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Being human Reflections on Life, Being Human, and Medicine Reflections on the Christian Life

The Little Acorn and Remembrances of My Father

It was the beginning my 10th grade year at Decatur Public Schools. “What is geometry?” the teacher said. “The little acorn fell to the ground and grew and grew until one day it looked at itself and said, “Gee, I’m a tree!” 

I still giggle when I think about that joke. When my girls had geometry, I told them that joke. Each time I tell the joke I think about my 10th grade geometry teacher. 

My teacher was my father. This past Sunday morning, my sweet father passed away in his sleep after a 16-year journey with cancer.

When I think about my Dad a lot of ideas and stories come into my mind. I loved to hear him laugh. He had a great sense of humor. He always had a little twinkle in his eye. A few weeks ago, we were talking to him about making sure that he got enough nutrition. I told him that it was important that he drink. “Ok,” he said, “Do you mean whiskey or what?” I looked over at him and saw the little twinkle in his eye. It made me feel so good to see that my Dad was still there. 

As a 5-year-old I remember an assignment where the teacher asked us about all of our favorite things. They asked us our favorite colors and our favorite foods. They asked us what our favorite activities were. I didn’t know they were going to tell anyone our answers. I told them very openly and honestly that my very favorite thing was getting to ride on the tractor with my father while he worked.

If I knew he was out working in the field I would walk to where he was and wait in the row for him to come by. He would stop the tractor. I would climb up on the back of the tractor. I would sit on the fender right behind him, bracing my feet on the upper arm of the 3-point hitch. I was happy to just ride along and be with him. I would watch him work and think about how I wanted to be just like him. I dreamed of the day when I would be driving the tractor. I watched how he plowed the field. I looked at everything he did hoping to be able to model it when it came my turn. 

He loved the farm. As I grew and started doing more and more on the farm I came to understand. This week as I tried to process things I found myself slowing to look at the fields of my parent’s farm. I imagined being alongside him again picking and sorting peaches, or moving bulk boxes of apples, or shaking and grading cherries, or being a small child walking out into the field for hopes of being able to ride with him on the back of the tractor.

It wasn’t just about how to drive a tractor or plow a field that I was watching. It was so much more than that. In everything that he did he was teaching me – teaching us – how to live. 

He taught hard work. He was not afraid of work. I used to be amazed at his energy. He could work and work and never complain. I would struggle to lift the crates of apples. In the cold storage he could not only lift the bushel crates and stack them, but he would take and stack one crate on top of another crate and then lift both of them high over his head. By doing this he could get them stacked one level higher than his highest reach.

I was always amazed at how he would wheel around on the small little forklift loading the storage and the trucks. In the peach orchard he would pull his ladder from tree to tree picking the higher branches. Even now in my mind I can see him walking over to the back of the trailer with a full picking bag, lifting it over the sorting net, and releasing the peaches out of the canvas bottom. Some of those days in the orchard the sun, heat and clouds of peach fuzz would get just miserable. In spite of the heat and heavy work, he never complained. He and Grandpa would chatter on and on as they worked together. In the mornings before we would go out to work, it was often Dad who would get up and make breakfast. To this day, I am the one to make the pancakes in our house, because it was usually my Dad who made the pancakes when we were growing up.

I was so proud of my parents being teachers. Dad was a very smart man. He knew so much about math and chemistry and physics. He was very much an educated and thinking man. When computers became a reality, he took on learning and then teaching computer science. It was no surprise that he would be the one to do this. This week two of my friends from High School reached out to tell me that they became teachers because of my Dad. It is no surprise that Bob and Mary became teachers. I told myself that if both of my parents and my brother and sister were all teachers I would not become a teacher. I now am proud to realize that I practice medicine with the heart of a teacher, teaching my patients, residents and coworkers as I do my job.

It was such an honor to be his son, growing up in Decatur. Everybody knew him and respected him.

He taught so much more than just math and science, however. I was amazed at how he ran his classroom. I never heard him yell or saw him get angry. He didn’t need to. The students loved and respected him so much that they just wanted to please him. If they were getting out of hand he could just stand-up front and look at them and they would immediately settle down. 

He taught us how to have a quiet and settled dignity.

He taught us about integrity. He taught us that the most important thing was not what people thought about you, but what you and what God thought about you. 

He taught us about faith. He taught us that God sees the intentions of your heart. If deep down your heart is in the right place, the rest will follow.

He taught us about kindness. He really believed Jesus when he said to “turn the other cheek.” He would have rather been taken advantage of than to strike out in anger against another person. It doesn’t mean that he didn’t want to hold people accountable for their faults. It was just that he was willing to be patient and by example let them eventually correct their wrongs.  Just like the dignified teacher at the front of the classroom, he didn’t feel the need to yell. He would wait and provide the example and by so doing teach.

I learned contentment. He taught that greatness was not measured by what the world thinks about you. Greatness is measured by doing what is the right thing. He made it clear to us, that if you live the life that God has intended for you live, especially a life that is focused on your family, you will achieve far higher greatness than many who are celebrated by this world.

I learned confidence.  We have the family story about the night that he had to figure out how to clean and dress out a deer. He went to his bookshelf and pulled down a book. He read how to do it and then, without ever having done it before, he just did what needed to be done. Time after time in my own life and work, I think of that story and just push ahead. If something needs to be done, I channel my inner, “Dad” and just figure it out and do it.

So, who was our Dad? 

  • He was a funny man with a twinkle in his eye and a great sense of humor.
  • He was a brilliant man, pushing himself to come off of the farm, to go to college and then to lead and educate in his community. 
  • He was a kind man, loved by all of us and so many in the community. 
  • He was a loving man. We all always knew we were deeply loved by him. 
  • He was a man of integrity. He would rather have suffered personal loss than to do something that would go against his conscience. He believed and trusted God that if he did what was the right thing to do, God would work everything out.
  • He was a teacher. He taught in the classroom certainly. But he also taught in the orchards and fields and in our home. He taught so many rich and good lessons. He was an excellent teacher.

My parents have been married for over 64 years at Mom at the time of his passing. That is just amazing. I have thought and prayed for how my Mom goes forward without him at her side. This is an important question honestly for all of us. As I prayed and thought about this something important occurred to me. We are not being left without bright, vivid and living images of him. For you see, so much of who we are has been molded and shaped and  formed by him.

I am in no way perfect, but there are parts of my personality and who I am that I really value. In those things I see my Dad. Sometimes when I was with him I would not have so much to say to him. That was because I didn’t have to explain to him so much of who I am. Who I am is very much him.

This past week I have been able to observe and watch an amazing legacy. I see so much of him in all of my brothers, sisters, children, nieces and nephews. Looking at them, and looking inside of myself, I am consoled because I see him.

To everyone who knew him, I encourage you to please look carefully at us:

  • If you see a kind heart, know that you are seeing my Dad. 
  • If you see a joy for being outside on the farm, know that you are seeing my Dad.  
  • If you see a servant’s heart, not afraid to work hard for the benefit of others, know that you are seeing my Dad. 
  • If you see people holding their heads high, doing what is right just because it is right, you are seeing my Dad. 
  • If you see a bright mind, learning and teaching, you are seeing my Dad. 
  • If you see confidence taking on doing something that you have never done before and just doing it because it needs to be done, you are seeing my Dad. 
  • If you hear a corny joke, or a snide funny little comment, you are seeing my Dad.

The little acorn fell to the ground and grew and grew and one day it looked and said, “Gee, I’m a tree.” 

Dad’s little acorns have grown and grown by the power of his person and example. I am so thankful that each of us who knew him can look with wonder and say, “Gee, I’m a tree!” and because of my Dad, they are really good trees.

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Being human Medicine Reflections on Life, Being Human, and Medicine Updates on my health

Green Bananas, Two Years Negative and Keep Going On With Life

Two years ago I had a kidney stone. That brought me to the ER. Late that night, an ER doc that I have known for many years came in with a very somber expression. He opened my CT scan on the screen and showed me my 10 cm left adrenal mass. That was followed by another CT scan, labs, then surgical resection, radiation and the chemotherapy mitotane. Adrenocortical carcinoma (ACC) was the pathological diagnosis. ACC is a rare cancer with only about 300-500 cases per year in the United States.  ACC can recur despite the best efforts to get rid of it. The protocol then is to do CT scans every 3 months so that if it comes back, we could respond and treat it.

In May 2020 I had some enlarged lymph nodes in my chest. Just when I was regaining confidence that this was going to be behind me, the reality of it all came home. We spent some tense days and weeks of wondering if it was back. My August scans showed the lymph nodes as being smaller. On November 1, 2020 I had my two year scans. Those scans now show the same trend (lymph nodes getting smaller) and thus provide clear reassurance that those are not likely cancer.

Good news.

It does have implications, however. It means it is ok to buy new shoes. I sometimes reassure my patients by joking that they can buy “green bananas.” The idea is that they will be around long enough to have them ripen and enjoy them. New shoes also implies that you will be around long enough to wear them enough to justify the expense. 

What it really means is figuring out how to go on with life.

I joke with my patients about this but it is not a joke. It is an important part of their treatment. They have to change their thinking. They have to start thinking about how to go on living. They have to do this even if they have ongoing symptoms.

We all have to do this even if the world is not behaving how we want it to.

We all have had to deal with this in 2020. In late March we locked ourselves in our homes to get through the storm of COVID 19. We treated it just like we do a blizzard. We made sure we had supplies. We found books to read or shows to watch. We set up a card table and started doing puzzles together. We could stop life because it was a crisis. We were excused from a lot of what normally makes up our lives.

I can remember in late April when I saw the COVID projections extending into 2021. A pit formed in my stomach. This whole thing was losing its novelty. We were going to be stuck dealing with this for far longer than any of us would like. We had to come up with different strategies. For my part, I wrote our governor. I pleaded with her to consider pulling together experts to consider sustainable models for social distancing and control of COVID 19. It was time to move beyond shutting down everything and holding our breath. It was time to think about how we could live with new patterns for 1-2 years.

All of us have had to come to some sense of understanding of how to live in an era with COVID 19. It is not what we want. We want to be together. We want to hug our friends and have big get togethers with our family and friends. We want to go and linger at our favorite restaurants and sit in coffee shops for hours on end. 

On top of this, 2019 and 2020 have brought really hard things for many of our family and friends. I find my prayer list growing and growing and growing. Life is hard. There are things that cannot be fixed.

For me, my CT scan result means accepting my current symptoms and learning how to live in the body that I have. I have been left with adrenal insufficiency. With this comes a variety of unexpected issues and limitations. It means that I am not normal. I have another blog that I have written about this and will share it soon. That will go into more details. 

In brief however, in June I started to feel crummy again. I worried it was a cancer recurrence draining my energy. I was waiting for the other shoe to drop. I would somehow just muddle along with fatigue, muscle aches, and dizziness until I had to go through the next wave of treatments for cancer.

It isn’t cancer. 

That means that it is not something that will get a lot worse. It also means that there is not necessarily a clear path through it to get better. It means that it is something that I am going to have to figure out how to live within. Some days I come home, and I just want to collapse. I think by and large I do a good job of hiding it. My wife can immediately see it. I don’t want to distress her by it. She is just too perceptive. 

I am now on more hydrocortisone. I have learned to push fluids and to have a high sodium (salt) diet. I have learned also to understand my limitations. I am also experimenting with exercise. All of that seems to be helping. I am doing better than I was in June.

What does this all mean?

  1. I don’t have any evidence of residual or recurrent cancer.
  2. I do have symptoms that are not magically going to go away. 
  3. I am going to have to learn how to manage my symptoms, live within them, and live for all the good things that I can do.

What does it mean for you?

  1. I am sorry for all the pain that 2020 has brought. COVID 19 and its limitations and implications have brought pain for everyone. On top of this it has been a year of enormous grief, pain, and loss for more friends than I can ever remember. 
  2. We do not have a magical cure. I cannot make COVID 19 go away quickly. I cannot also take away the pain from my friends, no matter how much I want to and no matter how earnestly I pray for them. 
  3. We go on. We live. We do what we have to do. We try to make the best choices and decisions we can but mostly we just have to go on with life.

This morning my body ached all over. I got up because it was at least as good to be up as it would be to be aching in bed. I took my hydrocortisone and plopped in a chair with my computer and my coffee. I waited for my body to warm up and get ready for the day. I would love to have a magical cure. Maybe I even secretly hoped that the scans would show cancer or something that would be a way to explain my symptoms in a way that could be fixed. I didn’t really want that, however. I am very pleased with my results. It just means that I need to get up, keep moving, and keep living.

This is what all of you have had to do. In spite of COVID-19, in spite of elections and election results (whatever they may be), and in spite of horrendous losses that can make both of those look trivial, you just get up and decide to live. Go ahead. Buy some green bananas. Treat yourself to a new pair of shoes.