Flashback 1999: "Right choice is in eye of the beholder

Mattress Show Room, W. & J. Sloane (Metropolitan Museum of Art)

     Decisions are hard. You have to make a choice, then live with it. At least they are for me. I know there are people who breezily acquire tattoos, shed jobs, buy cars, sell homes, without a moment's qualm. I envy those people deeply. They don't know how lucky they are. Even when I make a major decision easily, I can never be sure that a backwash of cold regret won't swamp me the next day. The Mattress Story came up twice in the past few weeks, and I realized I'd never posted it here. That oversight is now corrected.

     Went to buy eyeglasses the other day. I had mangled my current pair roughhousing with the boys, and while the glasses were still wearable, they threatened to snap at some moment of maximum inconvenience. Why not cleverly sidestep the crisis by getting a new pair first?
     But buying glasses is itself a crisis, or at least a tough decision. It's like buying a new nose. They perch on your face for years and years, defining you. And they cost almost as much as a new nose, which only makes the decision more difficult.
     Of course I told myself the Mattress Story, even before I got to the store, for support and inspiration. The Mattress Story is one of those cherished family tales used to define a person, in this case my brother Sam, the decisive executive.
     This was about 10 years ago. He had just moved from Tokyo to Chicago and was living with me on Logan Boulevard, sleeping on the sofa. He needed a bed. We visited a mattress store on North Halsted Street. Sam immediately flopped backward on a mattress/box spring set, closed his eyes, spread his arms, and seemed to doze for a second. Then his eyes snapped open and he popped up.
     "This one is fine," he announced. He moved to the cash register, taking out his wallet. This astounded me, shocked me. "But what about that one?" I said, wedging myself between him and the register, pointing to another, randomly chosen bed. "Or that one." The store offered about two dozen beds.
     "This one is fine," repeated my brother, a little impatiently. I began to protest, agog, but he stayed on his feet, paid for the mattress, and left.
     I could never do that. Never, ever, ever. I would have to carefully lay on each mattress, from the $100 aqua foam pallet destined for a fleabag motel, to the $2,500 deluxe luxury model, all gold and satiny braid, which I could never buy anyway. I would narrow them down to two choices that were completely identical, then agonize, back and forth between them, sweating and mumbling and flopping from one bed to another until a crowd gathered and I just picked one to end the embarrassing ordeal, so I could flee the store, heart palpitating, already regretting my decision.
     So you can imagine how an eyeglass store, with its hundreds of frames of all sizes and varieties, would pose a problem. I tried to coax my wife along to make the decision for me, but she was too savvy. "You can do it," she said.
     And I did, in my fashion. I actually, sincerely liked the first frame I touched. Stylish. Handsome, in my estimation. I thought about buying that one and being done with it. But no. That is not my way. I had to carefully examine every single frame in the store, forcing myself to select a second choice, which I then spent 20 minutes comparing to the first choice, sitting before a mirror, putting on one pair, then the other, then my present pair, again and again and again, polling the clerks, the optometrist in the back, flipping a coin at one point, contemplating running out to get my wife.
     And then I bought the first pair I tried on.
     But life offers compensation. While I agonize over the big-ticket items—I'm sure many people have less anxiety deciding to move abroad than I do choosing a sofa—at least there aren't too many of those decisions. It's not as if you buy a new car every week. And the small, what's-for-lunch questions are a breeze for me.
     I flop open the menu, pick something, usually a club sandwich on wheat toast, snap the menu closed, and am whistling and drumming my fingers, along with the waiter, while my wife silently stares at the menu as if it were written in a foreign language. And am I sympathetic, based on my own difficulties with certain decisions? Of course not.

      —Originally published in the Sun-Times, May 13, 1999

Can we stop sugarcoating horror now?

     With the anniversary of the start of World War II nearly upon us, a New Jersey publicist sent me an email last week, pitching the feel-good story of Dutch teenage girls seducing and killing Nazi officers.
     My first thought was: “It’s always the anniversary of some World War II event. The beginning. The end. Pearl Harbor. D-Day ...”
     My second thought was: “Yeah. Sept. 1. Sunday. Thanks for the advance notice. Making it ... 75 ... no, started 1939 ... 80 years.”)
     Girls killing Nazis. Tempting. Who wants to swim the depths of horror? To risk drowning in humanity’s bottomless evil? To realize just how tenuous our foothold on civilization’s shore? Very human to pluck at thrilling tales of heroism, bobbing on this sea of gore.
     But can you do that too much?

     The media rushes so quickly to comfort that it overshoots reality. What used to be a ray of relief from general horror has become the main event. And not just regarding the Holocaust. We’re too keen to put the bright spin on atrocity. Ten seconds of shock, then straight to “Wind Beneath My Wings” and closure.
     I’d suspected it before, after mass shootings, like the one Saturday in Texas. The grim law enforcement chiefs assemble around a podium to share what little is known about the killer. But not before they put in a plug for first responders — didn’t they work great together? Kudos all around for a job well done!
     Then the heroes are trotted out, dead or alive. The media can’t celebrate those fast enough, people who shielded their loved ones, who herded the terrified schoolchildren into an empty classroom and cowered in the darkness. Humanity at its best!

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Flashback 2011: Cutting out a kidney is gloopy work

     This is the second of two parts about Rachel Garneau's kidney donation in 2011. The first part is here. Of course I wondered how the donor has been faring in the eight years since; I tried to track her down, scouring Facebook and Nexis and calling the Notre Dame media affairs office. But nothing yet. 

      Before you can remove a kidney, you first have to find it. Which is easy enough in a general sense—Dr. Yolanda Becker wrote her initials in purple pen on Rachel Garneau's lower left abdomen, roughly above where her left kidney should be.
     But a human body is not a car engine. Not everything is in the same place. Laying eyes—or the laparoscopic camera used to see in the body—on the kidney itself is harder, like trying to find a shy hippo in a jungle thicket.
     Readers met the patient on Monday. If you thought the 20-year-old Notre Dame junior seemed blasé describing why she decided to donate a kidney to whoever needed it, you should have seen her at 5:45 a.m. Tuesday as she ambled into the lobby of the University of Chicago Medical Center's Bernard Mitchell Hospital, wearing black sweatpants and aqua flip-flops, clad in an air of utter calm.
     "I'm ready," she said, when asked, displaying no anxiety or apprehension whatsoever. The strongest emotion she showed was when the anesthesiologist told her she could keep the purple pen used to bird-dog her kidney.
     "Yes!" she exuded. It was indeed a nice pen.
     An hour later she was naked, unconscious, lying on her right side while nurses draped her body with blue paper coverings and padded her with yellow foam to prevent nerve damage from being in one position too long.
     At 7:33 a.m., transplant surgeon Dr. Piotr Witkowski took a scalpel and made a small incision in her stomach. In all, four small keyholes were cut there, to insert a tiny camera, a Maryland clamp, a stapler and a harmonic scalpel that uses ultrasound to cut and heat to immediately cauterize what it has cut.
     Her abdomen was inflated with carbon dioxide to create room so doctors could see. The operating room lights were turned off, except for one over the instrument tray, and it was eerie to be in an OR with the lights low, the surgeons and nurses all gazing at images on an HD color flat-screen monitor.
     What they were seeing is hard to describe. Up close, your guts are a gloopy, drippy, glistening jelly, a grotto of strands and lumps, an orange, gray, yellow, purple and maroon mess.
     Dr. Becker worked the scope. Dr. Witkow­ski manipulated the clamp in his left hand, the scalpel in his right, sometimes putting a little body English on it, like a pinball player. He easily spent two hours cutting away at what looked like thick plastic spider webs of mucus, tugging with a tiny clamp and cutting with a scalpel with a 1/2-inch blade.
     "Oh that's the artery right there," said Dr. Becker—getting to the kidney and cutting it out is a two-person job, with a third surgeon standing by. The operation's cost, $50,000 or so, is covered by the recipient's insurance.
     The clamp opened and closed like a blind metal crocodile, its serrated teeth grabbing the viscous material, while the bird of the scalpel came in to nip it apart, giving off puffs of steam. The kidney was well-hidden, at first.
     "Watch that vessel, it's underneath," said Dr. Becker. "Can you make a hole up here?" She has done this procedure—a nephrectomy—at least 100 times, and spoke of the various organs as if they were individuals. The touchy spleen, the adrenal gland that "doesn't like" being nudged—and the pancreas is even moodier.
     "The pancreas is the bitch of the abdomen," she confided.
     Eventually, the kidney is separated from Garneau's body except for a vein, the ureter and two arteries. Most kidneys have one artery, but remember, bodies vary. Some have an extra artery (and that's just the variety of nature. With multiple transplants, since dysfunctional kidneys are left in place, a person can end up with four or five kidneys).
     This kidney was heading to New York for a recipient whose loved one sent a kidney to Wisconsin, called a "cluster" donation.
     The doctors made a four-inch incision in Garneau's abdomen and only then, when it was open and ready, at 10:30 a.m., did they staple off arteries and the vein and cut them.
     Dr. Becker nudged the kidney into a little bag—imagine a small fishing net with a baggie at the end—and pulled it out of the incision. Using her hands to remove the kidney would be too perilous. "Kidneys are slippery, like newborns," she said.
     The kidney was drained of blood and filled with solution. Rich Cummings, procurement coordinator, put the kidney in a plastic jar, packed the jar in ice, bagged it and put it in a cardboard box marked "RUSH! Perishable."
     He walked the box briskly down the hall to Jim Damopoulos, of Sterling Courier, who took it downstairs and put it in the back of his Dodge Caliber and drove off to O'Hare to put it on a 1 p.m. United flight to New York, where the kidney was scheduled to meet its new owner at New York-Presbyterian Hospital.

     —Originally published in the Sun-Times, June 1, 2011

Flashback 2011: Giving stranger a kidney; 'I'm really looking forward to it'

Detail from "Still," by Damien Hirst, at the Art Institute of Chicago

    Last week, I wrote about a woman who donated a kidney to a stranger. Which reminded me: I had been here before, not only focusing on a young lady making an "altruistic" donation, but observing the surgery at University of Chicago Hospitals. I enjoyed revisiting the pair of columns, and thought you might too. Today we meet the donor, tomorrow we watch the surgery. 

     Before the sun comes up Tuesday, Rachel Garneau's boyfriend will drive her from her home in Elmhurst to the University of Chicago Medical Center, where a surgeon will operate on this perfectly healthy 20-year old college junior and remove her left kidney.
     Typically, this kind of donation is made to save the life of a loved one—you give your kidney to a brother or sister, for instance, suffering from kidney failure. Or, if you are not a suitable donor for your relative, you give a kidney into the national donation system, and somebody angling for a kidney for their loved one gives one to yours, forming a "cluster" of donation that can involve half a dozen people.
     But Garneau's four siblings are fine. She doesn't know anyone who needs a kidney. She just wants to donate hers.
     "We have a young lady, an incredibly generous person who said, 'I want to give up my kidney to just anybody,'" said Dr. Yolanda T. Becker, the transplant surgeon who will perform the operation and director of the hospital's kidney program.
     "I'm excited," said Garneau, a few days before the surgery. "I'm really looking forward to it."
      Altruistic donation of a kidney is not as rare as one might imagine. Nearly 1,000 people have done it nationwide. There is a website, Matchingdonors.com, that says it facilitated 100 organ donations and has 2,000 people signed up hoping to donate.
     Still, the number of people willing to give kidneys is nowhere near the need. The waiting list for kidneys nationwide has 82,000 names on it, and with dialysis such a taxing procedure, 12 people a day die in the U.S. waiting for a kidney to become available.
     Garneau is majoring in anthropology at Notre Dame, and is planning to study in Rome in the fall. She plays intramural volleyball. Eventually, she'd like to spend a few years in the Peace Corps, then start a family.
     What inspired her to consider this now?
     "I honestly don't remember what got me into this at all," she said. "I first started thinking about this three years ago, when I was 17. I've never known anybody who had kidney problems, I never knew anybody who had serious medical issues. One day, I started thinking about it, doing the research ... a few hours later, I went downstairs I told my parents I wanted to donate my kidney."
     Her mother and father reacted the way most parents would.
     "They sort of ignored me at first because they thought I was joking," she said. "When they realized I was considering it, they said, 'No. End of discussion.' They said the surgery is risky, what if you get hurt? What if you die? It seemed one of those things you say on a whim."
     But she persisted. Why?
     "Honestly, I don't know," she said. "I don't think it's a religious thing. I was raised Catholic. I never really felt like God was a part of this, necessarily. I guess it could be, but I never really felt that way. I decided to do it. I got this idea in my head and it won't go away. I can't not try to do something. My family has always been very giving, very charitable toward others. That could be a part of it."
     This kind of altruism is certainly nothing new for Garneau. When she was 15 she told her parents she wanted to help people overseas.
     "I decided I wanted to volunteer in Africa," she said. "They let me go with a friend for a month when I was 16. I went to Ghana to work in an orphanage."
     Her father, who works as a meat cutter, declined to be interviewed; her mother, a special education teacher, died suddenly in 2008 from an infection picked up in a hospital a month after she was diagnosed with leukemia—though Garneau points out that she decided to donate her kidney before she knew her mother was sick.
     Garneau approached the hospital last fall and assumed she'd donate her kidney by Christmas.
     Instead, she had half a year of interviews and medical tests.
     "We really put her through the wringer to make sure it was something she really, really wanted to do," said Dr. Becker. "The potential donor is seen by a social worker, a psychologist, a living donor advocate, to make sure we are not doing anything bad."
     The hospital held an ethics conference with two dozen doctors, nurses, social workers and psychologists to discuss the case.
     "Some were arguing very vehemently that there is no medical benefit to her," said Dr. Becker. "Some people felt she was very young."
     Many would-be donors are sent away.
     "About 30 or 40 percent we reject, for all kinds of reasons," said Dr. Becker. "They don't realize just what they're up against. We want to give them multiple opportunities to ask questions or back out. We made her come back almost half a dozen times. She's so unusual, so young. We want to make sure we're protecting our donors. I'm not going to whack somebody over the head and take their kidney out."
     What about the Hippocratic Oath, what about "first do no harm"?
     "She's an adult," said Dr. Becker. "She gave me permission. I did speak with her father, just to give him the facts. The operation is risky—any time you operate, there is a minute but very real chance of death. Still, I feel very comfortable that this young lady has given informed consent. She knows what she's getting into. If I didn't feel comfortable, I wouldn't proceed."
     Dr. Becker has done this before. I wondered how she felt, taking a kidney from a perfectly healthy young woman.
     "To be honest, in some ways it's more stressful to take one out of healthy person than to put one into a sick person, because you are taking something away from that healthy person," she said. "It's not an operation they need to have done. They're not sick. There is a slightly added level of stress."
     I mentioned to Dr. Becker that, in my view, if Garneau were signing up for the Marines we wouldn't think twice of applauding her selflessness, even if she were going to fight in Afghanistan, where she could possibly be injured in a far more grievous way than losing a kidney (your remaining kidney enlarges to pick up the slack, and since kidney disease typically strikes both kidneys, having an extra is only useful in the case of physical trauma, like a car accident).
     "That was the argument brought up at the ethics conference," she said. "It's less dangerous than going to Iraq and getting shot."
      Garneau couldn't quite put her finger on her exact motive. What does Dr. Becker think of what Garneau is doing?
     "I just think she's on a higher moral plane," she said. "She's great. She's awesome. She is just an incredibly generous person who saw this is the right thing to do."
      —Originally published in the Sun-Times May 30, 2011

Latest Trump move on border wall is straight out of Hell

Dante in the Piazza Santa Croce in Florence

     Almost any reaction to the daily doings of the unhinged, untruthful, craven, cruel, possibly insane, probably criminal, confirmed fraud we call our president can be justified at this point, from simmering outrage to protective indifference.
     And heck, I should add that unyielding enthusiasm is a common reaction that can also be justified — because you can rationalize anything. I hear every day from readers who believe passionately that Donald J. Trump is the best president the United States has ever had or could ever have, particularly when compared to the infamous criminal regime of Osama bin Obama.
     You think I’m joking? Let’s reach down and hook an email wriggling in today’s Spam filter.
     “It seems that people with morals are the underdogs these days,” Vicki Falsey writes to me and half the Sun-Times masthead. “So all the people that voted for Trump and love him don’t have a voice. Since Trump has gotten in office, your paper has been writing these disrespectful articles about the president. I cannot imagine anyone ever writing anything this ignorant about the worst president to ever be in office, Obama. Just so you know, Obama was the worst thing to happen to our country. He brought it down. Insurance will never be affordable again for the working class people. But, no one and I mean no one disrespected him. You would have lost your jobs if you said anything negative against Obama and his wife. Yet everyday, you mock and insult the president. You should be fired.”
     There’s more, but you get the point. And no, I didn’t argue with her. To what purpose?
     So to recap: many reactions to our leader, across a broad spectrum. That said, I believe my personal reaction to Wednesday’s jaw-dropper must be unique.
     The news: that Trump is so desperate to have a few miles of new border wall by election time, as a sop to his xenophobic base, he ordered aides to seize private property (“Take the land,” he said), skirt environmental concerns, and not to fret about any crimes they might commit (“Don’t worry, I’ll pardon you,” he told them).

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You don't seem to have a face

      All this social media stuff. What a waste. Arguing with strangers. Talking to ourselves, talking to computers, listening to computers, gazing at analytics that don't mean anything.
      I was postponing doing meaningful work Wednesday morning, and glanced at the portrait associated with my gmail account at the newspaper. My column bug from, gee, maybe 10 years ago. Maybe more. Out-of-date. The paper had a photographer shoot a new one earlier this year. They don't always use it, but it can take a long time for old stuff to work its way out of the system, and I'm not one to complain.
     This, I could change myself.
     So I clicked on the portrait, and the system easily pointed me toward inserting a new photo. I dragged in the new shot, jiggled with its positioning, clicked "Set as profile photo." Nothing. I tried a second time. That's when I noticed gmail's explanation of the problem.


    "Are you sure people will recognize you in this photo? It doesn't seem to have a face in it."
    Well, lah-de-fuckin'-dah. It sure seems like a face to me. But then, I'm biased. Older, sure, grey in the beard. But my face, and I'm sticking with it.
     Will people recognize it? Heck, some days I hardly recognize. I can't speak for all "people"—there's too much of that going around as it is.
     Annoying? Sure. But, honestly, I'm glad the system is so inadequate. I'm sure someday people will go to prison on this kind of error, but right now there are still a few bugs in the system, and that day isn't quite here yet, though the Chinese are rushing us toward it. Nor are they alone. This week it was learned that Amazon's Ring security system is partnering with 400 police departments, handing over images snatched from your doorbell camera for the "new neighborhood watch." An Orwellian phrase if ever there were, because that used to mean you watching the neighbors, and now it means strangers watching us all.
    Another reason not to have a doorbell camera.
    The third time, I got the photo to be accepted, using a very human strategy: I tried again, altering nothing from the first two attempts. Only this time it worked. Third time's the charm, as we used to say when we, you know, used to say stuff.
     There are still a few bugs in the system, thank God. The day this all works smoothly will be a scary day. Not that we'll notice anything is wrong.

Socialized medicine? We’re already a third of the way there

     Ready for a shock? Because if you aren’t, maybe you should stop reading now ...
     Wait, no, please don’t stop reading. That would defeat my whole purpose .
     Sorry. I’ll begin again.
     Ready for a shock? What percentage of Americans have health insurance? Sixty percent? Seventy? I didn’t have a number in mind before finding the true figure, but probably would have guessed around 80 percent.
     The answer: 91.4 percent of Americans in 2017, according to the U.S. Census Bureau. Or 294 million. Quite a lot.
     Not perfect. Particularly if you are among the uninsured 8.6 percent. But not as bad as I thought. And most surprising, given all the Republican blathering about “socialized medicine” is those insured break down into two-thirds private and one-third public — Medicaid, Medicare. More than a third of insured Americans — 37.7 percent — are protected by the government. So if you’re wondering how socialized health insurance might work, ask grandma.
      When I had my spine surgery last month, I considered myself lucky — “blessed” was the word that got into print. Blessed that I had good insurance, and wasn’t being bankrupted — I hoped — by a single operation. Medical problems are cited as the cause of two-thirds of the bankruptcies in the United States (although the actual cost for health care is only part of that; inability to work is the other).
     Granted, mine was good insurance, provided by a good workplace. When I checked before the operation to see how many sick days I had accrued, the answer was: “26 weeks.” I used two.
     Where am I going with this? I got a letter from a reader — if a note printed in all caps on a 3-by-5 index card shoved into an envelope can be called a “letter” The punctuation is mine:
     “HEY NEIL ... PLEASE FINISH YOUR NORTHWESTERN STORY. LOVE TO SEE ALL OF THE BILLS, DOCTOR INCLUDED. EVERY ITEM FOR THREE DAYS FIND THAT WOULD MAKE A GREAT STORY. TOTAL BILL. LIKE TO SEE IF YOUR NEW SPINE IS WORKING.”
     This falls in to the “double-dog dare” school of reader feedback. The question he poses is legitimate, but the taunting tone so schoolyard — what are you, 14? — reflecting a paranoiac misunderstanding of how newspapers work, at least this one.

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