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Posts Tagged 'Health'
A Whirling Dervish Named Jane: Riding RAGBRAI
August 2, 2016 leoadambiga	Leave a comment
Jane Reuss is a human perpetual motion machine. Anything that gets her moving and keeps her fit, she's on it. She loves notihng more than getting on her bicycle and going for dozens of mile. She's been doing it most of her life. A 60-70 mile roundtritp is routine for her. More challenging is the annual RAGBRAI ride across Iowa she makes. We were fortunate to catch her at rest for an interview before she raced off another of her jaunts. This is my Omaha Magazine (http://omahamagazine.com/) profile of her.
A Whirling Dervish Named Jane
Riding RAGBRAI
©Story by Leo Adam Biga
©Photography by Bill Sitzmann
Originally appeared in the May/June 2016 issue of Omaha Magazine (http://omahamagazine.com/)
When the Register's Annual Great Bicycle Ride Across Iowa (RAGBRAI) rolls around in July, Omahan Jane Reuss will saddle up with her Team Angry mates for the 15th consecutive year.
Reuss has cycled since childhood. Back then she would traverse the Interstate to Council Bluffs to get her Gitano serviced. Nowadays, she treks 80 miles on a single ride. She and her husband, Jerry, a retired Omaha firefighter, keep a getaway cabin in North Bend, Nebraska. The ride there takes four-and-a-half hours, but Reuss says it's a breeze.
Getting on a bike and going somewhere, anywhere, is her therapy.
"I just love it. It's like my time. Nobody can ask me anything," Reuss says. "I don't have to do anything except ride my bike, listen to music, or a book on tape. It's time off from my normal routine."
Reuss also golfs, swims, skis, and works out at the gym. Jerry joins her on shorter rides, and the pair play sand volleyball together.
"There are some mornings when I think I should just sleep in," she says. "But I don't know who I am if I can't be active."
Though she used to run, rollerblade, and even compete in women's triathlons, she prefers cycling now.
"It's a great, stress-free activity for any age, especially as you get older," Reuss says. "I'm seriously more comfortable on my bike than anywhere else."
For years she's commanded the road atop a Greg LeMond road model bicycle she's affectionately dubbed "Old Blue."
Reuss can't wait to do the week-long RAGBRAI again with riders she considers family.
"We do feel a real camaraderie. We do a lot of bike rides during the year away from RAGBRAI. We've gotten to be good friends," Reuss says.
Then there's the folks she encounters along the way.
"I love meeting people. The townsfolk are great," Reuss says. "It's a big party for them. They love us because we spend money."
She and fellow team members stay with host families while completing the 460-plus mile route.
Beyond the social aspects, Reuss enjoys testing her limits.
"I love the physicality of it. I love that I can do that," Reuss says. "I love the sense of community and accomplishment."
Not everything's ideal. She's waited out tornados in barns, slept in tight quarters on hard floors, and taken communal showers in school gyms. On one ride she took a hard fall that left her with a broken rib and punctured lung. After treatment, Reuss kept riding.
Reuss says she relishes challenges. Projects fill her garage and house.
"Thank goodness Jerry doesn't mind," she says. "He's very supportive."
In addition to bicycling, Reuss creates sculptures, often bicycle-themed, and works part-time at the Saddlebrook Branch of the Omaha Public Library. She sells her art at the Garden Gallery in Elkhorn, and even has a new commission to make a metal eagle for Eagle Run Golf Course.
In July, Reuss will be all geared up in jersey and gloves with a headband reading, "Not a sagger." Once again she will ride from sunrise to sundown atop "Old Blue," passing more than 400 miles of the Grant Wood landscapes called Iowa.
"I'm determined to do all the miles."
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Categories: Cycling, Fitness, Health/Wellness, Jane Reuss, Omaha, Uncategorized Tags: Cycling, Fitness, Health, Iowa, Jane Reuss, Omaha, RAGBRAI
Love Donor – Larry & Amee: A Father/Daughter Love Story
May 21, 2016 leoadambiga	Leave a comment
Here is a story I did some time ago about a prominent father and daughter in Omaha, Larry Kavich and Amee (Kavich) Zetzman. Their family business All Makes Office Equipment is a four generation success story. Just as Larry succeeded his father, who succeeded his own father in running the business, Larry eventually passed the business onto his daughter Amee and his son Jeff. After putting it in their good hands Larry was leading a carefree life enjoying his many hobbies and pursuits when he got sick. Suffering from advanced renal failure – his kidneys failing – his only option became an organ transplant. Amee became the donor for this life saving procedure that has given him a new lease on life and brought the already close father-daughter relationship even closer together than before.
I did this story for Metro Magazine (http://www.spiritofomaha.com/Metro-Magazine/The-Magazine/) and I am posting it here for the first time.
Read an earlier story I did about the multi-generational All Makes at–
https://leoadambiga.com/2012/06/17/bedrock-values-at-the-core-of-four-generation-all-makes-office-furniture-company/
Love Donor– Larry & Amee: A Father/Daughter Love Story
©BY LEO ADAM BIGA
Originally appeared in Metro Magazine (http://www.spiritofomaha.com/Metro-Magazine/The-Magazine/)
Larry Kavich and his daughter Amee Zetzman have always been close. They worked together at the family's fourth generation All Makes Office Equipment Co., where Larry headed things until turning the business over to his son Jeff and daughter Amee a few years ago.
The proud papa gave his "little girl" away in marriage. Amee and her husband Ted Zetzman have given Larry and his wife Andi two grandchildren. But the father-daughter bond went to a whole new level when Larry's advanced renal failure necessitated a transplant earlier this year and she donated her kidney.
Thus, Kavich became one of an estimated 28,000 persons to receive an organ transplant in the U.S. annually. More than 114,000 are waiting list candidates. Amee's one of 7,000 live donors projected to give an organ this year.The procedures took place March 19 at the Mayo Clinic in Phoenix, Arizona, near Larry's and (wife) Andi's snowbird residence in Scottsdale. Father and daughter went into pre-op together and separate teams performed the surgeries in adjoining operating rooms. Weeks of testing preceded the transplant to ensure the best possible match. After four hours of general surgery Larry had a new kidney and just as hoped his body accepted it without complications.
After only four days in the hospital and frequent followup visits, he's back to the full, active lifestyle he knew before his kidneys failed.
Far from the arduous experience Zetzman says donating is assumed to be, the two-hour laparoscopic procedure left only "three little scars." Compared to her C-sections, she says it's "no big deal…it's doable."
Hours after the transplant she walked down the hall to find her father sitting up in bed. She returned to work half-days about a week later.
Kavich says "it's a miracle" she gave him this gift and resumed her life without major interruption. Amee feels she only did what anyone would in the same situation. "If you knew you could change someone's life and you would still be OK wouldn't you do it?" she asks.
Still, her father expresses gratitude every week. And not just to Amee. His son Jeff Kavitch also offered to donate. (Mayo will only test one candidate at a time until a suitable match is found.) The siblings decided who would be tested first with a coin flip. Once her donor suitability was confirmed the transplant was scheduled. Amee says she and her family were "very proactive" in educating themselves and pressing for answers. "You have to be your own advocate," she says.
"I have a fabulous support team in my family," Larry notes. "We're the poster family for how things should happen. We're very fortunate to have had everything that could have gone right go right, and for that I'll be forever grateful to Mayo and to my children and my wife."
A Curious Journey
As Kavich readily admits, he's an anomaly in how his transplant journey unfolded . His new kidney functioned just as it should from the moment of insertion. His creatinine level and glomerular filtration rate steadily improved to where today they're normal, something they hadn't been since this all started in 1981. That's when Kavich, who's beaten Krohn's disease and prostate cancer, was diagnosed with a rare disorder, Wegner's Granulomatosis, that attacks kidneys and other organs.
"I had it 31 years ago and then the disease subsided and 15 years ago it came back," he says. "On each occasion I was put on chemotherapy and high doses of steroids. It was a very unusual circumstance because I never manifested the symptoms that my numbers would have indicated."
No loss of appetite or energy. No curtailed activities. It left doctors scratching their heads and Kavich feeling "I've been blessed." He was always told that despite how well he felt he'd one day need dialysis and a transplant. Not wanting to believe it, he says he was "living in the land of denial" in one respect but also maintaining his natural optimism in another respect.
He says Nebraska Kidney Association CEO Tim Neal connected him with people who are transplant success stories and provided "support and encouragement." He learned healthy regimens for eating right, drinking plenty of water and exercising. His wife filtered out any negative info. He wanted to keep everything positive.
He continued feeling well and living an unrestricted life despite progressive kidney disease, but late last year he finally had to face facts. He needed a transplant and doctors said he shouldn't hesitate if he had a living, willing donor. His children had already offered but he'd refused. Waiting for a cadaver donor could take years and his condition would require dialysis in the interim. The one thing he didn't want was a compromised life.
No Other Options
At a doctor's urging he and Andi visited a dialysis center, where he says, "I saw what would have been my worst fear come to pass. I completely broke down. That's when my wife called the kids and advised them I was in trouble." After Amee emerged as his donor she pressed for the procedure to happen as soon as possible so that her father could bypass dialysis.
"Once I got approved I was very persistent and they were totally accommodating in working with us, and my father did avoid dialysis."
In the extensive physical-psychological vetting process to determine a live donor match she says great pains are taken to ensure donors like herself are doing it for the right reason, i.e. not getting paid. She says it's made clear that one can opt out at any time for any reason.
Did she have any second thoughts? "I didn't. Once I made up my mind I was, 'Let's get this done.'" Transplant day, she says, is a blur of feelings. "It's an emotional situation for the family because we're both being wheeled away to surgery at the same time. It definitely affects the whole family, in all aspects."
Like her father she's struck by "the miracle of it," saying, ""It is pretty unbelievable that they can take part of my body and make it work with his. And his numbers from day one were great. Mine went back to normal quickly as my body adjusted to just having one kidney. It just all worked so fast."
Just as her father had ample support, she counts herself lucky to have had a support network. Her husband and kids, she says, "were on board, they knew papa was having issues. I have a good circle of friends who covered all my bases, and I have a brother who covered my office base. Not everyone is in that position," she says, adding that the National Kidney Foundation is trying to devise programs" to assist donors with things like childcare and out-of-work benefits they may need.
Enhancing Lives
The family wants the public to know what a difference organ donation can make, whether getting on the national donation registry or volunteering to be a live donor.
"Towards the end when my kidneys were definitely failing my future and my ability to live any sort of life was impaired. I would not be leading the life I'm leading had the transplant not occurred," says Kavich. "I am the richest guy you know and it has nothing to do with money."
He gives back today by volunteering with the Arizona Kidney Foundation. "I will go anywhere and talk to anyone about my experience," he says.
Another way to assist the donation community is by contributing to your local kidney foundation or association to help its mission of building awareness through education, screening and referral programs-services. For details, go to http://www.kidneyne.org or call 402-932-7200.
Categories: All Makes Office Equipment, Amee Zetzman, Business, Entrepreneurial, Entrepreneurs, Family, Jewish Culture, Larry Kavich, Omaha, Uncategorized, Writing Tags: All Makes Office Equipment, Amee Zetzman, Amme Zetsman, Business, Family, Health, Larry Kavich, Omaha, Organ Transplant
Sex talk comes with the job for Douglas County (Neb.) Health Department HIV-STD specialist Sherri Nared-Brooks
February 11, 2015 leoadambiga	2 comments
Talking sex is what Sherri Nared-Brooks does for a living. As the Douglas County (Neb.) Health Department HIV-STD Prevention Specialist she makes it her business to find out what risky behaviors people are engaging in and to get them tested and informed to help prevent them from becoming new casualties in the epidemic of sexually transmitted diseases impacting urban Omaha, particularly the Africa-American community. My profile of her and her work is in the February 2015 issue of The Reader (www.thereader.com).
Sherri Nared-Brooks and her mobile sex ed-STD testing clinic, ©Debra S. Kaplan
Sex talk comes with the job for county HIV-STD specialist Sherri Nared-Brooks: Telling it like it is no problem for this veteran on the sexual health frontlines
Now appearing in The Reader (www.thereader.com)
America's schizophrenic about sex. Images and hookups abound, yet in this information age many folks don't know, follow or discuss safe practices. That incongruity explains why sexually transmitted diseases are at epidemic levels and why things never slow down for Sherri Nared-Brooks in her role as Douglas County Health Department HIV-STD Prevention Specialist.
Her main focus is North Omaha, where the epidemic's acute among African-Americans. Her deep ties there, along with her straight talk and personal mission, give her street cred making the rounds at barber shops and clubs.
"I believe in keeping it real, so I talk in the vernacular they understand," she says of young men and women she encounters at her office or out and about.
She knows urban sex slang and doesn't make moral judgments.
"It's about accepting people where they're at and reminding them the things they're doing are putting them at risk, so whether it's at the jail or at a barbershop or I'm walking down 24th Street, I pass out condoms. They may not know my name, but they know me as the Condom Lady or the STD Lady."
She addresses the topic, too, at prisons, hospitals, schools, churches, community centers, health fairs. Always looking for nontraditional sites, she has eight public libraries holding screenings.
In her experience young people are cool talkng sex but what kids get at school, home, worship center or doctor's office is often woefully inadequate. That leaves teens gleaning often wrong or insufficient info where they can. Denial and magical thinking – "it happens to other people, not me" – run rampant. She fills gaps, dispels myths and emphasizes anyone not using protection or practicing abstinence is at risk, period. It's about education and testing, but it starts with self-worth.
"It's just about loving them and wanting them to love themselves. It's getting people to understand they're important and they need to take responsibility for their own health. I teach women they're the prize. When you know you're the prize you're not going to just give yourself to anybody, because once he gets it from you he wants it from your friend, your cousin. If you keep yourself, he doesn't have a choice but to respect you because you're respecting you.
"The things I teach I had to learn over my own lifetime," she says.
Raising five kids helped prepare her.
Then there's the fellas.
"I tell guys, if she's having sex with you that easy, you need to be afraid because she's giving it to everybody else, too, and if she's saying she doesn't want to use a condom you really need to be afraid."
When you have sex with someone, she stresses, you essentially have sex with everyone they've been with. It's all about exposure. She imparts the same message to folks engaging in same-sex relations.
She enlists business owners as foot soldiers in the fight to reduce STDs. Alesia Lester at Gossip Salon, 5625 Ames Ave., is glad to help the cause. "Sherri comes in and educates us and that allows us to educate the client. She makes people aware. She's very passionate about it and it's so needed. I had a child at 15. I didn't understand myself, so I definitely didn't understand my body. I wish I'd had someone that could have sat me down and talked to me without me being afraid my mom would know. Sherri makes it plain and people respect her."
"To me, they're champions in helping get the word out to educate people," Nared-Brooks says of community partners like Lester.
Nared-Brooks targets barbers, stylists, bartenders on the theory people open up about their sex lives to them. "You may not tell your doctor, but you're going to tell your barber. They know who's doing what." She schools owners on the basics, leaving condoms, fact packs and kits for on-site testing. Lester welcomes it all. Both women say confidentiality is maintained throughout.
With so many places to hit and so many people at risk, Nared-Brooks ends up doing much work on her own time.
"It needs to be done."
She calls her personal SUV "the STD truck" for all the supplies it carries. She trains others to do prevention-education work and she'd like to train more."There's only one of me," she says.
She's encouraged her strategy's working when proprietors take the lead. Lester and her salon colleagues all tested and customers often ask for kits. Confirmation comes, too, when people seek the STD Lady's advice about behaviors or symptoms and come in for testing.
"That makes me know I've done my job. Until we look at getting tested for STDs as a regular checkup and take away the stigma of it, the numbers are going to stay high. We need to give the message it's OK to get tested and it's kind of crazy to not get tested. You need to do it for yourself before you start sharing with someone else. And show each other your test results. Before my husband and I got married we showed each other our paperwork.
"It's about loving me."
Her husband, Walter Brooks, joins her on the front-lines of sexual health. They earned the Nebraska AIDS Project's Shining Star Award for their awareness-prevention efforts. It wasn't their first recognition. He covered prevention as a University of Nebraska Medical Center public relations specialist and still does for the Omaha Star. They met when he interviewed her.
She accepted his invitation to speak at his church. They've been a team ever since.
"My husband is awesome. He's like my biggest fan, my biggest advocate. We do this community service together. He knows it's not just something I do as a job. Right now, it seems like for me it's life.
"When I stand before God and give an account of my life I want to know I used all my talents."
Categories: African-American Culture, Education, Health/Wellness, North Omaha, Omaha, Sex, Sherri Nared/Sherri Nared-Brooks, Writing, Youth Tags: Douglas County Health Department HIV-STD Prevention Specialist, Education, Health, North Omaha, Sex Ed, Sherri Nared, Sherri Nared-Brooks
Lela Knox Shanks: Woman of conscience, advocate for change, civil rights and social justice champion
August 4, 2010 leoadambiga	2 comments
UPDATE: As the world turns these days I know when the subject of one of my stories on this blog is in the news by the corresponding uptick in views. When I noted dozens of viewers landing on my profile about Lela Knox Shanks I hoped for the best but suspected the worst, and sadly as some of you reading this right now already know she has passed away after a long illness. She is a woman worth remembering and if you haven't read the story below yet I trust you'll take the time to. If you don't know nothing about her, then by all means familiarize yourself with some of her work and experiences in the civil rights and social justice struggle. If you knew her or her story, you still might find oout something new about her you didn't know before. In either case, you'll be honoring her memory by reading about her good works. Rest in peace, Lela.
New Horizons editor Jeff Reinhardt told me about the subject of this profile, Lela Knox Shanks, and I'm glad he did. I'd never heard of her, but she's someone who deserves to be more widely known because she's spent the better part of her 80-plus years doing the right thing in the struggle for freedom, justice, and equal rights. Jeff and I drove to meet with her at her home in Lincoln, Neb., and we were both captivated by her unwavering commitment to equality. She's taken many brave stances in her life and she's paid some dear prices, but she's never backed down, never given up. She's a model and an inspiration for us all. I think you'll find as memorable and impressive as Jeff and I did.
JILL PEITZMEIER / Lincoln Journal Star
Lela Shanks, pictured in her home in 2008. (LJS file)
Originally published in the New Horizons
Activist, humanitarian, scholar, speaker, feminist and author Lela Knox Shanks could be excused for getting weary after a lifetime of agitating for equal rights. As an 81-year-old African American who came of age in the Jim Crow South and fought many civil rights battles in the Midwest, she's stood up against injustice. She's picketed, protested, demonstrated. She's written countless letters to elected officials.
Driving up to the cozy home in Lincoln, Neb. she's resided in 43 years, expressions of her activism are visible in sloganed signs on her porch: "War is not the answer," "Every human being is born legal," "The State should be about life, not death." She's butted heads with the-powers-that-be. She's advocated for the oppressed. At various times her activities have made her the object of harassment and surveillance. She's been arrested but never convicted for her civil disobedience.
Her partner in life and in social justice causes was her husband of 50 years, the late Hughes Hannibal Shanks, who developed Alzheimer's Disease in the mid-1980s.
A fellow product of the South, he fought his own battles on the job and in the community. Together, the couple proved an immovable force, never backing down from a perceived wrong, always striving to do the right thing. They saw much social progress flower in America, including gains by minorities in education, employment, housing. Their children, now grown with families of their own, are all professionals. The prospects for their grandchildren, bright, too.
AD marked the progressive loss of her best friend. She was Hughes's primary caregiver when little information about the illness or how to care for loved ones afflicted with it existed. She did what she always does when confronted with an obstacle, she educated herself and threw herself into finding solutions.
Hughes had been the family radical. He presided over lively discussions at the dinner table. Everyone was expected to join in. He and Lela were kindred spirits with their keen social consciousness. As dementia stole more and more of him, she said, "the thing I missed most about my husband was that I didn't have anybody that I could share that kind of intimacy of conversation with."
Her odyssey caring for him was a profound experience. It led her to write a book, Your Name is Hughes Hannibal Shanks: A Caregiver's Guide to Alzheimer's, that received praise upon its initial 1996 publication and 1999 reprint. It was a fitting project for a woman who earned a college journalism degree and worked for the famous black newspaper, The Chicago Defender, but who abandoned a dreamed-of career as a writer in deference to Hughes's wish she not work but raise the kids.
Reception to the book was so strong she became a much-in-demand public speaker, thus ushering in a new phase in her life as a lecturer and independent scholar. For years she's shared her insights on caregiving with audiences around the country. She's also given many talks about women's empowerment, once serving on a United Nations panel addressing the subject.
She's made many African American history presentations, too. Just as she became an expert on caregiving for AD by reading everything she could find on it, she researched black history so she could share this rich heritage with others.
"When I became a speaker on African American history for the Nebraska Humanities Council," she said, "I made a comprehensive study of it."
That's the way Lela does things. No half measures. It's all or nothing with her.
Her interest in history was stoked by the legacy of her great-grandmother, Hannah Mason McCrutcheon, who was born a slave. Lela knew her well and said this matriarch's proudest moment was having seen Abraham Lincoln speak. This is why Lela's so passionate to have history disseminated.
"I went to segregated schools (in Oklahoma) and in my school I took Negro history," Lela said. "So I grew up learning it. Plus, I heard famous African Americans speak at my high school. Mary McLeod Bethune for one."
Slavery was a taboo topic, however, in her family. Whenever Lela tried bringing it up with her elders, she said, "It was always, 'Baby, we don't talk about that.' It was too awful." It's a painful enough history that generations later some descendants of slaves would rather not be reminded of it. "I have relatives today that don't want me to ever say anything about that. I guess its' so degrading."
Linked as she is to that past Lela testified before the Nebraska Judiciary Committee last April in support of a resolution (LR284) that the state apologize for slavery.
"Words cannot really express the emotion I feel, living long enough to testify at such an historic hearing," she told members. "An acknowledgement by this official body of the historical facts of injustices perpetrated on African Americans due to race, dating back to the Nebraska Territory, clears the air and provides an atmosphere in which honest racial healing and reconciliation can finally begin to take place in Nebraska.
"Passage of this official document can hopefully provide school administrators and teachers with the courage and the information and the permission to teach, finally, an inclusive American history not yet included in American history textbooks, thus preparing all Nebraska children with a better understanding of themselves and their prejudices…and to live in the larger, multicultural world…"
After Hughes died in 1998 there was a hole in her that could not be filled. No one could have blamed her if she'd retreated from her public life. But she's gone right on fighting the good fight. That's because adversity is her old friend. "We were born into it," is how she puts it. Life in the South was a constant reminder to blacks of their second-class citizen status. "It was something I was constantly plagued by growing up," she added. "One of the hardest things for me to accept was why I have to be treated this way. Why can't I do something about this?" The experience toughened her for the hard times.
"My husband and I didn't set out to be activists. We really just wanted to have whatever a so-called normal life was and raise our family, go to church and do the things that were acceptable, support the government where we could."
©photo by Robert Becker
Lela Knox Shanks has enjoyed pressing flowers almost all her life. Her husband made the frames and she said she gave at least 500 as gifts.
Racism made that difficult. Said Lela, "From time to time as African Americans you get so tired of it all. You would like for it to just go away. You'd kind of like to not have to think about it. But we could not ignore it, there was just no way."
She and Hughes, a World War II vet 10 years her elder, met at Lincoln University outside St. Louis. She graduated with a journalism degree and he with a law degree. He worked for the Social Security Administration. They started their family in segregated St. Louis. When denied the opportunity to apply for jobs he was qualified for he moved the family to Denver, Colo. in the early-'50s.
"Denver was like heaven," she said, "because we could go to the swimming pools, we could go to the museums, we could go to restaurants. It was wonderful."
But when the couple's oldest child, Nena, was denied equal access to the education they wanted for her, Lela drew the line.
"I went to the Urban League, the NAACP, all the civil rights organizations, to see if there was anything they could do about the problem," she said. "There wasn't any help coming from anybody, and I just threw myself across the bed and cried, and then it just came to me — You're the one who's going to have to do something."
Questioning authority is something Lela inherited from her Okie upbringing.
"I'm not sure my parents would have even known civil rights, it was just that my mother was given intuitively the ability to speak up for herself. She was not afraid to be her own advocate, and I always say I learned that at my mothers breast because I never had that problem. It's a great feeling to feel like you always have the inner strength to speak for yourself. It was just given to me — that's the only way I can explain it."
Growing up under such "a powerful person" as her mother, who "defied whatever" was in her way, Lela knew she, too, could stand up for her rights.
This same sense of independence is something Lela and Hughes instilled in their own children. As a token of their admiration and appreciation for that lesson they presented her with a card that simply reads, "Question Everything." It's displayed on the mantel above her fireplace, next to some of her many awards.
"That's what my children gave me because that's what we had taught them — question us, because if you don't question us and state yourself and stand up for yourself as a human being with us, you won't stand up to other authority figures. And that's what you have to do in life — you've got to be your own advocate. You can't depend on somebody else being there for you."
When the time came for Lela and Hughes to stand together, they never wavered.
"We were different in many ways but we were essentially the same when it came to what was important to us. When we were courting we talked about what was important to us in life. We wanted to help our people but what, of course, I came to realize was that I was helping myself."
Faced with an unfeeling educational system and Hughes once running into a glass ceiling at work, the family left Denver for Kansas City, Kan. at the height of the civil rights movement. There, they butted heads with the public school board. She said boards then used such tactics as gerrymandered school boundaries, selective pupil transfers and feeder schools "to keep the schools separate and unequal."
Upset by this bias the couple joined others in lodging complaints and finally withdrew their children from school to enroll them in a "protest school" they opened at home. Others joined the protest by removing their kids from the public schools and having them attend what students lovingly called Shanks University.
Ten children in all attended Shanks U that 1962-63 school year. Lela was their primary educator. The ruling class though took a dim view of this renegade school operating in defiance of the established order.
"We were going against the power structure so they weren't about to certify us and that's why we were arrested for truancy," Lela said. "We didn't trust any of the attorneys there and so we went to Topeka to retain Elijah Scott, the attorney who filed the original brief for the Brown vs. Board of Education case."
The arraignment proved traumatic. Lela remembers: "Our attorney went to post the bond and while he was gone a couple deputies came over. One pulled on me from one side and the other pulled on me from another side, with my husband and children standing there. My husband knew not to move, not to say a word. The children though were yelling and screaming, 'Mama, Mama,' and hanging onto my legs, because it was obvious they were trying to take me away. That was the most terrifying thing about that experience."
Scott returned just in time, her bond posted, and she was released. Lela and her family left the courthouse breathing a sigh of relief.
In retrospect Lela said, "I can't even begin to imagine what would have happened to me if I had actually been jailed, because African Americans were telling us it was stupid what we were doing — that we were going to get killed. A lot of the parents wouldn't let their children play with our children. They were afraid because they just knew whatever we were doing we weren't going to win and something terrible was probably going to happen to us. In those days African Americans could be killed and nobody gave a second thought to it."
Lela ran afoul of authorities again when she and others were arrested for picketing outside a federal building. By this time she was active in CORE or Congress for Racial Equality. She was ordered to appear before a federal grand jury. Hughes couldn't be with her — he was in the nation's capitol for Martin Luther King Jr.'s historic march and speech on the mall.
She stood up to that inquisition with uncommon grace and eloquence.
"The first question a juror asked me was, 'What were you doing picketing the federal building?, and I said, 'I was doing what my husband is doing right now, and that's marching for my freedom.'"
Lela was acquitted but intrusions into her and her family's private life continued.
She said their home phone was tapped and that on one occasion three FBI agents showed up unannounced when she was home alone with her youngest child, Eric, demanding she answer questions, "trying I'm sure to intimidate us."
"They (the FBI) went on my husband's job and they went on the jobs of several other people who had been picketing," she said. "We received some death threats, just like all the rest of the people who spoke out."
Despite the risks, the Shankses stood firm. "We would not have done what we did if we had let fear take us over," Lela said.
Meanwhile, an integrated lay Catholic social action committee took up the fight to get black children an equal education. Lela welcomed the support.
"We decided it would not be wise to put our children back in public school. We were really afraid of reprisals. We had already had an incident with our oldest child," she said. "The black teachers were afraid for their jobs. They knew that in integration the black teachers lost out initially. They were the first to be let go. A lot of these principals and teachers we'd gone to college with. They were my sorority sisters, his fraternity brothers. And those people didn't want to have anything to do with us. We were pariahs, we were troublemakers."
As Lela can attest, being an activist can be lonely.
"It was always a struggle. I'm a human being and I wanted a fine house and a fine this and a fine that, like anybody would want, but I just found I had to forego that to do what I knew deep within was the right thing to do. We had both agreed that trying to do away with segregation was more important than making money."
After much wrangling the social action committee arranged for the Shankses and other parents to enroll their children in a Kansas City parochial school.
Hughes was transferred to Lincoln in 1965. The family found a home in an all-white district. He and Lela knew little about Nebraska besides it being the birthplace of Malcolm X and the home to a militant young barber, Ernie Chambers, "who dared to speak the truth to power." Forty-three years later she praised the outgoing state senator at a dedication naming the capitol's judiciary review room in his honor.
Before Hughes moved his family up north he went on ahead alone, unsure what reception awaited a black man in the Woods Park neighborhood. As a precaution, Lela said, he slept on a board in their home's bathtub. When a week passed without incident, he had Lela and the kids join him. One neighbor, who later became a close friend, asked Lela if they wouldn't feel more comfortable in the Malone area, a black section. Another neighbor circulated a petition "to get us out," said Lela. Nothing happened. The family wasn't going anywhere anyway.
Lincoln became home. The kids went to public schools — often the only blacks in their classes. Hughes still brooked no inequity at work. Once the nest was empty he finally relented and let Lela work — as a field supervisor for CETA with the Nebraska Department of Labor. She's immersed herself in Nebraskans for Peace.
The journey that is her life is "an evolutionary process" to "break through the boundaries of tribes, ethnic groups, religions, nationalities" that, she said, separate us. Her search is to "find that common thread…that lives in all of us and links us one to the other." She said this "unseen force pushes the human race forward to do new things, such as discover cures, invent the computer and to elect a Barack Obama. The change we need is already here. We just have to catch up with it."
Like most folks Lela's age the idea of a black president seemed remote and yet Obama's attained the highest office. Did she think she'd see it happen in her lifetime? "No, I did not, but without a doubt I knew it was possible," she said.
"Hughes would have celebrated Obama's election. We would have hugged each other and cried together." The way she sees it, Obama seized a moment in time when America was ready for historic change.
"Obama is a man for his time," she said, "and this is his time right now. I think the time is more important than the person. I don't think you can stop a thing when its time has come. You just can't stop it. And he's the man at this particular time."
No matter what happens during his administration, she said, things will never be the same because his presidency has broken barriers once thought unbreakable.
"Even if he's the worst president…it still will have changed this world, not just this country," she said. "It's inevitable that there will be psychological effects on peoples around the world, and that's just for starters."
The fact the White House is occupied by a strong black family presents an image that not all the marches during the entire civil rights movement could project. Obama's victory is a culmination of what that movement and a lot of other efforts to combat discrimination and racism fought so hard to bring about.
Lela recalls how not so very long ago even the suggestion that blacks be portrayed in the popular media like anyone else amused or appalled producers, whose views, she said, reflected the demeaning way blacks were held.
"I remember when I would hear advertisers on television laughing when asked, 'Why don't you use African Americans in commercials?,' and, 'Why don't African Americans ever kiss on television?' These were big Madison Avenue advertisers and they thought it was funny to even ask the question," said Lela. "Their reply was, 'White people wouldn't be interested in seeing African Americans kiss or caress. They don't want to look at them on TV.'"
The Cosby Show disproved that notion. That was a situation comedy though. Oprah's immense popularity has given lie to that thinking as well. But she's a talk show host. The Obama presidency is on a whole different scale.
"Every day now there's going to be a black face on TV for the world to see." Lela said. "I mean, they'll see his two little children and his wife, and him with his family, and see these people acting like what they are — human beings. That's part of that psychological effect that it will have."
Looking at things from a broad perspective, Lela believes the Obamas will do much to supplant the dehumanizing stereotypes that for so long have been used to denigrate African Americans. The First Family's example won't eradicate racism, she knows, but it will expose the fallacies of long ingrained beliefs that blacks are somehow inferior or different.
"The people who say that are people who have not yet discovered their common humanity," she said. "That's ignorance, sheer ignorance. That's the way I would describe it, because when you discover that common humanity then you know at least intellectually that you have to accept everybody as they are. It's the same with any of the differences (between people). When you get right down to it we're all just people. All wanting the same thing pretty much, and all doing the same things pretty much every day. Why can't we get this through our head?
"That doesn't mean I'm going to agree with everything you say. I certainly don't agree with some of the things Obama says. But you see when you discover that common humanity and you know that that DNA is virtually the same in all of us, you don't think like that anymore."
If nothing else, she hopes the Obama factor opens the door to multiculturalism.
"You know the great tragedy of the bigotry that we have so made a tradition in this country is that it denies us the enriching life we could have if we opened ourselves up to three fourths of the rest of the world's population, because three fourths of the world's population are people of color."
Her extensive travels to speak across Nebraska convince her the state is a microcosm for a parochial outlook on the world.
"Nebraskans have not permitted themselves to really learn enough about the rest of the world," she said, "and I think many Nebraskans still envision that the world is just like Nebraska — mostly all white."
Along with a broader world view, she's hopeful "a more inclusive history" — one that includes the whole of the African American experience — will be adopted and taught in schools, where there's a paucity of materials from a black perspective. "You can graduate from college with a Ph.D. having never read a book written by an African American," she said. It's something dear enough to her she's gone out of her way to promote it at teachers conferences.
"I made up a bibliography of books for children about black Americans in l986 to give to teachers. I took about 25 books with me to show to them. These were primarily children's books about every aspect of African American history, culture and life. Some of the schools where I spoke in during the '80's and '90's either had no books or very few about African Americans, so for awhile I bought books and donated at least one to their school libraries in honor of Hughes.
"When I talk on African American history I say, 'The important thing for you to know about the slaves first of all is that they laid the foundation for this country to be the number one economic power in the world through those 200 years of free labor.' Nobody ever talks about that. Let's talk about what African Americans were doing besides being slaves — they were inventors, they were artists, they were explorers, they were in every discipline of American life. There were always some free blacks, even in the midst of the darned slavery."
At times she's rankled by mainstream America boxing black history into one month, February. She said, "We ought to be talking about African American history in every month of the school year."
In an even larger sense, she feels Obama's presidency represents a return to the common origin of our species. "There's always deeper meaning of things than just the obvious and I think symbolically he represents taking America and the world back to where we began. History's been rewritten so much that people forget this is where it all started — in Africa — and symbolically he represents the possibilities of the uniting."
One thing Lela won't do is give Obama a free pass just because he's black. "I know that being African American is just one part of who I am and so my judgments don't go through that prism before they go through just common humanity." She realizes Obama must tread carefully. "I understand what he's going through. I know that as an African American he's going to bend over backwards trying to make sure he doesn't come across as a militant or these things that don't put you in good standing with the public in general."
Similarly, she doesn't view Obama as some kind of savior figure. "I don't feel that way about people. You have to be your own savior. And I'm not inferring I don't believe in a higher power." She does, explaining, while "I am not a member of an organized group, my faith is my anchor, my life. That is where I draw my strength from. My faith is what I hang on to. That is what keeps me going. Outer labels have different meanings for different people, so I avoid them. Ultimately, I believe it is our energy that tells people who we are."
To Lela's way of thinking, we're each responsible for making our own path. "I think everybody can be a leader and certainly should be their own leader," she said.
She'll judge what kind of president Obama is on his own merits and it's much too early yet to form an opinion. Lela will closely eye his decisions.
"Now whether he will be this person of peace, that's to be seen, we don't know that. Only time will tell," she said. "He's already calling for more troops in Afghanistan. He believes in the death penalty. Rev. (Jeremiah) Wright said he would be watching Obama just like he would anybody's administration, and that's exactly what I will be doing. And when I think he's wrong…well, I already wrote him two or three letters during the campaign about things where I thought he was wrong. I have a file. One thing I may write him a letter about is — if Rev. Rick Warren is acceptable why is not Rev. Wright? That is something I would really like to ask him."
If Lela's learned anything it's that the change we seek is within us. "With what I did in the civil rights movement, really the most important thing was that I changed myself. You've got to free itself. I learned I can't free other people, but I can share my experience if people ask for it and maybe something will have some meaning for them. But ultimately something has to be triggered on the inside for each of us."
In her book she writes about "finding the strength to face each new obstacle and a solution for each new problem. Difficulties can be transcended. There is always a new way. The choice is ours." Through her trials Lela has learned the art of surrender. That's why as trying as Hughes's condition was, she said, "I knew it was a gift, I knew it had happened for a purpose, never dreaming that I would go all over the country speaking to people that they have a choice in life. That they don't have to be a victim. That's really what I try to do."
For all her contentment, would Lela still be willing to go to jail for her convictions? "If my medical needs could be met, yes," she said. If she could relive her life, would she be an activist again knowing the sacrifices it exacts? "Yes, I would, because it gives purpose, meaning and value to my life."
Lela says one's words or actions tell only so much. "The doing is the being. I think it's what we transfer to each other in an unseen way that tells about you." In that case then Lela Shanks Knox is a warm light in the cold darkness.
In the Spirit of Juneteenth, Sixties Activist Timothy Fitzgerald Commemorates the Pillars of the Civil Rights Movement (prweb.com)
Clarence Lusane: Racism, Shirley Sherrod and the Obama White House (huffingtonpost.com)
NAACP takes on Tea Party's 'racist element' (thegrio.com)
Letting go of the past lifts a weight from caregivers (mayoclinic.com)
Categories: African-American Culture, Books, Civil Rights, Education, History, Lela Knox Shanks, Race, Social Justice, Writing Tags: African-American Culture, Alzheimer's disease, Civil Rights, Education, Health, History, Lela Knox Shanks, Race, Social Justice
Men of Science
Once in a while I have an idea for a story that entails my doing a set of short profiles of individuals sharing some common characteristic. In the case of this story, I profiled four senior men of science, all medical professionals and researchers of one kind or another in Omaha, Neb. I really enjoyed the challenge of trying to capture the essence of these men and their work in relatively few words. The story originally appeared in the New Horizons, and I suspect you will be as impressed as I was by some of their groundbreaking and lifesaving activities and findings.
The Man Who Would Slow Aging
Denham Harman, professor emeritus and world-renowned researcher at the University of Nebraska Medical Center, humbly chalks up his work uncovering the mysteries of aging to a series of chance occurrences. Born in San Francisco and raised in Berkeley, Calif., he displayed an inquisitive mind early on, developing a passion for building model airplanes and setting his sights on studying aeronautical engineering. But then one day in the 1930s his father bumped into an oil executive at a Bay area tennis club where Harman's brothers played and landed Denham a job as a lab assistant with Shell Development Co. "This was in the midst of the Depression — there were no jobs," Harman said from the cubbyhole office he still works in every day at age 86. This chance encounter affording an opportunity he dare not refuse set him on a new course — "I got shifted, so to speak, and I was very lucky" — that within two decades found him posing a radical theory of aging now accepted by the scientific community.
While working for Shell he earned his undergraduate and doctoral degrees in chemistry from the University of California, Berkeley, which, just happened to be one of the top chemistry schools in the nation. After working on lubricating oils he was transferred to the reaction kinetics department where, he said, "just by chance our primary concern was free radical reactions, which in those days was a very unusual focus. There was not that much known." His research helped Shell gain 35 patents, including one for the Shell No-Pest strip. Then, in 1945, his wife Helen unwittingly planted the seed for Harman's breakthrough postulation when she showed him a magazine article —Tomorrow You May Be Younger — about aging research in Russia. It got him so hooked on the idea of aging as a biochemical process he made the rash decision, at 33, to halt his career as an industrial chemist to enter medical school. When Cal-Berkeley flatly turned him down, telling him, ironically, "You're too old," he went to Stanford. Why change careers in mid-stream? "I just thought here's a field that's real interesting and which I know nothing about," he said. Besides, the question of aging still dogged him enough he sought a broader knowledge base with which to tackle the enigma.
During a 1950s stint at Donner Laboratory in Berkeley where, he said, "I didn't have anything to do but think, I figured it was a great time to look at this problem. So, I asked myself the question man has asked for a long, long time and still asks: What causes aging? What causes that transition? Everyone goes through it. We're all familiar with it. We more or less accept it. There's a lot of theories that try to account for that but no one theory is accepted. I looked at the problem from the premise there's a single basic cause. Mother Nature uses the same things over and over again and this is what you would expect. Also, it was obvious genetics and environment were involved. So, what could cause this to take place? I thought of everything I could think of, but it just didn't jive. I began to think maybe I had wasted my time getting on about aging — that maybe I didn't know enough."
Then, in one of those moments when a burst of inspiration arrives only after much deliberation, it came to him. He recalls, "I was sitting at my desk reading at the Donner Lab when all of a sudden it flashed in my mind — free radicals. I don't know where it came from, but there it was. I looked at that problem and everything fitted — the chemistry-biology fitted." The trouble is, initially almost no one else agreed with what he dubbed "the free-radical theory of aging." He was all alone, out on a limb and his many detractors "were trying to chop it off," he said. By the time he joined the UNMC staff in 1958, he was engaged in animal tests to support his theory. What kept him at it in the face of doubtful colleagues was, he said, his view the aging process is "a very important problem — it's the thing that kills us" — and his belief that the theory is correct. That's the reason I'm still at this problem. It works. Otherwise, as a chemist, I wouldn't waste my time if it didn't."
So, what are free radicals and how do they impact aging? Free radicals are molecules with an unpaired electron. These lone wolf electrons create havoc in cells, setting off damaging chain reactions that account, he said, for the effects we experience as aging. Free radical production is stimulated by oxygen, which provides the energy we need to survive, and by environmental sources, but over time free radical reactions increase to a threshold the body cannot tolerate and we die. Harman contends an increase in antioxidant — vitamin E, vitamin C, beta carotene — consumption decreases free radical reactions, thereby slowing the aging process. "You're putting in a preservative, in effect, that counteracts the deleterious effects." The benefits of antioxidants — from increased life expectancy and reduced incidence of disease — have been shown in studies of rodents and birds. His efforts to promote antioxidant use — he's long followed a daily regimen himself — has succeeded. "Americans spend around $4 or $5 billion a year on supplements, most of which are antioxidants, and even though I can't prove it," he said, "I'm sure a lot of those people will live longer then they would otherwise."
Harman, whose research was long supported by a patroness, the late Mrs. Leon Millard, has in recent years seen funding dry up, a frustrating turn of events he ascribes to changing research priorities. Of more concern, he said, is the scant work being done on life prolongation and disease prevention using his theory's tenets. "A great deal can be done, but we're not doing it, and that's disturbing." As for himself, he continues writing articles, making presentations and giving interviews that lay out his ideas. Retirement doesn't enter his mind. "I think you're much better doing something," he said. While he suspects his own life span may have been shortened due to recent health problems, he said time remains his main asset. "It's what I have most of, but these are things you can't predict."
An Uncommon Man's Search for Cancer's Hereditary Links
As just one example of the uncommon life he's led, Henry Lynch grew up a school drop-out and street fighter in a rough section of 1930s New York but persevered to become a medical doctor and noted cancer researcher. "I didn't pick fights but, boy, the neighborhood I lived in it was a very common occurrence to meet bullies, and you had to defend yourself," said Lynch, chair of the Department of Preventive Medicine and president of the Hereditary Cancer Institute at Creighton University. Even though he never attended high school — a result of his wartime service and working to support his family — he cultivated his naturally brilliant mind by reading "voraciously," saying, "I did it on my own. I spent every free moment I had looking up things in the library. I had no doubt in my intellectual abilities." Or in his physical prowess, which he put to use as a stevedore, farm hand and prizefighter.
Henry Lynch
Still a hulk of a man at 75, Lynch enlisted in the Navy as an under-age, but over-sized 16 year-old seaman in 1944. Serving as a gunner on freighters and transports, his tour of duty took him from the North Atlantic to the Mediterranean to the South Pacific. He boxed during his two-year hitch and once back stateside he resumed fighting as an amateur before turning pro. "I loved to fight," he said, adding he boxed under assumed names in a 20-bout pro heavyweight career in order to retain amateur status in a hoped-for bid to play college football.
At first, it was as much his desire to play football at the University of Oklahoma under legendary coach Bud Wilkinson as it was his need to feed his hungry mind that led this then street-wise New York tough to enroll in college there in the late 1940s. By the time his failed tryout with the powerhouse Sooners ended his gridiron dreams, he was "consumed with studying." He continued his studies at the University of Colorado and at Denver University and the University of Texas in Galveston. Trained in genetics, Lynch was serving an internal medicine residency at UNMC in 1961 when the course of his professional career changed. "I was called to see a family with multiple cases of colon cancer, but with no polyps. That was something I thought was quite unique. I studied that family. I went into great detail…not just studying the immediate relatives but extending it as far as I could to grandparents, aunts, uncles, cousins," he said. "And I collected pathology extensively and wrote up all the clinical histories so I could put together and really understand how this could be a syndrome, and ultimately it emerged as one." For his pioneering work, the syndrome was named after him. That first case history led him to track more families with colorectal and other cancers and it "influenced my whole decision to become a medical oncologist," he said. It was also the start of a massive hereditary cancer data base he manages at Creighton, whose staff he joined in 1967.
Like any new idea, Lynch's assertion some cancers have a hereditary basis was dismissed those early years. "People thought I was crazy. They kind of laughed or said I must be dealing with a chance situation or with an environmental factor," he recalls, adding he often paid for fact-gathering trips out of his own pocket in lieu of grant support. His faith in his findings did not waver, he said, because "with a background in genetics I saw what we call a segregated model in the way cancers were moving through families and I knew it had to be hereditary. Finally, it wasn't until the late 1960s that people began taking me seriously." Today, Lynch is an acknowledged leader in his field, the author of 12 books and hundreds medical journal articles and a keynote speaker at medical conferences around the world. Despite his lofty status, he still goes out in the field recording case histories. He said getting good data "is not just a matter of the history, it's winning confidence from the family members and gaining rapport. You've got to really care and they can tell right away whether you care or not. And I care. I really do. I care about them not just as research subjects but as human beings and they appreciate that."
He and his colleagues not only track but identify pathological genes that cause disease and they apply preventive methodologies, including prophylactic surgeries, that remove or reduce the risk of cancer in patients. Genetic engineering, he said, will one day allow physicians to manipulate mutant genes. "If we can figure out the chemistry we might be able to design drugs that are the antithesis to what that gene is making, so we can block it and we can cure cancer and other diseases. That's on the horizon. No question about it." Where does Lynch draw the line in genetic intervention? "I don't think we can foresee specific boundaries to this at this moment," he said. "But if used prudently with the cardinal feature being the interest of our patients and following the orthodoxy of do-no-harm, then I think it's fair to progress and to use all the tools God gave us to help humanity."
Still actively engaged in work at an age when most of his peers are retired, Lynch can't imagine quitting his passion. "Well, I will never retire. I just love my work. Besides, I don't have any hobbies. I don't know what I would do. My whole life is in this direction and I see a whole lot of problems there and some of them we can solve," said Lynch, who has a wife, Jane, and three grown children. "It's a joy knowing maybe I can help people."
The King of Calcium
When Creighton University endocrinology expert Robert Heaney discusses the benefits of good nutrition in fighting the onset or progression of disease, he has a knack for making what could be a dry recitation of facts into an engaging discussion. For example, listen to his explanation of why our calorie-rich modern diets are actually nutritionally poor in comparison with our forbearers: Hunter-gatherers, he said, enjoyed an amazingly varied diet by foraging off the land and its bounty of nutritionally-rich nuts, roots, leaves and berries, whereas since the agricultural revolution our diets have been dominated by cultivated seed plant-derived foods — cereals, breads, legumes, wheat, rice, corn, millet — that provide high energy but low nutrition. "One of the issues modern nutrition is confronting," he said, "is the role it may play in the chronic diseases that affect human kind today — cancer, degenerative cardiovascular disease and dementia. Does nutrition play a role there? Nobody knows. But there's some evidence it does."
Muddying the works, said Heaney, an Omaha native and Creighton grad who, with wife Barbara, has seven grown children, is the often spurious nutrition claims promoted by quacks and charlatans. "A lot of this stuff is just made up by people who don't know anything about what they're talking about," he said. "I'm not going to sit here like a crank and say, It's all nutrition — if you just ate right you wouldn't have any problems. That's not true. But I am convinced there is a role nutrition does play. The field I've worked in, osteoporosis, is an example." He said the high incidence of osteoporosis today is likely due to diets low in calcium and vitamin D, two essentials for keeping bones healthy and strong into old age. "If your calcium intake is low," said Heaney, the author of the book Calcium and Common Sense, "you are constantly withdrawing calcium from your bone bank in order to meet the needs your body has today. The problem is that as that goes on day-after-day, year-after-year, 24-7, that revs up bone remodeling and leads to structural weaknesses. So…much of the damage associated with osteoporosis is due to this high level of remodeling, which makes the bone more fragile." While some progress is being made in assessing who is at risk for osteoporosis, he said identification is complicated by the fact "we're immersed in a society in which everybody has low calcium intake but not everybody gets osteoporosis because some are more sensitive to low calcium and others are more resistant." He said factors that impact the equation are starting to be "worked out. For example, African-Americans have a bony apparatus that tends to protect them against low calcium intake whereas whites will tear down their skeleton much more readily."
Robert Heaney
Research by Heaney and others clearly makes the case for calcium and vitamin D in reducing bone fracture rates in older patients. He said where he used to be asked by science writers if calcium is vital or not, "I don't get those questions anymore. There's a high awareness of the importance of calcium and I suspect that's due to the media. What the general public doesn't know is how much calcium they need and what amounts are contained in the foods they eat."
According to Heaney, calcium is also a marker for a nutrition-poor diet. "We did a study at Creighton of 300 or 400 volunteers that found those who had low calcium intakes — meaning less than 70 percent of the recommended daily intake — tended to get less than 70 percent of the recommended intake of four other key nutrients. So, a low calcium intake tends to translate to having a poor overall diet low in lots of other nutrients." He said the preferred way to get patients to increase calcium is through diet. "The best way to get the nutrients we need is from eating other organisms. We don't know enough to put it all into pills. So, we stress food. If I can get you to eat calcium-rich foods then I know I'll have a much better chance of your getting all the nutrients you need because dairy foods are such good sources of so many of these nutrients. We recommend fortified foods as a second or third line of defense and only recommend supplements as a last resort." He is quick to note calcium is not the only nutrient crucial in osteoporosis and nutrition is not the only factor impacting the disease.
Even at 75 Heaney is still at the top of his game, evidence of which came with his being honored as the 2003 recipient of the E.V. McCollum Award from the American Society for Clinical Nutrition for his creative work as a clinical investigator in generating and testing new concepts in nutrition. For him, research is a never-ending exploration, journey and challenge. "It's all those things. It's always a question of why and how. Those are the interesting questions," he said, adding he's had a curiosity for how things work since he was a kid taking clocks apart. He said he "doesn't waste a lot of time pondering" retirement, adding he's too busy anyway between his research, writing and speaking commitments. Besides, the grant funds he secures for CU's osteoporosis research center are what keep it open. "The day I stop, the work stops. That's why I'm happy to keep doing it."
High Flying, Straight Shooting Doc
University of Nebraska Medical Center otolaryngology physician-professor and retired Air Force veteran Anthony Yonkers has applied his healing arts in a wide variety of settings. He's served as flight surgeon aboard jets, provided medical advice to Stratcom leaders running nuclear scenarios in its underground command post, taught medical students and resident physicians in training, conducted research into new head-neck procedures and performed countless operations that improved patients' lives. The Muskegon, Mich. native and University of Michigan grad came to Omaha in 1968 as an active duty Air Force major assigned to Erhling Bergquist Hospital at Offutt Air Force Base. As an ex-serviceman, Yonkers is widely respected in his role as an attending clinician at Omaha's V.A. Medical Center.
While never an Air Force pilot, he learned to fly in the Offutt AeroClub and even got to take the stick of T-38 trainers on flights he accompanied. These days, he pilots his own single-engine Mooney to medical conferences, family get-togethers and relief efforts undertaken by the Order of St. Lazarus, a humanitarian organization he is active in that provides medical care to leper colonies around the world. He and his wife Mary have four grown children.
When Yonkers neared the end of his Air Force active duty in the late '60s, he was set to go back to Michigan when a position opened in the new Department of Otolaryngology at UNMC, where he'd volunteered. "I was only going to stay a year or two to see how this brand new department worked out…and lo and behold I'm still here 35 years later," said Yonkers, who continued as a reservist, rising to the rank of brigadier general, until 1998. "It's been kind of exciting to see the department develop as we've added more staff and areas of concentration," including a center treating patients with head and neck cancers, a prosthetic division building radiation shielding devices to help save tissue and molding false ears and noses and a sleep institute addressing patients' chronic sleep disorders.
Yonkers and his UNMC colleagues participate in studies looking at everything from sinus infections to breathing disturbances to cleft lip and palette repairs to the treatment of papillomas of the voice box. He said new insights into treating medical conditions often arise from clinical experiences that prompt questions that in turn spur quests for answers through "studies of what best proven methods or accepted techniques work best in a given set of circumstances."
For Yonkers, one of the most pleasing aspects of his work comes in his role as a teacher. "It's fun in that you're seeing young people develop. You're taking a medical student with maybe one year of general surgery training and in four years you're turning him or her into a specialist that can go anywhere in the country and hold their own. That makes you feel good." He said practicing medicine gives him great satisfaction. "It's a fascinating area. It's an opportunity to work with people and to do something to alleviate their discomfort and to make their lives better. It's very satisfying." At 65, his passion for his work remains undiminished. "That's the reason I'm still here and not retired," he said. While he knows there may come a time when it's prudent to lay down his scalpel, he believes older docs like himself offer what cannot be taught or replaced. "Through the years you build a feel or sixth sense for things and it takes awhile to accumulate those assets and nuances. That kind of knowledge is hard to measure and is lost in a forced retirement."
It's Not Just Your Gene Pool (lewrockwell.com)
Study: Anti-Aging Supplements Best Taken in Middle Age (livescience.com)
Why Prostate Cancer May Not Run in Families (newsweek.com:80)
Mayo researchers develop new laboratory cell lines to study treatment for ATC (eurekalert.org)
Experts find gene variants for stomach cancer (reuters.com)
Alternative Treatment for Osteoporosis (brighthub.com)
Calcium and the Law of Unintended Consequences (theness.com)
Categories: Education, Health/Wellness, Omaha, Science Fact/Fiction, Writing Tags: Antioxidant, Berkeley, California, Cancer, Creighton University, Education, Free-radical theory, Health, Health/Wellness, Pop Culture, Radical (chemistry), Research, San Francisco, Science, United States, University of California, University of California-Berkeley, University of Nebraska Medical Center
I'll Be Seeing You, An Alzheimer's Story
July 11, 2010 leoadambiga	Leave a comment
Alzheimer's scares me. I suspect it does many people. I cannot hardly think of anything more devastating or tragic than having your mind slip away or watching helplessly as a loved one's mind fades into confusion, and ultimately oblivion. All of which is to say I was a bit queasy when I got the assignment to profile a woman with Alzheimer's, or more accurately to profile a family and their odyssey with the afflicted loved one in their care. But I was struck by the love this family has for each other and for their beloved Lorraine, who was variously a wife, mother, grandmother to them. The way they rallied behind her is a testament to the family. Of course, not all families are as close or loving, and not all Alzheimer's victims are fortunate to have such attentive support. If you're in the mood for a sentimental story that is based in fact, than this might be your cup of tea. The piece originally appeared in the New Horizons.
I'll be seeing you in all the old familiar places, and in all the old familar faces…
Blessed with the voice of an angel, the former Lorraine Clines of Omaha enchanted 1930s-1940s audiences with her lilting renditions of romantic ballads as the pert, pretty front singer for local bands. Billed as Laurie Clines, she was also featured on WOW radio's "Supreme Serenade," whose host, Lyle DeMoss, made her one of his "discoveries."
From an early age, she used her fine singing voice to help her poor Irish Catholic family get by during the Great Depression — winning cash prizes in talent contests as a child and, after turning professional in her teens, earning steady paychecks singing with, among others, the Bobby Vann and Chuck Hall orchestras at area clubs and ballrooms. After the war, she gave up her performing career to marry Joe Miklas, an Army veteran, semi-pro baseball player and Falstaff Brewery laborer. The couple raised seven children and boast 17 grandchildren.
The memories and meanings bound up in such a rich past took on added poignancy at a recent Miklas family gathering during which Lorraine, a victim of Alzheimer's Disease since 1990, sang, in a frail but charming voice, some standards she helped popularize in the big band era. Her family used the occasion to preserve her voice on tape, thus ensuring they will have a record of her singing in her senior years to complement the sound of her voice on platters she cut years before. While even advanced Alzheimer's patients retain the ability to hum or sing, Lorraine has clung to music with an unusual ardor that reflects her deep feeling for it and the significant role this joyous activity has played in her and her family's life.
"There was always music in the house — singing, records, dancing," daughter Kathy Miklas said. "When we were little we each learned two songs Mom recorded, "Playmate" and "Little Sir Echo," and we all learned how to dance to "Ball and the Jack." At their mother's insistence, the Miklas kids took piano lessons and at their father's urging, they played ball. "We really were lucky Dad loved sports and Mom loved music. It was a great combination. They made sure we did both. It was a nice foundation to have," daughter Theresa Ryan said, adding the family participated in neighborhood talent shows and competed in softball leagues as the Miklas team.
Even though she went from headliner to homemaker, Lorraine never stopped making music. She harmonized doing chores at home. She sang lullabies to her kids. She broke into tunes on holidays and birthdays. Away from home, she taught music at St. Adalberts Elementary School, vocalized in the church choir, led singalongs on family road trips and performed for her children's weddings. Ryan said she and her siblings knew that whenever Mama made music, she was in a merry mood.
"You would get a yes if you asked her a favor while she was singing. You knew that was a good time." Even now, despite the ravages of Alzheimer's, music continues to hold a special place in Lorraine's mind and heart. In a reflective moment one September Sunday afternoon Lorraine commented, 'We gotta get all the music we can." And then, as if remembering how music enriched life for her and her family despite scant material comforts, she said, "We haven't had a lot of other things, but we sure have had a lot of music." Accompanied on piano by Carolyn Wright, Lorraine found most of the words, with some prodding from husband Joe, to ballads like "I'll Walk Alone" and "Girl of My Dreams." When she got around to singing the bittersweet "I'll Be Seeing You," which is about being true to an absent loved one, Joe broke down in tears — the lyrics hitting too close to home.
"Not having her around" is the worst agony for Joe, who loses a little more of his wife each year. "It's hard to live alone," said Joe, breaking down with emotion. As he has seen Lorraine slip further and further away into the fog that is Alzheimer's, he has had to content himself with memories of "the good old days." He said, simply, "We had some good times." A son, Joe Miklas, Jr., said the cruel reality of the degenerative disease is that it feels like losing a loved one, only the afflicted is not dead but stranded in a dementia that makes them increasingly unreachable. unknowable, unrecognizable. They are present, yet removed, their essence obscured in a vague shadowland of the mind. "Physically, she's there, but she's not Mom anymore. We've lost our mother and yet she's still here." Kathy Miklas describes the experience as akin to "a slow grieving process."
Bill Miklas, the youngest among his siblings, is convinced his mother is, on some level, aware of the prison her impaired brain has confined her to, although she is unable to articulate her predicament. Evidence of that came only last year when, Kathy Miklas said, her mother confided to her, "'I think something's wrong with me, but I don't know what it is. It makes me feel bad that people are having to do things for me that I used to have to do for them.'"
The sad thing, Bill said, is "this disease has forced her to be isolated, not only from those around her, but from herself. She has to live within her world. She has to travel this journey, for however long, by herself. It must be very frustrating to her to realize when she talks she's not making sense. She can see the reactions on our faces, but her pride won't allow her to show she's debilitated. It's hard for her to look me in the face and say, 'I don't remember your name.' Yet even as debilitating as this disease can be…she still likes to sit and talk, and she's still a happy person."
As Alzheimer's evolves, its victim presents changing deficiencies, behaviors and needs. Mirroring the patient's own journey are the changing emotions and demands felt by family members. Just as no two sufferers are alike, the experience for each family is individual. Every step of the way, the Miklas clan has made Lorraine's plight a family affair. "Everybody just kind of took their part in it and did what had to be done," said Ryan. "I don't know what I would have done without them," Joe said of his family's pitching-in. Not everyone always sees eye-to-eye on how to handle things, but the Miklas's remain united in their commitment to do right by Mom. And, no matter what, they've stuck together, through thick and thin, in illness and in health. "We've kind of become our own support group," Joe, Jr. said. "We don't always agree, but we always communicate, which is the key."
Married 54 years, Joe and Lorraine hail from a generation for whom the vow "for better and for worse" has real import. That's why when she was stricken with Alzheimer's he put his life on hold to become her primary care giver at the couple's home, where she continued living up until about a year ago. Lorraine's first symptoms were shrugged off as routine forgetfulness, but as her memory deficits and confused states grew more frequent and pronounced, her family could no longer ignore what was going on. It all began with Lorraine making repeat phone calls to family members without knowing who she was dialing and not remembering she made the exact same call just minutes before.
Ryan said, "At first, we laughed it off among ourselves. It was like, 'Oh, did Mom call again to ask who's making the turkey for Thanksgiving? I told her 10 times.' And then, we got a little upset with her. We'd say, 'Mom, would you pay attention. You're just not listening.' There were other signs. Normally a precise, productive person who kept on top of her large family's many goings-on, she could no longer keep track of things. She let the house and herself go. She grew disorganized. And she seemed to just shut down. "I think one of the things we first started noticing is that she just wasn't doing as many things as she was doing before," Kathy said. "One of the striking differences was she'd always been very organized and efficient" but not anymore.
Concerned, Kathy convinced her mother to be evaluated by the University of Nebraska Medical Center geriatric team. "When the doctors said she didn't have any physical reason for this — that it's probably Alzheimer's — I was totally shocked," she said. The entire family was. Lorraine went on living at home with Joe. "I think our family…was in denial," Bill said. "We didn't want to mention Alzheimer's in front of Mom. I think a lot of us thought there was a mixed diagnosis. That, you know, it's not really Alzheimer's — Mom just forgets things. It's not that big a deal." From denial, the family gradually accepted Lorraine's fate, the diminished capacity that accompanies it and the demands her care requires.
To get to that point, however, the Miklas children first had to come to terms with how their mother's condition was affecting their father. "We were all kind of going on with our lives," Ryan said, "but I don't think we were focused too much on the disease because Dad was there to do the day to day caring." As the disease progressed and Lorraine grew more unmanageable, the job of caring for her 24/7 consumed Joe's life. He halted his active recreational life to attend to her needs. "Dad started to give up a lot of the things he likes to do," Ryan said. It got so that it was dangerous leaving her alone, even for brief periods, and no longer possible for anyone untrained like Joe, now 79, to always be on call. Overwhelmed by it all, he could no longer hack it alone, and that's when the family began the long, winding odyssey to find the right care giving situation.
Kathy, a private practice speech-language pathologist, steeped herself in Alzheimer's — from possible causes to drug therapies to support services to care providers. "I felt like I could deal with it better if I understood it. So, I started talking to the Alzheimer's Association and reading lots of stuff. As a family, we shared information about what Alzheimer's is and what goes on with it. I didn't want to miss an opportunity to do something or to have something because we didn't know about it."
Family members also attended conferences to glean more understanding — from health professionals and family care givers alike — about what to expect from Alzheimer's and what adjustments the family could make to ease things for themselves and for Lorraine. For further insight about her condition and how to manage it, they consulted one of the world's preeminent Alzheimer's experts, Dr. Patricio Reyes, director of the Center for Aging, Alzheimer's Disease and Neurodegenerative Disorders at Creighton University Medical Center. "We just lived and made adaptations and accommodations as needed," Kathy said. "We knew not to ask Mom to do certain things because she wouldn't remember them and we reminded her to do things she maybe still remembered how to do."
The family explored several care giving options: first, enrolling her in a respite day care program; next, arranging for a home health nurse to come each morning to assist with her personal needs; and, then, when respite/home care was no longer sufficient to accommodate her unfolding illness, they sought more intensive aid.
"In November, we decided it was not a good idea for Dad to have to constantly be on duty all the time," Kathy said. "We could see his health deteriorating from the stress…so we started looking at nursing homes." Lorraine was placed in one, but the family found its medically-based approach and strictly-regulated environment stifling for their mobile, verbal, social mother, who felt uneasy in such a restrictive setting.
According to Kathy, the site "just wasn't set-up to handle somebody like Mom. They had everybody get up at seven, eat breakfast at eight and go to bed by seven-thirty. Well, having been a singer — Mom never gets up at seven and she's used to going to bed at about one o'clock in the morning. Plus, they had her heavily medicated. One night, they called and said, 'Your mom is having a behavior episode we can't manage.' Well, I got there and she was having ice cream with a nurse. She was fine. Mom was very frustrated because in her mind this was her house and at night she got terrified. She would ask, 'Why are all these people in my house?' After a month of that place, we decided it wasn't working out."
Searching for the best care facility for a love one means weighing many complex issues and making many difficult decisions, not the least of which are financial. Although the nursing home was unsatisfactory, it did have the advantage of being Medicaid certified. As the Miklas's looked around for an alternative, they discovered most quality care centers do not accept Medicaid patients, are cost prohibitive on a private pay basis and, even if the family could afford to pay privately, they would face a two or three-year waiting list.
"We were struggling with what we were going to do," Kathy said. That's when they found new hope and the right fit in Betty's House, a residential assisted care facility, where Lorraine resides today. Where, at the large, institutional nursing home, Lorraine was anxious and irritable, the family has seen "a dramatic difference" in her mood at Betty's House, Kathy said, adding: "It's been a godsend. It's small and home-like, not like a nursing home. The lady who runs it, Mary Jo Wilson, cared for her own Alzheimer's-sticken mother for 10 years. She knows how to do Alzheimer's. She knows what you say, when you argue, when you don't argue, what's important, what's not important and she teaches her staff…that you give residents praise and tell them how happy you are they're there, and I really think that positive feedback is part of the reason Mom's been so calm and so happy the past few months. She's doing well."
And, relieved from the pressure of daily care giving, Joe Miklas began doing better, too. "Now, he can relax," Kathy said.
Joe is just relieved Lorraine is situated where she seems at peace. "She's safe. She seems to be happy," he said. "They're very good out there. The owner does a hands-on job. She's always around, supervising things. She's got some good help. It makes a lot of difference. I try to make it out there every other day if I can. Lorraine talks about coming home, and I'm not sure whether she has this (he gestured to mean their home) in mind or what. I thought she considered that (Betty's House) her home. It's hard to know."
He does know she's content whenever she breaks into song, as she did upon overhearing a conversation he had with another visitor to Betty's House. "We got to talking about music when Lorraine suddenly sang 'When Irish Eyes Are Smiling' and she just took it up right from there." Anything Irish elicits a response from her, said Kathy. "She's always been passionate about her heritage. St. Patrick's Day was a big day at our house. She'd sing Irish songs. Even now, when you mention something about being Irish, she'll go into her version of an Irish brogue" and maybe start up a song.
Music remains a vital conduit to the past. "Still, in spite of all the things she can't do, if you put a microphone in front of her, she turns into Laurie Clines, the singer," Kathy said. "Her body moves as a singer. Her voice changes and her intonation, her breath and her rhythm become that of the singer again." This transformation was evident the night son Tim Miklas appeared with his band, the Pharomoans, at Harvey's Casino. "I went down into the crowd where Mom was and we sang "When Irish Eyes Are Smiling" together. That was pretty special," Tim said.
Family and faith have defined Lorraine's and Joe's lives. Growing up within blocks of each other in south Omaha, each lost their father at a young age and each began working early on to support their family during tough times. They attended the same school and church, St. Adalberts, but didn't start dating until after the war.
"I thought she was the prettiest girl in school," Joe said, "but I didn't think I had a chance to get a date with her, so I just kind of put it out of my mind." After marrying and starting their own family, the pair made sure all their kids attended parochial school, scraping together the tuition from his modest Falstaff salary, and even saved enough for family vacations. "Family was very big to her and she passed that on," Theresa Ryan said. "I think they both wanted that family environment and worked very hard to achieve it." Bill Miklas added, "One of their man ambitions was to raise a great family, and I think they did a wonderful job."
Through the process of Lorraine's sickness, the Miklas's, always close to begin with, have drawn ever closer. If there's anything they've learned about dealing with a loved who has Alzheimer's it is, Tim Miklas said, "to try to maintain the courage to go on and make sure that person is still a member of your family. Maintain your relationship with that person as much as possible. At some level, some of the things get through to them." Whatever the family occasion, Joe knows his wife still "wants to be part of it, that's for sure."
Kathy Miklas advises others to "really value the time and the experiences you have with your loved one because you don't know what it's going to be like three months or six months from now. Like many people with Alzheimer's, physically Mom's going to last a lot longer than she is mentally." Another piece of advice she has is: "Give people choices. Give people dignity and the ability to have some control over their lives. For example, giving my mother the choice of when gets dressed eliminated a lot of arguments."
In the end, this Alzheimer's story is about the enduring love of a man and a woman and of a resilient family. "Theirs was a very subtle love," Bill Miklas said of his parents. "It was something you always felt. The same with the faith they lived. It was a constant. There was never a question — never a doubt. It was a very stable reality. I think Mom taught us a lot about faith and about commitment — to ourselves and to our family. She taught us not to focus on what you don't have but to enjoy what you do have and to find the value in that. Somehow, if I can take that to my family than that will be Mom's greatest legacy."
I'll see you in the morning sun and when the sky is grey. I'll be looking at the moon, but I'll be seeing you…
'Memory Show' a sweet, painful portrait of Alzheimer's toll (boston.com)
Caring for a Loved One With Alzheimer's: New Insight on Memory Care (health.usnews.com)
Test may catch Alzheimer's in earliest stage (abclocal.go.com)
Maria Shriver Raises Awareness of Alzheimer's Disease (psychologytoday.com)
Progress made on blood test screening for Alzheimer's (ctv.ca)
Half of All Alzheimer Cases Might Be Preventable (newser.com)
Categories: Aging, Alzheimer's, Family, Health/Wellness, Medical, Omaha, Writing Tags: Aging, Alzheimer's, Alzheimer's disease, Dementia, Family, Health, Medical, Mother, Omaha
ER, An Emergency Room Journal
June 16, 2010 leoadambiga	2 comments
To be honest, I was hoping for something dramatic to happen in the ER that agreed to accommodate for a few nights my hanging around, asking medical staff and paramedics and patients questions and taking voluminous notes. Nothing much did. That is to say, a stream of patients came through presenting all manner of problems, but nothing over the top sensational occurred. I think I still managed a good story out of the assignment. You be the judge. The article appeared in The Reader (www.thereader.com) as a kind of companion piece to another story I did based on ride alongs with paramedics. You can find the paramedics story on this blog as well. It's titled "Merciful Armies of the Night."
Originally published in The Reader (www.thereader.com)
Hours of Boredom and Minutes of Terror
Hollywood portrayals of hospital emergency rooms depict white hot action zones where medical drama and staff intrigue continue nonstop. What's a real ER like? Recent visits to the NHS University Hospital ER found a medical treatment center, social laboratory, educational classroom and last refuge all in one. An intersection where the gallery of humanity meets and various trends surface. A mission, a haven, a hell. Or, as one ER nurse put it, "We deal with the heart of Omaha here."
Like many staff, nurse Susie Needham feels the ER is THE place to be on the frontlines of medical care due to its fluid nature, one she summed up as "hours of boredom and minutes of terror." Unlike television's ER, long tedious stretches can grind by before a single trauma arrives. Then again, a run of critical or extreme cases can suddenly pile-up, kicking a slow shift into high gear. As Needham put it, "From moment to moment, it can change.
Most people that work here are attracted to the fast changing pace and the variety of different patients we see. It's never the same. You have to know a lot about a lot of different things, and that's what keeps you on your toes. It makes it interesting." On a Friday night in April Needham, a pretty freckled blonde with an impish smile, tended a diverse mix, including a bronchial pediatric patient with difficulty breathing, an adult drug abuser suffering withdrawal pangs and a drunk woman ostensibly there for stomach pain but whose battered body and frayed psyche told a more sinister story.
For the most part, ERs treat a procession of fevers, coughs, sprains, aches, cuts, bruises, breaks. Purely routine stuff. Unless it's happening to you, of course. Since one person's trivial complaint may be another's dire crisis, everyone is treated the same. No condition is refused. Nothing is taken for granted. Trained to assess and treat serious problems, medical staff try first ruling out any life-threatening cause before looking at non-critical or non-medical issuses. Most ER medical staff possess extensive critical care backgrounds, but it seems all ERs (the step-child of acute medical care) are not equal.
"Unfortunately, emergency medicine is still the only speciality where you just need a license to practice, so it's kind of a buyer-beware situation," said NHS Chief of Emergency Medicine Dr. Robert Muelleman. "At University, we require physicians be board certified in emergency medicine (spending a minimum three years residency in emergency medicine and passing written and oral exams). It helps ensure a certain standard of care or level of competency. Nationwide, probably only between 50 and 60 percent of practicing emergency physicians are board certified, but I think there are more, better trained board certified physicians today than there were 10 or 15 years ago."
On busy nights (Sundays are worst) patients stack up and long waits ensue. Triage nurses sort cases on an as-needed basis, with the severest seen promptly and the mildest set aside for a kind of walk-up window service, Fast Track. But again, unlike TV, where patients sweep through the ER unchecked, the real world entails staff documentation-communication for all patient admissions, treatments, releases. In terms of volume, University Hospital recorded 27,018 ER visits last year, a slight rise from 1998. Traumas typically account for about 3.25 percent of all cases.
Not long past dusk on St. Patrick's Day things were unwinding surprisingly slowly in the ER considering this was a designated trauma night (meaning area rescue services were to feed trauma patients there) on a Friday holiday known for alcohol-related injuries. Earlier in the day, staff treated a 43-year-old Omaha man knocked unconscious in a bar fight. Michael Kimball was brought in comatose. Massive swelling in his brain forced doctors to remove his skull to relieve the pressure. (Editor's Note: Kimball never regained consciousness and, two weeks later, was pronounced dead. Police cited insufficient evidence to file charges in the case.).
Hours later, during a protracted lull, staff lingered about "the hub," the ER nerve center, bantering in the irreverent MASH humor used for stress relief. Attending physician Dr. Paul Tran made a colleague, Dr. Rick Walker, envious by describing his sound sleep the night before, a rarity after the rush of a nine-hour trauma shift. When not hanging at the hub or crashing in the staff lounge, docs, nurses, techs and residents use computers and charts to monitor the condition of patients in surrounding non-critical care rooms and trauma bays (a total of 16 beds), to track the progress of lab workups, x-rays or other procedures and to file paperwork. A large grease board hanging high on the wall is smudged with running patient status reports. This checks and balances system aims to avoid patient-bed-meds. mixups
The staff perked up that night at the static-filled emergency band radio (always droning on in the background) report of a CODE 3 (critical medical) case en route, with an ETA of five minutes. Staff are uncanny at hearing the calls headed their way and ignoring the others. The paramedic's sketchy details described an elderly man who fell and hit his head outside a Bag 'N' Save. The man, whom paramedics found minus vital signs, had been shocked back to life. With the clock ticking, Dr. Tran, a slight Vietnamese native with a gentle bedside manner, conferred with colleagues on whether to summon the trauma team, a kind of in-house medical SWAT squad on call to treat the most severe critical care cases, or to handle things themselves.
It Never Gets Better
Dr. Walker, a beefy man whose pockets are invariably overstuffed with paperback novels and stethoscopes, has spent his entire medical career in emergency medicine. He said part of the appeal for him and others is the extreme nature of the work. "I think it's very challenging, and that's a large aspect of it. It's also a big adrenalin rush, and as I've assessed my life and career I've come to the conclusion I'm an adrenalin junkie, and I think that's probably what did it for me."
He said being exposed to the tragedy that accompanies trauma extracts a certain toll:
"You see bad stuff happening here, and it's stuff that, you know, can make you cry, like kids dying. It's tough and it can really get to you emotionally, and so what you have to do is build up a wall because otherwise you'd be breaking down every time you saw something like that and you could not function. That wall tends to stay up most of the time and the last few years it's become an issue in my personal life." Nurse Jackie Engdahl said it takes a special breed to work there, "Oh, definitely, Type A personalities make good ER nurses. You have to be very aggressive…very assertive because of what you deal with. You deal with not only ill and injured people, but intoxicated people and drug-induced and psychotic people. You gotta love a good challenge and you gotta be strong enough to whip into shape when the going gets tough."
For trauma nurse coordinator Kathy Warren, it's a matter of staying focused no matter how horrendous the reality before her. "Some of these cases are just horrible looking when they come in. You just have to totally ignore that and focus in on the task, so whether you're starting the IV or helping the docs with procedures, you detach yourself and just click into gear. You can't get nervous. You have a job to do," she said. Warren, whose job entails her dealing with family members, said staying composed is hard when working with parents who've just lost a child. "Sometimes I have to step back for a few minutes and take a deep breath. When I get home after a case like that, everybody knows its been a bad day as soon as I walk in."
Added Susie Needham, "People think you get callous or something, but you don't. Some of the things we see are heart-wrenching and no matter how many times you've seen them it still really bothers you. It never gets better."
Things finally began heating up again on St. Patty's Day once the Code 3 patient was wheeled in on a gurney by paramedics and lifted onto a bed in the T2 trauma bay. The heavy-set man of about 65 lay there in a coma, a breathing tube inserted in his throat and an IV snaked into one arm, his big hairy belly billowing up and down as a bevy of ER medical staff hovered over him to keep him alive. "I need, STAT, six units of platelets…" a nurse called out. "Tell respiratory to bring a vent, please," called another.
Then, when someone barked, "I need another set of hands up here," a tangle of arms belonging to eight nurses, techs and docs converged to perform, seemingly at once, multiple tasks, from hooking up a ventilator to running a blood pressure line to starting a new IV to drawing blood to attaching EKG electrodes. "Sir, there's going to be a tube going down the back of your throat," one of them said more out of habit than out of any expectation of a response. Lying there, totally exposed and vulnerable, his life completely in the hands of these angels of mercy, the man, referred to then only as John Doe due to a lack of ID, was an anonymous soul brought back from the very brink.
Time is critical in trauma or near trauma scenarios like these. That night's charge nurse, Scott Miller, said it involves quick, precise coordination and communication. "Everybody swarms in to get the job done as fast as possible. In a case like this you have Dr. Tran coordinating and everybody trying to feed information to him as to what they're finding at the same time as they carry out his orders."
When the whole trauma team is activated, a whole slew of specialists — from surgeons to anesthesiologists to radiologists to lab techs — converge on the spot, making teamwork even more essential. According to Kathy Warren, "You have a lot of people and everyone has a different role and, hopefully, they know their role so they're not getting in your way and you're not having to tell them everything. It usually works pretty well, and it's amazing the amount of things that can be done for a patient in a short amount of time when you absolutely have to. But that's what a trauma center is supposed to be able to do."
Emergency care often starts with the rapid response of rescue squads on the scene. Paramedic Tom Quinlan was among those responding to the 911 call that found Doe lying unconscious. "He was not breathing. He didn't have a pulse. So we started our CODE 99 (for clinically dead cases) protocol, which is intubate him, start an IV and do CPR. We ended up shocking him a couple of times. We finally got a pulse back and he continued to breathe for us on the way to the hospital," he said.
Added Dr. Tran, "Time is of the essence here. After so many minutes, it doesn't do any good, so it's all speed and skill. The man probably experienced sudden death when his heart went into fibrillation, meaning it didn't pump any blood and, so, the brain promptly became unconscious and he fell down and hit his head and only by actions of the paramedics did he come back. He was extremely lucky to have had everything done in that time, otherwise he would be dead by now."
Dr. Tran said the fall resulted in "about a five-centimeter hematoma on the back of the head." Since Doe was found unresponsive and bore a scar on his chest indicating a history of heart surgery, the question on Dr. Tran's mind was whether the patient's vegetative state was due to the fall or to some new cardiac event. Not wanting to overlook a potential cerebral cause, he called in part of the trauma team after all. As Scott Miller, explained, "We're assuming now he had some sort of heart event that caused him to fall and hit his head. We will be doing a CAT Scan to make sure there's not something else going on, like a big bleed in his head. We don't think that's the case, but you can't always tell for sure." Later, it was confirmed a cardiac event did trigger the trauma.
As for the long-term prognosis, Dr. Tran said, "I'm not sure of the condition of his brain function later on." By then, Doe was identified and his family contacted by nursing resource coordinator Regina Christensen, who met with family members. Part of hers dutie entails fielding inquiries from news hounds looking for material. She noted with incredulity some sound disappointed when a case is upgraded from critical to stable condition.
When treating a trauma, there is no room for bruised feelings. The required care must be delivered NOW. Hashing out differences can come later. One of the reasons nurse Jackie Engdahl likes working in the ER is the maturity of the people working there. "When I worked in other hospital areas there were very clashing personalities and people always bickering back and forth. But here, it's not that way. You say whatever you want to say to someone and then it's over and done with. There's never hard feelings." And, she said, where some physicians resent or reject nurse input this ER's docs welcome it. "The doctors here work really well with the nurses. The doctors trust our judgment and they really listen to us. They allow us to do a lot of things, which is nice." What about departmental romances? "There used to be between the nurses and paramedics," nurse Janie Vipond said. "It just depends on the group you have at any given time. But, yeah, it happens."
I Felt I Was in Good Hands
Amid the controlled chaos of an unfolding ER trauma, staff attend to myriad details, not to mention other patients. For the trauma patient whose life hangs in the balance, it can be a surreal experience of wailing sirens, flashing lights, antiseptic smells, probing instruments, strange faces and endless questions. There is fear, confusion, agony. There is even a strange sense of peace. Beverly Harter, a 62 year-old wife, mother and grandmother, has been there. How she got there is a story in itself.
On May 16, 1999 the Logan, Iowa resident was attending a graduation party at the nearby trailer home of a daughter. Various family members and friends were present. The weather was threatening that afternoon. When the sky turned ominous and a tornado warning sounded, the 12 partiers fled the trailer for their cars in an effort to outrun the storm. But it was too late. With a twister bearing down, they left their vehicles to take refuge in a roadside ditch. Huddled on the ground, exposed to the savage winds, the group was deluged by parts of farm machinery ripped asunder in the cyclone and propelled like shrapnel. The metal shards rained down on them, tearing skin, cracking bone, crushing organs.
When it was over, Beverly's daughter was dead and two grandkids, both injured, left motherless. Her son endured a broken clavicle. A family friend died. As for Beverly, she suffered a punctured diaphragm, a perforated bowel and two crushed vertebra. Her house was leveled. Ironically, the trailer escaped unscathed. Transported by a local rescue unit to Missouri Valley, Beverly was then taken by ambulance to the nearest trauma center, the University Hospital ER.
Beverly, who remained conscious during much of her ordeal, did not have to be told she was badly hurt. "I knew I'd suffered spinal cord damage because my legs were on fire, and they stayed on fire." she said. She also knew her daughter "was gone" and other loved ones injured. As for her Omaha ER odyssey, she recalls "bright lights," a sense of "time standing still" and "a lot of people doing a lot of things and asking a lot of questions. I was really hurting and kind of fading in and out from the sedation, but I was able to answer a lot of questions. They explained to me what they were doing at all times, and that was reassuring."
Indeed, despite her pain and grief, she recalls feeling calm. "You just have a sense that everybody's taking care of you and that they're all working together doing their jobs. I felt I was in good hands." She also felt the staff's compassion. "They were extremely sensitive and caring and protective about what happened to me and my family. They knew the devastation and loss we had. I was just overcome by their concern for our well-being," said Harter, who today is confined to a wheelchair.
Kathy Warren said she used to doubt whether the time she spent with families who suffered a loss made a difference until her own father died in the hospital and she found comfort in the support her colleagues gave her. "I realized how important it is to have somebody treat you with kindness and to let you grieve however you want to and to explain things to you. Ever since then I've really pushed staff here to sit down with families and to talk to them. It's not an easy thing to do as a medical person. Some people are better than others. But people don't expect us to be super men and women. To save everybody. They just need us to be there."
Not all exchanges are so pleasant. Patient complaints over long waits get expressed along the sarcastic lines of, "I'm sure glad I wasn't dying." Before things get nasty, staff try defusing the matter. "The basic strategy is to make them see you as being on their side," said Dr. Bob Muelleman. "On the other hand, you want to be very much in control of the situation. If it's just a matter of them yelling and cussing at you, well, that pretty much comes with the territory. Once in a while there's kind of a thrashing or flailing out. If you think there's the potential of them really getting violent you can call in security or police, but normally you can handle it on your own."
When care complaints cannot be appeased, they are passed-on, in writing, or addressed on-site by managers like Regina Christensen. "It can be anything from somebody upset that their mother's IV is out to something as complicated as a gang-related situation where the patient himself or his family is threatening staff. It's just an array of things," she said.
The Truth is Stranger Than Fiction
Meanwhile, back on St. Patrick's, a drunk middle-aged woman involved in a domestic dispute came in with an aching gut. However, the night's triage nurse, Susie Needham, recognized bruises and marks as signs of physical violence and sexual assault. After questioning the woman, a horrific tale of prolonged torture and bondage emerged that prompted ER staff to follow procedure and report their suspicions to police. Acting on the medical staff's input two officers, who earlier arrested the woman's boyfriend on misdemeanor assault charges, returned to open a rape investigation.
According to Needham, "If people come in here with traumatic injuries that don't really fit their stories, we call the police." Often, she said, such patients prove to be victims or perpetrators of a crime. Surrounded by staff and police in a room concealed by drawn curtains, the woman cried out, "I can't take it anymore. I don't want to take it anymore."
After examining the woman a visibly shaken Dr. Tran said, "It's one of the most remarkable cases of domestic violence I've ever seen. She has multiple problems. Number one is domestic violence and sexual assault. Number two is chronic alcoholism. Number three is a low platelet count. Number four is what appears to be an upper GI bleed." As part of hospital policy in such cases, staff called in a domestic violence-sexual assault counselor to apprise the woman of her rights and refer her to appropriate community resources. But, as ER staffers say they've seen far too many other victims do, the woman rejected police-medical entreaties to undergo a forensic exam, something required for a criminal inquiry, and declined pressing rape charges. She was admitted and treated for medical problems.
"What do you do?" a frustrated Needham asked. "That's tough," Dr. Tran said, "because once enough time passes, the evidence is lost. We can't do anything. You have to respect the patient's wishes. Patient autonomy is everything. Why did she refuse? Oh, fear, love rejection, sensitivity. Who knows? Unfortunately, it's common."
Bizarre, believe-it-or-not episodes are also common in the ER. Take the time an obnoxious drunk showed up with a fierce but inexplicable pain in his belly. After sleeping it off, he staggered up from his cot and only then did the ER doc notice a speck of blood, on the sheets, which upon closer inspection turned out to be from a tiny hole, splayed by burn marks, in the man's back. Apparently, he had been shot but was too drunk to recall it. Sure enough, an x-ray revealed a bullet lodged in the abdomen.
Or, take the time a stabbing victim arrived cut entirely from stem to stern, his entire rib cage exposed, yet conscious enough to describe the whole bloody fillet job some whore performed on him. Or, the time a man fell at home on a fireplace iron and walked in the ER with a small wound on his neck which, upon further exam, proved to be a deep puncture penetrating his cervical spine. For Dr. Muelleman, who treated all these cases while working in a Kansas City, Mo. ER, such incidents fall under the heading of "the truth is stranger than fiction."
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Perhaps the most frustrating cases are those involving entirely preventable injuries, especially those incurred while victims engaged in some high-risk, reckless behavior, like a young man Dr. Muelleman treated in Omaha who crashed his car while out joy riding and ended up paralyzed from the neck down. "I don't call them accidents anymore," he said, "because an accident suggests an act of God. I call them injuries because when people put themselves in these circumstances something is going to happen that didn't have to happen."
Anybody-Anytime-Anything
As ERs are traditionally the 24-7 stop-gap or catch-all of American medical care, the entire spectrum of need shows up there. In most public hospitals, no one is turned away, regardless of insurance status or ability to pay. "The emergency department is the safety net for many people seeking care who really have no other place to go, said Dr. Paul Tran. "Admittedly, there's going to be abuse of the resources because this is reserved for emergency cases, but who's definition of emergency is it? A toothache at 2 a.m. may be an emergency to you, but it may not be to someone else. We are here to take care of people from all walks of life and with conditions as minor as a toothache or as serious as a heart attack. And from that standpoint, it is very satisfying to provide people the last resort they need and to get the instantaneous gratification of turning them around."
Given its open door policy, "the ER is where you really see the cross-section of humanity and so, if there are social ills, you seem them in the ER," Dr. Muelleman said. "Some of the ills we deal with are domestic violence, drug and alcohol issues, child abuse, lack of immunization and lack of access to health insurance. Another segment the ER picks up on are the acute psychiatric and homeless populations." He said in an era of managed care, ERs play an increasingly large social service and public health role. "
So, if we're dealing with intoxicated people we try to get them in a shelter or detox center. If it's an abuse case we bring in social workers, police and protective agency professionals. If we're dealing with domestic violence, we make sure patients understand the resources available to them." Nurse Scott Miller is "troubled" by how many kids he treats who "are not well cared for" at home and "very frustrated by the large number of people with legitimate psychiatric problems who can't get seen" due to a lack of psychiatric beds locally. He said, "I've spent many hours fighting on the phone, calling medical staff at home, to get people admitted in the hospital when they don't really have a medical problem. But when no psychiatric place will take them, we can't just send them home."
Dr. Muelleman said where ERs have always tried educating patients about prevention safeguards and optional resources, "Some have gone to the extent of smoking cessation and substance abuse counseling. I'm just reviewing a grant for a hospital to screen Type II Diabetes, which is not something you'd traditionally think of as an ER doing. There is a real move toward ERs getting involved with public health, even things like bike helmet giveaways. Some have even gone as far as to give pneumonia and flu shots. Even here, during seat belt awareness week, we do educational stuff to let people know about the importance of seat belts."
As a survey of ER web sites will attest, there is debate in the medical community over the all-encompassing role of the ER. On this subject, Dr. Muelleman takes a pragmatic position. "You can't select why people use the ER. Once they're here, you can't ask, Why are you here again?, although you may be tempted to. I mean, I support the notion public health policy in America should be changed to help take care of people's health needs in a more comprehensive fashion than just having them go to the emergency room, but given that's not the case, the mantra in the ER continues to be — anybody, anytime, anything. That's exactly what it is. Should we change medicine so that doesn't happen? Well, yes, we should, but in the meantime we've got to do what we can to help people."
Some ERs post wait times by text, billboard (msnbc.msn.com)
Newly Insured are Likely to Congregate in Emergency Rooms (prweb.com)
Timesunion.com: If it's an emergency, they're on the clock (timesunion.com)
Text Your Way To a Short Emergency Room Wait [Medicine] (gizmodo.com)
Lengthy waits in local ERs (windsorstar.com)
Categories: Health/Wellness, Medical, Omaha, Writing Tags: Emergency department, Emergency medicine, Emergency Room, ER, Health, Hospitals, Medical, Medicine, Trauma Center, University of Nebraska Medical Center
Nancy Duncan: Her final story
May 9, 2010 leoadambiga	1 comment
I got to know the late Nancy Duncan better than I do a lot of my profile subjects. You might even say we became friends. I had written about her and her work as a professional storyteller. We hit it off. When she developed cancer and began undergoing a regimen of treatments and surgeries, she began doing what came naturally to her — putting her experiences into stories. When told she was terminal, she and I eventually arrived at the idea of her telling one last story, in effect, by sharing her odyssey with the public. The piece appeared in The Reader (www.thereader,com). Not long after the article appeared Nancy died peacefully, having said all her goodbyes and having left the gift of her humor and intelligence and grace with thousands in the form of her stories, which will live on forever.
Originally appeared in The Reader (www.thereader.com)
Professional storyteller Nancy Duncan felt the tell-tale lump on her right breast in 2000. She recalled it being "about two digits long, as round as a pencil and as hard as a rock. I knew the minute I touched it what it was." Doctors soon confirmed her suspicion. Cancer. "Somehow it had just sneaked through the mammograms."
After a mastectomy and chemotherapy, her illness appeared under control. Then, in April 2002, she found "a little chip of a tumor" under her arm pit. "They told me it had recurred, and when they found it there they figured it was somewhere else. They did a CAT scan and there were these little specks everywhere in my liver — like from a shotgun blast," she said. Her cancer had spread. "Metastasized. It's a nasty word. Nobody wants to hear it. You never know where it's going to go when it gets outside the breast," she said. "It'll go to your bones or to your lungs or somewhere else. Mine just happened to go to my liver."
"Well, Nancy, you're a terminal," is what her doctor told her. Terminal. Aren't we all? — Duncan wondered. The only difference between me and my doc, Duncan thought, "is that she thinks she knows what I'm going to die of." That, and the fact the malignant tumors carrying Duncan's death sentence play a cruel game with her. "They grow and then the chemo shrinks them. Enough so you can barely see them or they're not visible. In about four or five months, they figure out how to get around that drug and then they come back. That routine is what I've been doing the past two years," said Duncan, the Nebraska Arts Council's Artist of the Year.
Her four-year "dance with cancer" has propelled the former theater maven into a journey of self-discovery that's informed every aspect of her life and work. Her unfolding death is the subject of her final, most profound story.
"Storytelling is always a process of learning about yourself," said Duncan. "The story transforms along with you and that's exciting to realize that and to let that happen. It's a dialogue you maintain with that story for the rest of your life."
The most surprising thing to happen in the narrative of her evolving death, she said, is the tranquility she's found. "It's totally taken away the fear" she had of dying. Her late husband, Harry Duncan, an acclaimed poet and fine book printer, died at home under her watch. That experience is helping her prepare for her own death.
When she first got news of her terminal illness, she panicked. "Then, I remembered what Harry did. He just stopped eating and drinking and he was unconscious after three days and gone in a week. From the day he decided he didn't want to live anymore, he went in this kind of graceful state. It wasn't like he was a beaming idiot or anything. He just seemed totally at peace. Very relaxed. Loving. It was like he was teaching us all that when you're ready, you don't have to hang around and be tortured to death. So, I thought, I always have that option. My kids have agreed they're not going to mess with that choice."
The comfort Duncan gained in contemplating her own blissful exit carried over to a new freedom she felt on stage. "The interesting thing is I totally lost my fear in performing. I became completely relaxed," she said. "It was such a gift to be able to perform two years without any fear. Yahoo! Because that is what your audience really wants. They want you embodied in that art form. They want to see you, the most they can possibly see you, broken open. And fear just gets in the way. It's a barrier between you and the audience. It's a good thing, because it tells you this is an important occasion and you need to be present for it. It helps you stay on your toes. But it's also a bad thing because then you're editing, and you don't want to edit. What you want to do is listen to your audience and remember things and let them pop into the story. Why did I have to have cancer in order to lose that fear?"
She's considered her cancer from every conceivable angle. She's talked frankly about it in stories. In the published Losing and Getting, her cancer-ridden breast converses with her healthy left breast in a stream of bitterness, guilt and humor. She's talked about losing her hair but gaining a new appreciation for life. She's performed her cancer story for many audiences, but especially for women who are cancer survivors, patients and potential victims. She knows firsthand their fear.
"There's also a lot of lessons you learn…" Like the harsh reality of health care in America. "If I didn't have supplemental insurance I wouldn't be alive today because I couldn't afford all these chemo treatments. And a lot of people can't afford them. They don't have a choice. They're not given the opportunity to have their lives extended like mine has been. Given the fact there's so much money being made treating cancer and that cancer is growing exponentially in the world, there's no incentive to find a cure…and definitely no incentive to prevent it. I think we don't really want to prevent it because we don't want to change our lives. We're too lazy. We don't want to give up our fossil fuels and our fatty foods. We're so complacent. I'm as bad as anyone else. That makes me mad sometimes."
Since finding she's terminal, she's tried maximizing the brief periods she feels well between her taxing treatments, stealing moments here and there to work and to spend time with the many friends and relatives who comprise her extended care team. She's also managed performing occasionally and nurturing some of the storytelling festivals she's helped found and grow, particularly the Nebraska Storytelling Festival in Omaha. She's annually given 600-plus hours of volunteer time to Nebraska Story Arts, the organization that puts on the festival.
Even as her condition's worsened, she's continued being the state's most visible and vocal advocate for storytelling. Omaha sculptor Catherine Ferguson called Duncan "one of Nebraska's most treasured women. She has dedicated her professional life to connecting people to the arts and humanities. Nancy's performances have always gone beyond entertainment to become educational." Story Arts president Jim Marx said, "Her gift is to imagine possibilities, inspire others to join her vision and to will them into existence through tireless effort and encouragement." Nancy's daughter and fellow storyteller, Lucy Duncan, said, "She has a great generosity of spirit in her teaching of storytelling and wanting to spread the art form. Her support of my telling is a direct example. Instead of feeling, This is my territory, she says, Let's share this. She's done that with a lot of people — not just me. She's also very beloved in the national storytelling community."
Lately, Duncan's good spells have grown fewer. The artist has been homebound since the end of May, when she gave her "last" performance at the Darkroom Gallery in the Old Market.
Her three grown children and several grandchildren are staying with her now in the big mid-town house she and Harry shared. It's where he died of cancer in 1997. It's where she intends dying, too. As the debilitating rounds of chemo have taken her longer and longer to recover from, she's considered not undergoing them again, knowing full well stopping them will mean certain death.
"I have to pay such a huge price to feel good for about two months," she said.
For now, at least, she tarries on, telling stories to her grandchildren or soaking up
the good vibes of her army of friends who flit in and out of her place all day long. Some come to do chores. Others bring her things. Some just come by to chat.
Reminders of her friends are everywhere, most poignantly in the paper, silk and rubber hands adorning the inside of her front door. Each "helping-healing hand" was sent or delivered to her and is adorned with a message that's variously funny, outrageous, wise, enigmatic, just like the stories Duncan's told since 1984, when she turned away from a career in the theater to pursue storytelling professionally.
Some visitors come to say goodbye, although few use that word, because even though Duncan is physically frail now and needs around-the-clock support, her effervescent spirit shines through, making it all the harder to imagine her gone. The light-up-the-room sparkle is still there in her eyes. So, is the ear-to-ear smile. And the cascading laugh. Ah, The Laugh. It's an irrepressible cackle that starts in her chest, rolls up her giraffe neck and spills out her crescent mouth in a high-pitched sound that recalls the coyote-witch figures she portrays in tellings.
Then again, there's a chronic fatigue that didn't used to be there. Every now and then she catches her breath, swallowing hard to stem the pain from the stints in her liver. Her body, once as expressive an instrument as her animated face and voice, is gaunt and still, betraying the fight she wages to keep death at bay.
Her impending death is being recorded by Omaha videographer George Ferguson. The documentary she asked him to make is meant to help other dying individuals in their search for healing. It's only natural that Duncan, who's used stories as a way to interpret life, should use storytelling as a means of understanding her own end.
"I thought it might be useful to somebody else who's dying the same way, but also to see how useful storytelling can be in helping you go through this process," she said. "where grotesque things happen to you and people are poking your body here and there. And, where, in the middle of having stints put in your liver, people around you are talking while you're drugged. And the craziness of discovering systems that you are either a victim of or you have to figure out how to defend yourself against. Not to mention a whole new vocabulary you learn.
"I've met people who, when diagnosed with cancer, kind of isolate themselves and live at home quietly and some who sadly get really angry and stay angry until they die. And to me dancing with cancer has not been like that. I was angry the first weekend before the biopsy results came back. That was the weekend when I fired God and hired HER back a couple times. But then I got over that because I've always believed that in every trauma there's some kind of a grace at work and you just have to open yourself to it and figure out what it is. It doesn't make you a better person, but it says, Wait, stop, who do you really want to be? And, so, cancer gives you some time, mostly, to do that and that's a great privilege. I mean, I think it would be a great privilege to drop dead of a heart attack, but it wouldn't be for your family because it's so traumatic."
Her decision to have her odyssey filmed was one she came to after much thought. "It took a long time to decide what my motives were here. Was I just doing this out of ego? Was it really a good idea? I talked to a lot of friends about it before I talked to my family. Most of my friends said, 'Oh, yeah, you better do this because it will give you something to keep you busy.' My kids in the beginning were thinking what it would be like to have somebody around filming during the last week of my life. I wasn't thinking about that at all. I was thinking about talking about the things that happened to me in terms of my cancer, but also in terms of how the cancer affects my life and the stories. So, finally, I think my kids have all come around to it."
Storytelling, she said, constitutes the way we make sense of things. The story of her cancer and dying, she said, is "no different. Every time you narratize your story to explain something to yourself, that's healing, because then you're no longer so confused or befuddled by it. Then, when you tell it to somebody, they give it their own meaning based on their lives." This search for identity and meaning is one she thinks America suppresses in its instant gratification apparatus.
"I think all my work with storytelling has been trying to fight that tendency in our culture that does everything to avoid having people talking deeply to each other, especially about death or anything important. As a society, we want to be entertained and we avoid things that might make ask us to think or deal with situations going on in the world. Problems are not going to get solved until we sit down with somebody else and really listen to their stories, so we can get to understand each other rather than blowing each other up. The more we put labels on people, the more we're destined not to know them. When you really know somebody's else's story, you can't hate them anymore. It's a wonderful tool for peace," said Duncan, whose residencies in schools and other settings have used storytelling to break down barriers, to build self-esteem and to promote diversity.
"But nobody trusts it (storytelling), partially because nobody has ever listened to our stories. We narrow ourselves so much by not knowing each other. Storytelling works against that. That's why I keep working on storytelling."
She said too many of us seek the cold isolation of mass media diversions as substitutes for interpersonal communication around the dinner table or fireplace, where gathering with friends to talk and tell stories is a communal event and a celebration of our shared humanity. "That's what storytelling is all about."
Harry Duncan
Her many tales, from the repertoire of "platform" stories she's crafted for performance to the private stories she's passed on to loved ones, are sure to live on through her family members, all of whom, she said, are born storytellers. That's why her dying is more celebration than requiem. "Not only is it a celebration," she said, "it's a transition. It's a very important transition from my versions of the stories to everybody else's. Now, they're all going to own these stories. I would love to someday eavesdrop on them, although that's probably not possible." Her performance stories are available on CD.
Duncan's love for stories extends back to childhood. Born in Indiana to "depressed-alcoholic" parents, she did most of her growing up in Illinois and Georgia. A tomboy with a big imagination, Duncan roamed the woods in back of her Georgia house to act out the dramas in her mind. It was her pipe-smoking grandma, with whom she shared a room and found refuge with for eight years, that introduced literature and storytelling to her. "She read books to me until she dropped. She was not a big talker, but she told very well-honed stories all about her life. She was the unconditional loving parent in my life and my rock of stability," Duncan said. "If I hadn't of had my grandmother, I think I would have ended up in a booby hatch."
Expressive by nature, Duncan first heeded her talents as a writer, earning a scholarship to the prestigious University of Iowa Writers' Workshop in 1958. It was there, as a student, she met and married Harry, then a teacher and fine arts press director. Eventually, she and Harry moved to Omaha, where he ran the Abattoir Press at the University of Nebraska at Omaha. She acted on area stages and served as associate director of the Omaha Community Playhouse and as artistic director and, later, executive director of the Emmy Gifford Children's Theater (now the Omaha Theater Company for Young People).
She applied drama techniques to her early storytelling. She built her signature story performances around Baba Yaga, a witch character adapted from Russian literature, and a chicken. "Baba Yaga was really the one who broke me open because she could say anything," Duncan said. During the Fundamentalist Right's rise to power, Baba Yaga got her in hot water with some area school districts that outright banned or picketed her shows. She was even spat at once.
Dissatisfied with her hybrid of theater and storytelling, Duncan began shedding makeup and costume to explore and expose more of herself on stage. Once she made herself more present in her increasingly personal stories, she found her voice as a teller. She never looked back at the theater, which she found limiting. "In the theater, you're really not in charge of the material. The playwright or director is. In storytelling, there's no separation of yourself from the story. You have to take total responsibility for it. You can't blame it on the writer or director. It's a different kind of bareness-nakedness, but also a different kind of responsibility."
Speaking of responsibility, she hopes her militant views on cancer increase awareness. It's why she doesn't wear a wig or a prosthesis. "We need not hide the fact this is happening. If we hide the fact we have cancer…we're denying who we are. We're also making it easier for others to get it because we're doing nothing to prevent it," she said. "I hope my actions draw attention to the fact there is breast cancer in the world and that we need to do something to cure it. Moreover, we need to prevent it. Hiding it, to me, says the opposite. That it doesn't exist. Instead, we need to let women know, You have a job to do." She said many women don't self-examine or are afraid to. Why? "They don't want to know."
Duncan's curiosity, passion, concern and whimsy have made her a timeless teller and, when she's gone, her life and work will endure as a never-ending story.
Tall tales: Meet the storytellers spinning edgy new yarns for the digital age (independent.co.uk)
Healing with Story: Healing the Storyteller (health-psychology.suite101.com)
Categories: Entertainment, Folklore, Nancy Duncan, Omaha, Storytelling, Theater, Writing Tags: Breast, Cancer, Conditions and Diseases, Entertainment, Harry Duncan, Health, Nancy Duncan, Omaha, Reader, Short story, Storytelling, Support Groups, Theater
Alexander Payne: His Journey in Film
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The work-in-progress page is devoted to my acclaimed book about the Oscar-winning filmmaker and his work.
"This is without question the single best study of Alexander Payne's films, as well as the filmmaker himself and his filmmaking process. In charting the first two decades of Payne's remarkable career, Leo Adam Biga pieces together an indelible portrait of an independent American artist, and one that's conveyed largely in the filmmaker's own words. This is an invaluable contribution to film history and criticism – and a sheer pleasure to read as well." –Thomas Schatz, Film scholar and author (The Genius of the System)
The book sells for $25.95.
Available through Barnes & Noble, on Amazon, for Kindle and at other bookstores and gift shops nationwide.
Purchase it at–https://www.amazon.com/dp/B01MRORX1U?ref_=k4w_oembed_c1Anr6bJdAagnj&tag=kpembed-20&linkCode=kpd
You can also order signed copies by emailing the author at leo32158@cox.net.
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leoadambiga
Author-journalist-blogger Leo Adam Biga resides in his hometown of Omaha, Nebraska. He writes newspaper-magazine stories about people, their passions, and their magnificent obsessions. He's the author of the books "Crossing Bridges: A Priest's Uplifting Life Among the Downtrodden," "Alexander Payne: His Journey in Film" (a compilation of his journalism about the acclaimed filmmaker) "Open Wide" a biography of Mark Manhart. Biga co-edited "Memories of the Jewish Midwest: Mom and Pop Grocery Stores." His popular blog, Leo Adam Biga's My Inside Stories at leoadambiga.com, is an online gallery of his work. The blog feeds into his Facebook page, My Inside Stories, as well as his Twitter, Google, LinkedIn, Tumblr, About.Me and other social media platform pages.
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Subjects/Themes
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A Rosenblatt Tribute
Southern Fried Love Road Trip Diary I
Southern Fried Love Road Trip Diary II
Paul Williams: Alive and well, sober and serene, making memorable music again
Goin' down the Lincoln Highway with Omaha music guru Nils Anders Erickson
Lucile's Old Market, Mother Hubbard magnificent obsession: From one eccentric to another – Mary Thompson on her late mother Lucile Schaaf
Creative couple: Bob and Connie Spittler and their shared creative life 60 years in the making
Sun reflection: Revisiting the Omaha Sun's Pulitzer Prize-winning expose of Boys Town
From the Archives: An Ode to the Omaha Stockyards
Extremities: As seen on TLC's "Hoarding: Buried Alive" – Mary Thompson takes her life back one piece at a time
Paul Giamatti and Alexander Payne play catch up 15 years after 'Sideways'
Native Omaha Days Story Compilation
Kindred spirits Giamatti and Payne to revisit the triumph of 'Sideways' and the art of finding truth and profundity in the holy ordinary
Women still calling the shots at the Omaha Star after 81 years
Street prophets and poets depict 'A Day in the Life' of the homeless in new play by Portia Love
Duncans turn passion for art into major collection; In their pursuits, the couple master the art of living
North Omaha Summer Arts (NOSA) presents An Arts Crawl 8
The fringe of it all: Omaha Fringe Festival fulfills founder Tamar Neumann's dream
Orsi's: Historic Italian bakery-pizzeria reaches 100
Jazz to the Future – The Revitalization of a Scene
On cusp of stardom, Omaha singer-songwriter Jocelyn follows to thine own self be true path
Omaha native Phil Kenny a player among Broadway co-producers and investors
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