I was visiting a patient on my Monday morning shift at Treasure Coast Hospice. This was a gentleman in his late 50’s with cancer, who had been hanging on for over ten days. Family and buddies had come and gone, having to get back home both far and wide. I marveled at his tenacity. Just hanging on to that one thread from slipping into the netherworld. How does that happen?

If you don’t want to hear about death read no further. You would be joining many others who choose not to talk about it. They deny it exists. Our miracles of modern medicine convince us we can be cured of anything. We are not talking about what your body or psyche will be like on the other side. We are going to give you a few more precious months or years. Quality of life? What is that?
People have survived well past medical predictions. Some have even thrived and gone on beyond their wildest dreams. That is a marvel and a testament to their will and perhaps their faith. Yet so many cling to a hope that is a mirage. Their beaten bodies show up at our doorstep at Madera House. A battle well fought or a cruel injustice? Is it fair to the caregivers who have worked so hard for years? The question haunts me.
In hospice when a patient transitions it is quite evident. A person you spoke with yesterday may be in a semi comatose state. There is not so much a conscious decision but rather an automatic body response to survive at all cost. Your extremities become cold as your efforts to exist are centered in your torso. Breathing becomes more and more shallow and at times it seems to stop, only to frighten this poor old hospice volunteer to death by a sudden gasp. And then you pass.
If you are privileged to be there you realize a sacred event has occurred whether you are religious or not. There is a peace and quietude that ends a life of however long. When my son was born it was the beginning of being allowed in the delivery room for dads. The OB wanted to meet me to make sure I was not going to my knees. I was struck when he said that each time was a miracle. He opined, “There are five in the room and then there are six”. As I sat with this dying man I thought to myself, “There are three in the room and soon there were will be two”. The cycle of life.
Nobody wants to die but I don’t know of anyone who has beaten the rap. I think often of my own morality. I take stock on a regular basis and ask myself if I have lived a good life. It is not maudlin but sobering. “Life is precious” is more than a suitable aside after seeing trauma. I walk out of there humbled and with a different perspective on my crazy world.

Hospice is one of those institutions and philosophies that is so misunderstood. I have just been asked to join the board and I hope in the days to come to be part of a speaker’s bureau to tell our story. People freak out at the word and that is sad. It is the embodiment of empathy for one’s fellow man or woman. The word meant “inn” or resting stop in the journey during the Middle Ages. Indeed it is on this road of life.
Spouses and families are struck with denial and even a sense of abandonment when they commit to be part of us. The patient must be certified to have a prognosis of six months or less to live. Yet you can leave hospice at any time. We treat the pain of the illness not the illness itself. We do everything we can to make you and your loved ones as comfortable as possible. We are very good at it.
80% of Americans would rather pass in their homes rather than a hospital bed. In spite of this, 80% die in hospitals or nursing homes. We have both an in home and our residence program of care. We neither retard or accelerate your normal progression. You will be treated by some of the most caring and gentle professionals in the world. You are in our hands and we take that responsibility with the utmost of devotion.
Probably one of the most fascinating aspects of hospice is that people do enjoy a better quality of life. In Denver, I had a man in his eighties who escorted his wife’s stretcher into our residence in tears. He just blurted out to me. “I just couldn’t do it anymore”. I hugged him and told him he was home. I can’t tell you the number of families that state unequivocally they wish they had done it sooner.
The upshot of it all is that the patient is usually the one who get its most clearly. Their loved ones often don’t or are so intrusive as to create quite a ruckus. We are used to it but it is often comical when the one in the bed winks at me while the spectators think they are calling the shots.
I had a woman with ALS who chatted with me for about a half hour while scribbling on her IPad. She was beyond accepting of the hand she was dealt. She said the only problem was when people would start crying at her bedside. The two of us were laughing when she wrote,”They have go to get over this.” She gave me a big Thumbs Up as I departed upon the arrival of visitors. It is an amazing gig.
I love life. I love my wife and kids and grandkids and friends. I love doing what I do. In just about everything.
As always
Ted The Great
Factoids:
Medicare or Medicaid cover hospice and the cost of medication for your palliative care.
There are four levels of care:
Home Care: Patient visitation and monitoring. Usually one to two times a week by a RN or CNA.
Continuous Home Care: When a nurse is required for a continuous period of time.
Respite Care: To provide in our residence a break from caregiving for loved ones.
General Inpatient Care: For severe pain or other symptoms that require a skilled nursing environment.
Hospices are both Not For Profit and For Profit.
Hospices can provide grief counseling for members of the family as part of their mission. We all think we are rocks but it is highly recommended. Death is a life changing event for all.
In Denver there is a sign in the nurses station: “Angels Gather Here”. They sure do!

This morning I decided to take my Boeing 737 MAX for a spin. With everything going on today, the world has got to look a little better from 35,000 feet. Whoa TTG, that plane has been grounded. For mere mortals of course. Suffice to say
My airship banks hard left and the hard right trying to find some sort of equilibrium. I know the center is the preferred path but it is almost impossible to find it. Are we going to die? No stupid, just take it off automatic pilot. Trust your instincts.
If you can make it there you can make it anywhere. Bright lights and big egos. I think I will pass on the opportunity of a lifetime. I saw what they did to that little Swedish girl, Greta Thunberg. I read some critical assessments of her and these dudes don’t pull any punches. How dare she?
The foot stomping fiddling on Saturday night celebrates another successful passage of the week. The lyrics are at the same time sweet and gut wrenching, talking about the vagaries of life. The rise to the top of stardom and the crash beneath the collapse or booze and drugs. It is hope, love and tragedy all rolled into one. When was the last time I felt that?
Dedicated to country’s old-time roots, the Opry prohibited the use of electric guitars until after WWII, and drums weren’t allowed onstage until 1973. This conservatism extended to artists as well: a young Elvis Presley made his only performance at the Opry in 1954, and was asked politely to not come back.
I have been struggling with this session of Ted’s Head for three weeks. It is not that I have writer’s block but there is just too much jammed into my little brain. We have just completed a 3,000 mile version of Ted’s Magical Mystery Tour. From start to end there are stories to be told and experiences to relate. I hope I get it right.
We played golf and ate and drank too much single malt over a cigar one night. He is a hoarder and he brought out yearbooks where you looked like a dork or handsome devil depending on the time frame. Here’s to the brothers who are no longer with us.
The Biltmore in Asheville was built by George Washington Vanderbilt in the 1890’s and is till owned by his descendants. It weighs in at 179,000 square feet. It has 250 rooms including 35 bedrooms. I would love to have the listing on this place when they sell.
Fionn Fereira, hails from a remote town in Ireland. This teenager was walking on an isolated stretch of beach and happened upon a rock covered with all forms of plastic. With limited resources he researched what is a problem worldwide, microplastics. All by his lonesome and with no testing facilities, he developed a procedure to fitter water and won the Google Young Scientist Award of $50,000. He will be studying chemistry at the University of Amsterdam this year.
Producers thought she was mentally ill and she was admitted to a psychiatric hospital for three days after her performance. Silly boys. She just celebrated the 10th anniversary of her career.
Does a Mom or Dad consider their child too uncoordinated or aggressive enough to warrant the special attention among their other brothers or sisters ? Ditto trying to get into the chorale or AP courses. You will hear a parent describe their child as a nice kid but not exactly the sharpest knife in the drawer. Yikes!
You have often heard me cry in dismay at the “Why change, we have always done it that way” directive. It is that reluctance to try anything new or accept that maybe there is a different way to look at things that makes us stale and prone to obsolescence.

Since primitive days of humanity, the only way to survive was to protect oneself from wild animals or the local invaders. 
Unfortunately we are too busy making money or protesting about those that do, to employ some deep and serious soul searching. Maybe I think too much. It is a tragic flaw. Unfortunately the story line of this fairy tale ain’t looking too good right now. I hope I am wrong.

Did you ever come upon a small town either here or abroad and find yourself saying what a cool place? These people gather for coffee, fish in the local stream and the kids play sports at the local sand lot. Do you say these people don’t know what they are missing or maybe we don’t know what we are?
Set goals but make them reachable.
Can you be discontent with the world but content with you? I think so. How about you?
We are spending a couple of days with each of our kids’ families and then back we go. You know the old saying,”Fish and Family…They stink after three days”.
How about tear assing down a mountain path and
The college entrance scandals are symptomatic of parenthood gone awry. We bow to their every need. We are their sole sort of support both financially and psychologically. We have immersed them in bubble wrap.
Did they derive their thesis from years of study or is it the diploma of the streets that gives them a sense of authenticity? You and I have all run into someone who spouts off with not a lot of know how. Such are our times.



Can’t we come up with some sort of resin or epoxy that is indestructible? Isn’t there some genius out there come up with these seemingly simple solutions? Probably not sexy enough to spend one’s time on.
Maybe we should reestablish our priorities? Wouldn’t
The cost to the US alone is pegged at over $300 billion.
A couple of month’s ago, when I saw Notre Dame burning it was quite startling. A few years ago Kathy and I visited this wonderful cathedral. As we walked around the interior perimeter I remember thinking of the history involved. Not so much the art work but how many people had come and prayed and gawked over those centuries.
There was a fellow down at Desert Mountain in Scottsdale who built a 10,000 square foot house with two bedrooms. Go ahead. You can spend your money any way you want, but isn’t that a tad gauche?
Cut us open and we are all the same. We treasure our looks and our place in society. When it is over who really cares? Your clothes or cars or undrunk rare wines in your cellar are residue. Did you leave the world a better place or is the world better without you? Interesting question.