Tuesday, September 29, 2020

"A wild roller coaster ride through a dark tunnel"


     When I wrote last week, in a follow-up to my Sept. 8 Cologuard column, that the danger of follow-ups is there can be no end to them, I wasn't kidding. I thought I was done. I wanted to be done. And then I received this email from Timothy Hufman of Willowbrook. Tell me, what would YOU do? I really have no choice here:

Dear Mr. Steinberg:

     I have been reading your articles on Cologuard. I appreciate your mixture of humor and helpful information. Yesterday, you pointed out the pros and cons of using Cologuard as compared to getting a colonoscopy. One of the risks you mentioned with a colonoscopy was that its effectiveness depended greatly on the doctor who did the procedure. You pointed out that “Some doctors look harder than others. Some spend three minutes snooping around your colon. Others spend up to 14. The harder they look, the more they find.”
     I have come up with a technique to insure that my doctor does a complete examination – I join him (or her) in the examination. In essence, I have had a colonoscopy without taking any anesthesia. This allowed me to remain awake and alert during the whole examination looking at the same monitor the doctor was watching as he traveled through my colon.
      The experience was not painful as the colon has no nerve endings. “Meaningful discomfort” may be a more accurate description of the event. Most problematic was the initial insertion of the scope. All of a sudden, I got that “full” feeling similar to what one experiences seven hours after a huge meal when you are desperately looking for a bathroom. Thereafter, I was happily able to watch the show on the monitor from the comfort of my gurney with only mild cramping as air was blown into my intestine to inflate it for easy passage of the scope.
     Significantly, the procedure does not include an examination of the colon while “going in.” Thus, the scope quickly moved up my intestine with a view on the monitor similar to a wild roller coaster ride through a dark tunnel with only one small headlight illuminating the way.
     It was fascinating watching the scope make the hair-pin turns following my large intestine as it wound through my bowel cavity. Along the way, we came to one real sharp bend which the scope had a hard time maneuvering . As the doctor continued to struggle with getting the scope around the curve, I looked down at my abdomen, where the scope was stuck, to see my skin go up and down as if there was a finger in my bowel trying to push out.
     Finally, the scope reached the ileocecal valve which separates the small from the large intestine. At that point, the doctor began the examination by slowly retracting the scope as the camera, with its miniature light, illuminated the portion of my intestine that we were just leaving. At one point in our journey, I saw a dark spot on the colon wall. I cried out, “Wait, wait, what was that we just passed?” The doctor sighed and dutifully retraced his steps up the intestine to the dark area of my concern. It turned out to be a bran flake or some other debris that had apparently clung to the intestine wall during the preparation period when I flushed out my system. Having satisfied my concern, the doctor continued the journey.
     “Slow down” I said, when he began going too fast for me to carefully see the area we were passing through. Again, there was that sigh as he slowed down the retraction of the scope. Thereafter, aside from a few other pieces of partially digested food that we passed by, the rest of the trip was uneventful.
     Finally, at the end of the inspection, just before removing the scope, the doctor bent the camera around so that I could look at my hemorrhoids as they appeared from the inside. I think the doctor took a little pleasure in seeing my look of horror at what I was observing.
     With that, my journey was over. Although I was still cramping a little from all of the air still inflating my intestine, I was relaxed knowing that the examination of my colon had been thorough.


Timothy Hufman

Monday, September 28, 2020

Biden isn’t Bernie, but he’s good enough


     Friday I worked downtown, and ate lunch in Washington Square Park. It was a lovely day, and I lingered, just watching people walk by, glad to be in the city. Eventually I got up, and crossed Walton to spend the afternoon at the Newberry Library. Just as I crossed the street, this van drove up and parked, directly in front of the library.
     As I often say, it's better to be lucky than good.
     I snapped a photo, and almost turned to go. But I had to know: GOP stealth mockery based on ambivalence about Biden? Or sincere Democratic effort? I'd have bet on the former. The graphics were too slick for Democrats.
     "Sort of a Jews for Jesus thing?" I asked the driver, meaning, a wolf in sheep's clothing, trying to disguise itself as its prey. We talked at length. But even after I interviewed him, and then Sam Weinberg, the founder of "Settle for Biden," that qualm still lingered—this might be some elaborate scam, and I was falling for it. But I decided nobody is that good an actor, and you have to go with your gut.

     Sam Weinberg had to do something.
     He had returned last spring after 18 months abroad and found himself in the teeth of a pandemic. Instead of getting ready for his freshman year at college, the Chicago teen was watching disaster tighten its grip on our nation.
     Meanwhile, his friends looked at the upcoming presidential election and shrugged. What does it matter who wins?
     “I was seeing lots of people in my personal social circles and online saying things like, ‘Joe Biden and Donald Trump are two sides of the same coin,’” said Weinberg, 19. “That really incensed me on a personal level and on a policy level.”
     Rather than despair, Weinberg acted, using his generation’s irreverent view as a starting point, calling the group he started “Settle for Biden.
     “The name is reflective about begrudging support,” Weinberg said. “Yeah, he’s not our first choice. But he’s our only choice, and we have to live with him. Joe Biden is not the progressive ideal. But he’s a step in the right direction.”
     Chris Madden also had to do something.
     The Minnesota teacher heard about Settle for Biden and took a dramatic step. He bought a 2020 Ford van and spent $5,000 to wrap it in a mural touting the organization. Then he began to drive across the country.
     He arrived in Chicago Friday.

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Sunday, September 27, 2020

The world isn't really dying

Photos by Tony Galati

     "Got to the cabin yesterday," faithful reader Tony Galati writes. "The leaves started without me this year."
     Nature will do that. One of her sterner yet more valuable lessons is that the world chugs on whether we are there or not, whether we like it or not. Always has; always will.
     The vast majority of it anyway. We all have our little corners that we decorate or ruin, then mistake for the whole thing, a bit of unconscious synecdoche that no doubt is essential. We'd be overwhelmed if we pulled back too far too often and understand just what a dust mote we are traveling for a split in second in the vast twirling icy eternity of everything.
     Still, when things go south, as they do, and our minute slice of space and time curdles, as it has, that exercise can be curative. To divert our gaze away from our precious selves toward the beauty of the parts we aren't part of, the things we haven't screwed up yet. Pull back, look around, notice the forest from the trees, the leaves and not our footprints through them.
     Between the election and the pandemic and the economic calamity and the racial reckoning, I've heard the phrase "the world is coming to an end" more than once, and might have even used it once or twice myself. But the world is more certainly not coming to an end. Our little part of it, perhaps, though not yet and not without a fight. In the meantime, it's autumn.
Lake Superior

Saturday, September 26, 2020

Texas Notes: Socked feet over shag rugs


     EGD Austin bureau chief Caren Jeskey weighs in with her weekly update.

     Eight-point-one miles into a recent walk I started to hear a voice in my head. 
      “What is the meaning of your life? Why are you here?” 
      I am not sure why my mind went there on this particular day. How many of us have asked ourselves that question? If we have not, perhaps we are on the right path and have always been. Perhaps our calling came at a young age and we had the good fortune and drive to follow it. There have been times in my life I have been sure about my direction and did not question it, but these days I am full of questions. I want to be sure I am living my best life based on my true gifts and desires, and not based on what I think I should be doing, or what I feel falsely limited by.
     As a child, I figured my purpose was to have lots of fun: ride bikes, climb trees, and explore the underground sewers with flashlights during construction projects. I knew I was supposed to pitch in at home and bask in the love and attention of my family, extended family, and friends. I was supposed to show up at school on time and participate in learning, then have lots of fun and get into mischief during recess, lunch and after school, (and sometimes during school in the form of copious note passing). I was told I was smart, but I was not a disciplined student unless I loved the teacher and the topic interested me. While in class I often dreamed of swinging from the weeping willow branches outside, or skating on the iced over field outside of school at Rogers Park— where, sadly, many trees have been uprooted by a recent tornado in Armageddon 2020.
     In my daydreams I wondered whose house we were going to go to for lunch, or how much money I’d dig out of my pockets for a visit to Eastern Style Pizza on Touhy, the buttery crust dripping with grease calling my name like the pied piper. I kind of paid attention too, and was granted a space in the coveted philosophy class in 5th grade where we sat in a circle and contemplated our usefulness in the world. 
     Perhaps this planted the seed for me to realize that there is a purpose for me, and this may have been around the same time I started making a conscious effort to include everyone as much as possible. (Mom, Dad, is this true?) I’d sit next to the shunned kids in class, knowing it was the right thing to do. My heart always went out to the disenfranchised among us, and I felt it was my duty to help them feel welcomed.
     I’ve always had a problem with cliques that exclude others. I have to admit I was in one or two over the years, I suppose when I let my guard down and aimed for my own inclusion above all else. Honestly, I was happier hanging out with the smart, quieter kids and had a lot more fun with them. Being with the popular girls was stressful. They were more competitive and less present. They could not spend hours dragging socked feet over shag rugs and shocking each other, falling to the floor in hysterics. They were more concerned about hair and makeup and boys. I’d try to fit in but often felt like an outsider when doing so. There were some good memories, but my core group of two other girls and me playing with Barbies until we were “too old,” and sleeping three to a twin bed was more than fine with me. I wish I’d lived in that state of innocence for a lot longer than I did…
     Today it seems my purpose is simple; keep getting my chops up as a therapist via hours of Zoom classes and FaceTimes with mentors each month, staying as balanced as I can in order to show up for work and cope with pandemic stress, and get more clear about who I am and what I want. A quote attributed to Helen Mirren has been circulating around social media lately— her only regret at the age of 70 is not having told more people to fuck off. I’ve been finding ways to do this without those harsh words, by simply speaking my truth and setting clear and firm boundaries when necessary. It’s fun.
     After some COVID slumps and periods of intense anxiety, I’ve been in a good mood lately. I attribute it to radical self-care, nightly meditation to clear my thoughts and re-set, long walks and bike rides. A surprisingly lovely pandemic birthday a few days back— albeit far away from family and lifelong friends— also helped. For the third time in this blog I now have to mention my new favorite icon (among my old stand-bys: Jane Addams, Frances “Sissy” Farhenthold, Emma Goldman, and Snezana Zabic): Elisabet Ney. Two friends and I were granted a very special guided tour of her castle museum house on my birthday. We learned that the marble cherub boys signify how the combination of knowledge and an open heart (or for the religious, a connection to their god) leads to personal elevation and a sense of moving upwards on the journey of life. This resonates with me. Life feels so short now and something is telling me to keep things simple and as light as possible. It’s impossible to tune out the noise and haste of the world, and the dire nature of our country right now. If I can keep my head to the sky perhaps I will survive and help others do the same.

Friday, September 25, 2020

Leafy suburban paradise roiled by COVID stats

Lee Goodman updates the COVID death toll on his sign in Northbrook

     The media consisted of a camera crew from ABC 7, a helicopter, and me.
     Although I was there in my unofficial capacity. Not as newspaper columnist but as local resident. I had heard the chopper, looked at my phone — 3:57 p.m. — and remembered that at 4 p.m. Tuesday, Lee Goodman would update the number on his sign to 200,000 to reflect how many Americans have died from COVID-19.
     Lee is the sort of fellow no town should be without and, indeed, most towns have one. The local gadfly, or activist — lately I’ve referred to him as “the spoon that stirs the pot.” A retired lawyer, Goodman left the profession to devote his full energies to endeavors such as posting a sign at the busy corner of Shermer and Walters, an area set aside for free expression. It is significant that the other sign, already there, is promoting the annual Lobster Sale at The Episcopal Church of St. James the Less.
     As much as I would like to dive into exploring the identity of St. James the Less — cousin of Jesus, apparently — let’s keep our focus on Goodman’s sign.
     I witnessed its arrival Saturday — again, again, not in my journalistic capacity, but as a man smoking a cigar while walking a little dog. The sign drew reaction: a zealous spontaneous rally celebrating the glories of Donald Trump and the insulting absurdity of suggesting that a large number of Americans have died of COVID. I watched the commotion, briefly, then left with the conviction that this is going to be a very long six weeks, if not six months, if not six years.
     Tuesday, while I gazed at the helicopter, wondering what it costs to keep that thing in the air, a large, angry man marched up. “Why is the president’s name there?” he demanded. “What’s Trump got to do with this?” I am not given to direct personal confrontation. But the slow pitch of that question just hung there, right over the plate. Why should this guy be the only one allowed to yell? I swung on my heels.
     “If you have to ask,” I said, con brio, “you’ll never know.”

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Thursday, September 24, 2020

Apology to Wisconsin

     In mid-September, against my cautious nature, if not my better judgment, I drove up to 
the Upper Peninsula of Michigan, to Ontonagon, on the shores of Lake Superior. 
     Yes, it was risky. I'd be hanging out with half a dozen guys for the weekend. Mostly careful, older men like me. A couple younger guys, in their 30s. All people outside the bubble.
      I made up my mind not to go, initially. I've gone, geez, seven times before. Nothing worth getting myself sick over. Yet when the moment came: "Yes or no?" I surprised myself by saying, "Yes."
     Why? I always go. The year I didn't go, nobody went. It was my fault. I take risks as it is: shop in stores. Do interviews. I've been safe so far. It was a calculated risk. This pandemic could go on for years. You can't cower forever. Mental health is as important as physical health.
     I was more concerned about the drive up. My pal who has a place in the UP said he had gotten some hostile looks from gas station attendants on the trek. The mask. I knew we would stop at Held's. We always stop at Held's, in Slinger Wisconsin, about 90 minutes out, to load up on beef jerky for the weekend. It's thick, soft, homemade beef jerky. I used to buy enough to bring home. A souvenir from the Great North. But my wife complained about it smelling up the kitchen. My older son coined the perfect description:
     "It tastes like a burned-down house."
     That it does. So I only bought a pound and a half—about $33. It didn't last a day. 
     I was worried about walking into Held's. The transaction. Would I wear my mask? Or would I cave to local convention and go in unprotected? When in Trumpland, do as the Trumpkins do. How timid is that? Wear the mask and not care? I'd only be inside for a minute. Not a rough crowd, exactly, but not high tea in Andersonville either. Last year, a guy in front of me had a pistol. Not in a holster. Just sticking out of his trousers pocket.
     "Obscure columnist beaten to death with a side of jerky for wearing a mask..."
     I was relieved to see this sign on the door. Insisting, politely. The clerk—nah, that's too highfalutin a term for Wisconsin—the guy behind the counter, wore a mask. He cut me a generous hunk of jerky.
      Honestly, I wasn't worried until the drive back. What had I done? Now I have to wait two weeks to see if I get sick. Plus, when I got back home, I began to worry I'd have to quarantine. Went online, tried to figure out the requirements. I have a research day Friday at the Newberry. Would I have to cancel? No, there was a window—their numbers were down, while I was there. The COVID quarantine gate didn't slam shut, for a second time, until Tuesday. Whew. That was lucky. I
've been home for 10 days, and not so much as a tickle. Lucky. So I seem in the clear. 
     Bottom line: I'm glad I went. Took the heat in the sauna, plunged shouting into the frigid lake, hiked for a few hours, smoked cigars and drank can after can of Pabst Blue Ribbon NA. Talked and laughed and cooked—well, cleaned up, Rory did the cooking. Told jokes, dirty jokes, if you can imagine. It was a lot of fun, and fun can be hard to find nowadays.
    And although I did some across some kind of spontaneous Trump parade near the aptly-named Butte des Mortes, I was wrong about the mask situation. So my apologies, Wisconsin, for underestimating you. Those folks in Wisconsin can still manage to surprise. Let's hope they do it again in November.

Wednesday, September 23, 2020

Cologuard has drawbacks, but better than doing nothing

from Bartholomeo Eustachi: Tabulae anatomicae
     Three times a week is a lot to stand on my little newsprint soapbox, raise a tin trumpet to my lips, and blow.
     So if I expect you to regularly listen, I’d better not sound the same note, but skip from one tune to another. Because repetition is boring. But sometimes a shoe is left dangling, such as when I wrote about the Cologuard colon cancer test on Sept. 8.
     Reaction fell into two camps. Those grateful to learn of this new way to detect colon cancer with a home test. And those concerned with aspects I didn’t address.
     “Your comprehensive article on Cologuard does not cover the most obvious question — how many false positives? False negatives?” wrote Dr. Robert W. Brandstatter, a North Side dentist.
     “We have no real data to help guide patients and clinicians with what to do after a Cologuard test is done,” wrote Dr. Tibor Krisko, a New York gastroenterologist and assistant professor at Weill Cornell Medical in New York City. “If positive, a colonoscopy is clearly warranted (though there is evidence to suggest many people with positive results do not get the all-important, potentially life-saving colonoscopy).”
     The traditional colonoscopy — a doctor snakes a tiny camera into your intestines to look for tumors — has drawbacks. You must go to a hospital, risky in the age of COVID. You’re under general anesthesia, also presenting risks. Doctors might perforate your colon with the probe. The procedure is uncomfortable, time-consuming and expensive. So 40% of adults skip the test, despite its big benefit: detecting cancer when early and treatable instead of advanced and lethal.

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