If A Hippopotamus Can Fly: Why, oh why, can’t I?

News item: “…researchers discovered that hippopotamuses — which can weigh up to 8,000 pounds — become airborne with all four feet off the ground for up to 15 percent of the time while running at full speed, or for about 0.3 seconds.” (The Week, July 19, 2024)

I reckon I was airborne for about 0.003 seconds before my recent bone-shattering crash on a Seattle sidewalk. I weigh — well, a lot less than 8,000 pounds — and I had only one foot off the ground at a time as I walked at a reasonable pace. Yet there I was, flattened, while the hippopotamus continues to soar through the air. It’s a miscarriage of justice —an unequal application of the law of gravity.

Gravity is out to get us humans. We teeter around on two legs, at a distinct disadvantage to four-legged critters. Scientists tell us that our long-ago ancestors switched from four- to two-legged travel to save calories. We use less energy when walking than our relatives, the chimpanzees, who employ both knuckles and toes as they stride through the jungle. 

The World Health Organization reports that globally, 684,000 people die from falls each year. In this country, says the Center for Disease Control, falls are the leading cause of injury for adults 65 years or older and, even more frightening, the leading cause of injury-related death in that same age group. 

My friends and family offered all sorts of kindly advice during my two-week hospital stay, followed by a few days in rehab, and now as I continue therapy at home. “You don’t want to fall again,” they lovingly caution. Fact is, I didn’t want to fall in the first place. I’ve long been pro-active to avoid falling. I own and used a balance board; I stood on one leg while brushing my teeth; I continually engaged in core strengthening exercise; I wore sturdy walking shoes, and just FOUR DAYS before my fall, I completed a balance/fall-prevention class. 

“Perfect score,” the instructor told me, happily adding: “but of course, you had a perfect score at the start.”

The reasons we fall are complex. The CDC lists lower body weakness, vitamin D deficiency, difficulties with walking and balance, medications that affect balance, vision problems, foot pain or poor footwear, home hazards or dangers such as broken or uneven steps, throw rugs or clutter, etc. In my case, it was an uneven bit of concrete sidewalk. Gravity happens.

Reading through the CDC brochure, “Staying Independent,” I checked a definite “yes” next to the statement, “I am worried about falling.” The brochure commentary is not particularly helpful: “People who are worried about falling are more likely to fall.”

In his book “Falling Upward,” spiritual writer Richard Rohr offers a more encouraging point of view. In this “second half” of life, he suggests, we are free to fall, although not in a physical sense. We no longer have to protect our fragile egos, no longer must we “push the river,” no longer must we strive to have what we love, instead, we love what we have. Rohr cites St. Francis, who “spent his life falling, and falling many times into the good, the true, and the beautiful.” I’m willing to take that kind of fall.

I’m convinced my fall prevention work saved me from worse injuries and speeded my recovery. The CDC says one in every four older adults reports falling each year. I count as one this year, which means three others are off the hook. I hope, dear reader, you’re among the three.

Embracing Life’s Lessons: From Caregiver to Patient

If life is all about learning, I’ve just earned my post-doctoral degree following hospitalization. Ouch. I know. Self-serving puns aside, it was a novel experience to be IN bed instead of bed-SIDE.

For the past three decades I’ve been doing preparatory studies by caring for loved ones during their final passage of life. Among them were my husband, mother-in-law, mother, and sisters of my heart. I’ve witnessed the grim effects of stroke, cancer, heart disease, ALS, and simple, intractable aging.

With each passing I came to the same conclusion: I’m not particularly afraid of death, but I’m terrified of the health care industry. It is to be avoided at all costs.

When I made a full frontal landing on a concrete sidewalk nearly three weeks ago, my first thought was a prayer: please, no injuries requiring medical attention. 

“Nothing broken,” I announced cheerfully to the strangers who helped me up. What did I know?! I painfully crawled into an Uber for the short ride to my apartment complex, where a nurse checked my vital signs. I was alive.

“Ambulance,” he suggested.

“Nope,” I countered. “I’ll just ice my (screaming) knee and elbow. I’ll be fine.” An hour later I was on the phone saying, “ambulance.”

Once again I assumed the role of bedside observer, but this time observing myself as patient. I consciously sought a sense of detachment, witnessing my own experience as if I were someone else, watching, not judging.

I was not at all approaching death’s door, yet right there at my side were the beloved ones with whom I’d journeyed in years past. While I thought I was caring for them, they’d actually been teaching me: how to let go, how to accept, how and where to set boundaries, when to laugh, when to cry and grieve, how to bless and move on.

My husband, who died in 2007, has been especially present. A brainstem stroke left him with the unthinkable diagnosis of Locked-In Syndrome: a fully functioning mind “locked” inside a totally paralyzed body, unable to speak or eat. Yet he lived a meaningful life for another fourteen years. His presence is palpable, reminding me how he faced adversity with courage, determination and, most important, patience.

My mother sternly warns, “DON’T!” as I start to pick up a sock that fell on the floor. Mother broke her neck by falling when she stooped to pluck an errant thread from the carpet. She survived, but it was a long, arduous recovery. She ultimately died with cancer.

“Thanks, Mom,” I respond when I hear her voice. “You paid a heavy price to teach me this lesson.” I take the time to retrieve a mechanical grabber and safely pick up the sock.

When my dear friend Sharlene was diagnosed with ALS (Lou Gehrig’s Disease), her wry and playful humor rose to the top. Told the disease is incredibly rare, she declared, “I’m one of the CHOSEN.” She taught me that we are a mixed bag of emotions, all valid. She howled volubly with grief and rage every time the advancing disease robbed her of yet another function: walking, eating, talking.

When she could no longer speak, she typed jokes into her talking laptop and played them for strangers as we rode elevators at the medical center. One delighted passenger suggested she be hired permanently. She rather liked the idea.

With death approaching Sharlene spelled out her final request to me by painstakingly moving her one functional finger across the sheet on her bed: “Mary, write my obit.” I did, but I wish I’d done it better, made it more fun, like her.

I sat for hours with my soul sister, Mary Lou, who in her final weeks often resisted pain-killing but sleep-inducing medication. “I don’t have much life left,” she protested. “I don’t want to sleep through it.” 

Walking the route to humility

Our friendship had begun decades earlier when, as office colleagues, we discovered we both played piano. We began meeting weekly to play duets. Mary Lou insisted on playing “secondo” while I played “primo.” As in dancing, someone has to lead.

Thousands of miles and a multitude of shared adventures later, as Mary Lou lay dying she asked what of her possessions I wanted to inherit. I didn’t have to think about it.

“Your humility,” I quickly answered, humility not being one of my stronger suits. She had it in abundance, along with joy, grace, and a delicious sense of irony. Mary Lou shows up all the time now, her musical chuckle echoing in my ear at every pride-punching, ego-deflating event in my life.

“This is what you asked for,” she reminds me.

Appropriately humbled, I’m returning home today after two weeks in a hospital and four days of rehab. Therapy will continue at home. I’ll be aided by a walker, a leg brace, and many well-wishers from whom a river of prayer has flowed.

Healing is not a solo venture. If we think it is, we deceive ourselves. If it were up to just me, I could not, would not fully heal. Lesson learned.

Living In Denial: There’s no ‘sure’ in medical insurance

Here’s how a person without life-threatening injuries (just two fractured bones) gets to lounge in a spacious, expensive, private hospital room for two weeks. To borrow from the “Music Man’s” warning about the game of pool, my saga starts with I and ends with E, spelled I-N-S-U-R-A-N-C-E.

At the start of my recent hospitalization following a bad fall, we called to make sure of my  insurance coverage. We were told convalescent care for therapy following hospitalization and surgery would be “automatically” approved. A few days later, with no explanation, the benefit was denied.

This is a national epidemic. As I spell out my story, I’ll bet you’ll be thinking, “Well, I can top that one.” Any time I tell this tale, the listener (especially people working in health care) inevitably comes up with something even more dramatic. A study by the Kaiser Family Foundation (KFF) determined that, on average, 17 percent of “in-network” insurance claims — some 48.3 million — were denied in 2021. Some companies denied up to half the claims that came their way.

The Washington Post reported one company even has a position with the title “denial nurse.” Some companies use computer algorithms or even AI to “review” and deny benefits without having to look at a patient’s medical chart.

“[M]edicine has become big business. Now health insurance is, too,” editorialized the podcast, The People’s Pharmacy. “These two mighty industries are battling over who can make more money from our illnesses.”

Well, okay. Isn’t that the capitalistic American way? 

But wait a minute. Aren’t we good capitalists taught not to throw money away? To get the most bang for our buck?

After the order for my rehab was denied, we immediately appealed. I’ll spare you the excruciating details of the process other than to make two observations: communicating with an insurance company is as frustrating as trying to reason with a vending machine that’s taken your money and withholds your candy bar. Second, my doctor wasted valuable time on an alleged “peer-to-peer” (doctor-to-doctor) phone call. It turned out he was talking to a mere note-taker who asked a list of generic questions.

I consider myself fortunate. The hospital wasn’t about to discharge me — still too large a fall risk. There I sat, achieving little toward my goal of full recovery that I knew would come with intense therapy. The insurance company ultimately acquiesced. After a week’s delay, I finally made it to the rehab facility. It costs $604 per night. I haven’t seen the hospital bills yet, but on average, KFF says hospital stays in Washington state cost $3,843 daily. Let’s not do the math. It’s too painful.

“The system is broken,” said my doctor, shaking his head. Yet he shows up to work every day. He and more than 20 million other health care workers show up for stress-filled jobs. They tend to patients and side-step obstacles in a system that everyone knows is broken. From CNAs to surgeons, these are the folks who matter. And the bean counters?

They’re out to lunch.

Dependence Day: Are we really free, or are we kidding ourselves?

On day No. 12 in the hospital, as my fractured bones heal I realize I’ve been given an additional break —a pause.

When I met a Seattle sidewalk up-close and personal a week-and-a-half ago, it interrupted my schedule: things to do, people to see, places to go. Since then I’ve been given long, seemingly empty hours of “doing” nothing. My arena of activity is limited to a bedside table (15 by 34 inches — I measured it using tape from my knitting bag). The table is piled with notebooks, hospital menu, a few papers relative to injury and recovery, water jug, computer, phone, maybe a snack or two. 

If something I think I want or need is beyond my reach, it’s as unavailable as breathable air on the moon. Like that pillow, just four feet away, that would feel good under my fractured elbow just now. I’m capable of wriggling out of bed, shuffling the four feet (abetted by the hip-to-ankle brace stabilizing my fractured knee), grabbing the pillow, and shuffling back to bed.

BUT I’ve been strictly ordered not to get out of bed or even off the toilet without an “assist.” If I want to move about, someone else has to be present.

Happy Dependence Day!

We love to celebrate Independence and worship at the altar of Freedom (an altar banked with fireworks). When do we celebrate the greater gift of DE-pendence? 

Such a suggestion sounds almost unAmerican. We pride ourselves as being (as my late husband liked to observe) “independent as hogs on ice.” We wanna be free to do what we wanna do. At my age especially, independence is the NO. 1 goal —even though it’s a mirage.

We choose to ignore how much we depend on others. We can’t recognize that because too often the fellow human beings we depend upon are hidden within systems — health care system, transportation system, communications system. You can name many more. Just think about your daily activities and the systems that enable them and the people within those systems who enable you.

The other night (at the risk of being overly specific) my urinary catheter malfunctioned. What a soggy, humiliating situation! Barely awake, I mumbled apologies to the aide as she efficiently got me back on dry land. English for her, like many hospital personnel, is a second language. With her beautifully lilting accent, she replied, “That’s why I’m here on the overnight shift. To help you!”

After she left, I wondered if I’d just experienced a mystical divine presence. She’d seemed uniquely certain of who she was and why she was. It was powerful — as if destiny had hurtled us both through time and space so our paths would cross in exactly that moment, this place.

The African Bantu language gives us the word ubuntu, inadequately translated as “I am because you are.” I understand that to mean, “I would have no reason to exist except that you exist.” I’m guessing our culture understands that in a romantic sense, like the song lyrics: “I was meant for you; you were meant for me.” That’s a start, but ubuntu is universal. I suspect that word or a similar one is not in our vocabulary because it’s a foreign concept. In our individualistic world, co-dependency is considered a mental illness. 

Yet the mutuality of ubuntu is at the root of our humanity, our raison d’être. Thus showing up at 2:30 a.m. to change an old lady’s sopping bed linen becomes not just a job, but a reason for being. 

Happy Dependence Day — today, tomorrow, and every day of our lives!