Clearing/Cleaning

     Quick warning: this post will sound a bit depressing but it does end on a happy note.  And while it begins with medical issues we could all face, it may prove helpful to know a few symptoms of the unexpected.  But to start, what's with that title of clearing vs. cleaning?  It's amazing the similarities a single letter, or phrase --say, inside vs. outside-- can change not only a meaning but also change how you say it.  As an example, you can say IN the house, and have it make sense, but not OUT the house, unless you add "side" or sometimes a preposition such as "out OF the house."  To wit, if asked where are the keys, one could answer "in the house" but you couldn't say "out the house" unless you added "outSIDE the house."  Why is that?  Now imagine you're from Albania and trying to learn such nuances.  The bottom line, English is often a funny language when it comes to such odd and sometimes strict rules of grammar, so keep that in mind when someone talks to you with an accent.  But forget all that because we're going back to that clearing (the verb, to clear, as in "clear the table," vs. the noun, as in "let's have a picnic in that clearing"). 

      Just after I posted that no-looking-back piece, I decided that perhaps I should start doing some clearing out of my own, and what better place to start than with my emails.  Now I must admit that I am indeed a clutter-bug, that imaginary creature that strongly denies being a hoarder but tends to buy in bulk.  As for me, I can find a myriad of uses for almost anything, including using the rationale that it may be best to hang onto something just for awhile.  "Let's just put it over there for now," I'll say, which means it will never again see the light of day (but when it does, it will bring a happy smile of fake recognition and relief, as if to say, "I wondered what happened to that?," followed by another round of "this time I'll put it over here so I'll remember where it is.")  Placed altogether, this growing collection of stuff would be called "junk" by most people.  But me keeping emails?  Why would anyone keep so many emails, no matter how "important" they may have seemed at the time ("best to save that for later, so I can come back to it when I have time").  So I began scrolling, and scrolling, and scrolling, and gad zukes, my "saved" emails dated back to 2010...yes, an astounding 15 years of emails (and here I felt that I had been purging them as viciously as I purge my text messages which are lucky to survive an hour, much less an entire week).  Now admittedly, I only had about 3 saved emails from each of those early years so it wasn't as bad as it sounds.  But still.  Why would I have saved those?  Determined to read them again, I found a few gems from the past.  Not only were many of the letters long-forgotten, but many were from people who had passed, a glimpse back at what my brother and other friends once thought were funny or worth passing on.  So these few examples will give you a peek at what I apparently felt was worth keeping back then in my emails (for the most part, emails which are now deleted): 

 

     To begin, my brother was a source of inspiration to me, so his unexpected passing some years ago cut off an entire line of communication.  We would exchange everything from familial memories to recently read books (he often read entirely different subjects than me), to news quips, and yes, even humor.  I still miss his reasure chest of wisdom.  Back in 2011, my brother had forwarded a letter from his long-time friend (they'd known each other since high school).  It dealt with his friend writing to him about having a heart attack (vs. a stroke).  And truthfully, unless you've actually had a heart attack, most of us feel that something that catastrophic simply won't happen to us. But would we even know or admit that we may be having such an attack?  Wrote Global Statistics in 2025: Heart attacks, or myocardial infarctions, remain a major health concern in the United States, occurring every 40 seconds [emphasis mine].  Each year, an estimated 805,000 heart attacks take place, including 605,000 first-time events and 200,000 repeat cases...One American dies every 33 seconds from a cardiovascular-related cause, making it not only the top killer but also one of the most preventable.  Heart disease accounts for nearly 1 in 5 deaths nationwide.  Notably, around 20% of these are silent heart attacks, occurring without obvious symptoms and often going undetected.  

     What follows is my brother's friend's story story (edited down) and his description of what happened afterward.  Bear in mind, I would likely feel much as he did in denying something major might be happening to my body.  But almost more importantly, his story is really about the difference in medical care from a socialized nation (he lives in New Zealand) to that of the U.S.  Quite honestly, especially for those about to lose their health care because of the Republican party's stance, that alone may be enough to give you a heart attack.  Here is his friend's account of what happened: Last Thursday, I rode my bicycle into work.   I’m not sure how far it is but I’m a fit and  fast rider and it takes me 20+ minutes to make the journey through the city.  When I finished work Thursday, I decided to see how quickly I could make the journey home so I rode hard all the way and arrived home in 15 minutes – a little out of breath but feeling fine.  20 minutes later, as I was sitting and talking to Colette [his wife] as she prepared the evening meal, I began to feel quite odd.  My upper spine, neck and jaw began to ache and I began to feel a bit queasy.  I told her about this and went and lay down on the sofa to see if it would pass off.  After a few minutes, it seemed like it was getting better so I got up and we ate the meal she’d prepared.  But, as we got to the end of the meal, I began to feel poorly again and went and lay down on the sofa a second time.  The symptoms were the same with the spine and the neck and jaws but getting stronger.  Meanwhile, the pain I’d been experiencing had moved from the jaw and upper spine to the more classic just-to-the-left of center chest.  I never experienced the pain radiating down the left arm that I’ve heard is also a classic symptom of heart attack.  But, by now I was beginning to believe that what  I was experiencing was, indeed, a heart attack.  And that was an amazing thought.  I’ve always been fit, ate healthily and am a bit of an exercise aficionado.  And, here in New Zealand, over the last year and a half, I’d lost a fair bit of weight (205  to 187 lb.) which I didn’t think was too bad for a 5′ 11″ 63 year old male.   As it turned out, he and his wife drove to the ER clinic there which took a scan and saw a pinched artery (he admits that he should have called an ambulance instead of them driving themselves), and rushed him by ambulance to the nearest hospital.  A complete workup and emergency operation, including a MRI, a balloon to relieve the pressure to the heart, a stent inserted (to hold the artery open), meds and hospital stay --in other words, his total bill for everything, including the ambulance ride-- was $153 USD (you can read the full account of his heart attack on his blog post here).  He went on to add: People say that taxes in countries with socialized medical systems are high.  I don’t find them so.  People with good jobs here will pay up to 33% of their wages as taxes.  But, on the other hand, we don’t have to pay for medical insurance, automobile insurance or business liability insurance because a plague of lawyers hasn’t managed to take over the system here.  New Zealand has a progressive rate of 10.5% to 39%, wrote PWC).  Basically, New Zealand's tax scale has not changed in all those years.  Once you pass around $200,000 in income, your tax rate is 39%...if you made $2 million: 39%.  $2 billion: 39%.  $200 billion: 39%.  The savings pass down (a reminder that Trump's earlier tax returns show them virtually untaxed, wrote the report from NBC: The couple paid little in federal taxes during Trump's presidency and appeared to owe none in 2020 after reporting large deductions and expenses that resulted in a net loss of $15 million.  Trump then claimed a $5 million refund, according to the return.  Trump also reported zero charitable donations that year, the returns show.)   Norway has socialized medical coverage as well for all of its population, regardless of age or income, with a flat tax rate of 22% in addition to a wealth tax. 

     Contrast all of this with another letter from 2011, an account by Donna Smith in Common Dreams of a man who had suffered a stroke, as heard in a shared hospital room: When he awoke, he was in a hospital bed, unable to move most of the left side of his body, and wearing an adult brief due to his inability to control bodily functions.  His wife died some time ago, and at 60 years old, he is raising a teenaged daughter.  Periodically, his daughter, his sister, her grown daughter, his twin brother and his niece would come to his room.  Loud and a bit brash, they would call out orders to him to try to get him to move a limb or a finger or show some level of mental or physical activity that would point toward post-stroke improvement.  He did what he could to oblige.  His sister announced that she was “the bull dog” of the family.  She stated she was there to make sure he signed papers giving her legal authority over his daughter and his finances and that she would be in charge of next steps in the decision process for his medical care.  His brother was obviously shaken by the whole scene but also obviously unable to change the pre-stroke dysfunction in the family.  When nursing assistants came to his room, they would chastise the patient a bit for being too modest to allow himself to be exposed as they checked his brief and tended to his linens.  His mind and speech were sound enough for me to hear him repeat over and over again, “But my niece or my daughter could come in at any second.” To which the aides responded that he’d have to get used to the changes in his life...Soon enough, a group of doctors came into the room.  My husband and I were on the other side of the curtain that separated the two beds in the semi-private room, but we still could not avoid hearing the conversation.  The doctors checked the patient and listened to the “bull dog” sister recount the night the family found her brother slumped in his chair after the stroke.  The doctors also told the patient and his family that he’d not be discharged home but to a rehab facility – not the one where the doctors felt he’d get the best care but to one his insurance company and coverage would allow...My heart was about to break.  I thought of what this man had already been through – months of headaches and a medical system so disjointed he was being tested stem to stern with no relief in sight, then a stroke (while alone in his home), waking to his brain and his body malfunctioning and wearing a diaper, listening to his family bicker and banter about details of his life going forward, hearing his doctors say he is going to a facility not because it is the best but because the insurance company says so, and finally having people wonder why he doesn’t feel like eating?...If any one of us thinks we’ll know exactly where we will be and with whom when illness or injury strikes us, we are delusional.  It is enough to deal with the health event itself without all the other indignities.  Unless each of us would like to be in this man’s situation, we have to address the systemic issues that force this inhumanity.  Ask yourself, how hungry would you be?  Would the mashed potato or the banana or anything else in the mechanized, soft diet seem important (that is really what they call it).  And 10 days ago, life was pretty normal for him.

      Elisabeth Kübler-Ross wrote about her own stroke in the book she co-authored, Life Lessons: God was shrewd: my head was not affected by my strokes.  Talk about a way to teach lessons.  I can't use my left leg and arm, but I can talk and I can think...I must work on receiving, on learning to say thank you.  I must learn patience and surrender.  Throughout my life, I have given and given, but never learned to receive.  This is my lesson now, learning to receive love, receive care, to be nurtured rather than nurturing.  I realized that I had a big stone wall around my heart.  It was designed to pretect me from hurt, but it also kept the love out...Happiness comes from seeing ourselves as being okay, just as we are, today, without comparison to others, without reference to the way we were or the way we fear we will be.  At the end of her own book, author Susan Orlean reflected not only on her life but also on the many others she had read about, or written about (she had finished a story on obituaries when she wrote about this): They were good at something, proud of something; they discovered a groundbreaking drug or had a great pie recipe or "enjoyed crossword puzzles" or were the founder of something.  Death was the great leveler and the great magnifier.  It came for everyone, and when it did, it picked out each bit of your life that was distinct and lifted it up.  Here was your true measure at last, here was your mark on the world.  What was more, I had reached a critical marker of my own age.  I used to read obituaries and marvel at how old the people were.  Now I read them and marveled at how young they were.  What had changed was me.

      The randomness of life, or death, or even a stroke, also affected author Ann Patchett.  In The New Yorker, she wrote about her venturing down a deepening entrance to a glowworm cave while in New Zealand: In the punt on the river in the cave, beneath the dim light of glowing worms, it was my own death that consumed me.  If any of the strangers in this open boat lost their minds and threw a few of us overboard, threw me overboard, that would be that.  The river was cold and fast and headed to the center of the earth.  If there were a geological shift, an earthquake, a rock slide, that would be that.  The one entrance into this cave was, coincidentally, the one exit, and that small opening could close at any moment.  But more alarming than the ways in which this physical space could turn against us was the simple metaphor of a wizened little man pulling a boat down a river in the dark.  I had always believed myself to be pretty sanguine at the thought of my own death --I’d had a good long life, done good work, experienced true love, was generally A+ lucky-- but now all I wanted was to get the hell out of there.  I wanted to be above the ground and not beneath it.  After making it out, she reflected back on her "breakdown."  That’s the thing about your own death -- you can hold the truth of it for only a few minutes, and then it reverts back into abstraction...Death is not manageable, and the answer to the question of when is never going to be anything more than a good guess.  

     It all sounds dire, as well it should.  But make no mistake.  Your body, as much as your mind, does not want to die.  As but one small example of this almost unconscious fight for life, picture the world of our blood and how quickly it reacts to a wound or cut.  As Mary Roach wrote in her recent book, Replaceable You: When blood contacts a surface other than the inside of a blood vessel, it starts to clot within milliseconds. [thousandths of a second]  If a clot breaks free and lodges in the heart or brain or lungs, potentially devastating things like strokes and heart attacks can follow.  Clots form on medical tubes and devices because blood has proteins that recognize as "other" any surface that's not the lining of the blood vessels.  These proteins stick to that foreign surface and attract platelets -- makers of clots.  Platelets release chemicals to attract other platelets and to create fibrin, the gluey essence of a clot.  For this reason, people with any kind of implanted device that comes in contact with the blood --an artificial heart valve, say, or a stent-- must take an anticoagulant or antiplatelet to freeze the process.  Even the brief tenure of an IV tube during and after surgery demands some kind of antiplatelet.  On the other hand, she writes, the heart needs a brain.  When a person is declared brain-dead, their heart --along with their other organs-- begins to fail after around twelve hours, even if the body is being oxygenated on a ventilator.  The blood vessels lose tone, the capillaries start to leak, and within forty-eight hours it's all over...If a head injury or illness were to leave a pregnant person brain-dead, on a ventilator, their organs would keep functioning for the duration of the pregnancy.  But once the baby is delivered, the familiar cascade of organ failure would begin.  The baby's brain appears to be producing something that sustains the organs of the mother.

     Is all of that the bond of biology, or love?  And just how far can that go?  Masterpiece on PBS asked this question with two distinct approaches.  In The Great Escaper (filmed in 2023 and just released here in the US), a 90-year old Michael Caine and an 85-year old Glenda Jackson (at the time of filming) provided outstanding performances in recreating the true story of Bernard Jordan who "escaped" his nursing home (at age 90) to attend the 70th anniversary of the landing at Normandy Beach on D-Day.  It displays time and age and love and the values of generations often, and seemingly, forgotten.  And the loneliness of facing that point of life.  Another series on Masterpiece showed an entirely different view of how love can both bind and unglue lives, regardless of time.  Alice & Jack is a series that in a real life relationship would throw up more red flags than the Kremlin, as was said in the show.  And yet, just as with most budding relationships, after the rocky starts it somehow settles and leaves you wondering if any of us really have any control of how our lives play out.  As Elisabeth Kübler-Ross wrote at the end of her book:You don't get another life like this one.  You will never again play this role and experience this life as it's been given to you.  You will never again experience the world as in this life, in this set of circumstances in quite this way, with these parents, children and families.  You will never have quite this set of friends again.  You will never experience the earth with all its wonders in this time again.  Don't wait for one last look at the ocean, the sky, the stars, or a loved one.  Go look now.*

Graphic: mass.gov

     If you've always been a giver, then consider this season a time to receive...a thank you, a compliment, a smile, a helping hand.  Giving in is not the same as giving up, but rather can be a time of just graciously accepting.  Because after all, time's a wasting.  And as The Eagles sang: So you live from day to day, and you dream about tomorrow.  And the hours go by like minutes, and the shadows come to stay...If I could only stop my mind from wondering what I left behind.  And from worrying about this wasted time.  Stop worrying.  But do remember, especially during this period of overindulgence --not only with food & drink, but with friends and family, as well as finances and outlooks-- that should you happen to notice someone acting a bit unusual and perhaps suspect that they may be having a stroke, you need to act FAST -- Face (is one side drooping), Arms (ask the person to raise both arms), Speech (can they repeat a simple phrase, is speech slurred), Time (call 911 and mention "stroke"),  The faster a person can be evaluated at a hospital and have the correct drugs, the less chance of brain damage.  Timing is critical, as explained here.  As the Mayo Clinic wrote: Getting emergency medical help quickly can reduce brain damage and other stroke complications.  The good news is that fewer Americans die of stroke now than in the past.  Effective treatments also can help prevent disability from stroke (as noted, 2 million brain cells die each minute during a stroke).

     So enough of all that.  What happened to that promised happy ending?  Why not close with a T-Mobile ad?  Wait a minute, am I joking here?  But this was from an email forwarded in 2010, and is worth a glimpse at a happier time, a time when the unexpected brought a smile instead of a look of suspicion (and yes, it was actually an ad created, produced, and broadcast, by T-Mobile).  It was a simpler time of uninterrupted and unexpected fun, a time when people stopped and giggled, and weren't quite as stressed, even walking away refreshed (could you picture that happening now?). But almost more amazing was that all of this happened in the crowded arrivals section of London's Heathrow Airport.  Yes, London's Heathrow!!  Whatever happened to that spontaneity, not only by us as everyday people, but by advertisers?  Today's world of advertising is almost entirely filled with prescription drugs which not only remind you of how many ailments you might have, but also tell you of their drugs' many possible side effects --persistent rash, diarrhea, hair loss, liver failure, possible blindness, blood clots, hairy lips, not to mention stroke, heart attack, or possible death-- that you pretty much tune it all out because every ad has what seems to be identical warnings (but then, you still tend to take the pills).  Now after you watch this "ad" from the phone carrier, I must tell you that we did later called the person who sent that to us (he's now 86) and found him with a few more ailments but still laughing and in good spirits.  Hearing his voice after a few years had passed was truly as welcoming for us as what those arriving passengers experienced at Heathrow in those earlier times.          

  

                           

P.S.  If you want even more, here's how it --and other T-Mobile ads of the time-- was made...

*As for accepting yourself as the person you are, take away this humorous note from author Mary Roach on her explorations of replacing our body parts out of both necessity and vanity: Are you over fifty?  I urge you to steer clear of plastic surgery journals.  You don't want to know how you score on the Neck Skin Laxity Scale, the Croma Dynamic Décolleté Wrinkles Assessment Scale, the Forearm Photoaging Scale, the Fitzpatrick Elastosis and Wrinkle Scale, the Forehead Lines Grading Scale, or the Midface Volume Deficit Scale.  Trust me, you look fabulous.  Perhaps more meaningful were the responses from readers to a New York Times piece asking them to describe the "gratitude" in their lives in 12 words.  Wrote one reader: Only momentarily a widow.  Defibrillators rock! -- My one wild and precious life.  Enjoy the holidays, but more importantly, enjoy your life...