1

ONE LIFE
A Parable of Healing

J.Ron Eaker,M.D.

W ONE LIFE A Story of Healing J.Ron Eaker,M.D.

Roy clutched his chest. He had seen pictures of circus strong men with cinder blocks sitting on their chests waiting for a minion with a sledge hammer to crush the concrete, and now he knew how they felt. His rapid, gasping breathing triggered a feeling of suffocation not unlike what he had experienced in a childhood swimming pool accident. Its funny what runs through your mind as you try to die. He managed to wake up his still sleeping wife as waves of nausea rolled over him like a high tide. He really hated Monday mornings, and this morning was proving to be no exception. Eve, his wife of 19 years, roused easily, a habit she had cultivated in the course of raising three restless babies. She responded quickly realizing immediately that Roy was sick. Her nursing instinct told her that he was having a heart attack. There were few other reasons why a 44 year old with no apparent health problems would be holding his hands over his heart, praying it would continue beating. Eve instinctively fell into nursing autopilot grabbing an aspirin from the bedside table drawer and giving it to Roy. Take this honey and lie back down. Im calling 911. There would be time for panic later. Eve had seen to many people come into the ER sicker than they had to be simply because they didnt know what to do in such an emergency. Roy obeyed his wifes commands and, still clutching his chest, laid down on the ancient poster bed they had inherited from Eves grandmother. Eve hit the buttons for the emergency operator and hung up only to turn around and dial the ER where she had worked during her last rotation as a student nurse years before.

3 Hello, this is Eve Roper. My husband is having what I think is a heart attack, and Im on my way with him to the ER. The voice on the other end of the line calmly asked if she had called 911, and, when assured that emergency personnel were on their way, told Eve that they would be waiting for her at the ER. Roy, able to talk for the first time since the pain began, called to Eve for something to drink. Im feeling a bit better, lets just wait a minute and see if all this passes. It could just be heartburn from the barbecue we had tonight. Roy and Eve had dined at their favorite hole-in-the-wall restaurant, Bubbas, earlier that evening. They frequented the local barbecue hot spot at least twice a month and relished the uncanny ability of the owner to serve up any part of a pig imaginable and make it delicious. Nevertheless, it would not be the first time that Roy had need of an atomic antacid after a night of consuming porcine delights. Eve would have none of Roys misplaced optimism as she was already getting her purse and keys ready for when the ambulance arrived. She shed her nightgown and pulled on the first thing she could find. Eve counted her blessings remembering that the girls were at their grandmothers house for the night. School was out for a teacher work day on that particular Monday so the kids eagerly looked forward to a weekend of being spoiled. Not having them there would make an already stressful situation less hectic. The ambulance arrived within minutes and the EMTs quickly made their way to Roys bedroom to asses the situation. With the efficiency of an army drill sergeant the lead medic placed Roy on a wheeled stretcher and simultaneously gathered critical information from both Roy and Eve. No history of heart problems. What about any other medical troubles? None, Roy replied. Any medicines you take on a regular basis? I started some cholesterol pills about a month ago. Eve added, He does have some mild cholesterol problems but Dr.Franklin said the medicine was more a precaution than anything.

4 What about other episodes of chest pain, shortness of breath, or feeling faint? It was hard for Roy to answer now as the EMT placed a clear mask delivering oxygen over Roys mouth and nose. He simply shook his head no. Okay, lets go for a little ride. They synchronously lifted the stretcher and the legs automatically deployed, and they wheeled Roy down the hall and out the door. Eve was on the phone to her mother trying to sound calm, cool, and collected. It wasnt working. Now that the EMTs were there, she became the wife and not the nurse, and the emotion of the moment came crashing in like a windstorm. Mom, Roys not feeling well and I am taking him to the ER. On the other end of the call Eves mother sensed the urgency and easily detected the strain in Eves voice. She knew that Roy was like most men and wouldnt voluntarily go to a hospital unless his leg had been cut off or he had a metal spike through his head. The fact that they were on their way to the ER affirmed that this was no minor event. They agreed to say nothing to the girls until they both knew more of what was going on. By the time Eve hung up, they were postured in the back of the ambulance and pulling from the driveway. The driver was already communicating with the triage person at the ER apprising them of their passenger and their estimated time of arrival. County ER, we have a 44 year old white male, pale, diaphoretic complaining of substernal chest pain radiating to his neck. Vitals are currently stable, BP is 150 over 92; were getting EKG leads placed and four liters mask O2 is on board. Request permission to start an IV with Ringers Lactate. Ill let you know if there are any rhythm problems once we get a strip. Over. Instantaneously the ER triage nurse responded, Copy that. Go ahead with the IV. Well see you shortly. Roy was listening as best he could, but he was still nauseated and uncomfortable. He felt anxious and found it difficult to relax as the EMT admonished. It was obvious that both Eve and the EMTs thought he was having a heart attack. He shied away from anything medical, even refusing to watch doctor shows on TV. For the birth of his daughters he sequestered himself at the head of the OR table hiding behind the green

5 sterile drape purposefully avoiding any sight of blood or other body fluids convinced that he would rapidly become a casualty if he saw anything like on the Birthing Channel. Much of his fear was now stemming from his sense of helplessness. He was appalled by the thought of being out of control of any situation. It is said that fear can be dampened by knowledge, but knowledge alone cant mask the emotional impact of thinking you might die. In times of extreme emotional strain the limbic system, that primitive part of the brain that stores memories of upset and angst, pounces on the cerebral cortex like a wolf on a stray sheep. All rational, empiric decision making gives way to impulse. What you do and think in those moments are based on past connections; sort of remembered action. In a purely reductionistic way of thinking, you do what your neurons tell you to. Normally those limbic signals get filtered through the rational frontal cortex of the brain and you analyze, screen, evaluate and process all of your actions, thoughts, and behaviors; however, when faced with a severe, sudden stress like an acute illness, you simply put your brain on auto pilot and react. It is a survival mechanism that has been fused into our genes through generations of fight or flight scenarios. Roy was at that point now where he was simply reacting. A normally quiescent, rarely excitable person, he began to feel more agitated as his discomfort increased and his sense of loss of control heightened. His thoughts raced. Was he making himself worse by getting upset? Where are the kids? Why is Eve squeezing my hand so tight? Eve could sense his restlessness and tried to reassure him. The EMT positioned in the back of the ambulance glanced at Roys heart tracing on the monitor above his head and immediately grabbed the microphone. County, this is Star 8 inbound. Our rider has developed a tachyarrhythmia and his blood pressure is dropping. Bp is now 100 over 50. Request a lidocaine drip at five cc per minute and some mild sedation. Okay 8, go ahead. What is your ETA? While hanging a bag adjacent to the IV fluids the EMT replied swiftly, Looks like were about seven minutes out. Roger that, let us know if things deteriorate. Well be ready for you

6 The EMT, sitting to the left of Roy, told him that he was starting some medicines to calm him down and stabilize his heart rate. You should feel a bit better shortly, he said confidently. Roy felt the burning of the medicine as it entered the small vein on his left hand. Almost immediately he sensed a calming warmth that began in his head and literally oozed throughout the rest of his body. The pain seemed less, but he was having difficulty differentiating between perception and reality. That was some good stuff they gave me he thought to himself. In one sense he knew he was still uncomfortable but it was as if it didnt matter. How curious, he thought, that simply not worrying about the pain made it less real. If my thoughts are that powerful can I simply think away this presumed heart attack? Even in his drug induced, rapidly approaching brain fog he realized that perception and reality are not synonymous. No matter how positive his thoughts or how powerful his beliefs, if there was a fatty plaque blocking one of his hearts arteries, it was not going to dissolve on its own. He mused that this was a time for the pipe declogging of Roto-rooter, not the positive thinking of Norman Vincent Peale. Eve was positioned to the right of Roy and was suffering in her own way. Just the opposite of Roy, she knew too muchand she didnt have the benefit of Roys morphine. The fear of the unknown is founded in the knowledge of the present but fueled by the uncertainty of the future. If a little knowledge is a dangerous thing, then a little knowledge misapplied is even more damaging. Eve knew enough to speculate as to possible outcomes, and she quickly assumed that none of them were good. It has been said that fear of the future is paying a fee on a debt we may never owe. The fear that Eve felt was driven by emotion, experience, and uncertainty. She had reacted initially with an instinctual precision that stemmed from repetition and training. But now the realization that she was the wife and not the nurse broke down her faade of mechanical competency. She was afraid for Roy and afraid for her and the family. It wasnt a selfish fear, but one that seemed a natural outgrowth of her maternal instinct. I am a caregiver she thought, and it terrifies me when I cant take care and fix things. As she traced the path of the fluid from the IV bag into Roys veins, she bludgeoned her self esteem with the club of incrimination. I am a nurse for Gods sake, why cant I make it all better?

7 she lamented silently. Instantly she understood the absurdity of her thoughts. Was she all powerful? Did she posses some God given healing touch? No, these crazy thoughts were all based in fear. A fear she realized had to be conquered for no other reason than she couldnt afford to be stymied into inactivity. If she really wanted to nourish her identity as a caregiver now was not the time to be paralyzed by irrational thoughts. She told herself, Deal with what is real. Deal with the moment. She vaguely remembered a quote, Dont worry about tomorrow, for tomorrow will take care of itself, but she couldnt place where she had read it. It didnt matter. What it said gave her comfort and guidance. The reality was that something was wong with Roy, and she had to do whatever she could to help. The ambulance stopped abruptly, and Eve realized that they had pulled up to the ER entrance. The EMT riding in the back of the ambulance scrambled to the rear of the vehicle and quickly opened the door and asked Eve to step out and over to the side. Her legs, cramping from the brief but intense ride, were wobbly at first prompting the EMT to ask whether she was alright. Reassuring him she was okay, she quickly backed away from the rear door as the other EMT approached from the drivers side of the ambulance. Rapidly and with the gentleness of a mother lioness picking up her cub, the two men lifted the stretcher and placed the wheels on the hard surface of the Porto cache. The automatic doors responded to the motion of the men with the stetcher and the group made their way into the bustling triage area of the ER. Hey Mary, Ive got the chest pain here, where do you want us? The triage nurse calmly directed the men and Eve to a room on their immediate left just feet inside the entrance. She then paged the ER doc on the overhead. Eve, now clutching Roys hand, attempted to carry on a conversation with him to reassure her that he was alright. She felt that if she could talk to him it would calm him down and help to mollify her fears. Between the oxygen mask and the morphine the best Roy could do was mumble something about being late for work and peanut butter and jelly sandwiches. A young doctor wearing green scrubs and a blue long sleeve Tee shirt entered the room and introduced himself as Dr. Roundtree. One of the EMTs gave the doctor a brief rundown

8 on his newest patient and then sat over in a corner and started filling out his paperwork. Dr.Roundtree barked out some preliminary orders to the two attendant nurses hovering around Roy and then approached Eve and her prostrate husband. Mr. Roper, by your history it sounds like you may be having a heart attack but we need to do some additional tests to confirm that. Its also important to rule out other causes of your symptoms. Im going to get some blood tests and put these EKG leads on to get a good tracing of your heart activity. Just to be safe Im going to give you a clot busting drug that may minimize any damage to your heart muscle. The nurse in the room asked Eve to sign the consent for treatment. Eve had probably asked hundreds of patients to do the same but this was the first time she had been on the other side of the permit. She could feel her pulse accelerate as she rapidly scanned the document and realized the seemingly endless list of possible complications from treatment. My gosh, she thought, she had been so nonchalant in the past when she had pestered folks to sign the exact same papers and had not considered the insensitive nature of her impatience. Its just a formality, she would remark to the anxious signee. You can thank all the lawyers at the state capital for making us have you sign this. Its basically the same form whether you are getting a hang nail removed or open heart surgery! She had been embarrassingly blas in the past about the whole process. Now, faced with signing the consent herself, she grimaced as she thought of the many anxious persons whom she had prodded to put their signature at the bottom of the page. It occurred to her that both she and the many patients and loved ones before her had read little, if any, of the document. It was like asking someone to sign a will as they faced a firing squad. As she looked at the papers she pondered whether we ever acknowledge the extraordinary faith involved in health care delivery? Call it trust, faith, ignorance, fear, or hope, the result is the same. Once we enter into a hospital or a doctors office there is an intrinsic trust and faith that is built into the system. You have to know that the person treating you is your advocate and not an adversary. It sounds almost intuitive, but we take for granted that the motivation of the doctor or nurse is honorable. We expect there to be a moral imperative that guides all decisions about our care. We assume that the major factor influencing our caregivers

9 decisions is our wellbeing, not financial or otherwise. One of the greatest crises in health care today is the dissolution of that faith. Some patients become cynical and skeptical of doctors motives. More and more doctors see patients as numbers, diseases, or worse, revenue generating opportunities. Hospitals adopt a bottom line mentality and let finances drive service. Eve knew that she had to sign the consent, not bowing to the palpable pressure of a system in crisis, but as a statement of trust. She had to trust that Roy was going to be taken care of. Anything short of faith in the doctors and the hospital would be a crushing blow to her already fragile hope. She had to believe that Roy was getting the care he needed or it would nurture an anxiety that was contagious. Would her belief change the competency of the doctors and nurses? No, of course not. But her belief would change her experience and in turn, Roys healing, whatever path that took. By having realistic faith in the care of her husband, she could actually be a conduit for healing. Just as a virus spreads from person to person, so positive thinking becomes infectious. A person of faith, hope and purpose will not only boost their health but also the health of those around them. There is evidence that positive social networks influence such varied health matters as weight, immune system functioning, and yes, even heart disease. Unfortunately, the opposite holds true. Apathy, hopelessness and despondency can lead to physical and emotional maladies. Eve needed faith and Roy needed Eve, so signing the consent forms was a tangible display of her faith. The initial beehive of activity had calmed somewhat while Eve waited for the results of the blood work. Roy was becoming less drowsy and more aware of his surroundings. The chest pain had lessoned, but he was feeling the effects of the lidocaine and the clot busting drug. Hey Eve, he mouthed under the mask, whatever happens, dont let me see that light and tunnel thingy! It was reassuring that his morbid sense of humor was intact. In fact, Roys ability to laugh at himself and situations had diffused many tense times. He was gifted in utilizing humor in a way that wasnt ever offensive, and he was a master at subtle, gentle sarcasm. He took seriously the proverb that A merry heart does good like a medicine. He often joked that, like Tevye from Fiddler on the Roof, he sometimes

10 took liberties with Scripture misquoting and adapting it to the situation. This particular verse; however, rung true and had sustained him in tough times. As he was about to crack a joke regarding the size of his hospital gown, Roy felt a renewed pressure in his chest. A bell shrieked on one of the machines monitoring Roy. Within seconds, two nurses rushed into the room, looked at the monitors, and frowned. Eve glanced first at the machine and then at Roy. She went ashen as she saw his eyes roll back in his head and for just a split second his whole body went rigid. His body then went as limp as a dishrag and the monitors belted out a higher pitched sound. One of the nurses screamed, Call a code. Call it now! Eve knew that this was a signal to the rest of the ER staff that there was an emergency. Seconds felt like minutes as the nurses were joined by a host of technicians and doctors. In a symphony of efficiency each player expertly performed pre-assigned tasks that were as automatic as the sun rising. It was organized chaos to the uninitiated, but each movement and action was purposeful and essential. Eve was compassionately escorted out of the room by one of the nurses who she remembered from her brief stint in the ER. She knew from her training that she was only going to be in the way at this point. After a few agonizing minutes Dr.Roundtree came to the waiting area and spoke to Eve as she stood leaning on a corner post. Eve, with anxiety building like a rubber band wound tight, listened intently to both what he said and how he said it for clues as to Roys condition. Roy went into ventricular fibrillation. You know that is a very dangerous heart rhythm that sometimes happens with a cardiac event. It may mean that there is more damage to the heart muscle than we first thought. The labs we drew confirmed that it was a minor heart attack, but this complication puts a whole new twist on the prognosis. I thought, after reviewing the labs and the heart tracing, that he was going to do just fine. To be honest, hes got me worried now. Eve slowly made her way to a chair nearby, thanked the doctor, and, for the first time that day, cried. She cried for Roy, for her girls, for their life together. She cried for the fact that she had yelled at him last night for not taking the trash down. It seemed so trivial now. She cried because she was scared. She cried because she felt alone. She

11 cried because she couldnt make it better. She cried because God had let this happen. She had to blame someone, or maybe it was simply because He was the only one in the room with her now. Roy had heard the monitor go off and then felt a jumping feeling in his chest. This was different than he had felt before. No pain, just a weird sensation like a drummer playing with one drumstick, missing some of his beats. He suddenly felt very tired, and he wanted to tell Eve how worn out he was, but he couldnt see her in the room. He wondered where she had gone. He tried to call her name but couldnt form the words. His eyelids descended, which really didnt make much difference since he wasnt able to focus well. He felt as if he was in that place every morning right before the alarm clock sounds. He sensed that something had changed-something was wrong- but he wasnt sure what. As he drifted off he just kept thinking, I really hope I dont see that darn light and the tunnel thingy!

12

Chapter Two

Roy awoke feeling cold, hard metal on his bare behind. He was wearing a skimpy hospital gown sitting in a metal, folding chair. His chilly, exposed rear end sent shivers through his torso and made him feel as if he would have to be pried from the seat. Rubbing his eyes in the universal sign of confusion, he spent the next few minutes trying to locate his brain in time and space. How did he get out of the ER? What exactly had happened? Where is Eve? His thoughts were a twirling vortex of confusion. The brain fog slowly lifted much as it did over the sun heated water of the canal that ran adjacent to his house. As things came into focus it was obvious that he was in some sort of cafeteria. Older women in white aprons and hair nets and folks scurrying about gathering their food like squirrels in the Spring led him to the conclusion that it was also around a meal time. He didnt speculate as to which meal and to what time. He felt proud to ascertain as much as he had at this point. Still a bit dazed, he surveyed his own body and tried to integrate what he saw with what he last remembered. Indeed he was still wearing the flimsy, fabric gown from the ER, but all the IVs and monitors were missing. It was just him in his birthday suit with a cloth shower curtain for a covering. He became instantly self conscious as he realized he was not appropriately dressed for the occasionwhatever the occasion was. Actually he was that he was not appropriately dressed for any occasion except a colonoscopy! He remembered how he felt as a kid when he would sleep walk; lumbering semi conscious from room to room. He would often wake up in his older brothers room confusedly unsure of how he got there. Now he was here in some cafeteria decked out in a hospital gown, feeling the same confusion he did as a sleepwalking child. Gazing about he observed many tables, obviously designed for group dining, and a separate rack of condiments. Most of the clientele were in some sort of uniform, mostly the familiar nursing whites or scrub greens, so he surmised that he was in a hospital cafeteria.

13 Spending time in Countys ER was as close to any hospital as he had been in years, so he could only assume this was Countys cafeteria. This just magnified his confusion. His last memories were of frantic nurses and this only made him more unsure about time and place. His disorientation made him feel like he had awoken to an alarm clock not knowing how long he had slept. Did he crash in the ER a few hours ago as he felt he had, or had he been out of it for days? He remembered reading stories of people in comas that revived years later only to perceive that they had been asleep for a very brief time. Was this what he was experiencing now? A gentle tap on his shoulder brought Roy and his thoughts spiraling abruptly back into the present. Mind if I sit down Roy? came an inquisitive voice from behind his back. Roy turned slightly to glimpse the speaker hoping for a familiar face to help him decipher his current sate of affairs but instantly felt more confused. The lady who had asked to join him appeared mysteriously familiar yet identifying her was just out of the reach of his memory. She seems to know me, he thought, so maybe she will have some answers. Sure, have a seat, Roy said. I've got to tell you; however, I'm a bit foggy headed and confused. I apologize that I'm not quite sure who you are. The woman looked at him knowingly and casually remarked. I really didn't expect you to initially. My name is Jane Ferguson and the last time we saw each other was almost 29 years ago. And I dont mind telling you that Im not completely sure why of Im here either. Roy went from confused to just plain bewildered. Not only was he not sure where he was or when he was, but he certainly didnt recollect who Jane Ferguson was. The middle aged woman looked at him with a wry smile that betrayed little of her mystery. Ill tell you what I do know. Hows that for starters? Jane said. Roy, you were a student of mine in the 10th grade at Colonial High School in 1980. I taught you biology and health, or maybe a more accurate statement is that you were simply in my classes. If I remember correctly, you were not exactly a stellar student, so I cant say how much I actually taught you.

14 Roys expression of disbelief appeared both amusing and expected to Jane Ferguson. Okay, this is really getting weird now, Roy exclaimed. I started out this day in the ER with tubes in every orifice, and now I'm sitting in some hospital cafeteria wearing a see-through hospital gown talking to someone I haven't seen in 29 years - who for all the world looks the same as I now remember her 29 years ago - who then apparently picks me out of a crowd and decides to have a conversation. I think you can see why this is not an average day for me. As Roy continued to gaze confusedly at Jane Ferguson his rational mind began to function again and memories began tumbling back into his consciousness. He was a lousy student, but he remembered he loved Mrs. Fergusons class. She encouraged the students to explore science by participating which appealed to Roys hands on style of learning. I know this may sound crazy, but looking at you now reminds me of dissecting chickens. Jane Ferguson's eyes began to twinkle and her smile expanded. Roy explained, We had to do a science fair project at the beginning of the year and, like always, I waited until the last minute to put everything together. I hadn't even chosen my topic until the day before. I remembered how much fun I had chopping up frogs in ninth grade science class, so I figured why not graduate to bigger and better animals and dissect a chicken for my tenth grade project. Given the fact that the assignment was due to be presented the next day, I decided to accelerate the process and bypass some preliminary preparation, like getting a live chicken. Unfortunately, I had not completely thought out the problem of not having easy access to a chicken, so Monday night before the presentation was due I went to the local grocery store and bought a chicken breast. Billy Shire had told me that they kept all of the chickens organs stuffed inside the bird for cooking. It occurred to me that this would be very convenient since I simply needed to display the organs pinned to a poster board and describe how they were extracted from the unfortunate bird. My plan was set. Buy the chicken, extract the parts, pin them on a board, and go down in 10th grade history as having the grossest science project ever. I got the Butterball home and soon realized that Billy Shire was a liar. The inside of the

15 chicken breast was as empty as Billys head. My bird had been gutted! So instead of setting new standards for future students, I spent two hours before your class that day completely changing my project to a report on why Australian aborigines go barefoot. Jane Ferguson, laughing and shaking her head, was temporarily lost in her own memories. Believe it or not I remember that report. There are a few student projects that stand out, and I can say with confidence that was the worst paper I had ever seen. Now it was Roys turn to laugh, and it felt good. He hadnt felt jovial lately, especially given the recent events. This realization jolted him back into reality. Wait a minute, he squirmed. The questions began to rain down like a tropical downpour. This little walk down memory lane is a blast, but what exactly am I doing here, and why are you and I sharing these old times? I get the feeling that you have answers and I dont. First of all, why do you look the same as you did when I was 15? What am I doing in a hospital cafeteria half naked? What happened in the ER? Slow down Roy, I understand your confusion, but lets take one thing at a time, Jane Ferguson calmly reassured him. Jane took a deep breathe and began an explanation that would change Roys life. Let me start with a little story. Several years ago my mother developed breast cancer. She had been a very nervous, anxious person all her life so this really hit her hard physically and emotionally. She struggled through a year of surgery, chemotherapy, and radiation, but survived. At the end of that year she was literally a different woman. She looked different physically, but more importantly, she was a different person inside. Her heart was changed. In fact, everything about her was changed. She had a new calmness about her- a real peace. Knowing her prior disposition, I would have expected her to be just the opposite; more stressed, always worried if the cancer would come back. However, the reality was that she was a different person. She had a contented demeanor that projected peacefulness. She used to joke that she no longer sweated the small stuff in spite of her drenching hot flashes! Roy nodded his head in understanding as Eve had experienced a few of the hormonal night sweats.

16 Jane Ferguson continued, She was reborn in a sense. A new woman. I was in my twenties and not around the house much, so the change was fairly dramatic to me whenever I would visit. Mom said that having cancer was a wake up call. I was confused by this but she explained that the illness had forced her to confront her greatest fears and anxieties, and she discovered that she had two choices. Either she could choose to live as she always had, fearful and worried about the next moment, or she could choose to live in the moment, embracing the incredible blessings of God and the fact that she was around to enjoy those blessings. She chose the latter, and that made all the difference. Mom said repeatedly that without the crisis of cancer, her rebirth would have never taken place. My first reaction was that it seemed like a tough way to change. Wouldnt it have been easier to just make up your mind to feel and act less anxious? I hope I dont have to have cancer or some other crisis to force me to get rid of bad habits! Mom chuckled whenever she heard this, and through the years she heard it a lot whenever she would tell her story. She acknowledged that it was frustrating and bewildering that many times it takes a slap in the face to get our attention. But the reality is that often our lives are so entrenched in the comfort of monotonous consistency that even self destructive behavior is perpetuated in the guise of security. Many choose to live by the mantra dont rock the boat, but in reality the boat is sinking! Often we refuse to face change unless the choice itself becomes a necessary tool for survival. Mom realized that living her life in any way other than one that was based on faith, love, joy and wellness was fruitless and without meaning, and for the rest of her twenty years she was literally a new woman. Roy was entertained by the story but seemed a bit anxious himself. When Jane paused he asserted, I hear what you are saying. Ive known folks who have been faced with problems and chose to do just the opposite of what your mom did. They blamed God and everyone else for their illness or problems and became bitter and tiresome. But, and I dont mean to be impertinent here, what does this have to do with me? My sense is Roy that this is your wake up call. As I said initially, Im a bit unsure of what I am doing here myself but I will tackle that one a bit later. I get the

17 feeling that we both have something to learn. But since you were the one that was just being poked and prodded in the ER with a heart in revolt maybe this is your chance to change your behavior, your thoughts and, therefore, your life. Roy, you are 44 for

heavens sake, she lamented, Do you want to spend whatever time you have left worried about your next heart attack? Are you happy with your health the way it is now? Do you think you can change your self destructive habits? More importantly, is this the path you want your kids to go down? Is this the legacy you want to leave? Nothing was more sacred to Roy than Eve and the kids. Roy looked up and into Janes eyes when she mentioned his children. She had struck a nerve. Jane continued. Roy, you were dying in that ER, but you have to realize that your heart attack was not an isolated event that happened suddenly. It was the culmination of a lifetime of habits and choices. You have been working on that heart attack for years! Sure, it seems like you were the picture of health before the events of Monday morning, but it was a faade. The emperor had no clothes! You had fooled yourself into believing that you were healthy. Whether it was from a lack of knowledge or simply burying your head in the sand, you ignored the reality of the lifestyle decisions you chose. Hold on, Roy protested, Im not half as bad as most of the folks that Eve and I know. Im in a lot better shape than most of my friends. I think Im pretty normal. Roy, who was it in the ER grabbing his chest like he was being sat on by an elephant? No more comparisons or rationalizations. Truth is the best teacher and it is time to take a painful, honest look at your health. The reality is that normal is not healthy. If you are only normal in your diet, for example, you will most likely have a normal heart attack, a normal stroke, develop normal diabetes, and have normal hypertension. I am going to ask you to do two things in our time together. First, you are only to deal with what is real. No what ifs, no false perceptions, no excuses. And second, you must remember that to be healthy you have to think and behave abnormally! I know that sounds a bit crazy right now, but I think it will make more sense as we go along. Trust me on that one.

18 Roy remarked, Im still trying to understand whats going on here. Is this some sort of Charles Dickens Christmas Carol thing and youre the ghost of unhealthy living past? Jane chuckled. In a way I guess it is, but I am definitely not a ghost and you are certainly not Ebenezer Scrooge! She continued. I am a teacher. I have always been a teacher, and one of my reasons for being here today, I suspect, is not just to teach but to remind you of what you already know. In the tenth grade I taught you a class on habits for healthy living, only Im not so sure you gleaned all you needed from that class, especially with your fixation on disemboweled chickens. Roy was comforted that Mrs. Ferguson had not lost her sarcastic sense of humor. That was one of the things that made her a favorite of he and his classmates. He remembered that he had enjoyed the health class but had not taken much of it seriously. No one did at fifteen. We were immortal and stupid, he reminisced, a dangerous combination. Jane Ferguson rose and said, Before we can go on though, I think you need to get a more appropriate outfit. Roy was still only wearing the flimsy hospital gown. She got up and said she would be right back and walked out a side door. While she was gone, Roy took the opportunity to look around the cafeteria a bit more closely. It appeared that he was surprisingly inconspicuous because no one seemed to be paying him much attention. He decided to cease rationalizing his predicament and go with the flow as his youngest daughter was fond of saying. It made it somewhat more tolerable to see that those in the cafeteria around him seemed not to know he was there. Jane returned quickly carrying a green scrub suit. Here, put these on, she requested as she tossed the pants and shirt to Roy. Here? Now? he questioned. Jane reassured him that no one would be bothered by his quick change. He found this disconcerting, but she was right; no one noticed. Once he got dressed, Jane sat back down and directed his attention to the checkout cashier a few feet to his right.

19 Since were in the cafeteria, lets start this journey talking about food. Take a moment and gander at the mounds of chow piled on the trays coming through the line. Roy did as he was told and after a few minutes looked at Jane for some direction. Did you notice anything in particular? she asked. Well, the food looks pretty good for a hospital, and there seems to be plenty of it. I dont think these folks are going hungry! Roy observed. Exactly, Jane confirmed, and thats part of the problem. Most of us are blessed with access to a variety of foods; which is a good thing. Its just that, in turn, most of us get too much of a good thing! We get so caught up in the what kind of food should I eat quandary that we miss the bigger picture; that of quantity. How much we eat is more important than what we eat. When it comes to overall health, quantity can trump quality. You can get fat eating all low fat, low sugar foods if you eat too much of them. Hold on Jane. Ummis it okay that I call you Jane? I admit that its a bit difficult for me not to say Mrs.Ferguson, but I have a feeling we need a more personal touch to all this. Jane is just fine Roy. Anyway, youre saying that I can eat Twinkies all day long as long as I dont eat too many? No, thats not what I am saying, and that is the fallacy that many assume when you mention quantity without introducing at the same time its twin sister, variety. Roy was enjoying the joust and said, So what exactly do you mean about eating too much? We have become a society of consumption. Quantity has overtaken quality. The best way to either lose or maintain weight is to simply reduce the total number of calories you consume on a daily basis. It does matter what you eat, but it matters more how much you eat. The biggest misperception about all the fad diets is that there is some magic combination of protein, fats and carbohydrates that will unlock the health secret of food. The only reason those restriction diets work for weight loss is that they reduce the overall

20 calories consumed. If you are on a low carbohydrate kick, you are going to eat fewer calories. If you eat low fat foods, you are going to eat fewer calories. If you limit proteins like fatty meats, you are going to consume fewer calories. Are you starting to see the pattern here? Roy nodded and added, So its not so much that I had an omelet for breakfast, its that I had the bacon and biscuit with it. Right, Jane confirmed. But even more than that, its important that you have a two egg omelet and not a three egg omelet, and then dont pig out for lunch because you were so proud of yourself for skimping on breakfast. Sounds like you may be rationing food. You know thats one of the big reasons folks dont stay on diets. They dont like restrictions. Roy thought he would play the devils advocate. Jane countered, Have you ever seen how much quality food you can eat and get the same calories as a much smaller amount of calorie rich food? Quantity and calories are not necessarily related. It depends solely on the food type. You could eat two baked potatoes, minus the butter of course, for the same amount of calories in one bowl of granola cereal, and get one twentieth the fat! Its really a matter of knowledge and discipline. Knowledgestrike one, and disciplinestrike two joked Roy. Youre not alone in your distaste for responsibility, lamented Jane. The first caveat of good health is that the buck stops with you. No one cares more about your body than you whether you realize it or not. That goes for the government, your doctor, and even Eve. Good health is not by chance but by choice. Achieving wellness is not a right, it is a responsibility; a responsibility of the individual and not the state. Real health care reform begins by looking in the mirror. Roy, if you remember nothing else I tell you, remember this. The biggest health care crisis you as an individual will suffer is not cancer, AIDS, or heart disease; its you not making healthy lifestyle choices. Look over here. Jane pointed to the inside of the food court. Let me show you. Jane stood up

21 and motioned for Roy to follow her. He did so and immediately became lightheaded and felt his legs start to buckle. Whoa cowboy, I forgot you have been sitting here a while and probably havent eaten much recently, Jane said. Here, take this. She handed Roy a bright yellow, peeled banana and a cool bottled water. I would rather have a Coke and a cookie, Roy prodded. You prove my point too easily, Jane retorted. So would most people. They walked to the center of the food court and surveyed their surroundings. People of all shapes and sizes scurried about stocking up on a variety of foodstuffs. Even in their diversity they had one thing in commonfull trays. Jane continued. Notice that most of the healthy food is on the periphery while the calorie dense food is clustered more in the center. Its no accident that the junk items are most accessible and convenient. It just so happens that the same arrangement occurs in most grocery stores. Fruits, vegetables and whole grains are displayed around the outside whereas the popular processed and prepackaged foods are marketed in the middle. Its almost the same wherever food is sold or served, and its that way for a reason. Years of marketing and psychological study have shown that the higher profit, less nutritious foods sell better positioned in that way. The marketers code is make it easy and obvious. Nutrition is an afterthought, if at all. Youre always better staying on the periphery of the store than venturing into the center of doom Jane joked. Next, look at the choices folks are making. She and Roy scooted uncomfortably close to a young man of about thirty choosing his main course. This confirmed Roys suspicion that he and Jane were invisible to those around them as they clearly invaded his private space and yet he seemed not to care. Jane narrated. Hes got three choices, a meat, a pasta, and vegetables. He can feel satisfied and full by eating anyone of these choices but the difference in nutritional value is phenomenal. But what about taste? Roy questioned. One of the main reasons I pick something to eat is not because of its calorie content but because it tastes good. If Oreos tasted like tofu, I wouldnt eat them either!

22 Jane responded, Except for a few basic tastes, food preference is a learned behavior. It all comes back to personal history and choice. Thats why what we teach our kids is so critical. Most children have established eating patterns by the time they are two years old! I dont know many two year olds who shop and cook, so everything they put into their mouth gets there by way of mom or dad. Roy, never one to miss an opportunity to be a smart aleck said, I ate a mouse tail when I was 18 months old, and it certainly didnt come from my parents! I think you get my drift, Jane replied, trying her best to ignore his faulty attempt at humor. She went on, Heres another example. They strode over to the dessert counter. A large machine loomed at the edge of the table with four separate spickets for ice cream. The first two were the traditional flavor de jour while the last two were fat free/ sugar free frozen yogurt. Did you realize that you could have four cups of the frozen yogurt and still not have as many calories as one cup of the regular ice cream? That seems like a fairly simple and obvious choice, but just stand here a minute and see how many people make that selection. Ten minutes and eight people later the frozen yogurt tap was untouched. Roy, it is about making the simple everyday changes that count. One single dietary change, like eating baked chips instead of regular chips, gets magnified when repeated over and over. Remember, your heart attack was years in the making. What we choose now impacts us for a lifetime. And never forget, what you teach your daughters becomes their legacy. I guess if I dont choose wisely for myself at least teach my kids good choices. I see your point, Roy mused. Maybe you are teachable after all! Jane said, poking Roy in the ribs. Dont forget though, kids learn best by example. She continued, So nutrition - what fuels our bodies - is about choices that are based on knowledge. The first major precept is that amounts matter. Dont get bogged down in the high protein, low carbohydrate, fat free rhetoric, just remember that a calorie by any other name is still a calorie, and good health, weight control, and even moods can be improved by limiting calories. There is a

23 wonderful saying from the island of Okinawa. This South Sea island has a greater percentage of people over 100 years of age than almost anywhere else in the world. Before a meal they say Hara hachi bu which means eat until you are 80% full. I am convinced that practicing that advice is one reason they are so healthy and live so long. Roy added, You know, I do remember reading that people who eat a vegetarian based, low calorie diet tend to live longer and get sick less often. I could quote you study after study that shows that a simple change like lowering your total caloric intake by 10%decreases your likelihood of developing a chronic disease like diabetes and can even add years to your life, remarked Jane. I told you that you already know this stuff Roy. My job is simply to remind you. Do you happen to remember my Four Rules of Healthy Eating? I wrote those on the corner of the board at the beginning of the semester your 10th grade year and they stayed there all year. Roy stammered, Well, lets just say that I was more interested in the Four Rules of Healthy Dating at that time in my life. I honestly dont think I ever saw your rules, and my guess is that, even if I did at the time, I wouldnt have paid much attention to them. Oh, Jane mockingly lamented, What wisdom we waste on the youth. You said this was my wake up call, and I guarantee that Im now more awake than I was in 10th grade, especially given the weirdness of all this. Lets hear those famous rules, even if they are 29 years old. Believe me Roy, they are a great deal older than that. I didnt invent them I just copied what has been true as long as people have been eating, and that is a long time! One of the most frustrating parts of trying to eat well is knowing exactly what to do. The constant bantering about what is healthy and what is not makes us all a bit crazy, especially when the rules seem to change monthly. I know, Roy agreed. I cant pick up a newspaper or listen to TV without someone claiming, for example, that caffeine is bad for you. Then the next week the same people report caffeine is good for you; or hot dogs cause cancer one week and cure

24 chronic fatigue the next. Its really frustrating. Any wisdom you can impart that will still be valid ten minutes from now would be helpful. Thats the beauty of these rules Roy. They were valid years ago, I mean many years ago, and they will be true many years from now. There are a few things in nutrition that are absolutes and these come as close as anything out there. Lets grab a juice and sit back down and talk. Jane and Roy filled their Styrofoam cups with a cool, aromatic blend and sat at a table near the back of the room. Ive already touched on rule number one, Jane began, when we talked about eating a variety of foods. Remember in health class when we talked about the old four food groups: meat, dairy, fruits and vegetables, and nuts and legumes. Some fancy pants nutritionists thought they had a better way of categorizing things a few years back and developed the food pyramid, then the stair step pyramid and now the modified stair step pyramid. Whats next, the food Sphinx? The experts were on the right track but they made things way too confusing. It turns out that, when it comes to practical, healthy eating, all of the ways of categorizing food can be summarized by one word balance. Thats it. Rule number one is eat a balanced diet. There is no super food in spite of what the latest infomercial tells you. God designed a wonderful cornucopia of foods to choose from, not only for our pleasure but also for our health. The health fanatics who claim that you should eat tofu and rutabagas are as misguided as the junk food junkies. Its okay to eat a piece of peanut butter pie on occasion, just dont make it one of the four food groups! One of the best ways to enjoy your food and to teach kids good nutrition is to be creative and experiment. There are a bunch of cookbooks available now that teach what I cleverly call stealth nutrition. They relate simple ways to make wonderfully tasting meals that are nutritious, and no one has to know they are healthy, although I do think that healthy is becoming fashionable again. Frequent local farmers markets where you can get a variety of good food, often cheaper than you get in the grocery store. Its a great tool for teaching both you an your kids about the variety and balance necessary for a healthy diet. The Greek ideal of everything in moderation and nothing in excess applies magnificently to nutrition.

25 Roy couldnt help himself. He said, I suppose you learned that directly from Socrates. I understand you teachers like to stick together. You have a pretty good sense of humor for a guy who just lost 20% of his heart muscle, Jane countered. Anyway, the simple lesson is to eat from a variety of food groups to get the nutrition, anti oxidants, vitamins and minerals you need to stay healthy. And just dont eat too much of a good thing, Roy added. See, I am paying attention. So what is magic, miracle rule number two? Jane tossed her empty cup in the trash can adjacent to their table. The sun was now burning its way through the blinds in the window directly behind Jane giving her a soft, luminous outline. She continued, Now we get a bit more practical. Rule two is eat low fat meals, in particular, low in saturated and trans fat. Whoa, slow down there lady. You just said eat a variety of things and, in my book, I consider doughnuts part of that variety. You have glazed, and cream filled, and plain, and sprinkles. Now thats variety. Id forgotten how cute you think you are Roy. Some things havent changed in 29 years. Jane couldnt help but crack a smile as she chastised her former student. Yes, variety is good but that is not carte blanche to eat anything and everything. That would be like saying that you should read a variety of books to get a good education, but not specifying what books are worthwhile and which ones are trash. There is not a nutritionist worth their weight in tofu who would tell you to go out and eat more lard. Fat makes you fat, period. If you looked at the little plaques blocking your hearts arteries, you would find that they have the consistency of chicken fat, all rubbery and slimy, because they are mostly fat. Saturated fat, found mostly in meats, and trans-fats, found mostly in processed foods like cookies and snack foods, are the real bad guys. Eating a bunch of that stuff is like pouring grease into your pipes. Eventually things are going to get clogged up. I realize this sounds simplistic, but remember, everything you need to know about nutrition can be understood by a tenth grader! Youre right Jane, this stuff really is simple. Maybe thats part of the problem. Its so simple we think it cant possibly work. We have become so programmed to equate

26 complexity with quality that we forget some of the simplest concepts are the most profound. I understand and believe what youre telling me. Where I come up short is in the execution. How do I translate knowing into doing? Youre not alone Roy. In fact I suspect the number one reason for poor eating habits is not a lack of knowledge but a lack of motivation. Heres what I have learned as both a teacher and a parent. Its not about me. If I am the only one affected by the choices I make, then my interest in making wise choices waxes and wanes. But if I understand that I have an amazing influence on the lives of those who mean the most to me- my family- my thinking shifts. I go from me thinking to us thinking. Its no longer just a selfish desire to become super healthy, although there is really nothing selfish about it, but it becomes about the influence I want to have on my kids and grandkids. In other words, the nutritional decisions we make as individuals influence those around us, so it is never just about you. Its about you and all those who live and work around you. Just look back at my favorite movie, Its a Wonderful Life, and remember that each one of us has emotional tentacles that touch people we dont know in ways we may never imagine. This applies to all the health choices we make, not just nutrition. Hows that for changing your frame of reference and motivation? Roy dropped his head. Do I crawl under the table now or later? Thats some serious guilt. Dont see it as guilt producing Roy, see it as an amazing opportunity to positively impact the lives of your family and friends. Just because youve made some poor choices up until now doesnt mean you have to continue down that potholed path. The past doesnt equal the future. Roy paused pensively and then said, So we need to eat a variety of foods, but we must make sure that those foods are low in saturated and trans-fats. That's really not too difficult, given the ubiquitous labels that appear on every food item. Sometimes those labels really drive me crazy, but I know theyre important. Only if you read them! Jane remarked mischievously. That brings me to rule number three. You have to control your sugar intake. Diabetes in this country is

27 spreading like mononucleosis at a Britney Spears concert. Im mainly talking about what we used to call adult onset diabetes. We can't even refer to it that way now since more and more kids are developing this disease, and it's largely due to their over consumption of sugar. Two things will bankrupt this country in the coming years, obesity and diabetes. It will bankrupt us emotionally, physically, and financially if we don't take action to dam the tsunami. Do you realize that if a kid develops diabetes before the age of fifteen she will reduce her lifespan by an average of twenty seven years! That should scare the pants off any parent. And remember Roy, its the parents who have the primary responsibility for what is available for their kids to consume. Roy got up from the table and indicated that he needed to walk around a bit. Jane thought it was a good idea, so together they walked towards a small courtyard extending off the back of the dining area. The sun was bright but the air was pleasant and a few clouds kept the heat at bay. A squirrel scampered a few feet in front of them, anticipating a few morsels of food. Obviously this was a favorite spot for the little creatures to collect some goodies. Jane could see that Roy's demeanor had become more somber. She knew that this part of her message would strike very close to home because Roy's oldest daughter, Miranda, had been diagnosed with diabetes three years ago. Miranda had insulin-dependent diabetes, a form of the disease that arose from a defect in the pancreas and not from an over consumption of sugar. However, the impact on Roy was palpable. Roy remained silent for almost five minutes as he walked around the courtyard. The solace and quiet was in sharp contrast to raucous, busy cafeteria but was welcomed by both Roy and Jane. The gravity of dealing with a child who has a chronic illness was evident as Roys shoulders began to slump and his pace slowed. He loved Miranda beyond what he even thought was possible, and daily it ripped out his heart to see her struggle. He would gladly trade places with her. At times his sense of helplessness was overwhelming as his natural instinct was to be a fixer. Many nights he and Eve had spent hours agonizing over decisions about Miranda's health care. In the end, the daily struggle had brought Roy and Eve closer to all three of their children. They felt blessed by the

28 forces that held them together like a powerful magnet as they had seen other families torn apart in similar circumstances. Finally, Roy spoke. I'm sorry Jane, but this rule has really hit me hard. I know Miranda's illness is not of her choosing or from her behavior. And honestly that makes it more difficult to deal with. You mentioned earlier that health is a choice and not by chance. I agree with you to a point, but not in the case of Miranda and millions of other people with diseases they had no control over. I get confused. I'm all for personal responsibility. I'm all for being accountable for our choices, but what choice did Miranda have? What choice does the child born with Downs Syndrome have? What choice did my brothers daughter have about the leukemia that took her life when she was seven? Did she do something that caused her cancer? I dont think so. Sometimes I get so angry when I think about the injustice of all this. You seem to know a lot about me so you know that Im a man of faith. There's not a day that goes by that I don't both pray for Miranda to be delivered from her illness and, in the same breath, question why God allows all this to happen. You know whats funny Jane? Every day I get the same answer. Have faith. It's the same answer God gave Job when he questioned the tragedies that came to his family. It's the same answer Joseph received when he was at the bottom of a well left to die. It's the same answer Jesus had when he hung on a cross. I don't mind telling you that faith doesn't always come easily. But it really comes down to whether or not I believe in a loving God. If I do, then its inconceivable and incompatible with that belief that both my life and Miranda's life are without purpose. If I have faith in a loving, compassionate and present God, then its impossible for both His actions and interactions with me to be anything less than perfect. When I get mad at God - and I do- I remember the story of Jesus and the blind man. Jesus and the disciples were walking along the shore of a lake when they were approached by a blind man. The disciples asked, Teacher, why was this man born blind? Was it a result of his own sins or those of his parents? Jesus told them, It was not because of his sins or his parents sins. He was born blind so the power of God could be seen in him. Sometimes we dont see the big picture, or the big picture is so big that its just a blur. A loving God doesnt cause birth

29 defects or send disease as either punishment or retribution. Either you believe that or not. If you do believe and have faith then asking why is a desire to understand not a condemnation. If you dont believe, then of whom are you asking the question? Do I think I have any stronger faith than anyone else because I believe this? No. My belief is a faith that is built on brokenness and grace and it is through that same brokenness and faith that I find comfort. Jane reached out her hand and gently touched Roy's shoulder. Youve given me strength just hearing that Roy. Thank you for that gift. Your faith is your foundation. It will continue to serve you well through this and other tough times. In many ways it's like a muscle. You have to strain the muscle and literally break it down for it to become stronger. God didn't cause Miranda to get diabetes or your niece to get cancer, but he certainly can use that reality for good. We live in a broken world were choices have consequences, whether you have faith or not. Thats a lesson I need to remember. Thanks, Jane, Roy said softly. Thanks for understanding, and thanks for helping me to see new ways of ministering to my family. Roy was quiet for a few more minutes then a faint mischievous grin crept onto his face. I can't wait to cook a balanced, low fat low sugar, low taste meal for the gang! Roy walked back into the cafeteria and motioned for Jane to follow. The lunchtime crowd had thinned considerably, and there were just a few stragglers looking for a last minute snack. What do you say we walk around for a bit Jane? All this talk of food has strangely killed my appetite. Sounds good to me, Roy. That'll give me time to tell you my fourth and final rule for healthy eating. It's simple like the others but doesn't seem as intuitive. I call it the rule of roughage or in more practical terms, eat more fiber. Now that doesn't mean you have to go out in the field and graze like cow, although that would certainly be an interesting sight. Eating more fiber has a multitude of health benefits. It is especially beneficial to women with hormone issues. It can help regulate estrogen levels and decrease your overall cholesterol. People who eat diets with a healthy amount of fiber have a lower incidence of breast cancer, prostate cancer and heart disease. The best way

30 to get fiber is in its natural state such as on the skins of fruits and vegetables. I'm usually not a big supplement person, but here's where I bend that rule. If you're not able to get enough fiber through your normal diet then using a fiber supplement such as psyllium seed may be beneficial. Just remember that you also have to consume proper amounts of water for the fiber to be most effective. Roy looked pensive. So what I hear you saying is that I need to go find something that looks and tastes like tree bark, and then eat it. Its probably good for me and it will keep me regular! Jane laughed, I dont think I can top that. Just keep these four simple rules in mind and judge any diet plan or new way of eating as to whether they adhere to these principles. Youll be able to spot the imposters from a mile away. Roy acted as if he was taking notes and chuckled to himself. Jane walked over to the window at the back of the south wall and gazed out into the midday sun. She said to Roy, Come on over here. Theres something I want to show you.

31 Chapter Three

Roy and Jane wound their way through the maze of halls that surrounded the cafeteria. It was still disconcerting to Roy that no one acknowledged their presence. He would purposely look intently at those they passed in the hall, but he got no response. They entered a stairwell and descended a flight of stairs to a door secured by an electronic lock box. The sign on the door indicated that they were on the ground floor, and the ominous authorized personnel only moniker was emblazoned in red letters on the door. Jane took out a small ID card attached to neck chain and waved it in front of the lock box. The box immediately emitted a slight buzz and the sound of the door lock opening guaranteed their passage. After you, Jane offered. Roy strode through the door, commenting on Janes apparent all access status. One of the benefits of the job, she replied. To Roys surprise they emerged on the outside of the building, and the bright sun temporarily blinded him. Covering his eyes and trying to focus, he was engulfed by the distinct sounds of children laughing. As his vision improved he saw what looked to be a small playground about 20 feet from where they had exited the building. It was surrounded by a chain link fence and backed up to the building just opposite to the one they had exited. There were two swing sets anchoring each end of the play area and the middle was filled with a variety of apparatus, many resembling plastic cartoon animals. It looked like a comic book petting zoo. The entire area was blanketed with tiny brown wood chips no doubt serving as a barrier to scrapes and a cushion for falls. Then there were the children. The sounds Roy had heard indeed were children playing, running, and yelling in a cacophony of unbridled activity. Girls were chasing boys, boys were chasing girls, and it appeared that the teachers were happy to not be chasing anyone. Most of the kids looked to be around five or six years old, with a smattering of younger and older ones as a part of the mix. The universal commonality that bound them together was their perpetual motion. Absolutely no one was standing still. They were laughing, yelling,

32 singing, but always moving. A reflexive smile came to Roys face as he imagined his youngest, about this age, joining the melee. His joy dissipated rapidly as he recalled his rather precarious situation, not sure when he would see his baby girl again. Jane noticed the change and said knowingly, Dont worry Roy, I wouldnt be wasting all this time teaching you these things if you werent going to see her again. Roy froze, not sure if he should be thankful or fearful as he realized Jane had essentially read his mind. You know its kind of creepy when you answer my thoughts, right? At least lets pretend to stick to verbal communication from now on unless you want me to weird out on you. No problem Roy, but the reality is that people communicate volumes nonverbally everyday. What I just did was nothing special, just intuitive. People who know and care for one another are very adept at interpreting non-verbal cues. I bet you can tell what kind of mood Eve is in just by the way she enters a room. I see your point. I just didnt realize I was that transparent. Its not just you Roy, its any parent who loves his kids unconditionally. Its painted on their expressions and reflected in their mannerisms. So why are we out here with the kids? Roy inquired. I suspect this is part of whatever I am supposed to learn. You know, the wake up call thing. But Im having some difficulty in connecting the dots. For all I know the kids are about to have snack time, and you are going to demonstrate what horrible food they feed the kids in day care. No Roy its not snack time, its recess. And yes, this is part of what I want to teach, or should I say remind you. I trust by now you understand the importance of nutrition, so I want to move on to the second pillar of wellness. Pillar of wellness. I like that. Its classy and sounds impressive, Roy teased. As I was saying, Jane continued ignoring Roys jibe, The second pillar of wellness is exercise. Just take a look at those kids. They are in perpetual motion. That is the natural state of the human species. We are meant to move. Our bodies are the most miraculous creations ever to grace this planet and every muscle, tendon, and bone is

33 designed with movement in mind. There is no question that function follows structure. Picture a bicycle in your minds eye. The two wheels, the pedals, a chain connecting the two. If you came upon a bicycle and had never seen one before, it would be pretty easy to decipher what it was designed to do by just looking at its form and construction. It wouldnt be a good ladder to help you climb to the top of a building, but it would get you around that building pretty efficiently. Observing the structure of the bike leads to some definite conclusions about its intended function. The same applies to your body. Do you realize that hand movements alone involve over twenty five muscles and hundreds of thousands of nerve impulses? And just think of the amazing things that our bodies can do when they move. The possibilities are limitless. But what I want you to remember today is that exercise, moving your body, is essential to physical and emotional health. Just look at these kids. They intuitively know that exercise is good for them. They just call it play! We have had play programmed out of us as adults. We need to recapture the joy of movement and do it for both the health benefits and to rekindle the freedom we experienced as kids. God meant us to feel good after exercise, and there are some amazing things that make that a reality. We need to remember how to be a good animal! Okay, so I can see this is a passion of yours, Jane, but what about those folks who hear the word exercise and run straight for the couch? They would rather have their fingernails pulled off than run a mile. Who benefits by telling them that exercise is great? My guess is that they already know that. Youre right Roy. There are a lot of people who have never exercised and never will. Its all about choice and personal responsibility, but that doesnt negate its benefits. There is nothing I or anyone else can do to force someone to exercise. Even inmates in prison can refuse their exercise time if they so desire. Its a choice. I dont have a magic formula for instantaneously pulling someone off the couch of doom and getting them to aerobics class. Roy, both actions and inactions have consequences. I believe the transition from adolescence to maturity can be pinpointed to the time when you fully understand that what you say, do, and think results in predictable outcomes. You do this, you get that. You dont do this, you get that. Simple but profound! Im amazed that

34 there are many older persons who never learn this lesson. They entertain a fantasy that things like good health, weight loss, and wellness magically happen. Or worse, they believe that some magical, super charged, infomercialized pill or device will do the job for them. This is faulty at best and dangerous at worst. I dare say there is not a living, breathing adult who doesnt understand that exercise is good for their health, so not exercising is a decision that is made, not from ignorance, but by choice. But I can offer some motivational ammunition to help those who need it. Do you remember talking about nutrition and the importance of teaching your kids to form healthy eating habits? That same admonition applies ten fold to exercise. I read a recent scientific study that demonstrated that a kid is twenty times more likely to exercise regularly if at least one of their parents is a regular exerciser. That increased to thirty times if both parents exercised! If a child incorporates exercise into their lifestyle during their teen years, they are three times more likely to exercise as adults. Remember, its not all about you. Certainly the paramount reason for pursuing regular exercise is to improve your health, but the impact you have on the future health of your family and loved ones is immense. You, the parent, teach by example. You establish the benchmark for what is considered normal behavior in the family. Roy, listening intently, seemed to briefly be lost in his thoughts. Jane, as you were talking I couldnt help but think about my girls. I used to be a runner, but I guess you knew that. Some of the best times we ever had as a family were running in local races. The girls were quite young, maybe three, five, and nine, and we would go as a family on the Saturday morning of the race. Id put Maggie, who was three, in a baby jogger and Eve would watch Mollie, the five year old, and Miranda would run along with me. We had a blast; laughing with each other and taking our sweet time finishing. Believe me, we never set any time records or won any medals, but that was not what it was about. I really miss those times, he reminisced. Roy, not only were you having fun but you were teaching your girls the joy of movement. You probably werent even conscious of it. All the kids knew was that they loved spending time with daddy doing this running thing. I promise those times are not

35 forgotten and will continue to have a major impact on how they view exercise. What you did was to create a behavioral norm for them. Early on they associated exercise with many positive feelings; fun, camaraderie, accomplishment, and those associations tend to stick. Whats great about all this is that its also never too late. Just because kids are older doesnt mean that they are past some arbitrary point where learning ceases to take place. I beg to differ there, Roy quipped. Teenagers and teachable moments go together like politicians and intelligence; never the two shall meet! Jane continued, Anyway, my point is that inculcating exercise as a normal behavior early pays incredible dividends later. After all, what could be more motivating than leaving a legacy of wellness for your kids? For example, many families have been overweight for generations. You look at pictures of family gatherings and it is easy to see that there is a culture of unhealthy behaviors that is passed on from generation to generation. Sure, some of its genetic, but the vast majority of obesity in this country is fueled by eating too much and exercising too little. You can be the one who breaks the chain of learned, unhealthy choices. You can literally alter the lives of future generations by the decisions you make today. At times its a bit daunting, but I see it as an opportunity. I said earlier that you had to be living in a cave somewhere to not know the benefits of exercise. I need to clarify that a bit. I actually believe that is not completely true anymore. If we rely solely on information from an era when Jack LaLane was the major spokesperson of an active lifestyle, then yes, everyone knows that exercise helps with weight control and reduces heart disease. But research has progressed immensely over the past twenty years, and I think many people would be stunned by some of the benefits of exercise. For example, you can cut your risk of breast cancer by almost 50% by doing one and a half hours of aerobic exercise a week! Roy, did you realize that exercise can decrease your chances of getting Alzheimers disease and senile dementia? Wow, my kids think I already have that. Can it get rid of parental brain damage? Roy asked.

36 Playing along Jane said, No. That occurs as soon as the kids are born and doesnt resolve until they are making a five figure salary and doing their own laundry! So I see you have mellowed in these 29 years! chuckled Roy. Touche! The truth is that exercise is about as close to a fountain of youth as anyone has ever discovered. There is nothing else in Gods creation that can make you look better, feel better, act better, decrease your risk of heart disease, cancer, and diabetes, and doesnt cost anything to boot! And it is never too late to reap the benefits. Okay Jane, I am a believerI might not always be a doerbut I definitely understand that an active lifestyle is vital to health and wellness. What about some practical ways to get fit fast? I feel like I have some ground to make up. That attitude will serve you well. The first step is committing to a lifestyle change. And that is what it has to be, a lifestyle change. Exercising once a week is better than nothing, but not by much. Doing something every day, even if it is simply taking the stairs at work or parking farther away and walking or, better yet, walking on a lunch break, can magnify results. To get fit faster try to do even a little something every day for a minimum of 30-45 minutes. Roy listened intently but was temporarily distracted by one little boy who was running in circles. What made it humorous was that the teacher was running behind him trying to catch up. Roy could only imagine the reason for the chase, a nose that needed wiping, an anticipated disciplinary action, or maybe just for fun. Jane, watching that little rug rat and his pursuer has given me a great idea for a weight loss plan. Just spend the day following a five year old and do whatever they do, and you will be guaranteed to lose weight! Jane agreed, Youve hit on an important point there Roy. Years ago we didnt have to worry about our kids getting enough exercise; it came natural and we called it play. Now the average kid will spend six hours after school sitting on their behind watching TV, playing video games, or working on the computer. It is incumbent on the parents to not only set the example but also to provide the opportunity and the motivation for children and teens to get active. And you cant rely on the schools to shoulder the

37 responsibility of keeping kids active through the physical education programs. The only physical education some kids get in school is in the back row of the study hall, if you catch my drift. Over 40% of school boards have taken gym class out of the curriculum altogether! Even in those schools that have a gym class, the average student will be actually moving around only eleven minutes during an hour class! Remember when you were in school Roy? You were still taking a gym class even in the 10th grade and it wasnt creative dance or Tai Chi. It was running, lifting weights, death dodge ball, or something where you were actually moving most of the time. Yea, I have to tell you Jane, being a munchkin in high school made gym class about as welcome as a cold sore before the prom. I was built like a marshmallow and had the coordination of the scarecrow from the Wizard of Oz. You remember Mr.Boutwell, the gym Nazi? He used to relish those days when he would make us run laps until we threw up. How I miss those days and that smell! He was Attila the Hun with a coaches whistle! Jane reminisced, I do remember Joe Boutwell. He was a bit fanatic, the classic old style gym teacher, but there was no doubt he was effective in getting you guys to participate. But you know, I dont remember that many of you and your classmates were overweight. I know there are many reasons for being heavy but with almost 40% of kids being overweight or obese today, maybe we need a few more Mr.Boutwells in the school system. My point is that you cannot rely on the government run school system to provide either the motivation or opportunity for your kids to exercise. Its your job as a parent. It goes back to the legacy thing. What you do now will have an impact over a lifetime. Duly noted. Sorry I distracted you from your ways of getting fit fast, Roy apologized. You started with doing something, anything, on a daily basis. Whats next? Jane resumed her lesson. There are four more simple tools to exercise for optimal wellness. First, you have to make whatever activity you are doing aerobic. Aerobic simple means with oxygen. You see Roy, muscles burn fat, but they only burn fat in the presence of adequate oxygen. That means that if you are exercising too hard and get out of breath, your muscles dont burn fat efficiently. So your goal is to do

38 something, like walking, that gets your heart rate up but doesnt leave you out of breath. The speed that you walk or jog to achieve that balance will vary depending on your fitness level. For example, Eve may be able to jog slowly for a mile and not get out of breath and you may be able to do the same at a brisk walking pace. As you get more fit, your endurance will improve and youll be able to pick up the pace and still be able to carry on a conversation while doing it. Thats the goal. Got it, Roy confirmed. Muscle activity plus oxygen equals fat burning. Right. Now the next step is while you are doing that walk or jog, speed up for about fifteen seconds about every five minutes. Its like a variation on the old wind sprint philosophy. Studies show that this little addition to your exercise routine can accelerate your fitness level. You get fitter faster! Wait a minute Jane, you just said to not get out of breath while you are exercising. Now youre telling me to sprint? Im confused. No Roy, I dont want you to do wind sprints, I want you to very briefly increase your speed. That short burst wont get you out of breath for more than a few seconds but it will stimulate the body to work more efficiently. Okay, I see the difference now. Whew! I thought for a moment you were suggesting that I go back to the sprint, throw up, sprint, throw up days. I was going to boycott that one. Roy, one thing about these principles is that they are things that anyone can do, regardless of age or current fitness level. A wind sprint for someone just starting out may be nothing more than a brisk walk, whereas for a fit person it may be a brief all out gallop. The next principle I call building the engine. I said earlier that fat is burned in the muscles, so it follows that to burn more fat - and by the way, that is really what we are talking about in getting fit - you need more muscle. If you are in the trash elimination business and you want to increase the amount of trash you can burn, you have two choices. Either you can have more furnaces to burn the trash, or you can run your existing furnaces longer. The same applies to your body. Either you increase the lean

39 muscle mass or you use the muscles you have more often. I have found that time limitations get in the way of doing the latter, so it is more efficient to accomplish the former. The best way to build muscles is to lift weights. Roy cut in, I dont mind a good iron pumping session, but I just dont see Eve blasting the barbells, and I really dont want to to lie down in bed at night with a female Arnold Schwarzenegger! Not to worry, cautioned Jane. Thats a common misperception. A woman using weights will not become muscle bound, she will simply firm and tone the muscles by increasing their mass but not bulking up like a California beach dude. Doing thirty minutes of a simple weight training program a couple of times a week will jump start your fat burning furnaces. Since Im talking so much about weight and fat, let me make an important point here. The benchmark for judging your fitness and health is not your weight but your percent body fat. The amount of fat you carry on your body correlates with your health better than just relying on absolute weight. There are easy ways to check your percent body fat ranging from inexpensive bathroom scales to skin calipers at your local doctors office or gym. Your focus needs to be on changing your body composition not necessarily your weight. If you lose the fat, the weight will come off! Roy reviewed, So we need to do something aerobic, lift weights, and wind sprints for lack of anything better to call it. Im almost afraid to hear the fourth pearl of wisdom. I have a feeling it will be painful! Not to fear couch potato boy, Jane responded, Its really quite fun! The final piece of the puzzle is to cross train. Simply put, do a variety of things to fool your body. God designed you to amazingly adapt to almost any strain you are exposed to. Remember, that which doesnt kill you makes you stronger! That applies to exercise also. If all you do is run, for example, after a while your body adapts and doesnt continue getting as much of a benefit. Dont misunderstand me, you are still reaping benefits, just not at the same level as before. But if you run one day, swim the next, the

40 day after that do an elliptical machine, you will get fit faster. Variety is the spice of life and exercise. But what if I dont have a pool or I am not a member of a health club with all the fancy machines? Roy countered. Excuses, excuses, excuses. What did I say a few minutes ago? Walking is one of the best exercises aroundand its free. There are also very cheap memberships at places like the YMCA and YWCA, and they often have great facilities. Save the money you spend on five mocha latt grande thingamabobs and youve got your monthly membership fee. Its a matter of priority. You have to make exercise a priority or it will never get done. Schedule it in your Day Timer if you are that obsessive, but do something to remind you that it is an important part of your health. I remember a story about a law school professor who was lecturing his advanced law class about time management. He pulled out a large, clear canister, placed it on top of his desk and then began filling it with large rocks. He placed the rocks one after another until they filled the canister. He looked at the class and asked, Is the canister filled? The class, being the intellectual elite that they were, answered, Yes, its full. The professor quickly told them that they were wrong and took out a flask full of pebbles and poured them in the canister until they filled in all the spaces between the big rocks. He then asked, Now class, is the canister full? Still in the dark the class responded in the affirmative and he again chastised them. No it is indeed not he rebuked as he took out some sand and poured it into the canister watching it filter into the tinier crevices. Finally, he asked one last time, Now is the canister full? The class, finally wise to his ways, said that it was not. Correct! shouted the professor as he poured water into the canister until it reached the top. He paused and then asked the class, What does this little demonstration illustrate to you? One bright student rose and said, If your schedule is already full, you can always fit something else in! No! screamed the professor in frustration. I wanted to illustrate that if you dont put the big rocks in first there will never be room for them later.

41 Roy, exercise is a big rock. It has to be a priority and no excuse is good enough to jeopardize you health. I always knew that law schools were full of confused people, Roy remarked sarcastically. Anyway, I get your point. In fact you have me so motivated I think I am going to join those kids on the swing sets. Actually, the bell is about to ring. The kids are going inside and I want to show you something else that is pertinent to this discussion. As soon as Jane finished speaking a loud bell clanged and the kids slowly assembled by a door leading to the inside of the building. Jane guided Roy back into the hospital building and through a small corridor to their left. I want to show you the kids classroom to illustrate another very important key to good health. Let me guess. Youre going to praise the health benefits of finger painting! Roy joked. Just follow me my little clogged-artery friendand learn.

42 Chapter Four

Jane, with Roy in tow, came to the door of the hospitals day care facility and slipped inside. The children were nesting in a corner at the south end of the room. They were sitting on a bright blue carpet with individual multicolored carpet squares as their designated seats. Still a bit restless from playing, they fidgeted, poked, and prodded each other as they awaited instructions. The teacher sat down in a small chair in front of the children and began reading from a book. The story was the classic fairy tale of the tortoise and the hare. Roy stood and listened to the familiar fable about persistence and consistency. So now we are relegated to learning our health lessons from preschoolers? Roy inquired good naturedly. Actually, I wasnt planning on this particular story for any insight, Jane responded, but never look a gift horse in the mouth. The theme of the tortoise and the hares encounter is that slow and steady wins the race. I couldnt think of any better advice for exercise. The key to making exercise work in achieving fitness and weight control is doing it for the long haul. Healthy exercise is not just for bathing suit season, it needs to be a lifestyle - a way of living. You must spend more time off than on the couch of doom. The longer you exercise, the more the benefits. That applies on two levels. The more extended your exercise at any one time, the more benefits you reap from that session. In addition, the longer you incorporate exercise in your lifestyle the more benefits you accumulate. It has a additive effect. More is not better in all things, but when it comes to exercise, more is almost always better. Unless you are one of those nutty marathon runners. Roy said. Most of those folks look like refugees from a concentration camp! Maybe so, but they are powerhouse fat furnaces, and they will most likely outlive us all. But you are right, any virtue taken to an extreme can become a vice. So stick-to-it-tiveness is important with exercise. Is there anything else I need to know from this story, like never get in a foot race with a rabbit? Roy asked.

43 Actually there is one other pearl of wisdom that this tale illustrates and that is the principle of LSD. Jane, I really believe you have gone over the edge, Roy said. I may be mentally slow and having a heart attack, but I fail to see how hallucinogenic drugs and preschoolers has anything to do with exercise. Easy Roy, LSD stands for long, slow distance. The most efficient fat burning exercise you can do is one in which time matters more than anything else. Doing something such as brisk walking for an hour is more efficient at getting rid of those thunder thighs or beer bellies than a fast run for fifteen minutes. This is great news for average folks who are not well trained athletes. The key is to make it aerobic - heart rate elevated and not out of breath - and continue that for forty five minutes to an hour. That makes your muscles greater grease gobblers! And faster fat furnaces! Roy added. These alliterations are really getting out of hand, what else do I need to learn from these kids? As Roy and Jane were swapping sayings, the kids were finishing their story and slowly spreading out on blankets on the floor. Before long the bevy of activity that was so prominent minutes before was replaced by a surprising silence. It was rest time. The lights were dimmed slightly and some soothing music was emanating from a CD player in the corner. Roy was amazed at the cooperation of the kids who only minutes earlier were doing justice to the label yard apes. They were quiet and reasonably still as the teacher slowly walked among them. Roy thought to himself that either this bunch of kids had been secretly medicated or they had a top notch teacher who they respected. Jane confirmed it was the latter. Isnt it ironic, Roy mused, that as kids we have to be forced to take a nap and bathe, and as adults all we want to do is nap in the bath! Roy, sometimes you do surprise me, Jane said. But the reality is that one of the biggest health crises we experience is our lack of rest. I know this sounds somewhat contradictory after spending time touting the laurels of exercise, but actually being active and resting are complimentary.

44 Im all ears, Jane. Explain that one, Roy said somewhat confused. Okay, Jane replied. Ill take the extreme example of a bodybuilder. Are you making fun of my physique? No Roy, I realize youre in shapeif you consider round as a shape! I only want to use this example to drive home my point. If you talk to a knowledgeable body builder, theyll tell you that muscle growth doesnt occur while they are pumping the iron. The growth actually comes in the rest that follows. In other words, it is the rest that makes the growth possible. Its during the down time that the muscle repairs and heals, and that is when the muscles get bigger and stronger. What is doubly fantastic is that your muscles are actually burning more calories while you are lying on the couch asleep after a hard workout. All the energy that goes into healing and repair of the stressed muscles results in more fat burning and better fitness. The exercise doesnt have nearly the impact without the rest time. To get fit and stay healthy, you have to balance being active with getting rest. As Forrest Gump would say, Its like two peas in a pod. So whats the secret to getting restful sleep? Do you have some magic fairy dust I can sprinkle on every time I need a snooze? Roy prodded gently. Of course I do, Jane replied. I never want to disappoint a student! You can take notes if you want, she chided. Sufficiently scolded Roy sat back and prepared to listen. Roy, almost half the folks in the average American family have sleep difficulties. Whether its trouble falling asleep, trouble staying asleep, or simply not getting enough sleep, almost 100 million people struggle every day with getting the rest their body craves and needs. Roy seemed impatient. Okay, I accept that this is a problem - a big problem - but lets get to some practical ways of overcoming this barrier to health, as you put it. As you probably know my interest in this is more than academic as I have had sleep issues on and off for years. There was a time when I could quote verbatim every infomercial that played on cable TV between two and four in the morning. Thats a fate I dont wish on my worst enemy. You can only take so much fanny blasting, cash flow systems, and ab-o-matics.

45 Alright Roy, lets break it down into suggestions that even you can understand. Jane was adept at gently coaxing Roy back into the right frame of mind. The first step for anyone having sleep problems is to realize that they have a problem. I know how that sounds, but hear me out. Fatigue has become almost a universal complaint in our society. Everyone is sick and tired of being sick and tired. What many people dont realize is that poor sleep is the source of much of that tiredness. It seems somewhat intuitive, but you would be surprised by how many people dont make the connection. So, as I said, step number one is putting the possibility of poor sleep on your radar. If you dont know the problem exists, its hard to do anything about it. If you already know your sleep habits are a mess, step number two is going see your doctor and getting evaluated for any medical problems that may lend itself to poor sleep. Some medical problems that can create sleep disturbances are thyroid problems, heart disease, stress, diabetes, arthritis, depression, Lupus, Alzheimers disease, and even menopause. You have to attack any underlying problem before your sleep can be adequately addressed. There are also some severe sleep disorders that independently exist, and a good primary care doctor will be able to test for those or refer you to someone who can. Your doctor is always a good place to start if you are concerned about sleep or fatigue. Roy couldnt help but comment. The only problem is that it can take months to get an appointment with my primary care doctor, and then when I get his bill Ive got another reason to lose sleep! Anyway, Jane pretended to ignore him once again. Once a medical problem or true sleep disorder is ruled out, you then fall in with the majority of folks who just arent getting enough restful sleep. There are a few simple things everyone can do to facilitate going to sleep and staying asleep. Some suggestions may seem simplistic, but remember Roy, these are things any 10th grader can understand and use. Its not the simplistic nature of the suggestions but a lack of implementation that thwarts their usefulness. First, get rid of the impediments to good sleep. By that I mean stop doing the things that are known to keep you from cruising for a snoozing. The number one thing is caffeine, a highly addictive substance that would never get FDA approval if it came on the market as

46 a new drug. Its so ubiquitous in society that a whole mythology has arisen around coffee and tea. A staple of most meals, these caffeinated substances act as stimulants for hours. The downfall for many is the stealth caffeine found in many consumables like chocolate and sodas. Simply stopping or limiting caffeine intake can solve the sleep problem for many. I guess I need to sell my stock in Starbucks then, Roy quipped. Why do so many of your suggestions involve giving up lifes little pleasures? I mean, do you really expect people to chunk the chocolate and trash the sodas? I didnt say get rid of those things Roy, remember, everything in moderation. Just be smart about it. Dont consume any caffeinated drinks after lunch and read labels. Find out what sodas and what delicacies, like chocolate truffle cream puffs, have caffeine and which dont. What youll find is that there are a plethora of goodies out there that will satisfy your cravings but wont keep you wired. Okay, lets move on before I run over to the hospitality shop and grab a Latte and a Three Musketeers bar. Roy, have you ever had a glass of wine at bedtime to help you sleep? Im not much of a drinker so I cant say that I have. You would be surprised by how many folks do, and its probably the worst thing that they could do. How so? Alcohol acts as a temporary sedative and can help you fall asleep quicker, but you actually sleep less overall and the sleep that you get after a nightcap is less deep and restful. Like I said, thats not a big issue for me, but as Eve has gotten older I have noticed she enjoys a glass of wine at night. I wonder if that is affecting her sleep? Could be. Alcohol also acts like a diuretic so many people will have to wake up at night to go to the bathroom, once again disrupting sleep. Make a note to ask her when you guys are back together. Jane replied. Roy caught her reference and found this

47 reassuring as he still had an uncomfortable feeling about when or if he would get back from where ever he really was. Heres some other things to think about regarding sleep, Jane continued. It may sound like common sense, but then common sense doesnt occur commonly. Simple things like the room temperature can make a difference. Did you know that people tend to sleep better in a slightly cooler room? Dont forget about some other little things like the comfort of your mattress, scratchiness of the blankets, and the infernal itching of a loving pet. All these can distract from a pleasant sleep experience. If your room is naturally noisy due to its location in the house invest in one of the noise canceling devices, or even better, run a small fan or other device to provide white noise. During the winter months I use a portable humidifier due to the drying effect of the heat. Ive found that the constant whirring of the device actually helps me sleep better by drowning out ambient sounds. Each person is different in their response to sound with sleep, so work with your spouse so you are not inadvertently driving them crazy with your sleep aid! You know, I have seen those white noise devices advertised in magazines but always thought they were bogus. Maybe they do have some merit for some folks. Jane agreed and went on, Believe it or not, most people who have trouble sleeping stay in bed too much! I tell my students about a study from 1993 in which researchers actually improved the quality of sleep in 90% of individuals by reducing their time in bed by one hour. It may sound counterintuitive to tell folks with too little sleep to stay in bed less, but these researchers discovered that those who spent nine hours in bed, yet only needed seven hours of quality sleep to feel refreshed, eventually spread that needed seven over the nine hours and ended up with more fragmented sleep. It is the same principle that causes a worker to take nine hours to do a job that should only require seven hours. He adjusts his working to fill the time allotted to perform the task. In the case of sleep, this results in a less likelihood of reaching the REM sleep, which is the state of greatest rest. Sleep more, sleep less, Jane your confusing me here.

48 My point is that it is not necessarily quantity but quality that counts. Everyone is different in their sleep requirements so you have to find what works for you. Roy thought for a moment. Youre right, Miranda needs to sleep a couple of days at a time, but maybe that is just a teen thing! Actually kids are different. Their body is changing so rapidly that they do require more sleep. There is no question that sleep requirements change with age. Jane continued, Another helpful practice is to establish a sleep ritual. Do the same thing every night. This repetition prepares the brain for shutdown and makes getting to sleep and staying asleep more of a reality. Whether it is a warm bath, a good book, or listening to music, set a pattern that signals to your brain that its quiet time. The exception is the chronic insomniac whose rituals actually trigger anxiety. Thoughts like What if I cant sleep again tonight? filter into the brain once the bedtime ritual begins setting up a downward cascade of stress and sleeplessness. For these folks actually breaking their bedtime ritual may be an advantage. Roy chimed in. I just remembered something Eve and I did a while back. She found herself getting up in the middle of the night and looking at the clock. It freaked her out if it was two or three in the morning as she was afraid she wouldnt get back to sleep. She was a classic clock watcher so we hid the clock from view. A simple but effective solution: and it worked! Jane looked at the room full of kids and concluded, It almost seems clich to tell someone to get more rest. We all know its vitally important, yet we still burn out and worship at the alter of busyness. Its time to make a radical shift in our thinking. Integrate rest into your wellness program just as you would exercise and nutrition. Make it a priority. Focus on getting adequate and restful sleep. Take serious Gods command about the Sabbath. Its to be a day of rest in mind, body and spirit. Youll be a healthier person for it. Roy took a moment to digest what Jane had said. He continued to watch the room of resting kids and thought about his own children when they were that age. Miranda, the oldest, had been a mischievous child always looking for a way to avoid nap time. She

49 had become quite creative in her excuses and figured out early that Eve would buckle to her pleadings if she offered to clean up her room. Inevitably Eve would get busy doing something else in another part of the house and Miranda was left to do what she wanted, which rarely actually manifested in a clean room or rest. Maggie, the youngest of the three, loved nap time. She had always been independent, and Roy figured out that this quiet time was when she recharged from all the hustle and bustle of the day. Middle children tend to be unique in many ways and Mollie was no exception. Some days she would greet rest time with open arms and her blanket. Other days she would throw a fit that mimicked a grand mal seizure; whereas, still other times she would just sit quietly, never closing her eyes, but obviously solving all the problems of her pre kindergarten world. He missed these times greatly, and for the first time since encountering Jane, he longed to see his family. He was learning a great deal and was enjoying his new mentor, yet the experience was somewhat hollow without his family to share it. Roy, I see the sadness in your face, Jane began. I realize this is confusing and difficult, but remember, one of the major reasons we are together is so that you can share what you are learning. This isnt just about you. Just as your individual health decisions extend their tentacles to all those around you, so what you learn today is only fully realized if you share it, and who better to share it with than your family. We dont exist in a vacuum. What you choose to do affects those around you and it is a reciprocal relationship. In other words, we all live in a web of influence. Of course, the final choice of behavior is ours, but dont be fooled into thinking that what you do doesnt effect others; it does. It is a curious thing that we are often more comfortable sharing ideas of importance with perfect strangers more readily than we do with loved ones. Ill never forget a discussion I had with an evangelist friend. This was a passionate man of immense importance in the church who had shared the Gospel with literally thousands of people through his writings and sermons; yet in a moment of stunning honesty he told me that the most difficult time he had witnessing was with his own family. I was floored. I self righteously thought that, of all people, his family should have been the easiest to share with, and then I considered my own hypocrisy. Here I was, a health and biology

50 teacher - a fitness fanatic - and all the while my own family was choosing unhealthy behaviors that crippled their wellness. Maybe it is the intense love we share or the tight bonds of family, but whatever the reason, I didnt share with my own kids the importance of the things we are talking about today, and that is one of the greatest regrets of my life. A few years after I taught you in tenth grade my twenty year old son Drew was admitted to this hospitals ICU in heart failure. Thats right; heart failure at twenty! He was eighty five pounds overweight and hypertensive. This along with his sedentary life style had aggravated a relatively minor congenital heart valve problem. The combination of his physical condition and his lifestyle choices came close to killing him Roy, and I blamed myself. I had been preaching and teaching the benefits of healthy living for years, but Id not taken the time to communicate with my own family and show them how to apply those philosophies on a daily basis. Oh sure, I believe that each person is accountable for their actions. I didnt force feed Drew potato chips and M & Ms or glue him to the couch. He made his own choices. Where I neglected my duty as a parent was in providing both an example and information to enable him to make wiser choices. Its like if my children wanted to jump off a pier and swim in a lake. They have to get to the lake before they can jump in and enjoy the swim. They cant jump from miles away. Well, providing information and wisdom on healthy living for my kids is a way of driving them to the pier. Its their choice to jump, but I have a responsibility to get them to that point. You see, I believe I am more at fault than most because I know better. I dont have the excuse of being a health illiterate. My fault doesnt lie in a lack of knowledge but in a lack of action. Roy, never forget, knowledge is not power, it is only the application of knowledge that gives one power to positively affect the lives of others. No man is an island, and that applies to your health. Am I directly responsible for your health? Are you responsible for the health of your family? No. People make choices. People live their lives and suffer either the benefits or consequences; however, I believe we have a moral obligation to teach by words and deeds. Its like that same evangelist friend told me once, I plant and water the seed, but God makes it grow. Roy, my prayer is that you will plant the seed of good health for you and your family. Thats why youre here, and thats

51 why youre missing them right now. I said before that you already knew all this stuff. Im just here to help you remember and to show you its importance. Roy took a deep breath and pondered what Jane had said. This was the first time she had mentioned anything of her personal life, and he needed time to digest all she had revealed. Her honesty was disarming but more intimate than he had expected. He knew she was right, and in a mixed up kind of way this made him feel both guilty and hopeful. He felt guilty for not being the role model he should be but hopeful that he would have the opportunity to correct that in whatever future he was blessed with. He slowly sat in one of the tiny chairs that populate preschool rooms looking like a giant in a miniature world. For the moment Jane seemed lost in her thoughts and then turned towards Roy. Lets walk around outside and get some fresh air. I want to finish what I was saying about rest because its so important. Roy agreed that a walk would feel good, and he didnt want to disturb the kids even though no one had noticed either their arrival or departure. The two made their way back through the tiled halls until they reached a large anteroom at the front of the hospital. For the first time Roy noticed the sheer mass of people surrounding him. This cavernous lobby was the entry point into the hospital and it was full of people of every age, size, shape and color. To Roy most of them shared a common trait: they all looked tired, sick, and scared. The expressions on their faces and their body language gave the impression of a defeated army returning from the front lines of a lost battle. To his left he noticed a young family sitting alone on a group of chairs. The two small children were uncharacteristically quiet and subdued while the father whispered in the ear of his wife. She was restrained by a wheelchair and an IV pole, no doubt dripping some life giving, or maybe life destroying, medication. The IV tubing snaked around her lap and disappeared under her gown at the neck, holding her captive more strongly than a heavy chain. The scarf on her head poorly hid the few strands of musty, brown hair that were remaining, certainly the result of powerful chemotherapy. Roy couldnt help but think of Eve and his girls. What pain they must be feeling wondering about him. Would he see

52 them again? Would he be around to walk them down the aisle at their wedding? Would he ever hold his grandchildren and spoil them with ice cream? Would he get to cherish the years of rediscovery and togetherness that he and Eve had talked about once the kids left? The questions flooded his mind with a torrent of emotions as he gazed about the room. He realized that everything that was happening with Jane was no accident. Even being here in this part of the hospital at this moment had meaning. The pain that he was feeling, the pain of love lost and opportunities missed, didnt have to become a fixture. He had a choice. He had been blessed with a wake up call. He could take what he was learning, apply it in his own life and, just as importantly, share it with his friends and family. He looked up again at the bodies crowded in the lobby and saw pain, longing, desperation and sorrow in the eyes of many of those surrounding him. If they only knew, he wondered, would it make any difference? Jane guided him through the anteroom and out the revolving doors into the front of the hospital. He followed as she walked down a narrow path to the right of the main entrance taking a route that was obviously not well traveled. It was sprinkled with flowers that once had been cultivated but now had become seamlessly a part of the surroundings. Roy, lets go over here, she said pointing to a small open space at the end of the walkway. Its one of my favorite spots in this place. She continued down the small paved path, large boxwoods standing sentry on both sides, until she came to what looked like a meditation garden surrounded by foliage sheltering it from the nuisance of outside distractions. It was a small opening with not much room for more than two or three persons to sit, but was surprisingly beautiful and tranquil. A small stone bench sat in the middle and a large oak tree planted at the edge supplied cover and shade. A collection of green kudzu had engulfed the tree trunk and was creeping relentlessly towards the bench. Roy was shocked at how quickly he escaped the bustling feeling of the hospital entrance. He had traveled just a few feet and yet he felt he had been transported to another time and place. The air was pungent with honeysuckle and jasmine, a curious combination that was no doubt the intentional whim of an anonymous gardener. Jane took a seat on the

53 stone bench and motioned for Roy to join her. As he sat he looked directly in front of him and noticed a small metal placard supported on a thin stalk of iron. He surveyed the rest of the area and took note of a number of other similar placards positioned around the periphery of the garden. He could tell that each one had an inscription, but the writing was too small to read from where he sat. Jane broke the silence. Some of my favorite scenes in the Bible are when Jesus withdraws from the crowds, she said wistfully. I mean it wasnt as dramatic as healing the blind or sick, but it had meaning just the same. He usually did one of two things when he would retreat by himself. He would either rest, pray, or both. Roy, there is amazing power in that. There are times we need to just pull back and rest; recharge if you will. Our hurry-up-I-want-it-yesterday world doesnt place much importance on rest, in fact some would say that rest is a vice to be avoided. Those folks are confusing rest with laziness. There is a huge difference. One is purposeful renewal and rejuvenation whereas the other is purposeless waste. You have to make time to let your body rest both physically and emotionally or youll have to make time to be sick. Healing takes place at rest. Many of those people you saw in the lobby were suffering from illnesses that began from a lack of rest. I know that sounds strange, but rest is that important. Whether it is getting enough sleep or just taking down time to fuel the up time, rest has to be a part of our healthy living program. Jane paused and bent down close to the placard nearest to her. She began to read, Carly Elizabeth, we knew you only briefly, but you brought us unimaginable joy. Love Mom and Dad. She glanced at another. With loving memories and prayers for our unborn baby. Janes eyes moistened as she read the placard immediately to her left. For Angela Grace. You were truly an angel sent by Gods grace. She paused for a few seconds and said, Roy, this is a memorial garden for babies who were either stillborn or died shortly after birth. Its a holy place of remembrance. Ive come here often over the past years, and it never ceases to remind me of the tenuousness and preciousness of life. Here are the memories of moms, dads, brothers, sisters, aunts and uncles who understand the gift of life. I believe, as you do, that this is not all there is; that there is more to us

54 than our physical bodies. A place such as this reminds me that we are not here haphazardly. It reminds me to slow down and notice things. There is a purpose and meaning in all of us. I think that just being on this earth and being alive is testament to a loving God, and one means to glorify the Creator is by taking care of the creation. Look at your finger Roy. Look at all the whorls and twists and turns of your fingerprint. There is no one else on the earth, now or in the future, that has your fingerprint. It is uniquely you. Just as an artist proudly signs his masterpiece, so God has formed that fingerprint as His signature on the masterpiece that is you. Cherish what you are and what God wants you to be. Rest and restore to His glory. Roy rose from the bench and slowly made his way around the garden, softly reading to himself the testaments to those who were here so briefly. He paused and read the last placard at the far edge of the garden. Maria, my angel, my love, my daughter. We loved you even before you were born. It was inscribed at the bottom, Jane and Howard Ferguson. He began to cry.

55 Chapter Five

A slight drizzle began falling on Jane and Roy as they sat in silence. Both were somewhere distant, but the kindred nature of their journey kept them close in spirit. Finally Jane spoke. Roy, I think this is an appropriate time to visit another special place in this hospital. Its probably somewhere you never knew existed but, as I hope you will see, has an enormous impact on your health. Jane, before we go I want to tell you how sorry I am about your daughter. I dont know what happened, and I dont need to know. I just wanted you to know that Im sorry for your loss. Thank you Roy. What I want to share with you next actually involves Maria, but lets get out of the rain first. The two somberly made their way back down the trail to the front of the hospital and through the entrance gallery. Jane guided Roy to the right of the patient receiving area, still cramped with sick people and their families, through a set of large double doors into a hall that was much less congested; in fact, it was almost deserted. You could tell this was an older part of the hospital as its walls were covered in the pale, sterile tile so characteristic of the sixties. The contrast was stark going from the hustle and bustle of the main hospital to this offshoot of a back hall, and Roy actually was glad to be in more sedate surroundings. Jane stopped abruptly in front of a set of nondescript wooden doors only identified by a small nameplate at the top that read chapel. She opened the left hand door and walked in. Roy followed and was immediately struck by the Lilliputian size of the room. The lighting was muted and there were only three small pew-like benches, enough to seat no more than five or six people. There were no windows and the floor was covered by a weave carpet that had obviously not been changed in decades. At the front of the chapel was a small alter adorned with a hand-carved crucifix about a foot in height. Behind the alter was a poster sized painting depicting Jesus healing a cripple at the gate of Bethesda. The walls were draped in a drab, grey linen cloth wallpaper that

56 only magnified the gloomy feel of the place. All in all, Roy thought it was one of the most depressing rooms he had ever been in. Jane walked forward and sat in the first pew. Fortunately they were the only people in the chapel as the presence of any other visitors would immediately elicit an uncomfortable, claustrophobic feeling. Roy hoped they would continue to be alone until he remembered that it probably didnt matter as they seemed to have spent the entire day incognito. Jane remained quiet for a time, either in thought or prayer Roy couldnt tell which- and then broke the silence with a big grin and said, This is one of my favorite places on earth. Roy hesitated and then said, Youve got to be kidding! No disrespect meant, but I feel depressed after being in here just a few minutes. I know this is a hospital and all, but it feels like one of those chapels ina funeral home. I dont think I would exactly use that comparison considering your precarious situation, Jane jokingly countered. Right, Roy acknowledged. Let me rephrase that. Gee, this place is about as cheery as a screen door on a submarine! Roy, its not the bricks and mortar, its the symbolism and the memories and what they represent. Go on, you know I was just ribbing you. Things were getting too serious so I wanted to lighten it up, Roy sheepishly responded. As I was saying, this place provided me immeasurable comfort and solace in some very difficult times. A few years after I began teaching, actually even before I had the dubious honor of having you in class, I became pregnant with our - Howards and mine - second child. I was 41 at the time and needless to say we werent exactly trying. I mean, we werent doing anything to stop it, but we werent using anything to prevent it either. This is a bit more personal information than I need, joked Roy.

57 Hush up and listen, Jane retorted good-naturedly. We were ecstatic after the shock wore off and began thinking about how it would change our life plans. Howard was an obsessive planner and already had our retirement home picked out. He even knew what we were going to do ten years down the line, or at least he thought he did. Well, you can say those plans were dashed with the discovery of my pregnancy, but we were truly happy about it all. I felt wonderful for the first few weeks of the pregnancy, not exactly what I was expecting since I had thrown up my toenails years before with our first. The doctor explained to us at the first visit that, because I was in pretty good health, I would probably do just fine being of advanced maternal age. Thats how they labeled me on my chart! I certainly didnt think of myself as advanced in age, but the doctor reassured me that it was just medical lingo and not a derogatory reference. As I said, I had been feeling great so naturally I assumed that all was well. It wasnt. I had some routine blood work at around my fourth month and it came back abnormal. The doctor was reassuring saying that most of the time it was what he called a false positive, in other words, a false alarm for any problems. He recommended an amniocentesis, a procedure where the doctor pokes your abdomen with a long needle and draws some fluid from around the baby, to determine if everything was alright. Thats the way he put it; not to find something wrong, just to confirm that everything was fine. The amnio was less traumatic than I imagined, and Howard and I were understandably anxious for the several days waiting on the results. Ten years wouldnt have been enough time to prepare us for what we heard. I can still remember the phone call, Mrs.Ferguson, this is Doctor Shanes office. We need you to come in and discuss your amnio results. Thats all they said. Not that things are good or things are bad; just come in. I called Howard and we went together and sat in the doctors office for what seemed like hours. I knew as soon as the doctor came in the room that there was a problem. The words still echo in my thoughts thirty years later. Your baby has a chromosome problem called Trisomy 18. I wont mix words, he said. This particular problem is not compatible with life. Im very sorry. My first reaction was, what does he mean not compatible with life? Does that mean my baby is

58 dead? It cant be. I felt her moving yesterday. This has to be a mistake. These labs make mistakes all the time, I thought. But it wasnt a mistake. It was real. My baby girl had an extra chromosome that allowed her to develop and grow in the womb, but she would never live more than a few hours or days after birth. Her body systems would shut down and her heart would just stop beating. The doctor explained that it was not uncommon for babies like ours to be stillborn, but if they did make it to term, 100% die in the first few days of life. We were numb. The doctor let us digest this over a few days and then told us we had the option of terminating the pregnancy if we wanted. That wasnt an option for us. The rest of the pregnancy went by relatively uneventfully, and on May 8th 1978, Maria Louise Ferguson was born. She was a beautiful little girl with striking blue eyes and strands of dark hair. She died in my arms two hours after she delivered. Howard and I asked the nurses if we could go with Maria to the hospital chapel- this chapel- and be with her alone. We spent our last minutes with her right here, and I have been back to this place countless times over the years. You might ask, why come back to somewhere that holds such painful memories? Because it is in that pain that I found healing. It was through that pain and brokenness that my faith was bolstered. It was because of the pain that Howard and I learned to depend on each other and God. We knew that we couldnt handle the anger and hurt on our own, and we learned we didnt have to. That pain gave me purpose and perspective. Its not that we didnt suffer and that Marias loss was not tragic, but I was not going to let it fester in me like a boil under the skin. I never got hung up on the why us pity party. I know thats normal to ask, and if I am honest I have to admit that I probably thought about it briefly, but I realized that asking that was fruitless since there was no answer. I learned I had a choice. I could curse God for being an insensitive, uncaring, uninvolved spectator, or I could embrace His sovereignty and trust in His wisdom and nature. I chose to do the latter and so did Howard. It made all the difference.

59 Roy had remained silent as he listened to Janes story. He was struggling with a question that had always bothered him when it came to bad things happening to good people. Jane, do you thing God was responsible for Maria being the way she was? Could he have changed it if he wanted to? Jane sat for a moment as she pondered his question. Roy, both Howard and I asked the same question a thousand times. We live in a world created by God with purposeful parameters. God is God. He can do anything he wills, but he has made it clear through Scripture and his son that he wants us in a loving relationship. That cant exist without free will and natural law. We must have free will to choose to love or we become automatons - puppets. Without free will and choice, love cant exist. The price we all pay for this freedom is that some choices result in unwanted and unforeseen consequences. Likewise, natural law allows the world to exist where our choices, the exercise of that free will, has meaning. If for example, God temporarily reversed gravity and pulled a falling plane from the air every time there was an engine malfunction, we would have no basis in making choices. We would have no foundation to guide the consequences of our choices, and without consequences, good and bad, choices become arbitrary whims. God has given us a framework in which to live our lives and a basis to choose to be healthy and to choose a relationship with him in which we can have faith that those choices will result in meaningful outcomes. He has said that if we choose to believe in his son we will have eternal salvation. That is an unalterable absolute. It provides the foundation for faith. Likewise, the choices we make about our health have consequences. Granted, the salvation choice is a bit more important that the choice to exercise or eat right, but the principle is the same. By the same token, some things occur outside our choices. Maria didnt choose to have an extra chromosome. Was it in Gods plan for the universe that she die a few hours after birth? Im not God so its tough for me to say, and there have been a lot of people over the years much smarter than me who have been unable to answer such a question. If we live only in a world that is explained by logic and reason, then we have to give up on things like love which falls out of that

60 purvey. I can no better logically explain love than I can logically explain why some children get cancer and others dont. Some folks will just never get to a point where they can accept the premise that the supernatural exists. Lets be honest Roy, there are just some things science, logic, and reason cant explain. Thats not an indictment of reason but an acceptance of some things that are transcendent or above the natural - supernatural if you like - even when it comes to our health. Roy got up and walked forward to the alter, turned slowly and looked back at Jane. Its all about choices isnt it? he said in a way that almost seemed surprised. From the most mundane of what am I going to wear today? to the most profound of how am I going to live my life. Its deciding what I am going to believe. Its all choices that I make, not Eve, or you, or my kids. But me. And the choices I make do have an impact on those around me. I get it. Its about me in the sense that I have to make basic choices everyday, but its not only about me in the sense that those choices have consequences that affect those who are a part of me. He paused for a second as he digested what he had just said. I understand why this chapel means so much to you. It represents the choice you and Howard made years ago to embrace your faith instead of abandoning it. Youre right Roy, and that choice has guided our lives together ever since. Our faith influences all aspects of our lives, including our health. Roy nodded his head in understanding and added, What you say makes me think that there may be a closer link between faith and wellness than I previously thought. I never thought much of the faith healer stuff, in fact, it often embarrassed me when my non-Christian friends would talk about some televangelist telling you to touch the TV screen and receive your healing. I know many of those folks are sincere, but I cant help but think that even Jesus would reprimand some of those people. I remember that in many incidences Jesus entreated persons he healed not to tell anyone about the miracle. He didnt need the publicity, notoriety, or donations. He certainly didnt ask them to walk across the stage or jump up and down for the cameras.

61 I understand what youre saying Roy, but thats not the connection of faith and health that I mean. I think many people mix up faith healers with faith and healing. Faith healers are more about people and ego whereas faith and healing is more about the awesome power of God. For many years there was an intimate and recognized interdependence between a persons faith and their physical and emotional well being. In fact, through the ages the spiritual leader in a community was also the healer. It was only with the onset of modern western medical customs that the rift between health and faith widened. This chasm was institutionalized when medicine became a secular, empiric science purposefully devoid of any supernatural underpinnings. Its funny how the pendulum swings to great extremes before settling in the middle, which often better approximates the truth. Roy looked confused. Im not sure exactly what you mean I mean that a persons health is related to their faith beliefs, but certainly not exclusively. It is a balance. True wellness is a balance of mind, body and spirit. There are atheists who are physical specimens of health and vitality, and there are Christians who are engulfed by devastating cancers. A persons faith is not a get out of the hospital free card, but it is a fact that, in general, people of faith have fewer illnesses, heal better from disease, and live longer than those who profess no belief in God. This is a fine distinction so let me be very clear. Being a Christian will not protect you from disease and illness; religious people get sick. However, many of the behaviors practiced by people of faith reduce the likelihood of getting ill or staying ill. But that is only one piece of the puzzle. The faith community- the church - provides an important support network that helps not only in preventing illness but also in healing once illness strikes. Also, and some would argue, most importantly, is the impact of healing prayer. Scripture tells us that it is God who heals, and how he chooses to do that, either by medicines, through doctors, exercise, nutrition, spontaneously or miraculously is under the auspices of God, not us.

62 Thats a bit more clear, Jane. A persons faith affects their health by the choices they make based on their faith prescripts, by the support community of the church, and by Gods grace and intervention. I believe so. Anyway that has been my experience and what I interpret from the Scriptures, Jane responded. I read a quote from Saint Ignatius of Loyola that summarizes the relationship well. He said, Pray like everything depends on God and work like everything depends on you. I couldnt have said it better myself Roy joked. When Maria died I grieved, but I was not consumed by grief. Faith in a greater good and a loving God kept me from remaining in the pit. My faith wasnt a crutch, it was more like a ladder allowing me to climb out of the depths of depression. God was not a disinterested bystander, he grieved with me, just as he did when his son was killed, and then he provided the tools and direction to help me find my way back from the dark. I didnt avoid the darkness, I was just provided a light to find my way back. Jane, do you think God uses illness simply to teach people or even to punish sins? Roy asked. Those are two separate questions but the answer is interrelated so let me address them together. I dont think God sends diseases to people as punishment for sin. That price was paid 2000 years ago on a Roman cross. As believers, we dont owe that debt anymore. Thats what grace and atonement is all about. God has created a physical world where there are natural laws and those laws have consequences. If you jump from a two story window, chances are you will hurt yourself. If you eat contaminated food, chances are you will get sick. If you watch too much TV, chances are your brain will rot. The last comment made Roy laugh. I just thought I would see if you were listening. Anyway, those cause and effect scenarios will occur, so I guess in a round about way you can say that God is responsible, although I find this type of reasoning much ado about nothing. But, and here is the important distinction, I do believe faith and Gods grace can take any illness and make it purposeful. Take Saint Paul, arguable the person most responsible for the spread of Christianity second only to Christ himself. He,

63 by his own account, was struck with some sort of physical malady; his thorn in the flesh. Initially he prayed repeatedly to be healed of this problem, yet healing never came in the way he desired. What God did was to use this illness to teach Paul that Gods grace was enough for Paul to rely on. The thorn was the result of some natural process, remember Paul traveled all over the Mediterranean mostly by foot, and was subject to many situations that may have led to various illnesses. It is not in Gods nature to sit on his throne and toss illness at Paul or anyone else like Zeus throwing a thunder bolt at an unsuspecting mortal. But it is like God to take what occurs and use it for good, in this case a transformation of Pauls understanding of grace. I believe God does that today. I know He does because thats what happened to me. Jane, is it possible that what we are doing here, now, in this moment, is God using this heart attack to teach me lessons that I might never have learned otherwise? Thats between you and God, Roy. The answer to that is above my pay grade! The doors of the chapel opened and a young couple entered the small area. Even though they appeared unaware of the other two persons in the room, Roy sensed that this couple needed the room and their privacy more than they did. He motioned for Jane to exit, and they both slipped into the hall outside the door. Jane remarked, I see this room still provides comfort and hope, much as it did 30 years ago. Some things dont change. In a world that is defined by change, its good to see that there are some absolutes. It is incomprehensible to me to think of wellness without tying it to faith, but not everyone shares that perspective. What is fantastic is that faith matters not just when you are sick, but also in keeping you healthy. Many critics of religion use the argument that faith is simple a coping mechanism, a delusion that softens the blow of tragedy and difficult times. But Roy, religion isnt just about comfort. Indeed it does that and does it well, but it is more about how to live. It is about how to put one foot in front of the other and face both the good times and the bad. Your beliefs become the lens through which you view the world and a framework for making daily decisions. It is through knowing how to live and what happens when you die that religion finds meaning. Its no accident that the

64 instructions God has given us as to how to live lead us to physical and emotional well being. Roy walked to the far wall opposite the chapel door. It was all beginning to make more sense to him. Dont get to comfortable yet, Roy. Theres somewhere else we need to go now. Where you lead me I will follow, Roy sang playfully.

65

Chapter Six

The blast of cool air greeted them like a crisp Fall morning and, in spite of the No admittance except by authorized personnel warning sign, they walked through the double doors as if they belonged. Again the uncomfortable sensation of being alone in the midst of beehive like activity engulfed Roy. He was still perplexed by his apparent invisibility but had given up on any rational explanation. People in scrubs sauntered about purposefully yet the appearance of chaos permeated the environment. O.R. this is Shirley A woman in her early forties sat behind a glass partition answering the phone in what appeared to be a command and control center for a nuclear test site. In reality it was the front desk in the operating suite. Now Jack Ive told you before that any vendors have to be cleared by engineering before they can come in on a case. Its simple so just do it. The authority in her voice was unmistakable and only a fool would argue. Roy eased up behind the partition and turned his gaze to Jane who continued to walk down the sterile tiled hall. Jane dear, Im getting a bad feeling about whats going on here, he cautiously offered. I told you before Im not a big blood and guts guy and if we are where I suspect we are, Im guessing blood and guts are whats on the menu. He seemed very contented to remain anchored to the side of the glass partition. Roy, Jane stopped in her march down the hall and looked back over her shoulder, Youre right, we are in the domain of the surgeon, the temple of the anatomist, the inner sanctum of the scalpel wielding organ artist! Welcome to the operating room! Well, since you put it like that I feel so much better, chortled Roy. You might just as well have said you were trying to make me scream like a little girl because that is what I think I might do if I see anyones innards! Roy was clinging even more

66 firmly to the safety of the front desk as he realized that Jane was not content on remaining at the front of the suite of rooms. Now Roy, I have faith that youll do just fine here, and if you pass out its no big deal. I mean think about it. If you lose it in the midst of what we are doing its not like you will hit the floor or anything. For goodness sakes you should realize by now that the laws of physics are a bit skewed in our present situation. Roy pondered this for a second and replied, And thats supposed to make me feel better? Jane you have a wonderful talent for backdoor sensitivity. If you werent so much older than me I would have a hard time trusting you, but since you are my aged guide, I will defer to your experience and advice. Jane simply chucked and continued to walk down the hall. The passageway was populated with machines and gadgets of all shapes and sizes. It was like a menagerie of mechanical wonders, each with its specific purpose. A large box-like object was crowned by a huge C shaped arm that projected over the base. Opposite that was a smaller contraption that could have been a space shuttle dashboard as it was adorned with multiple dials, graphic readouts, and gauges. It was topped with a translucent elastic tube that was capped with a clear mask that obviously contoured to a persons nose and mouth. Roy followed after Jane and gave parting glances to the mechanics only guessing as to their usage. Halfway down the hall they both parted as a rolling bed bearing a recent customer of the knife barreled down the hall propelled by attendants at both ends. At the head of the bed a young anesthetist held a clear mask over the mouth and nose of the patient while thrusting her chin skywards to maintain her airway. Life giving oxygen flowed from a metal canister rigged to the headboard. Leading the bed was a nurse who seemed as accomplished as a NASCAR driver as she navigated the hallway hardware with the ease and expertise that could only come from years of experience and an innate understanding of the proper position of each piece of machinery. Roy was taken aback at the speed at which the bed traveled in the hallway obstacle course but had to focus on keeping up with Jane as she continued her journey towards the hairpin turn ahead. As they reached the end of the hall they negotiated a 90

67 degree turn left and found themselves facing another windowless stretch punctuated by doors on their left and the ever present array of mechanical objects on their right. Several other mainly female attendants hurried from room to room in a purposeful dance of efficiency. They were all adorned in similar scrub outfits, yet thy seemed to express their individuality in varying and colorful head coverings. One older woman had a flowery bonnet while the younger person trailing behind her had a red and gold emblazoned head covering obviously supporting her particular alma mater. Some simply wore the generic lunch lady type of hair covering and chose to assert heir individuality in other ways. For instance, Roy couldnt help notice the variety of shoe styles and designs. There were clogs, tennis shoes, Crocs, and even the occasional penny loafers. Some were covered with a paper protective slip on while others were simply naked. Roy finally caught up to Jane and inquired about their purpose in the OR. I take it there is a lesson to be gathered here, Jane, but the anticipation is killing me. Not literally of course, as that is what I am trying to avoid, but you get my drift. What gives? Jane stopped outside one of the hallway doors and answered Roys question. Youre a quick study. Youre right that nothing were doing is without a reason and that applies to this foray into the inner workings of the human body. Roy stopped her, Wow you have really developed a flair for the dramatic! Come on, what is this foray into the inner workings stuff. You sound like the narrator of a bad PBS documentary. Say what you mean and mean what you say for goodness sakes. Jane retorted. Listen my young friend, Ive seen some pretty good PBS specials, so thanks for the compliment. I was just trying to set the tone. After all we are about to enter into a very unique environment, one that very few people ever see up close and in person and one truly steeped in history and mystery. Properly scolded Roy propped himself against the wall between two empty stretchers.

68 Okay mighty guide and mentor, sorry for the lack of respect, but I have to remind you that I dont especially feel awe and reverence when I see this stuff. I generally just get grossed out. Understood, Jane answered, and forgiven. But hear me out on this because in the end I think youll find some important stuff. She continued, The operating room is in many ways like a big family. There is definitely a hierarchy like in any family and a subsequent division of labor. Each person has a well defined role and if they work together the result is not only magic but often a saved life. There is a shared bond among individuals that have a common experience. Its a lot like what sailers on a ship or soldiers on the battlefield experience. Anytime you are in a unique situation for a period of time you develop a relationship with those who are there with you. You can take people from incredibly different backgrounds and bring them together in a situation like an OR and get a synchronicity of common purpose that results in amazing accomplishments. In the OR, even with the pecking order that necessarily exists, there is a commonality that begins with something as simple as the similar scrub clothes. You saw individuality expressed in the variety of hats, but virtually everything else is structured to provide both functionality and commonality. There is a sense of community in this place that is not necessarily unique but vital if it is to work. Community is important here because of the interdependence of activity. In the OR, if you are not working and thinking together, people get hurt. Okay, that makes sense to me. Folks have to have a sense that they are part of a bigger picture, a community, if you will, to be effective. Right Jane asserted, but it goes beyond that. The community itself is responsible for perpetuating the environment. By that I mean that the community becomes a source of energy that feeds each of the members. Roy hesitated, Wait a minute youre starting to lose me there. This is sounding way to esoteric. I get worried when you start talking energy and all that. Jane thought for a second and replied, All right let me try it this way. Whether it is in the OR, the office, or the family, we are bonded by shared experiences

69 and purpose. That is what really defines a community, and each of us can be part of a number of communities. Its not defined by a set of strict rules, in fact most of the time it may be unrecognized as a specific entity. We go about our business every day relatively oblivious to the various communities to which we belong. What I am saying is that community matters to our health and well being as well as to the functioning of the community. We find our health, both physical and mental, is effected by the various communities and networks to which we belong. And interestingly, the more we belong, the healthier we seem to be. Now I see where this is going, Roy surmised. An introvert like me would be better off getting out and being a part of something rather than sitting at home reading or watching reruns. Thats some of it Roy, but theres much more to it. Lets go into this room and I think I might be able to illustrate this better. I was really afraid that you were going to say that. Isnt this something I can learn right here in the safety and bloodlessness of the hallway? Suck it up buddy. In we go. Jane pushed the door open and the two travelers went in. Roy was initially struck by the relative calm. It was nothing like the TV medical dramas where every surgery was a crisis. It appeared to him that things were progressing in a routine manner, much like you would see in any office, except for the naked body lying supine on the single table in the middle of the room. The walls of the room were covered by tiles that created a slight echo even with normal conversation. It was if they had walked into a bathroom from the 1950s with tiles throughout. The reality was that the uniformity spawned practicality as the room was washed down between each surgery case and the contour of the walls made for easy cleaning. Again Roy was struck but the apparent clutter of mechanical devices yet it became clear that each was precisely placed for maximal utility. At the back of the room a young woman in scrubs was busily gathering sterile packages from a contraption that looked like a supply cart from an Office Depot, stacked high with wrapped bundles of sterile instruments; the tools of the

70 trade. To Roys right, on the opposite side of the patient, was a long cloth covered table filled with metal instruments of all shapes and sizes. He recognized none of the devices but surmised that they were the surgeons battle implements poised to combat whatever enemy lurked in the crevices and cavities of the female laying before him. A nurse, attired in a sterile gown, stood by the instrument table like a sentry guarding a precious treasure. At the head of the table a man was gently stroking the patients hair and whispering gently in her ear. Roy guessed he was the gas passer or anesthesiologist he first learned about from M.A.S.H. reruns. The anesthesiologist was gently whispering in the ear of the patient, Ann, youre going to sleep now. I want you to think of someplace you want to be. Someplace relaxing and calm. Take some deep breathes now. Thats it. Slow in and out. Think good thoughts. All the while he was injecting a milky substance in the intravenous line of her left arm. As the substance snaked down the tubing eventually invading her left antecubital vein, the patient slowly closed her eyes and the rhythmic rising and falling of her chest ceased, signaling a cessation of breathing on her own. She was now completely at the mercy of man and machine, any failure on either could result in death or permanent disability. Even in the simplest of procedures, done thousands of times, one small mishap or malfunction can have catastrophic results. It is no wonder anesthesiologist often describe their lifestyle as one of hours of boredom punctuated by moments of terror. In long operations the anesthesia part of the procedure can be somewhat on auto pilot, always still vigilant and monitored for any changes, but nonetheless somewhat monotonous. However, the moment someone goes to sleep and stops breathing can be hairy at times. The doctor has to secure an airway and initiate artificial breathing in a matter of seconds. Likewise the awakening procedure can elicit unexpected consequences and seeing someone resume breathing on their own at the end of a procedure is always a welcomed sight. Roy was taking all this in and looked sheepishly at Jane and said, If this is as bad as it gets I think Ill be okay. These folks just look like they are taking care of

71 business. Theres none of the rushing around and Page doctor so and so stat kind of stuff. Oh yea, and no blood yet Now Roy, did you really expect to be in an OR and not see some blood at some point? Jane countered. Ive heard about all this laser stuff which is supposedly bloodless, and heck, Dr.McCoy just waved this little tricorder thingy over the sick Star Trekkers and they got well. Jane gave a side glance in Roys direction and said, Guess what Roy, youre not in Klingon territory and youre not in Kansas anymore either. As she said this the door at the far end of the room opened and another person in scrubs backed his way into the room. His forearms were held at a right angle to his body with his hands in the air. He greeted the nurse rummaging through the instrument cart and made his way towards the nurse who was already gowned and gloved. Hi Alice, he offered cheerfully to the scrub tech. And what do we owe the honor of your presence this morning? Doc, you are truly blessed, she responded. In other words I drew the short straw! They both chuckled as she placed a blue paper like gown first through the surgeons arms and then the other nurse secured it around his waist and neck. While this brief ritual was transpiring the circulating nurse was busily removing blankets from the patient exposing her to God and all present. Roy winced reflexively and turned his head slightly to shield his eyes, not being accustomed to such exposure. He glanced at Jane, who nodded in reassurance, and then refocused his attention on the activities as they progressed. The nurse donned some sterile gloves and proceeded to scrub the patients belly with a rust colored solution giving her an instant suntanned appearance. It was clear to Roy that this was a regimented procedure and not one of random design. There was a specific pattern to her strokes and precise locations for the scrubbing. He could almost imagine her as an artist painting on canvas instead of a torso. As soon as this ritual

72 was complete the surgeon began placing drapes over the patient, covering only the area that was to be the focus of the operation. Roy was struck by the almost choreographed nature of the cleansing and draping with rarely a word spoken between participants. Each person in the room was performing a function assigned to them and each participant intuitively understood both the order and importance of each function. The surgeon, in spite of years of training and experience, was completely dependent on the other team members to do their job or he would not be able to do his. Once the sterile field was exposed the players in the drama took their places. The surgeon confidently sauntered to the patients left side as the scrub nurse positioned herself opposite him. The table containing the sterile instruments straddled the patients torso below the operating field like the tray on a car window at the local burger place. Seemingly suspended in air it was festooned with instruments in a predetermined and precise fashion. Again Roy was impressed by the almost wordless direction and seamless coherence of the activity. The silence was punctuated only by the persistent beep...beep...beep of the heart monitor continually checking for a steady and regular heartbeat. The soporific repetition had an unnerving effect on Roy but was obviously easily ignored by others in the room. No doubt their brainstems had long ago filtered out this sound until there was the slightest alteration which would then illicit an immediate corrective response. Roy said,You know Jane, there is a real difference once those drapes go on. Its almost like the patient disappears and everything changes, it becomes less personal. Jane thought for moment and replied, I bet if you ask the surgeon he would tell you otherwise. Im sure the good ones never forget that there is a person with a family, cares, hopes, and dreams behind every drape. Youre right, but dont you see what I mean? Every part is hidden except the small area they are going to cut. I guess I just imagined something different. The banter was interrupted by the surgeon asking the anesthesiologist, Bob, we ready?

73 Cut away my good friend! replied the man at the head of the table. The scrub nurse picked up the scalpel in preparation as the surgeon said,Knife. Holding the blade an inch above the alabaster belly for a brief second, the surgeon then rapidly lowered the instrument and began his incision. A line of crimson trickled across the shaved mons pubis and the taught skin edges retracted easily. Traction and counter-traction Alice, thats the key to a successful operation. Just look at those beautiful tissues separate. Alice obliged and shot a look to the circulating nurse which said How many times have I heard that before? Roy was so captivated by the drama that he failed to notice that he wasnt feeling squeamish. Jane had also become enthralled witnessing a sacred ritual that few ever see. Just like the disaster scenes following tornados, the person on the ground always says you have to be there to get the full impact. Thats the way it is in the OR. All the TV and movie representations cant possibly capture the tension, drama, and emotion of being there. How about some sponges Alice. It looks like this gal has been hitting the Goody powders. She seems to be oozing from everywhere. Alice unfolded several square cloths and fed them to the surgeon as he mopped up what appeared to Roy to be an impressive amount of blood. After about a half hour of constant activity with only staccato commands, Hemostat, Kelley, Kocker clamp, sponge, the surgeon seemed to be a bit more at ease. An hour later the surgeon remarked, I think were about to wrap it up Bob, she looking okay? Doing peachy Bob replied somewhat nonchalantly. During this entire episode Roy had been transfixed and in awe of what he was seeing. Left behind were the inhibitions and fears as he felt he was in a sacred place. He was unaware of time as he followed the surgeons hand motions, deftly tying knots and manipulating tissues. He felt like he did when he saw a great musician play a

74 symphony or read a magical paragraph constructed by a masterful writer. It finally dawned on him that he was witnessing ... passion. That was the only word he could use to describe this event. Each player, each member of the operating room community, seemed to have a passion for what they did and that made it work. It wasnt simply that they enjoyed what they did. It went beyond that. Passion was what brought them in day after day in spite of the stress and long hours. Passion provided the energy, the drive, the reason. Jane, these folks are artists. Watching them is like seeing a Broadway play or hearing the Boston Philharmonic. What a gift! Jane picked up on his enthusiasm. Youre right, but I think it is the passion that sets them apart. Dadgummit Jane, there you go again. It really creeps me out when it seems like youre reading my mind. Dont worry Roy, reading your mind is sometimes like skimming the comics! Jane grinned as she playfully pocked him in the shoulder. The good humored banter was shattered by a loud alarm bell emanating from the anesthesia cart at the head of the patient. Whats going on Bob? the surgeon asked as he prepared to shed his sterile gown. Pressures dropping Carl, any chance there were some bleeders left in there? It was dry when we left. The bellys not distended. I dont think anythings going on inside, the surgeon quickly assessed. The anesthesiologist rapidly re-calibrated some instruments and eagerly looked for the new readings. Pressures ninty over fifty and she is getting tachycardic. I dont want to wake her up with this going on. Shes getting tougher to ventilate. A PE maybe?

75 PE stood for pulmonary emboli, a potentially fatal complication involving a blood clot that has found its way the the vessels in the lungs. If unrecognized or not properly treated it can kill in minutes. Pressures down more. Get me some Nipride. This is looking serious Carl. I think we need to call a code. Roy looked at Jane quizzically and asked, Whats going on? Do we need to be here for this? This seems too familiar and the little hairs on the back of my neck are at attention. Normally that means get out of wherever you are, but in this weird setup Im not sure what to do. Lets hang here for a moment. We are obviously not in the way. Jane replied. Just as she finished speaking a steady stream of people burst through the OR door and vaulted into action. Roy was struck by their apparent calmness and wondered if anything worrisome was really happening. The new six bodies in the room began tasks directed by the anesthesiologist and the surgeon. One burly younger man began rhythmic chest compressions while another nurse stood by recording every action on a clipboard. In a rapid but organized fashion the team began to pull the patient back from the brink of medical disaster. The prior silent orchestration was now a cacophony of sounds. Get me some bicarb! Whats the tracing showing now? I need another line in stat! Roy stepped back to try and take it all in. What started out as a relatively routine surgery had now exploded into a full fledged emergency. Jane motioned for him to follow her out the door they had originally entered. I feel like a voyeur now, she commented as she stepped out into the back hall. Roy, obviously shaken said, Wow, things turned on a dime in there. I didnt understand much, but it sucked me in. I hope she is going to be all right.

76 Jane walked slowly down the hall obviously contemplating what to do next. Roy followed obediently. She stepped back through the double doors leading into the OR and found herself in the hallway connecting the OR suites to the emergency room. People were passing on both sides, each preoccupied with their own purpose in being there. Jane, listening to an internal voice, moved slowly down the hallway and approached another door to her left. An electronic key box stood sentry and without hesitation she punched in a four digit code to gain access. The door buzzed and she pushed it open and motioned for Roy to follow. I dont know about this Jane. It seems like every time I follow you through a door something creeps me out. Maybe Im better staying out here. Come on Roy, I think this is a quiet place that we can talk about what we just saw. This whole day has been full of meaning and Im having trouble figuring out why we found ourselves in that last situation. I told you at the start that this is a journey for me too. I know its hard to believe but I simply dont have all the answers about this. Roy hesitated then walked through the door. If Ive learned anything today its that nothing is random. Roy commented. What do you think? The room they entered was a small space, maybe 15 feet by 10 feet, and looked for all the world like a small hotel room. A single bed and nightstand stood at one end and a TV was placed opposite on a small table. The lighting was poor at best with essentially a desk lamp providing the majority of the dull illumination. An overhead recessed light was centered in the ceiling but looked as if it was populated by no more than a 15 watt bulb. In what would have been a normally claustrophobic experience for Roy, he seemed strangely unencumbered by the close quarters, especially given the person sitting on the end of the bed. He looked at the figure, hunched over with his elbows on his knees and hands cradling his head in a pose of obvious sorrow. The scrub suit identified him as someone recently departed from the operating room, yet Roy didnt immediately recognize him.

77 Jane whispered, although it had already been established that wasnt necessary, simply because the atmosphere demanded it. I think that is the surgeon from the room we were in. Roy had grown accustomed to the bizarre nature of time in this adventure so it was not hard to accept that they had come upon such a scene after apparently just leaving the room where a young woman was struggling for her survival. The young surgeon was talking to himself, or perhaps talking to someone unseen as muffled sounds drifted around the room. His anguished tone reflected a soul racked with grief and confusion. A gentle knock on the door interrupted the broken monologue and the surgeon reached over to open the door. From the corner Jane and Roy could see out in the hall immediately exterior to the room and there stood about six similarly clad persons instantly recognizable as the team from the OR. Doc, we dont want to bother you, said one of the six standing at the front, but we just wanted you to know you did everything you could. We all did. You know better than us that these things happen. We dont pretend to know why, but it hurts like the devil when it does. Another of the nurses added, You were so kind with the family. That had to be hard. But we also know you are hurting and just wanted to tell you we understand and care about you. Were family behind those OR doors and we just wanted you to know were here for you. The surgeon looked up at each one of the six and responded with misty eyes, Thanks, that means the world to me. Ill be okay, but having you guys understand makes a difference. No other words were spoken, they didnt need to be, and the group quietly walked down the hall and out the double doors protecting the privacy of the on-call rooms. Jane and Roy, feeling somewhat intrusive at this point, walked slowly out of the cubicle and into the hall.

78 This is a bit too heavy for me right now, Jane. I think we need to leave this guy to his thoughts. I feel like Im in the way at this point. I agree, Jane replied, Lets walk outside and talk. They proceeded through the double doors and into a hallway with an elevator to their left. A brief ride down three floors to the lobby, and they were back in the entrance to the hospital. It was as bustling as they had experienced before so, craving a quiet sanctuary, they walked out the front doors into a courtyard flanked with some wooden benches. Lets take a load off here, Roy. Have a seat. Trying to relax after the disquieting experience, Roy sat silent and looked at the folks passing by. After a few minutes he mused, So what was all that about? Ive been thinking on that, Jane replied. I think its about community. I think its about the importance of community in how we live. That OR is a microcosm of our lives. There you go with those big words again! Roy interrupted. Sorry I didnt put that on a fourth grade level. Let me try again, and tell me if I am going to fast. she retorted. We all live in communities, whether we realize it or not. Some are rather obvious, like our town or our neighborhood, but some are more subtle, like our family and friends. The folks we are around at our work form a community just like we saw in the operating room. Its a somewhat loose association but nevertheless still functions as a group. It was obvious that each person in that room had a position, a role if you will, and in some way everyones actions had an influence on everyone else. That is what defines a community I believe. A group of individuals that have a connection in that the actions, beliefs, or thoughts of individual members exert some influence on other individuals in the group and the group itself. Each one of us is a member of many different communities and the interaction can be quite complex.

79 Yea, I remember seeing something one time about a diagram of spheres of influence where there were all these intersecting lines and circles all done to show how interconnected even the most seemingly isolated of us are. Jane continued. Exactly. And that is especially true in this world of virtual communities like FaceBook and My Space. Those things have redefined what a community is because in the past there had to at least be somewhat of a physical proximity to communities, but that is long gone. Its kind of the globalization of interconnectedness. People might argue about whether this is a good thing or not, but the fact remains, people get and stay connected differently today. I dont think it is so important how they get into a community, but that they are in one. I see youre probably wondering what all this stuff has to do with you and health, given that has been the theme of this day so far? Well, now that you mention it I was a bit interested in where this was going. I mean, it was cool seeing the OR and everything, and I was amazed that I didnt pass out, but I suspect there is another point to all this. Jane thought for a moment and then said, I think the point is that communities are important for ones well being. Its not a number thing. By that I mean I dont think healthy people are those who are members of the most communities. What I mean is that for true wellness, remember that balance of mind, body and spirit, a person must have some significant relationships. Study after study shows that those folks who are the most isolated, without vital communities, are the most unhealthy. In turn, those folks who maintain meaningful relationships tend to be most healthy. Roy said, You know, when my dad died one of moms friends told her that the worst thing she could do was to stay home and stop doing the things she and dad had enjoyed doing. So many of those things involved going and doing with other people and it would have been so easy just to neglect those friendships, drop her membership in those communities if you will, and become somewhat isolated. Ive seen a lot of folks do that, and they seem to just go downhill rapidly. Mom stayed engaged, and I am

80 convinced that not only helped her grieve the loss of dad but also was good for her mental and physical health. I think youre right Roy. That scenario is pretty common as I think weve all seen those things play out with older folks, but it seems to be true for the younger crowd also. Ive read where people who have a well connected social network are at less risk for heart attacks and strokes. In that case Paris Hilton should have the cleanest arteries around! Roy joked. Thats not exactly what I meant by socially connected silly. I meant that folks who have a network of friends and colleagues that share something in common, even if it is a hobby or interest, tend to be healthier than, say, someone who is more isolated. Most of us dont think of these associations as having anything to do with our health, but they really influence it. What do these communities do for our health? Im not sure I see the connection other than the example I told you about my mom. Communities do several things that affect wellness. One, they provide common rules of behavior for the group. If you hang out with a bunch of folks who smoke, for example, you are much more likely to smoke. Thats an obvious connection, but it can even be more subtle. Research has shown that overweight people tend to associate with other heavy people. On the surface this sounds kind of ridiculous to consider. You bet it does! Are you saying I need to ditch my buddy because he is a few pounds overweight? Not all all, Jane countered. All this research said was that people with similar likes and dislikes, both in behavior and belief tend to migrate to similar communities. Its still a conundrum, the chicken or the egg thing, to determine if there is some deeper connection that influences behavior, but the reality is that who we associate with influences health choices we make. I tend to view that in a positive vein in that this provides an amazing opportunity for us to have a healthy influence on our communities.

81 Did you ever think that choosing a healthy lifestyle for yourself may set off a chain of events in anothers life that would lead them to healthy decisions? This is especially important in the family, but equally as influential at the workplace or anywhere else you interact with people to whom you are connected. What an amazing opportunity to establish a positive legacy! Yea, I hate to admit it, but its not just all about me! Roy, you joke but I think you understand the implications. Community matters. Just like we saw in that room after the OR disaster, community also provides comfort in times of trouble. And mother Mary comes to me, seeking words of wisdom. Let it be Roy sang. Sometimes you are a real pill, Roy! Roy laughed some more and then said, Yea, those folks really touched that doc. You could tell he was torn up about what happened in the surgery. Indeed. But what was interesting was not so much what was said, but simply their presence. The act of just being there was the comfort he needed at that moment. When we are physically or emotionally distraught, we dont need some detailed expose of reasons why something bad happens, we just need someone there. That is what a community does. And remember, a community can be just one other person. Its not defined by numbers. Its defined by connection. I think this is one of the most important roles of community in relation to our individual health. It can be seen as a ministry of presence. Without a connection or a community we can feel isolated and alone, especially in times of physical and emotional turmoil. This isolation can even worsen our situation, whereas someone or a group of people just being there in those times can be as healing as any therapeutic means. I promise you that surgeon began his healing emotionally the minute his OR family paid him a visit. Roy chimed in, Weve got a group of old ladies at our church I call the casserole patrol. Their motto is have casserole, will deliver. Anytime anyone is sick, or there is a death, they are there in minutes with a broccoli concoction or a meatloaf

82 surprise. Okay maybe that is a bit of an exaggeration but its like they have an ambulance scanner and get instant notification of any tragedies in the church. Thats what I am talking about, Roy. The church community is a perfect example. They could be delivering belt buckles instead of casseroles and the effect would be the same because its all about the caring. Knowing people care about us makes us healthier! And in turn, caring about others keeps us engaged and healthier also. Is this a great system or what? You win on both sides! Jane continued. Let me break it down to an even more specific level. One of the greatest fears many of us have is the potential of developing a disease like Alzheimer's or another form of dementia. Take away my physical functioning, but dont destroy my brain! Anyway, it now appears that staying engaged in a community can even promote brain health. Weve known for a while that activities that promote continual learning-doing crossword puzzles, learning a language- can lesson the impact of aging on the brain. Now we see that social interaction, be it in person or even virtually, can reduce the likelihood of someone developing reduced mental functioning due to age. Wow, so doing crossword puzzles with a gang of like minded puzzle patrons really would hedge your bet! Something like that. Jane continued. Even things like memory are improved in people who maintain active connections with others. One of the most powerful recent findings was that people who had active social networks of family, friends, and co-workers had a 50 percent lower risk of dying over a given period than those with fewer social connections! Thats pretty incredible, remarked Roy. Any ideas why that is? There are a number of theories. Some feel that people who are more connected seek preventive care more often, are less stressed, and have overall habits that favor illness prevention. Regardless, it seems clear that being an active member of a community is a critical part of the wellness equation. Roy concluded, With apologies to John Donne, No healthy man is an island!

83 Youre right! And this is not just some American cultural phenomenon, it applies to every society and group of people in which it has been studied. It doesnt matter if you are living in Paris or Peoria, you can be healthier if you stay engaged in a community. Roy and Jane sat for a moment pondering the conversation and then suddenly Jane stood up and said it was time to go. Roy had become accustomed to her abrupt changes, but couldnt help asking, So what now? You know Roy, Im not sure.

84 Chapter Seven

They crossed back through the main entrance, sort of the Grand Central Station of the hospital, and this time took a corridor to the left of the great hall. Jane led Roy down a long, sterile passageway that was more populated than its twin on the opposite side of the entrance. They walked through a set of double doors into an entry way that sat next to an automatic door that was activated when approached. Roy looked out the clear panes of the door and saw a circular driveway. He recognized this as the entrance to the ER. His visit had come full circle. He was back where the adventure, if you could call it that, had begun. He started towards the automatic glass doors when Jane stopped him and signaled that they were going in a back entrance. They both turned around and entered a door almost hidden from view set off to the right of the entry way. Upon entering Roy was struck by the busyness of the area. Nurses, doctors, aides, and clerks were either talking on phones, laboring over computer terminals, or hurrying to their next assignment. No one was sitting around. It was a large area with a bank of rooms on the right and a central nursing station that oversaw all that occurred in each of the rooms. Papers and charts were scattered on the desks around the perimeter of the central work area and computer screens filled the desktops. The air was thick with the sounds of people talking, machines beeping, and the ever present intercom system paging incessantly. Dr.Black to triage. Patient arriving in trauma 1. Xray is on line 3. Roy hesitated, Jane, are we here to finish things? Am I going to wake up and be back where I remember things were before we met? To be honest Roy, Im not sure how things are going to end up. I just know that right now, right here, I need to tell you something else thats important for you to hear, Jane responded. Weve been focusing on what to do to achieve optimal health but now we need to look at some things not to do. Often it is the things we neglect or dont do that have a devastating effect on our wellness. The other side of that is there are a number of things that we choose to do that can destroy all the good we accomplish by

85 living an otherwise healthy lifestyle. After all, the Ten Commandments are both thou shalls and thou shall nots! Roy moved out of the center of the hall to be able to concentrate on what Jane was saying. I knew we were gong to get to the restrictions at some point. All this stuff was just too positive, Roy kidded. Its not really about restrictions, it just seems most folks take their health for granted and expect things just to work as they always did. Think what would happen if we treated our cars that way. Everything wears out eventually, tires, engine parts, windshield wipers, but they all function better and longer if we are proactive and change the oil and get regular maintenance. Also, if we do things we shouldnt, like put water in the gas tank, even the best tooled machine will break down. Well, our bodies are the same way. If we exercise and eat well but then smoke, for example, it negates most of the benefits and dramatically increases the risk of problems. Honestly. Roy said, I dont know many marathoner vegetarians that smoke. Is that really a problem? There you go again, mister extreme. I agree that many who adopt healthy lifestyles also choose to avoid unhealthy behaviors, and maybe that example is a bit over the top, but you would be surprised how many young people, in particular, practice contradictory lifestyles. Thats a term I havent heard. What is a contradictory lifestyle? It sounds like something a Washington bureaucrat would come up with. Jane replied, That term describes a person whose life is not guided by any defining beliefs. They are the classic relativist who makes decisions based on the utility for the moment. If exercise serves a purpose, than I will exercise. On the other hand, if I want to get disgustingly drunk because I am out with the boys or celebrating a business deal, then I will do that because I feel like it. In this example my decision making process of determining right versus wrong relies solely on its utility at the moment. In this type of worldview ethics - right and wrong - is defined by the circumstance. If you

86 have the if it feels good, do it mantra as a guiding principle in your life then choosing to avoid certain behaviors becomes relative and inconsistent. You dont get drunk the night before a big presentation because it may affect your performance, not because it is wrong morally. Without a firm foundation on which to base decisions we flounder in a maze of inconsistency and relativism which ultimately and inevitably leads to poor decisions about health. And understand that I am referring to health in the holistic context, that of mind, body and spirit. Each person must choose the basis for their worldview, always being cognizant of the fact that their particular way of viewing the universe influences everything from their health to their spiritual life. So if I have, for example, a biblically based world view then I tend to make decisions grounded in what the Bible teaches. If I have an atheistic worldview, I tend to make decisions based on what I feel is right and wrong. Im not saying that you cant make moral judgments as an atheist or agnostic, but it is more by accident than design. In a relativistic belief system right and wrong morality- is based on feelings or situations. It is subject to whatever way the wind is blowing at the time. There is no consistent foundation on which to base choices. Thats kind of a scary proposition to me. If there actually is a moral law, and I believe reality and the observation of centuries of history confirms that there is, there has to be a moral law giver. There has to be an originator of that law. There has to be some established standard that teaches that murder is wrong and compassion is good. Understanding of right and wrong is predicated on knowing the difference. There is only one logical explanation of that originator, a supernatural being that transcends space and timeGod. If there is no moral lawgiver or originGod then morality has no transcendent reason or basis. It simply arises from either an individual or collective belief of whoever is most influential or powerful at any given time. There has to be a basis that goes beyond the whims and fancies of an imperfect society. Roy I dont want to get bogged down in philosophy, but my point is that choosing between good and bad health behavior is like any moral choice. It starts with a set of consistent foundational beliefs that are based in reality.

87 Wow, you almost lost me with some of those if, then machinations, Roy admitted. Let me see if I caught the gist of it. Exercise good: smoking bad! You are incorrigible Roy, Jane lamented. But in your own sometimes I am stuck in the 10th grade way of putting it, you are right. Now lets look at some other not so obvious self destructive choices to avoid to remain healthy. You have three wonderful daughters and I know you have taught them well about sex. Whoa Nellie, Roy interrupted. Lets be clear, Eve has taught them well about sex. I get red faced when they leave their bras on the bathroom counter. As I thought, but my point is that most people are aware of the dangers of sexual promiscuity in this day and age. Obviously unattended pregnancy is the big consequence, and that could lead into another discussion about abortion and its consequences, but we will leave that to another day. A more insidious agent of destruction lurks in the bedrooms and car back seats today. When I was growing up everyone was aware of gonorrhea and syphilis. Herpes, the gift that keeps on giving, was just gaining in popularity. Im not sure I would put it that way. It sounds like herpes was a new dance or something. Any way, gonorrhea and syphilis were feared but not dreaded because they were both treatable. A needle stick in the rear with penicillin and you were good to go. Herpes provided a new twist as it became the guest that never left. Once it came calling, you were stuck for life. The good news, if you could call it that, was that it remained more of a nuisance than anything life threatening. Now the rules of the game are totally different. Its like sexually transmitted diseases have gone from the minor leagues to the major leagues. Figuratively and literally. Roy couldnt resist trying to make light of a tough subject for him. What I mean, continued Jane, is that now there are diseases that are sexually transmitted that can kill you! HPV or Human Papilloma Virus is estimated to affect 20 million people in the United States, and it is the number one cause of cervical cancer in

88 the world. Fifty to seventy five percent of sexually active men and women will acquire a genital HPV infection at some point in their lives! Here is a virus that has been undeniably linked to a deadly disease and it can go undetected for years. Thats led some doctors to refer to cervical cancer itself as a sexually transmitted disease. Quite a change from the good old days of bugs we could cure. The most effective way to prevent HPV is abstention. Granted this is not a popular option with some, but then neither is death! Wow, thats kind of dramatic dont you think? chimed in Roy. Sometimes, with kids especially, you have to get their attention. Remember Roy, all this is not just about you. I realize this may never affect you personally, but thats why I mentioned it in the context of your daughters. Hopefully you have learned that your actions and choices spread waves like a pebble dropped in water. If you and Eve dont educate your kids about these and other things their health will suffer. Youre right, Roy confided. What they dont know can kill them! Just then a nurse stuck her head from the door of one of the nearby exam rooms and yelled in a controlled but emphatic way, I need some help in here now. Shes crowning! Roy stepped back confused by the request. Crowning? Was someone getting some sort of regal reward? Jane just looked at him, shook her head and walked towards the door where the nurse was stationed. Roy followed. As soon as they stepped into the room it became obvious that something dramatic was happening. Roy didnt want to be there, but he was sandwiched between Jane and the wall and was going nowhere.. A small Asian woman was lying in the middle of a triage bed wearing nothing but a frown, and the nurse who had just called for help was between her legs gloved and ready. Even Roy could see that a baby was on its way, and soon. He turned his head and moaned, Ugh, Janeare you sure this is where the next lesson takes place? This is making me very uncomfortable. Im really not good at this kind of thing. As he was speaking a young ER resident ran in and immediately put on a pair of gloves and a gown. Roy speculated that he was no older than twenty five but he exhibited a mature confidence that exuded control.

89 Your doing great Gladys, he said to the nurse. Just keep a little gentle pressure on the head and Ill be there in a sec. He finished getting ready and efficiently took the nurses place in the line of fire. No sooner had he positioned himself then the mother-tobe let out a banshee scream that could have been heard in the Starbucks across the street.

AAAAEEEEEEEEEE! Get it out! Now! Push for me now Mrs.Chu, he demanded. The nurse counted, 1..2..3..4..5..6 breathe, now push again! One more guttural scream from Mrs.Chu and Roy hesitantly looked down and saw a tiny head emerge, followed almost immediately by the rest of the body. Blood and body fluids were everywhere; the floor of the room looked like the scene of a horror film. Roy had never seen such a mess and it only added to his anxiety. The newborn let out a shriek and announced to all present that he had arrived. Roy, too stunned to speak, looked at Jane. What in the world was he doing here? he thought. Everything had happened so fast. He barely had time to gather his thoughts. He slowly regained his composure and his stomach and gazed at the baby boy being swaddled under the careful watch of the nurse. Roy was a blank. What could this possibly have to do with the days events? Jane sensed his apprehension, but remained stationary and said nothing. The doctor was busy with Mrs.Chu, who had been transformed in the space of a minute. She had undergone a complete change of countenance. Her body, only moments ago was writhing in agony now lay relaxed and calm. She asked the doctor if everything was alright. The young doctor reassured her that both she and the baby were doing great as the placenta found its way into the interns gloved hands. Roy once again felt like a voyeur, seeing things he shouldnt be a party too, yet Jane appeared completely at peace. The baby continued to squall and then, almost on queue, became quiet and contented. The nurse cradled the swaddled child and then laid him on the new moms chest. Roy was mesmerized. He had never seen anything like this ever. There was a look on the mothers face that he remembered from the birth of own kids. All of his children had been born by c-section yet he remembered the look in Eves eyes as she gazed up at

90 Miranda for the first time. That was the same expression that he was seeing now. He could only describe it as unconditional love. Nothing else fit. Nothing else would do it justice. He was surprised when Jane touched him on the shoulder and motioned for him to step out into the hall. He followed her somewhat reluctantly now and closed the door behind him. Why Roy, I think for the first time today you are speechless! Youre right. I really dont know what to say. That was the most amazing thing I have ever seen. Im glad that I didnt have a big breakfast though! Jane laughed and directed him to a small room off the side of the ER where families sometimes gather. We can talk here for a few minutes, she said. Roy, you were just part of a very special event. I shy away from calling it a miracle. After all miracles by definition are outside of the natural and occur rarely. Otherwise they wouldnt be miracles. So I dont think it is appropriate to label something that occurs every minute of every day as a miracle. Nevertheless, the birth of a child is always special. I like to think of it as Gods way of declaring that the world should continue. Every newborn shares something with every other newborn; the capacity to learn. Granted there are huge differences in that ability, and some babies are not capable of functioning above an almost instinctual level, but the vast majority of babies come into this world equipped to learn. No baby is born with a genetic propensity to smoke or to consume alcohol. Every baby instinctively knows it is good to move your body. Just watch one for a minute and that will be confirmed. Psychologists tell us that one of the initial learned behaviors humans adopt is smiling. My point is that the baby you just saw being born is just waiting to be taught. She is truly a tabla rossa or clean slate. She needs instruction in how to love and how to live, and yes, how to eat well, rest, exercise, manage stress, get checkups, and worship. Its up to you and me, Roy, by the example we set; by the life we lead; by the principles we teach. It is a sacred obligation we owe to those around us, be it family, friends, or even strangers, to do our part in solving the health care mess we are in both personally and collectively. We do that by wisely exerting our God given right of choice. I cant make choices for you nor you for me. I

91 cant force my son to do the things that I know will bring health and happiness. I gave up taking the responsibility for making the choice for others years ago when I realized it was not mine to make. But I think it is morally repugnant to give up making those choices for myself as it may be the beacon that lights the path for others. Do I have a moral responsibility for the health choices of others? No, I do not. My only responsibility is living my life in the healthiest way possible, but my highest motivation in doing so is to positively affect the lives of others. Should I take care of those who need my help, who are sick and infirmed, who are unable to care for themselves? Absolutely, Jesus set the example. The greatest thing I can do for that newborn child regarding her health is not to institute a government run health system, provide universal health insurance, or outlaw all fast food. The greatest thing I can do is to choose to live a healthy lifestyle. It teaches her by example. It prevents her from being burdened by taking care of me when I get sick from self destructive practices. It arms her with information to make her own decisions. Roy summarized, So I am my brothers keeper, but I am not my brother. I have a responsibility to take care of myself and so do you. Jane reflected, The only way we are going to survive the coming years burdened by health care costs threatening to bankrupt the country, emotional bankruptcy due to the stresses of poor physical health, and spiritual abandonment secondary to our failure to understand the connection between faith and health- is to believe and execute the core values that we all know. Remember I said at the beginning that I am just reminding you of things youve already learned. In assessing our health we must embrace the precepts of individual rights, making sure that we never forget the individual responsibility that accompanies that. We must realize that a government entity cannot and will not be the answer to our health care ills. We must remember that knowledge is critical but it is the application of knowledge that is power. We must make choices based on our foundational beliefs that are absolute and unchanging even in the face of popular opposition. We must become a people of faith, as therein lies the backbone of individual worth and personal and communal generosity. The greatest sacrifice we can make in

92 achieving good health is to deny ourselves the right to abuse our God given bodies. In other words, you are an amazing creation and the greatest praise you can offer to the creator is to take care of his masterpiece. Jane, I really understand and agree with all you are saying, but something still bothers me. Are you saying that I am responsible for bringing on every disease I might develop either by my thoughts or my actions? Not at all, and Im glad you brought that up because that is a common misperception especially when you talk about personal responsibility. We live in a world where accidents happen, bacteria and viruses run rampant, cancers grow, birth defects occur, and heart disease develops. The list of possible maladies is endless, and people who do all the right things get sick just like the rest of us. I remember seeing a bumper sticker that summed it up well, Eat healthy, Exercise daily, Die anyway! Im saying that choosing a healthy lifestyle dramatically reduces the chance of these things happening early and excessively. We all die sometime Roy; however, I believe an admirable goal is to shoot for what I call a condensed senescence. Yea, like I have any idea what that is. I dont believe I remember you giving us that term on our 10th grade vocabulary test! Condensed senescence describes staying as vigorous and active as long as possible, and then when the end comes, have it be as brief as possible. None of us are going to live to be 120 anytime soon, but wouldnt it be great to go dancing and write a book at 95! Choosing to live a healthy lifestyle by doing the things we have talked about will greatly enhance the likelihood that you will be in command of your physical and mental facilities for as long as possible. Say you live to 85, instead of getting sick and feeble at 65 and living 20 more years in poor health, dependent on family and friends, why not be going strong until 83 and have only a relatively brief time of poor health. Obviously my crystal ball is broken and I cant predict how long any one person will live, but I can say with absolute certainty that following the precepts I have helped you remember will make your journey one more approximating the 83 year who stays sharp!

93 Makes sense to me, but I bet you may have some trouble convincing a kid or even a young adult that making wise choices now will pay off immensely in the future. You know we live in an instant gratification society. Look at the economy. Its a mess largely due to a short term outlook and greed. I dont see peoples practice of healthy behaviors any differently. That is why the change has to come from inside. You have to decide beyond any doubt that doing the right thing for your health is wise and pleasurable, and doing the wrong thing is foolish and painful, for both you and your family. You have to know and believe that as you would any foundational precept. So that little baby that just delivered has a lot of decisions to make over the next eighty or so years! Roy surmised. As do his parents, Jane added. Roy glanced back out into the hub of the ER and said, So Jane, I dont believe you can top this for dramatic effect. Where are we off to next? Actually Roy, we have come to the end of the line. Oh, maybe that was a bad choice of words considering where we started. Touch, my wise little guide, Roy said somewhat hesitantly. But I still havent figured out why youwhy now? One thing I have garnished from all this is that nothing happens without a purpose, and I just cant figure out why you were sent to me. I mean, I certainly needed it. I had forgotten -as you put it- all this stuff and the refresher course waswell, refreshing to say the least, but why not some famous person or doctor as my guide. Dont I rank a Plato or Hippocrates? Roy, Jane replied, you have been and will always be one of my favorite people if for no other reason than your sense of humor. But did it ever occur to you that maybe it was you who was sent to me? Ive shared with you some things that Ive not shared with anyone else, ever, and in verbalizing my thoughts and feelings, Ive been healed. Sometimes we carry things with us for years and simply need the right opportunity to unburden ourselves so healing can take place. I was telling you many of the things that I needed to hear again myself. Health and wellness is not just about the body but it is

94 being healed in your heart and your spirit. Youve helped me do that today. I could ask you the same questions. Why you? Why now? But for me the answer is not important. Your presence on this journey has been valuable merely because of thatyour presence. Many times those who need us the most just need us to be there. Our presence is enough. We dont have to do anything or even say anything. People just need them to know we are there and we care. Good health begins in the head with our thoughts, but if it bypasses the heart and feelings, it comes up short. And Roy, hopefully now you see that it was not about you. In many ways we have seen, it never is. Did you learn some valuable lessons? I hope so, but more importantly you were an essential part of my healing. I dont expect you to fully understand how this all came about. I dont. How does a woman thirty years your elder come across you in a hospital cafeteria; you having aged thirty years and me not? How does a man lying close to death in the ER find himself talking to his 10th grade science teacher over coffee? I havent the faintest! But the facts remain that it was exactly what I needed at the moment, and hopefully what you needed. Actually, I believe that we both have been given gifts; gifts of wisdom, gifts of healing, gifts of faith. The question that we both face now is not Why? but; What now? What do we do with these gifts? Like you said, nothing happens without a reason, and maybe the reason for our time together lies in the future. It lies in the response we give to the what now? question. Roy, Im at peace now. I have something very difficult to face, but I feel I can face it head on. I know I am not alone. I suspect you are facing some challenges in your immediate future. I honestly dont know what that future is, but I know that you will be a better person, more capable of facing those challenges, from our time together. Now its time for you to go Roy. Eve and the girls are waiting.

95

Chapter Eight

The sounds were muffled, but Roy could make out a few voices, recognizing none. He was laying supine on a gurney as nurses and doctors huddled around him in a cacophony of activity. As the words became more discernable he heard one of the doctors say, Hes back in sinus rhythm, lets get him ready to go up to the cardiac care unit. Roy drifted back off to sleep as two nurses unlocked the wheels on his gurney and pushed it through the partition. Roy woke to the sound of the incessant beepbeepbeep of the cardiac monitor, typical accoutrements of the intensive care unit. The oxygen tubes in his nose were irritating and making his throat dry and sore. His first sensation was one of hunger, a good thing he surmised. He looked around the small sterile room and tried to get his bearings. There was a small window to his right and the light streaming through indicated that it was sometime during the day; but what day was not readily apparent. He was disoriented to time and place but otherwise thinking clearly. He looked directly in front of him and saw a large plaque proclaiming Today is Tuesday, May 8th in big black letters. He slowly remembered that he had come to the hospital on a Monday. Was this a day later or a week later? He was unsure. As much as he tried, his brain wouldnt wrap around the flow of time that had transpired since his ride in the ambulance. He thought of his time with Jane. Was it real? Was it a dream? Of course it was a dream. How can someone come into an ER in full cardiac arrest and have a leisurely walk about the hospital moments later? There was something in his gut that told him that it was not that simple. Maybe the sensation was just the hunger pangs asserting their dominance. Either way, he labored trying to reconcile the events of the ER with his present state; whatever and wherever that was! He rapidly concluded that logic was not his friend in this endeavor. A young girl in nursing whites strode into the room. Roys first reaction was to search his memory to see if she resembled any of his other old high school teachers!

96 Reassured that she was not another messenger, he relaxed. She cheerily greeted him by name and said, Im glad to see you checking things out this morning. Youve been quite the snoozer the past several hours. Im Alexis your nurse this shift. You may only be stuck with me today though because Dr.Grover has already said he may transfer you to telemetry tonight if you keep doing so well. She wandered over to the IV hanging above his head and adjusted the rate of flow. I think you gave your wife and kids quite a scare though. Shes been here all night and the kids only left this morning to shower and eat. Theyre really sweet folks. Let me finish giving these meds and Ill go get her from the waiting room. Alexis darted from one side of the bed to the other adding some unknown concoction to each of the bags hanging from the IV poles. Roy, still not quite awake and alert, took it all in. There was an IV in both arms and sticky round patches placed across his chest. Each patch had a wire that led to a small box above his head that gave a continual graphic read out of his heart rate. A small TV hung suspended from the wall to his right and a sink on the far left wall completed the dcor. She finished her duties and left though a curtain drawn across the door of the room. Moments later he saw Eve pull back the curtain and slowly make her way into the room. She seemed cautious in her approach as if she was unsure of who she would find. Roy opened his eyes again, saw Eve, and smiled. Thats all it took. Eve burst into tears releasing hours of tension and fear. She hugged him as best as she could given the constraints of the wires and tubes and then stood back and just looked. Well Squirt, she had called him that since their dating days, that was a heck of a way to get out of going to work! He laughed and said he would be fine working overtime if it would keep him out of the hospital. Eve replied, Actually, I think thats part of the reason youre in here! They spent the next few minutes holding hands and joking, then Eve became more pensive. I guess we have some changes to make, right Roy thought for a moment and replied, You dont know the half of it! He decided now was not the time to relate his adventure with Jane because inevitably he believed that Eve would write it off as a drug induced dream, and he didnt want to

97 trivialize it that way. He decided to wait, as much as it pained him, to find a time when he could relay all that he had learned. He was determined to answer Janes question What now? with meaningful action. Indeed he could not predict the future for him and his family, but he committed to choosing health, and that was the most important step. He was determined to leave a legacy of good health for himself and his kidsand their kids. And now he knew how to do that. That evening as he was preparing to go to the telemetry floor, Alexis, working a twelve hour shift, came into his room to make the final preparations. I wouldve had you ready a bit earlier but your neighbor in room four needed some extra time, she relayed. He had noticed some of the nurses going in and out of the room next door all day. You notice things when all you have to do during the day isnotice things. Simply being polite and trying to make conversation, he asked if everything was okay. Alexis told him that the patient next door was an older gentleman in the last stages of pancreatic cancer. It had been a long battle for him, and it finally looked as if it was drawing to a close. His family and wife in particular were spending most of their time with him and the nurses had become quite attached to the whole group. She said he had been in the unit for a week and was not expected to make it much longer. The family has been amazing during the ordeal, even ministering to some of the nurses who were taking care of Mr.Ferguson, she said. Roy hesitated when he heard the name. Was it merely a coincidence? Then he remembered Janes admonition that nothing happens without a reason. He asked Alexis if his neighbor happened to be named Horace Ferguson? Indeed it is, she replied, Do you know him? Not really, Roy said. I might have known his wife. She may be the same person who was a former teacher of mine. You mean Jane? What a delightful lady! When she first came here with Horace, she was understandably a basket of nerves, but over the past few days she really has become a rock. She has been so sweet to him and has even taken time to talk with the night nurse about her crazy kids. Jane really seems like a wise soul. Sometimes I just dont understand where some people get their strength.

98 Roy was quiet, not sure what to make of this scenario. Alexis continued to make preparations for his transfer, eventually getting him situated in a wheelchair for the trip to the floor. Eve had left a few minutes prior to made a quick trip home to get some more clothes and to make sure the girls were doing okay. As Alexis wheeled Roy out of his room, he asked if he could say hello to Mr.Ferguson, if he was up to a visitor that is. The nurse poked her head in room four and said something Roy couldnt quite make out and then turned and wheeled him into the room. Horace Ferguson, a whisp of a man, was propped up at a 45 degree angle in his hospital bed. He was pale and cachectic from the ravages of his disease, but his eyes were focused and intent. He motioned for Roy to come in. How are you? I understand we have a woman in common, he said slyly. Roy immediately liked Horace. Indeed, Roy replied. Mrs. Jane Ferguson, if it is the same lady, was my 10th grade biology teacher at Central High. That would be my Jane alright. I dont guess there are two of them. Im not sure the world is ready for that. Horace began to chuckle weakly and it quickly turned into a raspy cough. When he regained his voice he said, Sorry about that, I keep forgetting Im sick. At that moment Jane Ferguson walked through the room door and drew back the curtain that separated the door from the bed. At least Roy thought it was Jane Ferguson. She was a much older woman than he had met earlier, and she walked with a slight limp, favoring her right side. Roy looked at her closely and immediately knew that he was looking at his mentor. For a fraction of a second he thought he caught a hint of recognition in her eyes, but he dismissed that as she asked, Horace, I didnt know you had company? Why Jane, you must be getting senile. Dont you recognize one of your former students? He was obviously fond of playing with her. You do look familiar, but forgive me for not remembering your name. Jane said. Roy, unsure of what was happening, introduced himself.

99 But of course Roy Roper! she said honestly excited. I had you a couple of years and you were just an awful student! She glowed. Well, Mr. Ferguson, I can tell you your wife is in full possession of her faculties because she remembered that very accurately. Roy replied. Its good to see you Roy, although from the way youre dressed it looks like it could be under better circumstances. Have you been ill? Just a little heart break, he joked. But doc says I will be back to my old ways soon. Maybe the old ways are not worth going back to though now that I think about it. You may be on to something there, Jane responded. The night nurse came in the room and said that they needed to get going so they could give report to the next shift. Roy reached out his hand to Horace and told him he would keep him in his prayers. Some folks say that and dont mean it, but I get a sense that youll stand by your word Roy. Thanks for stopping in, Horace said. Roy turned to Jane and thanked her for letting him visit, and he wished her and Horace well. Does she not know me? He wondered. Was this all a big faade, a dream? Its like she hasnt seen me since high school. As he was being wheeled out of the room, Roy turned and looked at Jane one last time. Oh and Roy, she said, Say hello to Eve for me. And she winked.

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Keys to healthy Living

Eat balanced, low fat, high fiber, low sugar meals. Reduce total calorie intake. Exercise daily. Get adequate rest. Manage stress. Join a faith community. Bond with others. Avoid harmful behaviors Never forget that the choice is yours, but the impact is beyond you.