Archive for the Health/Medicine Category

GLAUCOMA, CATARACTS AND FONDLING

My father, the original Ezra, developed a medical condition in his eyes called glaucoma during the early 1930’s when he was about 50 years of age. From everything that can be read and from advice from ophthalmologists, glaucoma typically makes its appearance around the age of 50 years.

Five children of my father survived to adulthood. I was the youngest surviving child. All the other four siblings developed glaucoma. And so as I got within hailing distance of age 50, it was my custom to see well respected ophthalmologists. My AT&T duties had me stationed in Washington, D. C. at that time. Just before I left Washington to return to New York, the ophthalmologist there told me that “incipient glaucoma” had begun to affect my eyes.

All five Carr children were painfully aware of what glaucoma had done to our father’s eyes. In unprofessional terms, glaucoma seals the drainage glands from the eyes. As a result, pressure will build up within the eye. If untreated, blindness is the inevitable result.

When my father contracted glaucoma, surgery on the eye was about the only way to relieve the pressure. Within a few years, my father’s eyes had scars from the many surgeries and by the time he passed age 60, he was approaching blindness in both eyes. As I visited the ophthalmologist

in Washington, memories of my father’s scarred eyes and his blindness haunted me. The Post brothers at Barnes Hospital in St. Louis preserved as much sight in my father’s eyes as long as it could be done. All of the Carr children are grateful to Laurence Post and to his brother, two fine ophthalmologists.

But the Post brothers had very few chemicals to control the pressure that glaucoma brings. By the time that my Washington ophthalmologist told me that my eyes had “incipient glaucoma”, there were several new drugs available to deal with pressure in the eyes. Surgery was a last resort. In effect, my father was born too soon.

When AT&T decided that they wished for me to come back to New York as the General Sales Manager, I soon went to see John Kennedy of the Short Hills Ophthalmology Group. Kennedy was a good man with whom I was quickly able to establish an effective rapport. At the time in 1969, my age was 47 years. As time went on and as the disease progressed, John Kennedy offered new prescriptions to keep glaucoma in my eyes under control.

By the early part of the 1990’s, John Kennedy said that he had dealt long enough with the pressures of his profession and elected to retire. In 1969, the Short Hills Ophthalmology Group consisted of Doctor Fonda, Doctor Ball and John Kennedy, all graduates of New York University. When Kennedy retired, he was replaced by Richard Robbins, another product of New York University. At the time, Robbins must have been under 30 years of age.

For a time, Robbins was able to keep the pressure in my eyes at acceptable levels even if the pressures were on the higher side. And then in the mid-1990’s came the development of cataracts on both eyes. There is no reason for me to suspect that the chemicals used to control glaucoma could have caused cataracts. There have been people who developed cataracts without ever having glaucoma, so I take a pass on that question. When Robbins informed me that the cataracts were “ripe,” we agreed to go ahead with surgery.

The first surgery was on the right eye and it proceeded even though pressure in the eye was high borderline. Later, Robbins said he had to perform some heroics as the operation took a bad turn, but recovery was fairly rapid and my sight was greatly improved.

A later operation on the left eye came out badly. There was great pain. Finally, Robbins suggested laser treatments to the left eye. He administered four or five of those treatments on separate occasions and all of them ranged from unpleasant to painful.

Robbins then sent me to Joseph Patti whose practice is limited to diseases and surgery on the retina and the vitreous. Patti operated on my left eye at St. Barnabus Hospital and for a time, there was improvement. But it did not last long. Patti was a good caring man.

So I wound up back with Robbins with the New York University credentials. There were more examinations and a trip to a Dr. Spaeth, a world renowned surgeon in Philadelphia who gave me no help at all, even after we waited for him for three hours. And so Robbins then suggested that what I desperately needed was a trabeculectomy. He said the man to perform such an extremely delicate operation was Ivan Jacobs of Watchung and Westfield, New Jersey. When I asked Robbins if he would trust his sight to Jacobs, he eventually said he would. It is my profound belief that he had heard about Jacobs and had never met him, so any assurances to me about Jacobs were uninformed.

So Jacobs began his trabeculectomy on my left eye. Somewhere during the operation, I overheard Jacob muttering to his helper that a choroidal hemorrhage had occurred. Later, when I was bandaged and sitting in Jacobs waiting room, he acknowledged that the choroidal hemorrhage had taken place. Jacobs distanced himself from the operation saying in effect, you win some and you lose some. I knew then that the sight in my left eye was gone and Jacobs didn’t seem to care. I saw him several times after the surgery and his cavalier attitude remained. It was my fault that I needed a trabeculectomy, was Jacob’s attitude. Everyone knows that surgical procedures don’t always come out successfully, but Jacobs in my estimation, was a monumental jerk.

I made several more visits to see a Dr. Green at Robert Wood Johnson Hospital. Eventually, he told me there was no hope. At the end of this process, I asked Robbins for my records as I intended for his tenure to come to an end.

After I left Robbins’ care, he apparently turned his attention to female patients. From what we know now, Robbins allegedly fondled seven women while conducting routine eye examinations. He was indicted on February 4, 2003 and charged with nine counts of fourth degree sexual contact. If he is convicted, he could face up to 13½ years of jail time. I suspect that he won’t spend much time in jail, but at least these charges and this indictment will give him something else to think about as he examines future female patients. He may also think about his lawyer, Alan Zegas, who is in the top tier of criminal defense attorneys. His fees for a case of this sort are probably quite substantial.

Now that you have met Robbins and know about his indictment, it is of utmost importance that you should know what excuse Robbins offered for his conduct. When the Essex County Prosecutor’s Office sent a female officer to Robbins for an eye examination in the summer of 2000, he allegedly fondled her just as it is also alleged that he had done to other female patients. He was then presented with charges about his conduct. Robbins said that he fondled women not for any such thing as sexual excitement. That never entered his mind. He said his hand, or hands, were searching their chests for evidence of future eye problems. So you see, old Robbins was on the job looking for eye problems down the road. It is a source of great disappointment that the seven women who charge that he fondled them don’t see that brother Robbins had their best long term interests at heart.

Now I have recited my story of blindness in one eye resulting from the tender ministrations of Robbins to set up one overwhelming point. From one end to the other, Robbins and your faithful essayist were involved for about four or five years. During that time, he performed just about every conceivable ophthalmologic process on me including surgery. At no time, did Robbins ever put his hand or hands down the front of my shirt or blouse either inside or outside my attire. I even wore scoop neck tee shirts to entice him to look at my chest for signs of future eye problems. For this reason, Robbins was completely unable to diagnose that eye troubles, including blindness, awaited me. This was a complete dereliction of duty on Robbins’ part.

It is my proposition that after Robbins and his lawyer Zegas deal with the indictment of this past week for inserting his hand or hands down the front of dresses or blouses of female patients, either inside or outside the garments, that he face a more serious charge against him. That, of course, is his FAILURE to put his hands down the front of my shirt or blouse and as a result, he was completely unable to diagnose what lay ahead for me as I dealt with serious eye matters. There is no excuse for Robbins dereliction of duty in my case. My chest was exposed to view as I never wore a tie when Robbins was to be visited. He simply never explored my chest in search of future eye problems and for that, he must be held accountable.

E. E. Carr
2-6-03

A Post Script. I have been a patient of Dr. Eric Gurwin of the Summit Medical Group for the past eight years. There was a time under Robbins when the pressure in my eyes ran to 38-40 whatever the measurement for pressure is. The current pressure in my one remaining eye is now between 16 to 18, which is a monumental improvement. It is to be noted that Professor Gurwin has achieved this dramatic drop in pressure without ever examining my chest which, of course, is traditionally where future eye problems are found – according to Robbins.

~~~

Why even try? Why try to defend yourself from that position? All Robbins managed to do with his (hilarious) defense was insult the intelligence of everyone involved, including the women who he had already wronged. Way to go, dude.

Some good news: he was convicted.
From http://www.njecpo.org/Press/pr_306.html
Acting Essex County Prosecutor Paula T. Dow announced today the sentencing of Dr. Richard Robbins, age 40, of Short Hills, New Jersey. The sentence culminated a lengthy investigation that began in 2001 into the sexual abuse of female patients under Dr. Robbins’ care.

Earlier this year an Essex County Grand jury returned an indictment against Dr. Robbins, charging him with having committed the crime of criminal sexual contact upon six of his female patients, and an undercover female Essex County Investigator. The indictment spanned a period from March 1, 2000 through June 20, 2001, during which time Dr. Robbins touched the breasts of those females during the course of performing eye examinations at his former practice located in Short Hills, New Jersey. Dr. Robbins pleaded guilty on June 30, 2003 to seven counts of criminal sexual contact.

During the sentence, Deputy Chief Assistant Prosecutor Robert Laurino told the court that Dr. Robbins had violated his Hippocratic Oath to “do no harm,” and breached the duty of care and trust he owed to his patients. Superior Court Judge Thomas R. Vena, in addressing Dr. Robbins prior to the imposition of sentence, noted that “the harm you caused was enormous.”

Under the terms of a plea agreement, Dr. Robbins permanently surrendered his license to practice medicine. He was sentenced to three years probation with mandatory counseling, and was subjected to numerous court costs and fees. He was also directed to reimburse the Prosecutor’s Office $2,085 for the costs associated with its investigation.

Acting Essex County Prosecutor Dow noted the courageous efforts of Essex County Investigator Janine Traccamore, whose service in an undercover capacity led to the arrest of Dr. Robbins. “She put herself in harms way to prevent other women from being similarly abused” Prosecutor Dow stated.

NO REGRETS

When a man, such as myself, reaches the seventh decade of life, his friends and relatives congratulate him warmly and ask about his state of health. They seem to really want to inquire how long do you think you may stick around.

When the eighth decade turns over on the speedometer, the efforts of friends and relatives become a little more pointed. They are concerned because the old timer may not eat as much as he did at age 30 or they may read road signs that they believe the older person can no longer see. And if in conversations with a slightly younger person, if the name of a politician or a physician does not roll off the tongue, the younger person may diagnose Alzheimers.

Wile the elderly person may appreciate the solicitude of his younger friends and relatives, there is an element of wonder about why you are still hanging in there. In my case, it seems to me that assuring the inquirer that every body part is working and that a change in subject might be appropriate. All done with a laugh, of course. The laughter may be forced but it is preferable to a discussion about the imminent demise of the decrepit elderly person, namely me.

When people close to me ask about how my fortunes are succeeding, it has an unintended effect on me. Tor all these years, the end of life has been a subject that has been rarely considered. Surely, Miss Chicka and I visited Paul Ippolito, one of Summit’s leading undertakers, to enter into a pre-paid arrangement to have our bodies promptly cremated. At heart, our visit to the Ippolito establishment was done primarily because of a proposed champagne party that we proposed to sponsor once Ippolito had done his work. First comes Ippolitto’s ministrations, then the reception, not the other way around.

But entering into a prepaid arrangement for disposition of our bodies does not constitute grounds for saying that we have a death wish. It is simply and purely a business arrangement made while our minds were unclouded by any other thoughts. Now the kicker is that the prepaid arrangement pays a 5% interest premium to us every year, so it is a prudent investment as well. Sorry, only one to a customer.

Many people think that my mother gave me her build and her sense of Irish humor. For that I am grateful. On the other hand, Lillie, my mother, was engrossed by the idea of death and the thought in her mind, that she would be rewarded unendingly in a place called Heaven. Her favorite hymn was “Amazing Grace.” Running a clear second was the hopeful hymn called, “How Beautiful Heaven Must Be.” She envisioned a place high up in the sky with no sin and no sickness and with angels with wings where their shoulder blades should be. She always said, “That is where I am going when my work on earth is finished.”

As life unfolded for me, none of Lillie Carr’s confidence in a heavenly after life ever made sense to me. My disbelief started at age six when my mother proposed to “save” me, among other thoughts, for a better life after death. And my disbelief has now lasted more than 75 years.

In 1943, German ground forces (The Wehrmacht) and German Air Forces (The Luftwaffe) managed to destroy two of the planes on which I was a member of the crew. In the first shoot-down, there was a lonely period of four days in the sands of the Libyan and Egyptian frontier before rescue came. In the second case, the Germans took me prisoner and it was necessary for the Italian Partisans to come to the rescue. From beginning to end, about seven weeks elapsed in this episode which started at the prison camp at Rimini, Italy.

Now the point in pointing to my unfortunate experiences in 1943, is that at no time did my thoughts ever wonder to being a casualty of war. Whereas my mother would have wrung her hands and would have gotten a preacher to help her pray, my thoughts were exclusively devoted to how am I going to get out of here. Obviously, the thought that soldiers were regularly shot occurred to me, but visions of heaven never came into my mind. My sole occupation was how do I get out of here. On no occasion did I ever ask to see a chaplain from either the United States or the German Army.

My mother would never have understood my mind set, so I can’t ever recall discussing the subject with her.

E. E. CARR
August 24, 2003

~~~

This is not where this essay originally ended. From here he uses “Aside from the well meaning inquiries about my health and longevity, it appears to me with events in Iraq, Israel and Afghanistan taking the turn they are, that death is a popular subject in the Middle East” to segue into a discussion of martyrdom and virgins in paradise. The essay stops midway through one of these thoughts, so the entire section is omitted here because it’s been discussed at length in these essays. I think he just found this sort of claim to be a special kind of absurd, perhaps due to its unique combination of sexism and specificity.

People who tease old people (or anyone, really) about Alzheimers are assholes, full stop. Not much else to say there.

DISPARATE PONDERINGS

The title to this essay, “Disparate Ponderings,” may well reflect the influence of the New York Times editorial pages upon my brain. The ponderings in question really have to do with remembrances of years past. There are six thoughts in this essay and I hope that some of them will remind old-timers of the days before television and e-mail ever existed.

One of my recent ponderings had to do with female girdles. It seems to me that in years past whenever a female reached the age of puberty, she was obliged to buy herself a girdle. The Sears Roebuck catalogue, published annually each fall, was avidly read by the females as well as the males in our household. I can assure you that Sears had girdles galore. There were long ones and short ones, as well as black ones and flesh-colored ones. What baffled me then in the old days was why a young woman weighing no more than 110 pounds would need a girdle. Yet it seems to me with my faulty memory as a guide that every young woman looked forward to the day when she could order a girdle. In those days, women wore silk stockings with a seam up the back. It is hard to believe but there was a time in this country when there were no panty hose. I suspect that girdles were worn for the sake of keeping the silk stockings anchored so that they did not fall down around the ankles.

But the Second World War seemed to have altered everything. There was a shortage of rubber, and silk stockings were a thing of the past. Your old essayist cannot say that he misses girdles or silk stockings, but it is pleasant to ponder the fact that in the age before television came along there were such things. Sears Roebuck has fallen on hard times and, as an economist, I would suggest that it has much to do with the demise of the practice of women wearing girdles.

Now that we have settled the issue of girdles, another question arises about “Do you remember?” There was a time during the 1930s when athlete’s foot was a matter of serious medical concern. During my years in high school, when the boys would take showers following the gym classes, athlete’s foot was a common occurrence. It is not clear to me what causes athlete’s foot but I can tell you that it existed and that once someone had acquired it, it was difficult to rid oneself of it. During my high school years, I had at least two or three cases of athlete’s foot, which had to be treated with a liquid I remember as Camphophenique. Athlete’s foot was so common that advertisements for its cure appeared in almost every newspaper in a small ad at the foot of the newspaper. The pictures in those ads showed athlete’s foot at its worst, with cracking and peeling of the skin around the toes.

I am not here to proclaim that athlete’s foot was an ailment affecting only youngsters but as I also recall there seemed to be no athlete’s foot in the United States Army, where men traipsed in and out of showers at all hours of the day. This of course assumes that one saw service in a location where there were showers. There were occasions when men did not remove their shoes and socks for a few days at a time, yet my recollection is that no one ever seemed to complain of athlete’s foot. I suspect that athlete’s foot went the way of rheumatism, which has now been replaced by the more upscale term of arthritis.

Now that we have disposed of girdles and athlete’s foot, we must turn our attention to Charles Atlas, a gentleman who promised to turn “98-pound” weaklings into 210-pound behemoths. During the years of the Depression, many magazines were adorned with the advertisements of Charles Atlas. There were half pages and full pages, and each one of them showed a man with bulging muscles who contended that he used to be a 98-pound weakling. I never knew anyone who was taken in by the Charles Atlas advertising, but it was good entertainment during the Depression when there was no television or email.

I suspect that Charles Atlas was a man who sold barbells and other weightlifting equipment. That statement is totally unsupported by fact and it flows only from my memory that some of the people who posed for Charles Atlas advertising seemed to be carrying barbells. How it was that he changed a 98-pound weakling into a 210-pound behemoth never was clear while I was reading those magazines, and it remains unclear to this day. Yet there is a certain nostalgia about recalling Mr. Atlas because his advertisements were so widely printed that almost everyone in this country knew who he was. Perhaps your preacher might not have known who Mr. Atlas was, but I suspect that 95% of his congregation would know a good bit about Charles Atlas. I never heard Mr. Atlas being interviewed on radio and it is clear that no one ever referred to him as Charlie Atlas. And so it is up to us old-timers to remember that
Mr. Charles Atlas ever existed.

Now we turn to another pondering that took place during the Depression years. During those years, there was a great drought that settled all over the Mid West and into the plains states, so that the skies were virtually cloudless. From time to time, I assume wealthy advertisers would hire small aircraft to write their messages in the sky. The messages were brief, but they were quite effective, judging by the number of people who seemed entranced by them as the skywriter went about his work.

Skywriters always flew single-engine airplanes, which were of course propeller driven. They must have carried a tube of white exhaust that, when released, could linger in the sky for several minutes. Naturally, I was entranced by skywriting. It seems to me that letters such as “e,” “f,” and “t” should have been the easiest to write. The more difficult letters would be the letters “s” and “b.” My memory is that it would take perhaps ten to fifteen minutes for a skywriter to write his message in the sky. They only wrote the name of the product, and there was great excitement among the viewers after the first letter or two appeared as to what the message would eventually read.

My last exposure to skywriting came, I believe, in the early 1960s, when my family accompanied me to the New Jersey shore. On a cloudless day, a skywriter would appear and would write a message for the benefit of weekend viewers. There was even a romantic occasion when a skywriter wrote “love U” for the benefit of some love-struck youngsters.

No matter how you cut it, I was a draftsman who had a great interest in the formation of letters, here on the earth as well as in the sky. My regret is that I never had the opportunity to ride aloft while the letters were being written. One of my companions as a child always hoped that the skywriter would misspell a word. To the best of my knowledge, that never happened. All the words were correctly spelled and I regret to this day that skywriting is a function of a long-forgotten era.

Now that we have disposed of my pondering about skywriting, let us turn to a pondering about a wonderful entertainer named Burl Ives. Ives was a singer of folk songs who, like many other singers of folk songs, played a guitar. He was the son of a farming family from Jasper County, Illinois. Jasper County is far removed from the metropolitan areas of Chicago, Indianapolis, St. Louis, and other environs. But in the end, Ives eventually made it to New York where, in 1940, he was given his own radio program. His voice was absolutely distinctive. Fortunately, my ponderings have been helped along because I have several recordings which I have made into compact discs which offer such selections as “Blue-Tail Fly” and “I’m Just a Poor Wayfaring Stranger.” I am happy to report that folk singing is a vibrant art that has survived the assaults of rock music, hip hop, and other attacks on mankind.

Ives died a few years back at the age of nearly 90. I suspect that a good many of my older readers will recall him fondly. I certainly recall him fondly and my ponderings take me to the point of inquiring, “Where will the future Burl Ives come from?”

There is one other pondering that takes me into the field of religion where I am usually reluctant to go. In this case, however, it is a matter of economic circumstances having overtaken the teachings of a church.

For many years, the Roman Catholic faith has taught the evils of artificial contraception. Simply put, they dislike every form of birth control. The only exception came during recent years when the Vatican reluctantly approved the use of “natural birth control,” which seems to exist only during the time of the infertility of the female. I suspect that there are thousands of unplanned pregnancies that happened with the use of the so-called “natural planning.” My belief is that natural planning worked perfectly if one or both parties were sterile. But be that as it may, it appears that the economic circumstances of the 21st century generally require those who engage in sexual intercourse to use birth control. When one thinks about the cost of raising a child and putting him through college, sometimes at the expense of $50,000 per year, most people will conclude that fewer children are better than many.

Perhaps these economic circumstances came along a little late because your old essayist is the seventh child of an eight child family. But I was born in 1922 and today things are much different. There is a medical group that we patronize that has many nurses who have graduated from Catholic schools. As a general principle, it seems to me that those nurses are producing only one or two children per couple. One nurse had her second child not long ago and proclaimed that “This is it!” These are healthy young women who, I suspect, are not going to live the rest of their married life in celibacy. And so it is that the Popes over the years who have denounced the evil effects of birth control now find their parishioners practicing that art. With the cost of raising a child, particularly for those who plan to send their children to college, I can only say that this is a logical improvement.

Well, there you have six cases of disparate ponderings. Perhaps it can be argued that my ponderings reflect a wandering mind. Naturally, I would not agree with that conclusion but I would argue on the other hand that my ponderings recall an era when life was simpler and perhaps more rewarding. Any man who contends that my pondering about girdles for example is evidence of a disturbed mind will most likely never recall the use of girdles. Whatever my ponderings reveal about my inner soul is probably irrelevant. At my age I am very happy that I have enough cerebral power left to think about things such as girdles, athlete’s foot, Charles Atlas, skywriting, Burl Ives, and birth control. I would argue that men who have those kinds of ponderings ought to be celebrated with caviar, foie gras, and the clinking of champagne glasses.

E. E. CARR
August 16, 2008

~~~

These type of essays do a number on my search history. In one tab I have a whole set of pretty horrible images of Trench Foot (they definitely had that in war, even if athlete’s foot wasn’t a thing), and in the next there are all these hokey old ads for a bodybuilder man. Incidentally the Charles Atlas company, insofar as it still exists, seems to have not updated their advertising since the campaign that made them so famous. It’s a pretty incredible throwback to go to his site.

Girdles and skywriting are both common, too. Skywriting is pretty typical at big events like airshows, and girdles go by “Spanx” now but it’s the same deal. Another fun set of search terms, by the way, is “Spanx” followed by “Burl Ives.” I like to think that somewhere out there is a VERY confused advertising robot who very much would like to figure out what I’m trying to buy, but can’t at all piece together what these terms have to do with one another.

A LETTER TO MY READERS AND FRIENDS

Last December when I wrote the essay “Sing No Sad Songs for This Old Geezer,” it was intended primarily to tell my friends about the onset of blindness. Your responses have been overwhelmingly generous and I am deeply touched. I am not that good and not that courageous. The situation now is very much like it was in the melancholy days of World War II during the North African and Italian campaigns. At that time, it was my intention to do my duty, and to get from one day to the next without being killed. That is not necessarily courage; it is a matter of survival.

Your generous responses have led me to produce another few essays. The first two, dated before October 31, when the lights were turned out, were written by hand. On several occasions, I found that the right-hand margin of the paper did not stop my pen from writing. It just went on to the desk. Clearly, at that point I was becoming blind. The later essays, dated in the current year, were dictated rather than written. This is a difficult form for me to master, as I have always written essays in long hand until this time. Dictating without notes is a difficult exercise, but it is slowly being mastered. In the old days, there were essays that wrote themselves. In the new days of dictating, essays don’t write themselves anymore. About the closest I could come to having an essay write itself is the one called “…He Kept It For Hisself.” I hope you enjoy reading the essays.

Speaking of the onset of blindness, my old friend Howard Davis posed a question to me that required very little in terms of preparing an answer. Howard, as you may know, is the poet laureate of Defiance, Missouri, a job that pays something in excess of two million dollars or dinars a year. Howard asked me what was the last thing I saw before they turned the lights out. I am sure Howard envisioned a bed of daffodils or roses growing on a trellis or some romantic thing that would enhance his poetry. In point of fact, however, as much as it may disappoint Colonel Davis, the last thing I saw before the lights went out was the precious commode in the pre-op room in the Wills Eye Hospital in Philadelphia. I don’t know how Howard will make a poem out of that situation, but that is not mine to question. It is up to Professor Davis whom I know will make an epic poem which may be an ode to a commode.

I hope you enjoy reading the essays. The newer ones, written by dictating, require a lot of polish. They are not as well written as those written earlier in long hand. But be that as it may, this is the current state of affairs.

Again, I thank you for your very generous comments with respect to “Sing No Sad Songs For This Old Geezer.” As I said earlier, I just am not that good.

E. E. CARR
March 5, 2006

~~~
Below, I’ve linked my best guesses for the essays that he’s referring to. I’m pretty sure about the first two, but the second two come AFTER this note is dated, so I don’t know what the deal is with that. They’re all about blindness, though.

https://ezrasessays.com/?p=2227 A BUCKET OF WARM SPIT 10/10/05
https://ezrasessays.com/?p=2239 REFLECTIONS AS LIVES DRAW TO A CLOSE 10/23/05
https://ezrasessays.com/?p=1611 “WHO ARE YOU GOING TO BELIEVE: ME OR YOUR LYING EYES?” 3/13/06
https://ezrasessays.com/?p=1617 IT’S ONLY THE FIRST INNING 6/23/06

A LETTER TO A FRIEND CONCERNING LIFE AFTER BLINDNESS

Word has reached these ears that you have expressed the view that life would not be worth living if blindness ever occurred to you. This letter is not meant to chastise or to criticize that point of view, because the author has had many of those same thoughts in recent years. I fully understand the thought about life not being worthwhile after blindness occurs.

The purpose of this letter is to encourage you to consider the thoughts of a recently blinded man before your idea about life not being worthwhile is set in concrete. It seems to me that there may be some merit in the views of a person who recently became blind and who may offer some thoughts on the subject.

My bona fides are fairly obvious. For eleven years, I did without the sight in my left eye due to an expulsive choroidal hemorrhage during a trabeculectomy which is a process aimed at relieving pressure on the optic nerve. This summer, the pressure apparently expanded in the right eye, and despite all efforts to save it, it was also lost. A trabeculectomy on the right eye was performed at the Wills Eye Hospital in Philadelphia in October and unfortunately, it did not restore my sight. So for better or for worse, I am now a completely blind man. I do not see shapes or shadows or anything of the sort, I simply stare into blank space.

The major purpose of this letter to a friend is to tell you that it is still possible to enjoy life even after the devastating onset of blindness. I am trying to say that the onset of blindness does not mean the end of life. It just is not so. There is absolutely no gainsaying the fact that your life after blindness will change fairly dramatically, but that is not a reason to say, “I want to do away with my life because of blindness.” At this early stage in my blindness, the facts seem to say that blindness can be worked around and can be accommodated in spite of the debilitating effect it may have on a person. Clearly, a person afflicted by blindness will need a substantial amount of help. For example, I can no longer write checks. If I wrote a check, the bank would instantly reject it. There is a debate about eating because I am not yet ready, as a blind man, to appear in a public place to consume a meal because my eating habits have been altered by blindness. On the other hand, I have been able to resume many of my activities, starting with getting around the house, going shopping, and things of that nature.

Being blind does not mean the end of everything. Ray Charles, the entertainer who died recently, once contended that his blindness was only 1% of his total experience in living. I rejected that thought in an essay called “Ray Charles is Full of Spit.” Blindness is considerably more than 1% of a person’s living experience. On the other hand, there is no reason to say that 99% of my life is now shot, therefore I will retire to a hole in the ground and pull the dirt in over me and wait until an angel comes to carry me away.

Yes, you will need some help. Balancing your check book is one subject and reading a newspaper is another. Those things have to be worked out over time. But the burden of what I am trying to say is that those things are surmountable. Please understand that blindness cannot be defeated. It certainly can not. But it can be accommodated and lived with. When a thing is accommodated and lived with, there is no drastic reason to end one’s life. In the short time that I have been completely and totally blind, I have learned how to use the white cane and how to get around the house, not totally easily but with a modest degree of proficiency. As each day passes, it seems to me that my repertoire of experiences as a blind man grows slowly and so, in time, I hope to live a life resembling the life I had when I could see. I know that will never happen, but it is something to strive for.

When one considers what has happened to the people, to the soldiers, who have been badly injured and mutilated in Iraq, those of us who are blind have absolutely no reason to moan about it. A news report a week ago portrayed a 21 year old soldier who not only was brain damaged, his eyes were shot, he was blind, he was unable to breathe, and he had to be fed through a hole in his throat.

Good gracious, that is nothing compared to a man like me who even at 83½ years is able to exercise 4 days a week and is capable of doing a lot of things. When I see a report about what we are doing to our soldiers in Iraq, I am angry beyond reason. But it also demonstrates the fact that those fellows have a lot more reason to want to end their lives than those of us who acquired blindness late in life. I hope this gives you a thought or two about ending your life.

As I conclude this letter, I wish to point out that blindness does not flow from any celestial creature. It is not a function of Jesus, Allah, the Holy Ghost, Joseph Ratzinger (the new pope) or Jerry Falwell or Pat Robertson to order a case of blindness. But most significantly, regardless of the candles that are lit and regardless of the novenas that might be said, all of those creatures who reside somewhere above the clouds cannot cure my blindness or yours either. The thought that blindness could be cured by some appeal to a celestial creature went out of style at least in the first or second century. It is up to you to live with the situation and make the best of it, as opposed to praying and hoping that it would go away. The fact of the matter is, blindness is a permanent condition and must be lived with and taken into account at every turn.

I hope this letter reaches you when you are in a receptive mood and before your views about ending your life are firmly established. If you should decide that life is now not worth living, more than anybody else, I will respect and understand that point of view, because I’ve had those thoughts myself. I hope this finds you well. Blindness is not something to be happy about, but if nothing else, I can tell you from my small experience, it can be lived with and it is not a proper reason to consider ending anyone’s life.

Warmest regards,
E. E. CARR
December 25, 2005

~~~

Pretty heavy subject for a Christmas letter, Pop! Still, this is a sweet and realistic note, which is hopefully exactly the type of honest assessment that the recipient needed to hear at the time. I hope it made an impact.

A MATTER OF DIGNITY

Those of us who have lost our sight frequently wrestle with the thought of our potential uselessness. It has always been so. In the Irish folksong, “Johnny We Hardly Knew Ye,” an Irish soldier who served with the British Army returns from a battle in Ceylon minus two limbs. The song’s lyrics say, “You haven’t a arm, you haven’t a leg, you’ll have to be put with a bowl to beg.” While Johnny retained his sight, I’m sure that his sense of uselessness dominated his thoughts. And so it is with those of us who have lost our sight.

Simply put, those of us who are blind are incapable of doing many of the things that we have done all of our lives. If we try to help around the kitchen for example, it is quite likely that we will cause more problems than if we sat on a chair and remained silent. The other day, for example, when I intended to deal with the electric stove top, the results were two burned fingers. And the dish in question never got stirred.

If I elect to help set the table, it seems to me that the glasses are always a gross impediment. Sometimes I knock them over. Retrieving plates for the next meal helps very little. I tend to knock over other dishes as I try to extract the plates. The point is that uselessness is always a consideration for the visually impaired.

Around the kitchen, I fold the paper bags the grocery store gives us so that they may be placed in a rack on the back of the kitchen door. I am able, with a high degree of fumbling, to fill the glasses with ice on most occasions. Leaving the kitchen, I am able to help my wife by going to the front porch and retrieving the newspaper. In that same spirit, there comes the matter of taking out the garbage from the garage to the street.

Taking out the garbage involves a total of four trips to the street. There is a trip the night before the garbage is collected and then there is the matter of retrieving the empty container the next day. This happens twice a week. Every other week, there is also a need to take out and retrieve a second container which holds the cans and bottles for recycling.

The driveway here from the back of the garage to the street is at least 90 feet long with Belgian blocks defining its edges. I find that I can make my way from one end of the driveway to the other by using my white cane to tap on the blocks. It is remarkable to me how easy it is to stray in a direction that I had never intended. Completely blind persons such as myself have no sense of direction. I have no idea whether I am walking east or west or north or south. It is for this reason that blind people tend to stick to walls that help guide them. In this case, I use my white cane to tap on the Belgian blocks to keep me on course for my eventual destination at the street.

A lot can go wrong in the 90 feet of driveway. On two occasions, I overshot the driveway and wound up well into the street. On another occasion I became turned around and wound up in front of the neighbors house going down the street. Unfortunately, the street is also lined by Belgian blocks. Remember, I told you that I have no sense of direction.

My solution to avoid wandering into the street was to install a metal device alongside the Belgian blocks that would return a different sound to my ears as I approach the street. For blind people, ears and hearing are extremely important. When the thought of installing metal devices in front of the ordinary Belgian blocks first occurred to me, my thoughts turned automatically to a gentleman I have known for dozens of years. That gentleman is Matthew J. Pepe.

In the 1960s, I owned a house in a town called New Providence, New Jersey. Somewhere along the line, the patio outside the recreation room split in the middle and sunk. As a result, when rain occurred, the sunken patio funneled the water into the recreation room. When that happened, I consulted with a neighbor, Nick DiNunzio, who suggested that the man to call was Matthew Pepe.

Mr. Pepe poured a new patio for me and things were well taken care of. From that time until now, all of my concrete work and driveway work have always been referred to the Pepe organization.

When I called Matthew Pepe and explained my current problem about the garbage containers to him, he understood immediately. When I demonstrated to Mr. Pepe how I tap the Belgian blocks on my way to the street, his only question was, “And you are dragging the garbage can behind you?” I assured him that that was the case. From that point on I left things totally in Matthew Pepe’s hands.

Within a week or so, Matthew Pepe returned with his two sons and with three other men who work for the organization. They installed two metal deflectors that when tapped would return a different sound to my ears. One two-foot deflector was installed about 25 feet from the end of the driveway and the other was installed about six feet from its end. On the occasion of the installation of the metal deflectors, I gave them a test hop. As I walked slowly down the driveway and hit the first deflector, my wife tells me that there were smiles all around in the Pepe group. When I hit the second deflector, their smiles turned into laughter and cheers of approval. My test was a complete success.

When this project started, I explained to Mathew Pepe that I needed to take the garbage containers to the street to overcome my sense of uselessness. Matthew understood me completely. He said simply, “It is a matter of dignity.” Matthew Pepe is no psychologist nor is he a psychiatrist. He and his sons are simply hard-working people who install driveways for a living. Pouring a new driveway is tough work. Certainly it is not a matter of shuffling papers in an office. It is backbreaking work.

So you see, while Matthew Pepe is not a psychologist, he instantly understood what I was trying to accomplish. Matthew and I have known each other for many years. He correctly concluded that what I was trying to do was to overcome my sense of uselessness. When he said, “it is a matter of dignity,” he was absolutely right. And when he said that, a tear or two developed in my useless eyes.

So you see, if you have a driveway or walkway to be constructed, the only place to go is to Matthew J. Pepe of New Providence. And if you are fighting a sense of uselessness, Matthew Pepe is the man to see. If he concludes that it is a matter of dignity, Matthew and his sons will take up your case.

E. E. CARR
October 15, 2006

~~~

This one made me happy. Pop always especially valued his interactions with people who do real physical labor for a living, so I’m sure that made the whole affair just that much more pleasing to him. I think that affection probably stemmed from his job at the filling station, where he learned about what it’s like to do exhausting work while being subject to all manner of customers’ whims. In that same vein, I bet that Pop was always nice to various customer service reps whenever he had to deal with them.

BLOODY NOOSE-I-NANCE

EEC dictation 11-17-05 1st DRAFT

The subject of this essay today is blindness. No circumlocutions, no euphemisms, just plain blindness. The blindness, of course, has to do with your old essay writer. As time went on during the recent series of eye operations, it became apparent that aphasia began to make giant strides toward erasing my memory of words and phases. Aphasia has to do of course with the inability to recall words.

This essay is written not as a perverse to spoil anybody’s yearend celebrations, but rather an attempt to deal with galloping aphasia in my own case.

It just so happens that the subject I have chosen is blindness because the two are, in my case, closely related.

It is not in my interest to attempt to persuade you to render any sympathy for me. Far, far from it. This essay is simply a device as a means of achieving some more mental agility which will push away effects of aphasia.

The fact of the matter is that once glaucoma takes a hold on your eyesight, there is not much you can do about it but to fight it. But in the end, if you live long enough, glaucoma may be the winner. I am the son of a blind man who lost he site to glaucoma some where age of 64 or 65 years. I am the brother of a man who lost his sight somewhere near his 60th year. I am the brother of another fellow who lost his sight near his 70th year. So the object is to outlive glaucoma but it is not always possible to do so, witness the recent events having to do with myself.

What I would propose to do today is to first welcome all of those who wish me well. On the hand, there are those who offered to say a prayer in my behalf. For those offering to say a prayer, it should be observed that, my attitude for 65 years toward religion has been one of non-belief in organized religion, disorganized religion and unorganized religion. I appreciate the thought, but it appears to me that prayers will not necessarily change things.

The thought today in this essay, is merely to account for certain factors that I had not known before blindness set in. The blind person has no series of reference compass. He does not know if the is facing east or west, north or south. It is easy for him to become confused and it is easy for him to loose his balance and fall down.

Beyond that there is the thought that things are not always what they seem to be. For example, when a room is entered by a blind person like myself, if things go well, in a series of functions, good results will occur. On the other hand, if there is some confusion, the whole deck of cards tends to fall over. For example, it has seemed to me that there are rooms in this house that occasionally have been rearranged. With the door on the one end of the room as opposed to the other end. At the same time, there are occasions that the doors that I count on to get me from one place to another do not add up, and I wind up being easily and totally confused. As things have worked out, logic seems to be the only savior. If I can locate one familiar object, say such as the dresser, then the rest of the objects tend to fall in place. But in the meantime, there is great confusion as to where I am and how I am going to proceed, simply because of the confusion generated by my lack of sight.

At the moment, I am doing fairly well in the familiar surroundings of our house. The bathrooms and the kitchen etc are well known and I can get to them with no great trouble. One the other hand, during the 1950s, 60s and 70s, builders built a large number of home called split-levels. In those split-level, there are a large number of stairways.

Some of the stairways are 6 or 7 steps. No matter how you cut it, they are stairways and they can be fallen down fairly easily. This is the second split level house that I have occupied. And it is necessary at all times to keep in mind where the stairways are located.

Venturing outside the house requires my close association with my wife Judy, who acts as my eyes. Without her, I would be pretty well up the creek without a paddle. Last Saturday we bought a white cane which is a very valuable instrument but it still does not match sight. Going outside requires unfamiliar territory to be negotiated. That is an onerous task in many cases. Being blind tends to wear the blind person down, as every second is consumed with fear of falling down or some other catastrophe. Both when I am with Judy, and the walking stick I tend to get along fairly well.

I think that by this time, you have the fact of life in my case and I am required for better or for worse to deal with it. Blindness is not an adventure as in a pregnancy, but it is a fact that has to be dealt with. All of this leads to this essay and leads me to the title of this essay and reflections on my relationship with my father.

Ezra Sr., a very proud man, was completely blind for the last 12 or 13 years of his life. The five Carr children all understood that glaucoma was an ailment that could be transmitted from one person to his children. In this case, blindness has gotten to my brother Earl. And Charley died at age 60 and thus seemed to avoid blindness. The two women involved seem to have been able to live normal lives despite acquiring glaucoma.

When my father developed glaucoma, he turned himself over to the Post brothers who operated out of Barnes Hospital, a well known institution in St. Louis. At that time, it seemed to me that surgery was perhaps the only solution in an attempt to handle glaucoma. Before long, my father’s eyes were an unsightly mess. During the Depression, my father went for quite a while without a job, through no fault of his own, until he landed a position that was to care for the grounds in a large subdivision in University City, Missouri. In spite of his ability not to see things, he tried to trim a tree at the end of his career. He said he believed that he was stepping on a limb of that tree, and of course there was no limb. He fell on his skull, fracturing it, and ended up in a hospital. That was the end of his career and for the next 11 years he was housebound.

At first, people used to come and drive him to church, but within two or three months, that came to an end. He was reduced to sitting next to his Atwater Kent and listening to the news reports. Eventually he began to listen to adventure stories about the wild west. He more or less threw himself into the action.

Ezra Senior, as I have said before, was a very proud man who treasured the life that he had left in rural Illinois. He refused to give in to city ways. When he for example, went to a small café near his house, he would order a white sod-ee, not a white soda. The name of the state that contains L.A. was pronounced Cal-i-for–nee, not California. One of my sisters attempted to make his language a little bit more modern, but every time she said something, he reverted to his former ways with greater tenacity. I stayed out of the debate about locutions as I knew where it would end.

Ezra Sr. was a man who honored his Irish forbearers, which resulted in his use of the strongest epithet I have ever heard, which resulted in the word “bloody.” When we were out driving in one of his Studebakers, if the engine talked back to us, he would say, “I’ve got to fix those bloody tappets.” Another one of his mispronunciations had to do with the word nuisances. It turns out that if George Bush, who graduated from Yale and then took a masters degree from Harvard, can say “nuc-u-lear,” then there is no reason for my father to avoid saying noose-i-nance. My old man was not without his faults, but he was a tough guy. He said about his blindness, “Yes, it’s not easy to deal with, but more than anything else, it is a bloody nuisance.”

And so I tend to take pretty much the same attitude that it is a bloody nuisance that will have to be dealt with. I am, of course , not happy about the loss of my sight but I am philosophical knowing that everything that could have been done, was done. So as a pragmatist, I intend to live as best I can, for whatever time remains, with the thought that there could be some good come out of this whole mess.

I appreciate your staying with me thorough this essay during the Holiday season. If things go well, perhaps next year we might have a more pleasant message.

E. E. CARR
November 17, 2005

ADD EARLIER:
Blindness teaches patience. And secondly, blindness has the virtue of never causing anyone to search for his eyeglasses again.

~~~

I’m publishing a draft, because:
1) it gives some fun insight into his iterative process post-blindness,
2) it’s sufficiently well-assembled to stand alone as an essay, and
3) it’s the last thing from 2005 to be published.

I think he got in the remark about not having to search for eyeglasses in a later essay, because that certainly rings a bell.

WHAT WAS THAT GUY’S NAME?

In a previous essay, I commented on the effects of aphasia, which is a stroke-induced ailment. As I mentioned in that essay, aphasia is a brain-related injury as opposed to a heart-related injury. People who have strokes often call for the cardiologist but in fact what they need is a neurologist.

One of the characteristics of aphasia is that it hurts not at all. That is to say, your arm or your leg or your head doesn’t hurt, but the hurt will only be to your confidence and your feelings of well-being. Aphasia has to do with the inability to recall names of people and other items of interest. It is quite possible, indeed it is more likely, that I can describe all of the circumstances surrounding an individual or an item of interest and still be totally unable to recall its name. That is aphasia. As I reported earlier, I could describe the NBC announcer Tom Brokaw, who wrote the book called The Greatest Generation, in great detail but I could not recall his name. At least I am a civilian with no great responsibilities any more but it would be catastrophic if I had aphasia were I to be a druggist. For example, I would mix up a prescription and put it in a bottle; a customer would come in and I would tell him to take two in the morning but I can’t remember his name. He might tell me that what I had prepared for him was an aspirin. That’s fine with me, but I couldn’t recall it.

Another aspect of aphasia is that highways with numbers on them are a blur to me. I can’t really recall the difference between Highway 78 or Highway 80 or any other highway anymore. All of this goes to say that I would not be a great guide to lead you around this part of the country or any place else. Another aspect of aphasia is that I frequently forget its name. In addition to that, I frequently forget the name of glaucoma, the ailment that has taken my sight. As I say, aphasia hurts not at all but it is a problem to be forced to ask my wife or my friends, “Who was that fellow?” or “What was the name of that highway?”

One of the few benefits of aphasia is that the people at the Kessler Rehabilitation Institute told me to write essays as a means of stimulating my brain activity. At this point, I suspect I have written perhaps 200 such essays since 1997. For unknown reasons, I have never enumerated them all. They are in binders behind my desk and the totality of the binders suggests that perhaps 200 have been written. But nonetheless aphasia offered me the opportunity to be instructed by Shirley Morgenstein who remains as one of my treasured friends.

In preparing for this essay, I had forgotten the name of the Kessler Institute and had to be reminded by my wife. Earlier this evening I wrote a letter to William Rudin, the man who bought 32 Sixth Avenue where there is a plaque honoring the dead from World War II among Long Lines employees. I remembered Rudin’s name but of all things I forgot for a time the name of one of the dead men who sat within seven or eight feet of me and whom I knew very well. His name was Bernie Wheeler and he was killed shortly after the war started because he was an army reservist who was called up immediately.

I have been writing essays as you can see since 1997 and I suspect that if I had not written essays, my ability to recall names probably would be much worse. Nonetheless, recalling names of people or places or things still poses a problem. On the other hand, there are names that come to me almost instantly from people I knew not very well at all. For example, I have known Tom Scandlyn for 48 years. Over that span of years, I met his wife perhaps five or six times. Nonetheless I can recall Naomi Green, her maiden name, almost instantly yet I can not fish out the name from my mind for the Kessler Institute of Rehabilitation. Please go figure.

My advice to all my readers is fairly simple. If you wish to avoid aphasia and all of its attendant disabilities, please do not lay yourself open to having a stroke. On the other hand, if you are ever afflicted with aphasia, I will welcome you to the club, providing I can remember your name. And as I said at the outset of this essay, aphasia doesn’t hurt at all. There are no aches or pains or anything of the sort. You may become insane from not being able to recall a name but that doesn’t qualify as something that hurts. Again, my advice to you if you wish to avoid aphasia is to avoid having a stroke. But on the other hand, my neurologists have been lovely women. So there may be some benefit after all.

While I am in a state of I am going to torture my baseball playing grandsons by asking them if they know who had the names of “Big Poison” and “Little Poison” and the Detroit pitcher called Eldn Aucker. Those three fellows played major league baseball in the 1930s and 40s, and my grandsons will go nuts trying to figure out who they are. For the private information of all of my readers, Big Poison and Little Poison were Paul and Lloyd Waner, who played for the Pittsburgh Pirates and Eldn Aucker was the submarine pitcher for the Detroit Tigers who pitched in the 1940s and perhaps the early 1950s. It will be a pleasure for me to watch somebody else trying to figure out who that name represents. Those two baseball playing kids may develop juvenile aphasia, which will be my contribution to the lexicon of neurology.
==========================

While we are in the business of extending remarks from previous essays, I thought that it would be well to extend remarks on the essay written earlier having to do with old time language. You may recall that was the essay where my mother, upon learning of the death of my father, commented, “I reckon he was plumb wore out.” As soon as the mailings were taken to the post office, four more thoughts occurred having to do with ancient English language that I had not thought of before. For example, if a lawyer stands up in front of a jury and says, “I aim to prove this man is innocent,” he means “I intend to prove this man is innocent. Intend has apparently simply replaced aim in the American language. There is another aspect here. My parents would consider the word “cemetery” an upscale word. Ordinarily they always referred to what we now call cemeteries as the graveyard. It is hard for me to understand why graveyard was replaced.

Finally, there is the matter of dinner and supper. For example, Tom Scandlyn invited Judy and me over to his house for lunch. In old-time English, my parents and his parents would have referred to the noon-day meal as being dinner. The meal that is eaten at the close of the day is called supper. I suspect that Tom will agree with those designations.

As time goes on, I suspect that more words will pop into my mind having to do with latter day substitutions for perfectly adequate words that existed in the old days. If that happens, I will try to keep you informed.

E. E. CARR
May 17, 2006

~~~
As a fun fact, it seems like this essay never finished its editing process; it wasn’t sent to Pop’s normal mailing list. It featured a few edits from Eva that indicated that it was still incomplete. However, it was the only one I could find that hadn’t yet been put on the site. I’m away from my normal computer where I track all these sorts of things (I’m at a wedding in Austin) so it was surprisingly difficult to locate a new essay to publish, so here we are. I’ll be double checking when I get back that I haven’t somehow missed a year full of essays or something, but from the looks of it this project may soon be complete. Strange for me to think about — I’ll write more on that when it happens.

THE EFFECTS OF APHASIA

There are those in academia who claim that knowledge of Latin gives a student a major leg up when it comes to understanding other foreign tongues. I am a great dissenter from that viewpoint. Latin is of no value in deciphering some of the world’s major languages, such as English or German, or any of the languages of Eastern European groups or of the Asiatics, such as the Japanese or the Chinese. It seems to me that Greek counts most when dealing with non-English words. Take Aphasia. The Greeks say it is the loss or impairment of the power to use words usually resulting from a brain lesion. As far as can be determined now in the 21st Century, the Latin speaking academicians had no word for it. Only the Greeks. So stay with the Greeks.

I have no claim to academic credentials. The Clayton Missouri Public Schools had me as its student through all 12 grades in their system. John Bracken was Clayton’s long time superintendent of schools. They taught Latin, but as far as anyone can remember, they taught no Greek at all. At Clayton, Latin was a subject of great disinterest to me as I avoided study of that dead language. I had no interest in being a priest. On the other hand, after I left school and began to work in filling stations, it was my lot for Tallis Liacoupoulus, a Greek who worked in a small nearby restaurant, to become one of my best friends. He worked for an uncle, Leon Antonapolus. His family spoke Greek among themselves and with my being curious, they would sometimes explain Greek words or sayings to me. So when it was time to join the United States Army, I knew a little about Greek speech and virtually nothing about Latin and I wound up in Italy.

The definition that the Greeks used to describe aphasia is quite accurate insofar as it goes. Clearly, those who experience aphasia will find their ability to use words impaired, and they will have their pride tested. Sometimes the impairment is greater and there are times when the brain simply refuses to function. And there are occasions when an aphasia impaired person has a thought in his or her mind, but it is delivered in a garbled fashion. On other occasions, the aphasia affected person will not enter a conversation to express a thought because it may be forgotten by the time he or she wishes to speak. And there is more which I will try to describe in this little exploration into the effects of aphasia. That is what this essay will attempt to describe.

Since late November, 1997 when I had a major stroke, aphasia has been my constant companion. Fortunately, the stroke did not impair any of my limbs. It seems that the main result of the stroke was the brain lesion which caused, in the beginning, a severe dose of aphasia. So I have wrestled with aphasia for the past five years and I expect it will be with me the rest of my life. So those are my bona fides to comment on the effects of aphasia. I did not plan on becoming a commentator on what causes aphasia. I am not qualified to do that. In my case, it just happened. Now it is my continuing intent to defeat and subdue aphasia rather than having it the other way around. In the main, after five years of trying, I think my efforts have been fairly successful.

When it becomes apparent that the stroke sufferer has lost the power to recall words, there is a chance – or perhaps I should say a danger – that he or she may simply remain silent. This is a matter of pride. There is the embarrassment factor at work here. Forgetting words and concepts is an embarrassment. An even greater embarrassment is to have the stroke sufferer deliver his comment in a garbled fashion. The mind may have a strong idea of what needs to be said, but the tongue mixes up the subject and the predicate so that the comment is very difficult to understand.

For example, at Overlook Hospital in Summit, New Jersey, while the staff had me in intensive care, there were six or eight other bodies in this small room. It became very warm there so the obvious solution was to turn down the thermostat. I knew what the problem was, but it was impossible for me to express that thought about being hot – or cold for that matter – in any fashion. And thermostat never entered my mind. Finally, a nurse came by and I drew her what looked like a thermostat facing and I showed her how if I moved the imaginary needle to the right, sweat would appear on my brow. Moving it to the left caused me to shiver. She got the idea, but in that whole episode, I couldn’t think of the words “thermostat” or “warm” or “cold.” Having to use a crude drawing might possibly be an embarrassment, but I waded in and let any embarrassment take a back seat.

There is another factor at work here having to do with the intrusion of a word or words that make no sense whatsoever. Let’s say that “carnival” weighs on your mind, as some of these nonsense words often do. And let us say that today, a waiter asks you about your order for lunch only to be told that, “I would like a hamburger and a carnival.” There are dozens of nonsense words that I had to purge before I spoke. In any case, this is another reason to remain silent rather than to risk embarrassment. Pride again.

The dictionary definition of aphasia as we said earlier, is the loss or impairment of the power to use words. Man, that’s only the half of it. What do you do when your brain completely shuts down or goes on strike? In some cases, the better off aphasia sufferer will search for a synonym. Let’s say he can’t think of the word “watch.” If his brain is at work, he may say “timepiece” or “Timex” or “Movado.” But when your brain simply shuts down completely, there is a period of silence which is a major embarrassment. In my case, there is a background of labor negotiations, lobbying and speechmaking where it was necessary to have a quick response to everything. When my brain occasionally shuts down, even at this late date and even at my age, I feel embarrassment. I understand embarrassment. And I comprehend pride.

Perhaps what is more embarrassing is to forget the subject under discussion. This may not happen much anymore, but when there are allied subjects to the main subject, it is a real problem to remember what points B, C and D are when they are ready to be broached. Losing a train of thought can happen very easily and it has not much to do with the impairment of the power to use words. It has to do with forgetting and losing the train of thought. Again, it is an embarrassment even if it happens in private.

This happens often in writing. My handwriting is about like other peoples, I suppose. Sometimes, I will have a thought and it is urgent to write it down before it is forgotten. This results in words that are misspelled or words that make no sense at all. Before the stroke well into my 75th year, I could easily retain those thoughts until they could be written and recorded. After the onset of aphasia, it is important that the thoughts be recorded quickly before being forgotten. As I said earlier, not being able to recall a word is only the half of it when it comes to aphasia. Forgetting is a major problem.

Now we come to the issue of concentration. Since aphasia became a major factor in my life, I find that it is urgent that all my powers of concentration be applied to the subject at hand. When it comes to reading stock tables, it is often difficult for me to remember which letter follows what other letter. “M’s” and “N’s” are good examples. Locating Comcast, for example, is a bit of a problem because it is necessary for me to sound out the word and to realize that it is “Comcast,” not “Concast.” Before aphasia, I never had that trouble. This same problem applies to looking up words in the dictionary or names in the telephone directory.

If I had trouble with the alphabet in reading stock tables, looking up words in the dictionary or dealing with the telephone directory, it all pales in comparison with my bank statements. I never claimed great expertise with numbers, but aphasia really threw a monkey wrench into the gears. All I am talking about is a simple checking account. In a month, perhaps I would write 25 or 30 checks. But when Chase sent me a monthly statement, I knew that a major battle was about to be joined. I am doing much better now, but I still look forward to the arrival of the monthly statement with a degree of distaste and I blame the lingering effects of aphasia for this outlook.

Now a little more about concentration. When driving my car, I never use the radio because it would impact my concentration. As a flyer for the U. S. Army Air corps – later the Air Force – we were trained to listen for noises that might presage engine trouble or for the sound of bullets hitting the plane’s skin. Those factors do not apply anymore, but I am not casual about driving a car. It is important that concentration be applied so that I don’t forget what I am doing. It goes without saying, that cell phone usage does not ever occur in my car. Another long term effect of aphasia.

I find also that words spoken by other people during a TV newscast, for example, are distracting. My concentration on the newscast is broken by the distraction which all goes to show that with the after effects of aphasia, it is largely possible to do one thing at a time – but not two or three things at a time.

Related to concentration is this thought. In a complex sentence where two or more people are involved, it is often difficult for me to determine who did what to whom if the account goes on in great detail. In my letters and essays, I usually deal with only one subject at a time. When I attempt to bring in other characters in an effort to make the account more concise or to save space, even I am unable to tell you who the “he” or “she” is in the concluding lines in the sentence structure. For example, in the attached story by Sam Dillon in the New York Times, I read only a part of the story before I was lost between Father Anderson of the Archdiocese of St. Louis and the man who claimed he had been sexually abused, Mr. Andreas. Perhaps if I subscribed to the Catholic faith, I might be able to distinguish between the litigants, but the lingering aspects of aphasia makes it not worth my while to figure out who did what to whom and who is the litigant and who is the defendant. For not understanding Sam Dillon’s story, I am prepared to spend the centuries after my demise in Purgatory. Serves me right for getting aphasia, which was invented by Satan himself.

In the foregoing paragraphs, I have told you some of the reasons for doing nothing about treatment for aphasia. Embarrassment and discomfort with the effects of aphasia are significant factors. Pride is sometimes the major factor. I know that from first hand experience. But those factors are of no consequence when the cost of doing nothing is considered. The overwhelming factor is that doing nothing is not an option. It is not an option to say that overcoming aphasia is too much work or can’t be done. Simply put, it has to be done. Certainly, it is hard, hard work and no one else can do it for you. Early in my aphasia experience, Shirley Morganstein, the Director of Speech Therapy at Kessler Institute for Rehabilitation, gave me a homework exercise that she thought would take ½ an hour or even one hour. I spent eight hours on that little project. I’m glad I did, but that homework assignment tired me greatly.

As soon as Overlook Hospital released me, Judy and I made a beeline for Kessler. During my two weeks in Overlook, some women who claimed to be speech therapists came to my room and gave me exercises. For example, name 12 vegetables or 10 automobiles makes. They took advantage of my being a prisoner of the hospital and attempted to sign me up for longer term work once I had gained release. Judy and I – mostly me – were put off by their high pressure tactics. So a day or so after leaving Overlook, we were in Shirley Morganstein’s office and she agreed to take me on as her student.

Shirley is a no-nonsense director and teacher who has no patience with people who show no sign of trying to help themselves. Failure to bring homework to the session would result in an imposing demonstration. I made sure to do what I was told even if it took eight hours to do what others would consider a half hour task.

Not long into the three days a week therapy sessions with Shirley, she suggested that I write essays. Our next meeting was on December 8, 1997. That day is of some significance to me because in Italy in 1943, I was shot down. In 1953, my wife at the time and I adopted a little girl. And, our second daughter was born on December 8 in 1956. So that date has some significance to me. In my first essay, I wrote about what that day has meant to me.

Because I had sessions with Shirley on Monday, Wednesday and Friday, it kept me hopping to deliver three new essays a week. I am not sure that Shirley demanded three new essays a week, but that’s what I gave her. Shirley traces her ancestry to Poland and Rumania. I had no idea of that fact as I began to write of my travels in Europe. When we got into the essays and I showed her my many souvenirs and my multiple passports, I suspect that Shirley became interested in what I was describing. After she told me about her ethnic background, I took her an ancient Polish flag in a small frame as well as a doll from Rumania.

In the five years since I finished at Kessler, my guess is that about 350 pieces of prose, including dozens of essays and countless letters and e-mails, have been written at this desk. Some are better than others, but there is a hidden ingredient in the written word as opposed to the spoken word. When an aphasia afflicted person is writing, he can take his time about the right word or the right phrase. Perhaps he may consult dictionaries or other reference works to find the right word or phrase. Or he may ask his wife. There is no immediacy to getting the word right and hence, no embarrassment. If my brain locks up while writing, which happens less often these days, I simply wait awhile and after some time passes, the words come back to me.

Writing is the most valuable contribution to speaking orally for me. If I have written about a subject, when I speak it poses much less of a problem. Perhaps the rule ought to be that writing should precede speaking. Obviously, that is not always possible, but writing helps immensely when speaking.

Shirley of Kessler is nobody’s fool. She had no idea whatsoever that I could write an essay. I knew I could but Shirley was completely in the dark on that subject. But in the end, writing is what brought me back from the jaws of aphasia and Shirley Morganstein is a proper heroine.

As you can see, recovery from the effects of aphasia is a long term investment that takes a lot of work. Having people like Shirley Morganstein – a tough teacher – around was a great help. And mostly, having my wife Judy to look after me and to give me thoughts of how I might improve was nothing less than crucial.

Aphasia it not the end of the world. From time to time, it frustrates me particularly when I know a word that I have used 10,000 times, will not come to my mind or to my tongue. Ah, but there are certainly worse things, so to the extent it can be done, I am inclined to laugh about it. The saving grace is that the word which won’t come to my mind or tongue this afternoon, will roll out of my mouth this evening without my even being aware of it.

Now to all those people out there who cluck their tongues and diagnose alzheimers for every word forgotten by older people, I would recommend that they be introduced to aphasia. Or perhaps they ought to talk to me or to Shirley Morganstein or to Judy Chicka. Nobody can claim that he or she is as quick as they were 40 years ago, but when I forget a word, it doesn’t mean that the alzheimers caretakers should ready a bed for me. It is a long struggle, but with the help of my friends and my wife Judy, old Ezra will do pretty well indeed. When I worked for Uncle Sam, nobody in the Army ever heard of anyone having alzheimers or aphasia. Now at this late date, this old soldier does not intend to succumb to ailments that nobody ever heard of – except for the Greeks.

All things considered, it is my hope that after reading this essay on the effects of aphasia, that you found it instructive or that you enjoyed it. On the other hand, if none of those positive factors apply, remember that when I began to deal with aphasia, I was unable to say “warm” or “cold” or “thermostat.” Those words were light years beyond my reach. The point is that with my background and with the help of professionals, I can now say pretty much what I think. A few years ago, this stroke victim was largely mute. If I can do it, if I can come back, surely other people can do it as well. Stay strong and get to work on your exercises and, in my case, on my essays.

This essay is being written for those currently suffering from the effects of aphasia, be that now or in the future. It is not written as a means of attracting sympathy for myself. I need no sympathy. In my case, I have wrestled with the aphasia tiger and I believe he has been largely subdued. So don’t waste any tears or hand-wringing for me. Save that for those who are dealing with the aphasia concern right now or somewhere down the road in the future. If those aphasia afflicted people work hard and stay strong, I am certain that they too can dispatch the aphasia tiger.

E. E. CARR
November 27, 2002

~~~

The revelation here for me was that writing about a given topic “cleared” that topic in his mind, and made it easier to access going forward. That actually seems like it might explain why he went on to double the count from 350 essays to the final count of 700+. (Fun fact, this is the 701st essay to be published to this site!) The way it’s presented, writing about these memories cleared out some mental cobwebs and let him speak more confidently about those topics going forward. I think in a more literal sense that means that these essays were re-wiring the neurons in his brain. New, alternate paths were created to access knowledge that was closed off by the brain damage caused by stroke, which is amazing. I’d imagine that raw persistence and laughing off the hard moments probably helped tremendously.

REFLECTIONS AS LIVES DRAW TO A CLOSE

For two or three years, it has been my intention to write an essay on poetry. If there is a human who knows less about the mechanics of poetry, it would be my pleasure to meet that person. Knowing almost nothing about how a poem is constructed does not bar me from commenting on the finished product any more than citizens are barred from comment and criticism of politicians who know nothing about how a good government should work.

If and when my pen takes paper to record my thoughts about poetry, it will be my contention that the best poetry today is written by lyricists who write poems that are meant to be sung.

Going a step further, it would be my contention that the best poet-songwriter these days is Eric Bogle, a native of Scotland who moved to Australia nearly 35 years ago. Bogle is a prolific author who sings the songs that he has composed including his lyrics.

In all likelihood, Bogle’s best known works are two anti-war songs having to do with the First World War. There is “And the Band Played Waltzing Matilda,” a description of the sad adventures of an Australian soldier who was involved in the Battle of Suvla Bay in the Gallipoli region of Turkey. The second is formally called “No Man’s Land.” It is also known as “Willie McBride” and “The Green Fields of France.” That last title is a misnomer because the inspiration for the song came from a British military cemetery in Belgium. That is a small point of no consequence. The burden of the song is a strong indictment of war.

“And the Band Played Waltzing Matilda” is a long song-poem which describes the enlistment of an Aussie soldier, the battle, his wounding, and, in later years, his thoughts as his old comrades parade on ANZAC (Australia-New Zealand Army Corps) Day in April. These four lines from “And the Band Played Waltzing Matilda” have stuck with me for years. The people of governments that promote war should be equally haunted. The lines are:

“Then a big Turkish shell knocked me arse over head,
And when I awoke in me hospital bed,
And saw what it had done, well, I wished I was dead,
Never knew there were worse things than dying.”

-Eric Bogle

The Aussie soldier lost both legs when he said, “Never knew there were worse things than dying.” I suspect that thought has crossed the minds of many ill people for whom medical science offers no cure or even temporary relief from pain. In some cases, dying would be a release from constant pain. Only the state of Oregon recognizes this miserable situation, but the Bush Administration seems determined to wipe this right off the books and make assisted suicide a major crime. How stupid. We spare household pets the pain of suffering, but such a release is denied to humans. Again, how stupid.

Bogle’s second well known song is his visit to the graveside of Private William McBride, presumably a Scottish soldier killed in the First World War. The first verse sets the stage.

“Well how do you do, Private Willie McBride,
Do you mind if I sit here down by your graveside,
And rest for a while ΄neath the warm summer sun,
I’ve been walking all day and I’m nearly done.

I see by your gravestone you were only 19,
When you joined the great fallen in 1915.
I hope you died well and I hope you died clean,
Or young Willie McBride was it slow and obscene.”

Further on there are these lines:

“But here in this graveyard
It’s still no-man’s land,
The countless white crosses stand mute in the sand,
To man’s blind indifference to his fellow man,
To a whole generation which we butchered and damned.
For young Willie McBride it’s all happened again and
again.”

The chorus is the refrain:

“I hope you died well and I hope you died clean,
Or Willie McBride was it slow and obscene.”

Bogle offers two prescient thoughts here as they relate to lives drawing to a close. The first is the idea that “never knew there were worse things than dying.” The second is the “hope you died well and I hope you died clean or was it slow and obscene.”

From my own point of view, the thought that human suffering comes about because of a god or a saint prescribing it is rejected out of hand. The supernatural forces that reside somewhere above the clouds is a figment of an overactive imagination. Simply put, as we grow older, our bodies seem unlikely to fight off diseases and ailments that were of no consequence early on. This must be a matter of natural progression from birth to death. But natural progression moves often in cruel ways. Part of the cruelty is that fatal diseases haunt older people. It is not a matter of an ailment taking us away as Bogle says, dying quickly and cleanly, but a matter of imposing a burden for such a time that people will conclude that we didn’t know there were worse things than dying.

A few examples might make the point. For more than 50 years, the Vincendese family has owned and operated Berkeley Hardware in Berkeley Heights, New Jersey. The man primarily responsible for its success is Angelo Vincendese, better known as “Lefty.” For the half century that Lefty has been my friend, he has been a dynamo. As he has approached 80 years, he has slowed down and needs some days off. Krones disease has caught up with Lefty. When Judy asked Lefty last week how he was feeling, Lefty gave her a pragmatic answer. He said, “I will never feel well again.” The last thing Lefty would ask for is your sympathy or pity. Lefty’s suffering is such that he must think Krone’s is worse than dying.

There are two of our neighbors who lost their husbands to Parkinson’s Disease. It wasn’t quick and it was not clean. Those brave women tended to their husband’s medical condition for more than three years. As life draws to a close, nature picks on the vulnerable in a cruel and vicious manner.

Two other examples come to mind. One was an atheist, the other a nun. In 1948, when Henry Mencken was a successful and a powerful figure in the publishing business, he suffered a debilitating stroke. Mencken was the bane of preachers and politicians and those who promise you some sort of eternal ecstasy provided you died first. In the years following the stroke, Mencken was unable to write. His mental processes were so afflicted that he could not compose a story or an essay, much less a book. And this was the man whose prose was the gold standard in American literary circles. He lingered for six years before death finally released him. During that time, he must have thought that perhaps his crippled condition made death an attractive alternate.

On the other side of the coin is Mother Angelica, a Catholic nun who was the driving force behind the Eternal Word Television Network. Mother Angelica was the chatterbox of EWTN. There were times when she lectured on her personal guardian angel. She gave him a name and called on him to help her out of tight spots. Why she had a male guardian angel is beyond me, but she called him “Stoney” as in a stone wall. In all seriousness, she told her TV viewers that they could also have a guardian angel – if they really believed. Mother Angelica’s pleas fell on deaf ears.

Mother Angelica must have spent an enormous amount of time before the TV cameras. She was the sales person for selling religious knick-knacks and trinkets such as a plastic heart of Jesus. She was a very busy woman. Three or four years ago, she disappeared from EWTN’s studios. After a long delay, the network announced, without saying so, that she had suffered a stroke that robbed her of the ability to speak.

She may be nearing 80 years, but in the end, she is denied the opportunity to broadcast as Mencken was denied the opportunity to write again. The atheist and the nun. Nature moves in cruel ways. Mother Angelica lives in a Catholic facility and is waiting for God to call her home. In the meantime, she must curse her inability to speak. Remember, some ailments are worse than dying.

There is one other example involving the televised broadcasts of a Presbyterian Church in Summit, New Jersey. We watch the broadcasts until the choir has sung. One of the points in the service at this church is a few minutes devoted to “Joys and Concerns.” An assistant preacher asks for congregants to stand and announce a joy or a concern. On the joy side, someone may announce the arrival of a baby. Ah, but on the concern side, people will ask for prayers for a terminally ill cousin. On some occasions, prayers are asked for a person who must undergo an operation.

The concerns outweigh the joys regularly. Those who ask for prayers may want to avoid the inevitable. No one in this Bible believing church has ever asked that prayers be said for someone to have a speedy, dignified death as in Bogle’s “No Man’s Land”. No one!

Now to close the circle, age and glaucoma have caught up with my eyesight. If all goes well, there will be a delicate operation to drill a hole in my one eye that will permit the aqueous fluid to drain. I have not requested prayers of any kind because of my fear that the prayers would go to the god or saint who ordered me to become afflicted with glaucoma in the first place. Glaucoma is an insidious inherited disease. In my case, it was inherited from my father. Gods, saints, prophets and ascetic worshippers had nothing to do with it.

As difficult as it seems, there may be a bright side to my diminished eye sight. It is clear that when it is necessary to go from one place to another, poles, doors and walls intrude and are hit. There was an occasion when a step was missed resulting in a fall. But think what has been learned that will benefit religious organizations for centuries.

Joseph Ratzinger, the German soldier who became the current Pope, has launched a vigorous drive to root out homosexuals from Catholic seminaries in the United States. Curiously, Ratzinger, who headed the Vatican office of the Inquisition before his elevation, has not moved to separate priests who may be gay. The fury is directed at his seminaries but nothing has been said about the graduates of those seminaries who may be gay. It may have to do with the shortage of priests or it may be a matter that God and the German Pope can come to an agreement on later. In the meantime, no word at all about pedophiles. Is the Pope confused between being gay and being a pedophile?

For all those religious organizations that require male celibacy, one of the products of my limited eyesight may provide a heaven-sent answer.

You may recall an essay from this corner about Saddam Hussien’s jockey shorts. As a result of that essay, I now wear Saddam’s style of jockey shorts. When a man or a seminarian or a religious cleric wears jockey shorts, they must be worn properly to adorn the front of the male body. With my lack of sight, I have discovered that it is disastrous to put the shorts on backwards. But if the German Pope is serious about his new crusade against American seminaries, he can order all seminarians to wear their jockey shorts backward.

There is one more thought to offer in the drive to stamp out gayness in American seminaries. That is to put the shorts on turned inside out. It has the same effect as wearing the shorts backward.

Clearly, the Ed Carr innovations for the use of jockey shorts will be a godsend to those who wish to stamp out gayness in American seminaries. In all modesty, I expect to be decorated for my profound contribution to celibacy in seminaries. Perhaps a robe or a ring would be appropriate.

Well so much for male underclothing. Dealing with the ailments that overtake us at a vulnerable time is not an inspiring subject. It is simply a matter of pragmatism. It happens and nothing is gained by pretending that it is not the case. The sad fact is that Lefty, the hardware store owner, may never feel well again and it happened as he approached 80 years. If the situation becomes so serious, there is always refuge in Eric Bogle’s words, “Never knew there were worse things than dying.”

A final thought. Males seem to contract ailments that last a long time. The wives who take care of them are brave and seem more than willing to make the sacrifice to care for their men. From all of the men, a rousing salute is indeed in order, as well as – “Waltzing Matilda, you’ll come awaltzing Matilda with me.”

E. E. CARR
October 23, 2005

~~~

Real cheery one there, Pop. But I guess that’s kind of the point — there’s a class of things out there which can’t be made nice by trying to have a positive outlook, or by praying about them, or by really anything. There are some indignities that have to be borne slowly or painfully. I think that the ‘worse than death’ part may still be an exaggeration in many of the cases he described above, however. For sure there’s something cruel about a career writer being rendered unable to write, but that doesn’t mean that death would have been the preferable result to Mencken’s stroke. I get that if you’re in some sort of true prolonged agony, there are circumstances where death potentially seems more appealing than life, but there’s to me a pretty wide gap between that and just being majorly inconvenienced.