwards Deming, underwrote its set of business principles that in many ways led to the supremacy of products such as Toyota and Sony. You can’t knock a business philosophy that turned a nuked Japan into one of the world’s most successful economies.

But TQM also has an anti-social side. Several of the articles I wrote were based on conversations I had with HR people in which I learned that each employee has to think like a self-employed businessman. Everyone in the company has to apply their skills to a specific task. Once that task is completed, you target your skills at another project. If no additional project exists in your department, you have to look for one in another department. If there’s no match between your skills and a company project, you have to look somewhere else. Where you look is up to you.

I couldn’t help but think that employees had become like the itinerant carpenters or schmate peddlers of a foregone era who carried their tools and wares on their back. Sure, we were free to hit the road and hire ourselves out. But how would we negotiate wages on our own? Where would we call home? What would we be loyal to? Where would we live?

By the time I got to IBM in 2000, I didn’t hear much about TQM. But by then, the TQM belief had become an implicit part of corporate ideology. Today it is even sewn into the warp and woof of Internet culture. To wit, it has turned millions of people into amateur businessmen and artistic producers who delight their customers with everything from Beatles memorabilia to videos of concerts, salsa lessons and porn. Of course, most of the goods people are buying and selling are crap. That’s because the department stores, newspapers and companies that used to serve as a critical filter for ideas and products are vanishing. It’s now incumbent on each one of us to become his own producer and distribution center — whether we are qualified for the task or not. Each of us has become a glorified schmate peddler.

In our age, the I-am-my-own-master mentality promotes a super-individualistic, highly circumscribed way of acting and thinking that is turning everyone into a self-important mediocrity.

I see the results of this hyper-individualism in at least two places.

  • Newspaper websites. The New York Times website, for example, lets you design your own news feeds. Let’s say all you care about is “news about Barack Obama.” Click on “subscribe” and the Times will e-mail you links to Obama stories. By now, of course, every newspaper that has managed to survive lets you pick-and-choose the news at no cost to you. What you are getting is a Balkanized approach to public affairs. “Reading” the Times has become like asking the three blind men to describe the elephant. We are all looking at the Times, but we have no shared cultural experience of it. What happens when a society cannot even decide on what conversation we should have?
  • Facebook. This “social utility” lets you create a customized universe of “friends” whose “stories” you can track to your heart’s content. “Friends,” of course, can be people you met for five minutes at a conference. And “stories” are stories only in the sense that “war” in 1984 is “peace.” They aren’t stories at all, but trivial notes that publicize an acquaintance’s favorite restaurant or movie. In any case, these stories simply mirror your own likes and dislikes. Facebook collects these biases — that’s all they are — to create your own “individualized” online “profile.” What a surprise. Your Facebook friends listen to the same kind of music, watch the same kind of movies and vote for the same kind of president as you! The pressure to conform with the herd is as strong as it is on any sixth-grade playground. 

Two things are happening at once: The disappearance of the job is forcing us to become individual peddlers of our own narrowly defined skills. And our individualism is turning us into narrow-minded conformists.

I don’t think anybody in the mid-1940s could have foreseen that Total Quality Management, which helped rebuild Japanese industry and brought customer-focus to the American corporation, would have contributed to the obsolescence of the job and the silliness of individuality. 

Goodbye, jobby! We hardly knew ye!

See the Wordle image of this blog post.

See also: Putting yourself out there on a shelf to buy [The New York Times]

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A sign of the Times.

The New York Times building logo

Might the Times one day go the way of Pan Am?

The New York Times arrived at my door on Saturday morning like the half-dead victim of a Mafia hit. It lay face-down on the fold, hurled by a delivery man who no longer expects a Christmas bonus next December. In a month, maybe two, he may even toss the poor anemic broadsheet into a mass grave down in the lobby, and we tenants will be forced to identify our own copies by the toe tag: an apartment number marked in black ink at the top of the front page.

The Times in this post-newsprint economy stirs my pity in the same way that the Twin Towers did in 1993 after a car bomb attack attempted to bring Tower One down onto Tower Two. What once looked like an indomitable journalistic edifice now looks as vulnerable — and as outdated — as the nineteenth-century serial novel.

I remember the time — was it only seven years ago? — that I joined a boycott of the paper to protest what I saw as unfair bias against Israel. Back then the Times was a mighty media giant with the power to project an all-knowing, albeit tendentious, journalistic voice. For my friends who were diehard Democrats, just saying “I read it in the Times” was evidence enough for them that their point-of-view was persuasive and mine wasn’t. When we argued about Israel, or any number of stories in the paper, I often felt like the therapist who has to assure her clients that it’s okay to skewer the parents. The Times wasn’t an infallible authority figure and its critics weren’t wayward children.

I don’t regret participating in that short-lived boycott. But I wish I had foreseen just how fragile the Times would become in an economy buffeted by the new media and a new financial instrument called the credit default swap. Because whither goes the Times also go The New York Post, The New York Daily News, The Wall Street Journal and all the rest of the old-economy papers. Who could guess that by March 2009 the weekend edition of The New York Times would start to look as insubstantial as South Jersey’s Courier Post?

How I am contributing to the erosion of the Times

In my own defense, I never intended to contribute to the Times’ debt — estimated now to be about $1 billion. In fact, for 35 years, I have been precisely the kind of reader the Times has nurtured.

In college, for example, when our dorm chipped in to buy the Sunday Times, I was the first one early Sunday morning to tear into the “Arts & Leisure” section. When I got my first corporate job and discovered the vagaries of the capitalist system, I poured over “The Week in Review.” As a 23-year-old staff writer for Liberation News Service, I read the international news so that I could understand how the Times supported the status quo. In my more conservative years, I read the same news and concluded that the Times‘ editors were in favor of any social movement, the more radical the better. As a novelist and book reviewer, I read the “Book Section” from cover to cover to see what the competition was writing. When I wanted a break from my graduate school studies, I studied the Saturday crossword puzzle as if it was a page from the Nuremberg Chronicle. And if the “Sports” section had a human interest story, I even read that. Reading The New York Times was like working for a global organization: If you got tired of one department, you could try to find something interesting in another one.

In my view, what’s contributing to the welterweight size of The New York Times is my getting laid off from IBM. The Times marketing people were not wrong to have their telemarketers call me during my boycott years. In spite of my curmudgeonly relationship with the paper, they knew I would “come home” some day. Their own demographic surveys had long tracked my interactions with the paper’s various sections, its advertisers, its online features. The Times understood that somebody with my vocation, educational background, cultural interests and religious affiliation would philander with the likes of The Wall Street Journal and The Economist. But when it came to defining a political and cultural reference point, I could always say — with respect or mockery — “I saw it in the Times.”

Consider that this year IBM has laid off an estimated 4,600 employees like me — people who have either an BA, MA, MBA or Ph.D. Consider further that a lot of those former employees are 45 and older. Now you’re talking about a well-educated, semi-affluent demographic that consumed just about every section the Times ever published. It’s true that this same Internet-savvy demographic has been responsible for a precipitate slide away from the Times‘ print subscription in favor of the el cheapo Web version sans ads. But I for one can vouch that I continued to look at the print edition for clothing sales, restaurant and food news and home furnishing ads. Without the job, I’ve put a moratorium on all discretionary spending.

What I do look at these days are the advertising circulars. Did you know that you can save 40 cents on a box of Ziploc (R) Brand Bags and a dollar on any size of Woolite Dry Cleaner’s Secret? Who knew that “just 20 minutes in your dryer delivers affordable dry cleaning results?” As for all of you erstwhile fashionistas, you can get a complete pair of single-vision eyeglasses at Factory Eyeglass Outlet in Queens, Long Island and Staten Island for $39.95. I always knew those Calvin Klein frames were a rip-off!

I am also beginning to rue my annoyance with the pound or more of advertising circulars that used to fall out of the Times as I carried the paper from the door to my L-shaped sofa (great Times-advertised deal at Fortunoff’s). Nowadays the pickins are slim. This Saturday I found only three thin circulars. They too are vanishing along with the Times itself. Just when I need them the most.

See a pictorial implication of this blog post in Wordle.

See also: Seattle Paper Shifts Entirely to the Web. Could you cry?

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