Then, a 20% Chance; Now…

“The purpose of life is to live it, to taste experience to the utmost, to reach out eagerly and without fear for newer and richer experience.”

   ——–Eleanor Roosevelt

A mini-celebratory brunch is in order: the doctor reported both heart and aorta are sound.

“We’ll take you out,” we say.

“You’ll come here,” she insists. “The best bagels, fresh eggs, delicious fruit, plus quiet and lots of room.”

We relent.

Four years ago, the collapse—after a symphony hall concert.

She attended concerts often—multiple subscriptions, with friends and alone. And the art galleries, the library lectures, the thrice-weekly swims, the scheduled trip to Macchu Picchu…

That evening, she was alone. 

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Ambulance rides to three separate hospitals. Number one: ill-prepared for such an emergency. Number two: heart attack—quick; give her blood thinner. But then the correct diagnosis: a ruptured aorta, meaning the blood thinner was a clearly awful decision. “Won’t operate,” said the head doc. “Too old; too risky.”

But three’s the charm. “Bring her here,” said the vibrant young female surgeon, expert in repairing damaged hearts and valves, at a larger affiliated hospital.

Afternoon next day: We—in-laws and daughters—met with the surgeon, a tall, slender, soft-spoken woman whose brown eyes were at once warm and riveting. She minced no words.

“Without surgery, she will soon die.

“With it, a 50% chance she’ll die during surgery or within the next three days.

“A 30% chance she’ll survive the surgery but then suffer a stroke or other event that would seriously impair her functioning and quality of life.

“There’s a 20% chance she’ll walk out of the hospital and resume her life.”

What would you do?

“What do you think?” we asked the surgeon, who also happened to be kind and empathetic.

“She’s come through all this time, and two moves by ambulance, and her color’s still good,” the surgeon said. “She’s been leading an active life until now—I think it’s worth a try.”

When asked about the prior surgeon’s reluctance to operate, she said: “The patient is 81, with a ruptured aorta—clearly in extremis. It was not surprising he [the surgeon] wanted to head for the hills. But the family members come in and say she swims 3 times a week, is very independent, very functional. That sways away from ‘let the poor old lady go…’”

Shortly after 9 pm, nearly a full day after the collapse, the surgeon came to see us, her lovely face looking tired but illuminated. “It went very well,” she said. “We repaired the aorta, the aortic valve, and the mitral valve.”  The patient, she said, “is a picture: most people after surgery are pale and puffy. She looks like herself.”

Later, she acknowledged: “I had major doubts, but one of the great benefits of a large hospital system like this was that I spoke with my chairman and another specialist in aneurism repair. I said, ‘I know what you’re going to say, but…’ Both felt it was reasonable to operate.”

Three days after surgery, when the patient was speaking and demonstrating an understanding of commands, the surgeon pronounced her, in highly technical terms, “a miracle.”

When we first saw her, she greeted us with a big smile. But when the nurse told her she was about to swab her mouth and make her more comfortable, the former school principal uncharacteristically replied: “Bull s—t!” The surgeon expressed delight: “Profanity and criticizing breakfast are two excellent prognostications,” she said wryly.

“This was a Type A dissection,” she explained to me. “The pipe has burst. You sew in a piece of material, being careful not to leave gaps and not to miss a stitch. It’s like sewing a sleeve into a jacket. It’s not difficult, but you have to be meticulous. If you miss one stitch, you spend a lot of time regretting.”

As the patient prepared to leave for a rehab center at the end of her hospital stay, the surgeon said she expected her to resume her life and live for a number of years more. The surgeon has already been proven right. 

That brings us to today’s brunch, served on china—no paper plates. images-17A nicely arranged platter of cut-up fruit sprinkled with almonds forms an edible centerpiece. After brunch, I have to fight her to let me do the dishes.

She tells us about the concert she’d been to the night before, and the gallery visit the day before that. Her eyes are bright, her face unlined and attractive without a touch of makeup. Her mind totally sharp—despite a stroke some months after her surgery, which minimally damaged her vision in one eye.

She explains—without complaint—that she needs to rest a lot more than she once did. And she’s more concerned about walking about the city in the winter, fearing a fall that might hurt her fragile back (she’s had several fractured vertebrae). “I feel somewhat isolated,” she says.

She can’t keep up with the group of women nearby who meet daily to pursue one cultural event after another. One, in her 90s, lives on the 13th floor of her building, and walks up and down the stairs twice a day in addition to her other activities. I am exhausted just hearing about her.

She talks about my blog, describing the posts she most enjoys. She asks me how I feel about it. “I love it,” I tell her. “It’s so freeing to be able to write about anything I choose, and I enjoy the dialogue with my readers. It’s a source of great satisfaction for me.”

“That’s the way I feel about this,” she says. And she points out her new response to that sense of isolation. Once an art teacher, she has painted and sculpted—both before moving to special ed, then becoming the principal of two schools for autistic children—and since retiring. But those art forms require space and effort expended to clean up. Now, in her 86th year, she has found the ideal medium for her present circumstances: paper collages. 

She points to her “studio”: a corner of her dining area holding scissors, Elmer’s glue, pieces of cardboard and styrofoam for backing.

Suddenly, we see the works, positioned throughout her apartment. Each one is a visual delight—demonstrating a keen esthetic sense and a creative mind channeling itself in a wholly new direction. 

A large one features Eleanor Roosevelt, the Statue of Liberty—its torch the highest point on the collage—and other images and references to that era: Social Security, the UN, the WPA.

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Another—also large—is a replica of her favorite concert hall, pieced together from performance programs and advertisements. One depicting penguins and divers in the ocean is a work in progress. And on and on.

Her sources of inspiration? She combs through discarded magazines and the detritus of junk mail, finding things that strike her just the right way. That sea bird that hovers over one work? “He just caught my eye and spoke to me,” she says.

And so she meticulously pieces together from multiple sources all kinds of stuff, building new and larger stories than the ones she’s extracted—at the same time enlarging her world and, as we look at these works from all angles—ours as well.

I am in awe of this remarkable woman, who spends almost no time complaining and a great deal of time creating. How many of us will move beyond our limitations and find new ways to reach within ourselves for personal satisfaction and growth—regardless of our ages?

As I think about the doctor who refused to operate on her four years ago because she was “too old” and it was “too risky,” I find myself pondering those nearly impossible decisions about how much to do when an older person is “in extremis.” 

A 20% chance didn’t seem like much, but we in the family are forever grateful to the wise surgeon who felt it was worth the risk, guided us accordingly, and then used her brilliant skills to make that decision the best one.

 

As always, I welcome your thoughts, experiences, stories, and in this case, philosophy about how to confront these difficult decisions.

Annie

PS: Back, by request, is the 5-star like-ometer, below. Click on the star on the left if you find this post “awful,” the star on the right if you find it “excellent,” and so forth. WordPress people continue to have the “like” option below. (You may be able to click on the stars as well; I’m not sure.)

I greatly value your comments and feedback.

 

31 thoughts on “Then, a 20% Chance; Now…

  1. A very remarkable woman indeed.

    That third hospital that operated on the woman sounds very much like the hospital in the only new TV series I found worth watching this year- New Amsterdam- until my housemate who watches sports 24 hours a day got back from holidays and hogs the house’s sole TV. I think I only saw the show’s 1st 2 or 3 episodes.

    She sounds like a woman who very much enjoys enjoys life.

    The way she puts together collages sounds exactly like the way I write.

    You were asking me how I go about writing.

    When I read how she puts together a collage, that sounds like a visual equivalent of how I put together a story.

    I remember attending a series of lectures as a child at church that were delivered by a Brother William Sibley an Episcopal monk at the Episcopal monastery in Santa Barbara California.

    But after one lecture when we broke up into smaller groups, we put together a collage.

    It was actually a lot of fun.

    Perhaps something to do when I get older.

    Liked by 2 people

  2. I’m glad you visited, Christopher. Yes, she’s an inspiration to us all. Her reaction to the post was: “Gee, I guess I’ll have to sign autographs now.”

    Such an interesting analogy between her collages and your writing! Based on the creativity that flies out of your chapters, I’m sure your collages would be happy surprises.

    Is this the same housemate that bemoaned your writing as a waste of time? Must he be a permanent fixture in your life? I don’t like him one bit. Perhaps you can get a small TV of your own?

    Liked by 1 person

    1. Yes, the same one who bemoaned my writing as a waste of time.

      Yes, I’ve thought of getting a small TV of my own.

      Perhaps someday I shall.

      There’s actually very few shows I do watch so maybe I’ll be content with just a tablet for now.

      Like

  3. Very informative post as usual Annie. It hits home as my dad is still active in spite of a few recent setbacks. He is 88 years old and still cooks, cleans, grocery shops and attends Christian meetings on Sunday. (Weather permitting)
    This is due to the wonderful in-home care he has received recently and rather aggressive procedures last year to keep his heart working.
    I applaud the doctors that say yes and give seniors that 20% chance to keep on living the best quality of life. If my dad’s cardiologist didn’t believe that, he (dad) wouldn’t be here.
    It brings me joy to hear people making choices that increase their wellbeing, regardless of age.

    Liked by 1 person

  4. Darnell,

    This is such a meaningful comment on so many levels. I greatly appreciate it.

    I have been wondering how your dad is doing since you wrote about your concerns about him; I’m delighted to hear that he, too, has resumed his daily activities.

    And your use of the word “joy” captures my own sense of pleasure from and admiration for those who never stop growing.

    Thanks very much for visiting and enriching this dialogue.

    Annie

    .

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  5. Well, it’s a killer, this piece. 20% and still reaching for what’s good, what’s possible. The love of family. The dedicated surgeon. The shifting form of expression on the part of the patient. As you know, I feel I learn a great deal from your blog and this post is certainly no exception. Thanks for writing it (brilliantly, I might add — love your technical prowess on top of everything!).
    Your faithful reader,
    Denise

    Liked by 1 person

  6. Wow, this post is very inspiring to me! Thanks for posting it Annie.

    My first thought while reading this was “God, I wish I could be like her!” and what I immediately realized is that I would have to learn how to have a more positive attitude to be like your relative. It’s not that I am a pessimistic person, but I couldn’t call myself optimistic either…somewhere in between.
    I also believe that her amazing surgeon was an optimistic person. Her optimism allowed her to look outside the box and see her patient as an women who could defy the statistics.

    As I do, I went to the internet and found an article that suggests a five step program to help you be a more optimistic person. The same article (actually a blog post) sites a study (Mayo Clinic) that concludes: “In a model that adjusted only for sex, a measure of optimistic vs pessimistic explanatory style was a significant predictor of survival during a 40-year follow-up period such that optimists had Increased longevity.”
    Here is a link to the blog post:

    https://www.talkspace.com/blog/become-optimistic-person-easy-ways/

    Liked by 1 person

    1. Thanks very much for your assessments and for the link. Though I have written about optimism in terms of mindfulness, I think we can learn from many different sources. I’ve been working on another post on this topic as well. Stay tuned!

      Annie

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  7. The surgeon expressed delight: “Profanity and criticizing breakfast are two excellent prognostications”
        Love this.

    Meticulous stitching
        Y’know, my Mother was born in 1920, the year women were given the right to vote (from a historical perspective, not a long time ago), and in her day, women only stitched sleeves and generally were rarely surgeons. Not all women liked to stitch clothes, although they were told that they should like it. And I’ve seen knitting procedures and it looks to me as being very tedious. It would be quite a Zen project to calmly knit pearls of wisdom while dreaming of better things.
        It reminds me of several episodes of the TV show “M*A*S*H” where Hawkeye admires his stitches during surgery. In one episode he recognizes his stitch work so he knows it’s one of his former patients returning from the battlefield again. In another episode he is sent to the front and his staff back at the 4077th is worried about him, but they recognize his fresh stitch work on an incoming casualty and so know that he is still alive.

    Wonderful Joie de vivre and the odds</b
        Hmm, given all the facts (if they could be properly measured), the odds were actually 90%. Actually, it would seem that calculating “odds” with limited knowledge gives wrong results in every field of endeavor. I remember that they used to interview math “experts” about the odds of winning the lottery and they’d always say that given the number of choices and the number of tickets sold that there should be 10 winners of the grand prize that they’d have to share. But very often, there was only ONE winner. So they stopped bringing them on to make fools of themselves. (One possible explanation is that a lot of people only pick their birthdays or other “lucky” numbers and so they limit their choice of numbers).
        And then there’s the cliché: “The odds of getting struck by lightning are greater than…”. I think that a lot of people are getting struck by lightning or going down in plane crashes. It would have been difficult for even Sir Isaac Newton to contemplate the theory of gravity while watching an apple fall if he sat with a wet key under a tree during a lightning storm and failed to observe the run away apple cart racing towards him. Madame Curie would not have been a great scientist had it not been for the fact that her husband was killed by a horse and wagon and she could take credit for her scientific work out of the shadow of her famous husband. Odds of her being noticed were very low.

    Liked by 1 person

    1. oops. I did’t close the boldface bracket. But actually because of the background color it’s hardly noticeable. What are the odds of that? Odds of mistakes and typos are very high with me when I’m thinking and expecting my fingers to know how to type and format like a stitch in time.

      Liked by 1 person

    2. True story: we have good friends who are also good friends of Hawkeye’s (Alan Alda). At one point, he was critically ill in the mountains of Peru, I think, and our friend, an internist, was asked to speak with the surgeon. He told her there was an intestinal blockage, and surgery was necessary to save Alda’s life. Our friend advised his wife to agree. The surgeon told Alda, “We have to do an end-to-end anastomosis,” and Alda said “I know exactly what that is. I’ve done lots of them on “M*A*S*H”!

      Liked by 1 person

      1. That’s an interesting connection. I found an article: it was Chile. But I think that Shirley Maclaine was in Peru (“Out on a Limb”) when she had a shamanic vision about Bella Abzug and Mayor Koch running for office?? Both are life changing events of a spiritual or mystical nature perhaps. I could see how I might confuse Chile and Peru because of it if I were trying to remember the place. A category association, sort of like Peru= mystical or something.

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      2. Actually, I totally ruined the story, and in fairness to Alda and the historical record, I must clarify.

        Before operating, the surgeon explained that they would remove the blockage and resect the colon by sewing the ends together. ALDA SAID: “Oh, you mean an end-to-end anastomosis? I’ve done lots of them on M*A*S*H!”

        On a different note, the phrase “knitting pearls of wisdom” is lovely as both metaphor and pun. You do know (or do you?) that “purl” is a word akin to “knit.” (Knit one, purl two…).

        Liked by 1 person

      3. Oh yes, I saw that in the article I found about the nuances of who exactly said what. Oh yes, I did know about the sound of the knitting terms but not the spelling — I didn’t know it was “purl” rather than “pearl”. But I knew the sounds so that was the metaphor I wanted to make. Fortunately, the expression has the spelling that I was familiar with, and the sound-to-sound is enough to make the allusion.

        Liked by 1 person

      4. In the one poem I’ve posted to date (“Thoughts Engendered by Pajamas With Feet,” which is very close to my heart), I refer to aunts and grandmothers intent on warming my daughters with their crocheted caresses. Just thought I’d weave that into the discussion.

        Sound-to-sound is very good.

        Unfortunately, I have to go. I’m sure we’ll chat again. Very glad you found me.

        Annie

        Liked by 1 person

    3. I’ll take all this up with my friend the actuary.

      Doug, is my blog the only one in which the print in the comment box is so light? I wonder if it’s because of the “theme” I selected.

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      1. Yes, I think it is the theme. The themes with black on a white background look darker. In those themes, a bold face shows more contrast. Here it’s hard to see. Let me see if I can remember how to make the symbols visible, if not I’ll look it up later. OK I’ll try this <b> put stuff between brackets </b> and you get put stuff between brackets

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      2. OK. That didn’t work. I guess you’d have to change the theme. But anyway you can see what setting you have for your computer’s screen brightness. Some people make it extra bright for games and dark for pictures etc. But that’s messy and unless you’re an expert I wouldn’t fool with that. Oh well, in short, I don’t know. I’m using a different WordPress theme — you can look at mine

        Liked by 1 person

      3. Thank you for your efforts! I do like my theme, so I guess I’ll ask the HEs (that’s my gender-neutral term for the Happiness Engineers) if there’s any other workaround — and I think I know the answer.

        But I’ll definitely visit your site; seems to me we should be following one another — now that we’re such good friends.

        Like

  8. It is good to read of this woman in your life who continues to live life in a way she finds meaningful.

    Unfortunately I have lived with a situation that falls in the other 80 percent. My mother is a bit older and has lived through a series of declines after an emergency event in 2014. It is like falling down a flight of steps in slow motion with recovery from each new event steadying her for a time, but on a lower step than she occupied before.

    It is good that you (and she) are not there.

    Like

    1. So very sorry to hear about your mother. I know from personal experience (with my dad) how hard it is. This seems to be the too-frequent scenario associated with greater longevity. My hope is that more of us find ourselves with what Dr Andrew Weil calls “compressed morbidity”—relatively good health into our 90s, followed by a brief final illness.

      I’m thinking of your mom and you.

      Liked by 1 person

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