HinesSight

Let's all be compassionate Warriors of Reality in 2021

My hoped for New Year's resolution is that as many Americans as possible vow to do better at being (1) more compassionate and (2) more in touch with reality.

I see these goals as being complementary. 

Compassion requires a clear-eyed view of what is causing our fellow humans, animals, and other living beings to suffer. If we aren't correct about what is real, versus what only exists within our own mind, we'll be thrown off track by misplaced concern.

For example, here in Oregon there's currently a push by some to demand that businesses shut down by Covid restrictions, such as restaurants, be allowed to reopen.

OK, that shows compassion for restaurant owners, most of whom are having a tough time during the pandemic. But it's important to also recognize the reality of 344,000 COVID-19 deaths and the many people who suffer, often for many months, from the virus even though they didn't die because of it.

It isn't easy to find the right balance between compassion for a particular group, and compassion for a different sort of people, especially when doing right for one means doing wrong for the other.

But we have to do our best.

And the only way to accomplish that, doing our best, is to combine the compassion that almost everybody (psychopaths excluded) has for people who are suffering with our equally important capacity for separating fact and fiction in the world at large.

In other words, the subjectivity of compassion should be married to the objectivity of knowing reality as it is. The progeny of this marriage will be offspring we can be proud of: wise actions, productive activism, pleasant feelings of having done the right thing.

Since compassion is a natural reaction to seeing other people going through hard times, on both an individual and societal level we need to emphasize the knowing reality aspect of my Compassion + Reality = Right Action equation. 

Compassion is akin to an engine that propels us onward in an effort to make things better. However, without a navigation system that ensures we're going in the correct direction, we run the risk of wasted motion.

Or worse, destructive motion.

I'm inclined to believe that most people set out to do the right thing. Within their own mind, they've concluded that doing this or that is justified to accomplish some desirable outcome.

Problem is, often their good intention leads to bad results because they are clueless about facts that either are deliberately ignored or innocently unaware of.

Examples abound in 2020. Here's several that come to mind.

The Black Lives Matter protests in Portland started off well: peaceful, with a powerful message of the need to reform policing and end systemic racism. But things went downhill when protesters engaged in property damage and confrontations with police. 

There was no discernible purpose behind the setting off of fireworks, defacing of buildings with graffiti, breaking windows, and such. Business owners in downtown Portland suffered through nightly protests that went on for months. 

It seemed obvious that the Black Lives Matter cause was being hurt, not helped, by the increasingly destructive protests. But reality never broke through into the closed minds of the protesters. They were caught up in the game of taunting law enforcement officers and damaging property for no good reason.

In this case it was liberals, with a heavy dose of anarchists, who failed to realize that compassion for Blacks who endure injustice had to go along with an understanding of the reality that violence in the streets was undermining the legitimacy of the Black Lives Matter movement.

Meanwhile, conservatives and Trump lovers were embracing an ever-expanding variety of batshit crazy conspiracy theories. QAnon infected the psyches of people who believed that Democrats were running a pedophile ring from the basement of a pizza parlor. Then came deniers of the reality of COVID-19, and of the efficacy of wearing masks to prevent infection by the virus.

Currently a large share of Republicans have bought into the baseless claim of their Liar-in-Chief, Donald Trump, that Joe Biden's win was the result of election fraud. In this case I can't discern any degree of compassion in their efforts to subvert democracy and steal the election for Trump.

It's a shameful power grab, an attempted coup, that will end only on January 6 after their last-gasp effort to derail the free and fair presidential election fails in the halls of Congress when 306 electoral college votes are counted for Biden and Harris.

Our country can't thrive, and maybe even survive, when so many citizens are either unwilling or unable to acknowledge reality. Those of us who favor fact over fiction and truth over falsehood can't merely sit by in our comfortable corner of the reality-affirming landscape.

That's why I like the term, Warriors of Reality. When we see that someone -- elected official, Facebook friend, whoever -- is trying to tear down the shared reality that binds us together, we need to say "No! This is the truth. You have no right to your own facts, just your own feelings about what is true."

Reality is the ultimate big tent. Reality holds everybody who chooses to take shelter under it. Reality doesn't need us; it is we who need it. Reality is more important than the air we breathe, the water we drink, and the food we eat, because reality is what makes all these things possible.

Deniers of reality not only harm themselves, they also harm all of those who depend upon it -- which is everybody.

So if you've ever felt the need to fight for something, fight for reality. With compassion, not violence. Those who deny reality often don't know any better. Giving them facts in a calm, cool, collected manner may help them.

If not, reality still stands, with or without them.

 

I finally fill out an Advance Directive. But not a POLST.

Well, it only took me about forty years. Better late than never, as the saying goes.

Tomorrow I'm taking an Advance Directive to my family physician when I go for my annual physical exam, so it can be made part of my medical record. I've had this booklet from Oregon Health Decisions sitting at the bottom of a pile of papers in my office for a year, at least.

This booklet replaced a previous booklet that I lost or threw away.

It's kind of strange that I've been so reluctant to make my end-of-life wishes known, since I was the first executive director of Oregon Health Decisions in the 1980s, when this pioneering citizen-based bioethics organization got off the ground after a brilliant psychiatrist, Ralph Crawshaw, worked to get it going with the help of me and many other Oregonians.

In fact, I wrote the first advance directive booklet published by Oregon Health Decisions. Since back then I was in my 30s, whereas now I'm 72, it made sense that I'd put off filling out an advance directive for quite a while.

And I readily admit that as I grew older, I did my best to avoid thinking about the not-so-cheery prospect -- a certainty, actually -- of my eventual death.No longer. Yes, I'm still pretty damn healthy, though I have a couple of health problems. Most people do at my age.

I just felt it was time to do the Advance Directive thing. Probably the Covid crisis helped spur me to do this, since the prospect of being kept alive via a feeding tube, ventilator, or whatever when there is no hope of recovery isn't an appealing notion. 

What gave me the most trouble was deciding whether to complete the brightly colored POLST form that had been inserted in the booklet. That stands for Physician Orders for Life-Sustaining Treatment. My wife, Laurel, has a POLST even though she also is healthy with just a few relatively minor medical issues. 

Laurel is convinced that she doesn't want CPR, should this ever be a consideration. I believe Laurel is correct that the view of CPR in movies and TV shows, where a person recovers nicely after getting this potentially live-saving procedure, often doesn't reflect reality. For example, one CPR web site says:

Overall, all of these side effects mean that, if a person does survive CPR, their long-term health could suffer and they may be alive, but it is possible that their overall health and quality of life is significantly affected. Additionally, the psychological ramifications of a near-death experience can greatly affect a survivor, leading to anxiety, stress and depression, among other psychological conditions.

A POLST appears to be the only way to make sure that you don't get CPR, since a POLST becomes part of a registry available to medical professionals, and you can carry a POLST card with you. 

On the other hand, the POLST form says that it "is usually for persons with serious illness or frailty." And POLST.org has this FAQ about which patients should be offered a POLST form.

The POLST form is not for everyone; a POLST form is appropriate for patients who are considered to be at risk for a life-threatening clinical event because they have a serious life-limiting medical condition, which may include advanced frailty. For these patients, their current health status indicates the need for standing medical orders for emergent or future medical care.

Also, these are the patients at the greatest risk of having a medical emergency but who may not want our standard of care (standard of care currently being that everything possible to attempt to save someone's life must be done). For healthy patients, an advance directive is an appropriate tool for making future end-of-life care wishes known to loved ones.

So I decided to complete an Advance Directive, but not a POLST. I can always go the POLST route later, should this seem like a good thing for me to do. 

The Prom is a great feel-good movie (ignore The New Yorker)

Hah! A seventy-two year old father, me, showed in one instance he's more culturally with it than his forty-eight year old daughter, Celeste. 

Usually Celeste has seen, or at least heard of, cinematic offerings before me. After all, she lives in Orange County, which is a lot closer to Hollywood than I am here in Oregon.

But in a post-Christmas FaceTime call this afternoon, I asked Celeste if she had seen The Prom yet. No, she hadn't. And it appears she wasn't even aware of this Netflix production.

I highly enjoyed The Prom. So did my wife. I don't get why Rotten Tomatoes has it with a 58% positive review from critics and 68% from viewers. 

In my utterly personal opinion, this story of two girls who aren't allowed to attend their Indiana high school prom as a couple was well-acted, entertaining, and moving.

It's full of song and dance numbers involving the four lead actors: Meryl Streep, James Corden, Nicole Kidman, and Andrew Ranells. I thought the last two sentences of The New Yorker review by an overly snooty Anthony Lane missed the mark.

It's possible both to agree entirely with the movie's politics and, at the same time, to feel that you're being strangled by a rainbow, and we should thank the Lord that "The Prom" wasn't released before the election. I can think of some states, not just Indiana, where wavering voters, disgruntled rather than wowed by the film's remorseless plea for tolerance, might have swung in the opposite direction.

Well, maybe those of us old enough to distinctly remember when lesbians and gays were really discriminated against in high school, way beyond what The Prom shows, find the aforementioned "remorseless plea for tolerance" more appealing than younger viewers like, perhaps, Lane.

Having spent 1962-66 at a small (400 students or so) central California high school in Woodlake, I watched the inspiring end of The Prom with tears beginning to form in my eyes.

Partly because I admired the courage of the student, Emma (played by Jo Ellen Pellman), who wants to take her girlfriend to the prom and meets resistance from a behind-the-times parent organization. 

And partly because I was inwardly cringing at the memories of how the guys in my high school referred to homosexuals. We'd throw around insults like "You homo!" and "Faggot!" with gleeful abandon. 

Naturally there weren't any known lesbians or gays in my high school. Yet probably they were there, just underground. In fact, they might have been using those epithets I just shared themselves. If you're afraid to be outed, you have to show that you're part of the heterosexual in-club.

I wish I could apologize in person to anyone harmed by how we spoke about homosexuals back then. My only excuse is that we didn't know any better. There was zero mention of homosexuality in any class I took in high school, so far as I can remember.

Plus, there definitely was no attempt by the teachers to encourage respect for diversity, including different ways of expressing one's sexuality than the societal norm. Back then homosexuality was viewed as an aberration, a moral failing, something to be mocked and condemned.

I can understand why young people today who live in liberal areas might look upon The Prom as making a big deal out of something that is taken for granted by most high schoolers today: being attracted to the same sex not only is no big deal, it isn't any sort of deal, just the way things are.

That's wonderful. But The Prom still has a message that needs to be heard, because not everyone agrees with what I just said. Are you listening, Indiana? 

Here's the trailer.

 

The Dreaded ChristmasLess Newsletter is funny and dark

For your holiday amusement, here's the 2020 Christmas letter from Nancy, a friend of my wife. Nancy has a great sense of humor that leans toward the dark side -- which I find highly appealing.

I've changed the names in the letter just in case anyone doesn't want their identity splashed across cyberspace. Enjoy....

The Dreaded ChristmasLess Newsletter

Not much going on this year. I got to know my couch better. Discovered new flavors of Cheetos. Immediately answer all emails, texts, IM, voicemail, tweets, Instagram, GroupMe, anything really as I am just so gosh darn happy to communicate in some form with a human.

On March 16^th, I realized that every type of employment I have involves people. Tried teaching Aqua Aerobics online but appearing in a swimsuit made the internet crash. Wanted to continue playing for churches but it’s against the law.  

Smartly, I began teaching piano online. Acquired lots of students from Russia and Somalia who will be paying me as soon as I forward all my bank account info to them.

Didn’t realize how much I missed being able to smack around a tiny little ball until Squash was forbidden this year. Took up PickledBall, a fun game where you drink 5 shots of tequila and then try to make a useless plastic ball go somewhere. My powerful serves are working well against opponents who fearfully wait from 2 courts away.

On July 26^th, Thomas was born. Never before has a child so bright, athletic, intelligent, handsome, and funny graced our planet. Can’t actually go visit him, but Marissa sends me photos and videos so I know he is not just something else that my mind created. He sleeps well through the night with just a little nip before bedtime.

Sara has single-handedly revived the economy in our area with frequent use of DoorDash and UberEats. By spending $50 on an order of french fries, she supports our local economy. She continues her studies, now entering her 14^th year of university. Not to be outdone, Robert has also gone back to school trying to Master something or other.

Waldo, our seriously solemn stray, likes the pandemic. Sara and I fight over whose turn it is to give him a walk.  With no pesky piano students around trying to pet him or inflict other acts of indulgence, he leads a carefree existence.

As this marks the strangest year ever, I have seen kids begging to go to school, forbidden by their teacher to watch presidential debates and barred from sports fields. For us adults, a night out means dressing up for dinner with a mask, gloves, fleece or fake fur, and then being escorted to a table in the street.  

 Anxiously awaiting the New Year, or really any year except this one, we wish you a Merry Mazel Tov and Happy Blursday.  

Wait, what day is this?

Pac-12 championship game shows how sports imitates life

Yesterday the Oregon football team defeated USC 31-24 in the Pac-12 championship game. The win was satisfying for me in many regards, some of them philosophical.

Not that philosophy was on my mind as I watched the game with rapt attention. I got so nervous in the fourth quarter I was shivering with excitement and worry, so had to put on a sweater to make it through the final minutes.

There's something about a well-played close football game like this one that resonates for reasons well beyond the obvious.

Sure, Oregon was the underdog, a 3-2 team that was in the championship game only because Washington, who came out on top in the Pac-12 North, wasn't able to play because of their Covid cases.

So that produced a pleasing plot line. Oregon backs into the championship game in a surprising fashion, encountering big bad USC with a 5-0 record, an excellent quarterback, and a top-notch receiving corps.

Those were some of the big themes that laid the foundation for an intriguing football game. But as I was recollecting high points from the game after it was over, I kept thinking of the small things the game turned on.

Which reflects my philosophical interest in chaos. I delved into chaos theory when I was writing my first book in the mid-1990s, a study of how the new physics related to ancient mysticism. 

I learned that chaotic systems aren't random. They're deterministic. However, the determinism is non-linear, since a small change can have a big effect.

The "butterfly effect" is often cited as an example of chaos, where theoretically the flapping of a butterfly wing in one part of the world can lead, through atmospheric causes and effects, weeks later to a hurricane happening in another part of the world. 

Of course, those small changes are so difficult to discern, most of us look upon our life as being the result of Big Things, not small things.

We ascribe the general course of our life to our personality, our education, our upbringing, our genetics, and such -- not, say, to an overheard conversation in a college cafeteria (I've told that story on one of my other blogs).

Likewise, the outcome of the Oregon-USC game looked like it was going to be determined by whether USC could pull off another win in the fourth quarter after trailing for the entire game, which they'd done several times before this season. Their talented quarterback, Kedon Slovis, appeared to be on the way to doing that with about four minutes left. 

I recall an announcer saying that Slovis was trying to throw the ball away to avoid a sack. Or maybe it was just a really bad throw. Regardless, at first it looked like Oregon defensive back Jamal Hill wasn't able to intercept the pass while staying in bounds. 

Then instant replay showed that Hill did manage to pull off he interception in an amazing fashion. Behold...

That changed the course of the game. Oregon went on to win. Now the sports talk is whether Oregon deserved the victory that gave them the Pac-12 championship. Some say no. Some say yes. 

All that talk rests on some small things. Hill juggling the ball and being able to control it at the last moment as he fell out of bounds. One of Hill's feet being inbounds by an inch or two. Slovis throwing the ball in just the right way to allow Hill to barely intercept it.

Without each of those small things happening, the Big Deal of Oregon becoming Pac-12 champions could have been erased. 

Such is life. The proverb "for want of a nail," says Wikipedia, is a reminder that "seemingly unimportant acts or omissions can have grave and unforeseen consequences."

In this case it was grave from USC's point of view, fortuitous from Oregon's point of view. Last night's game showed that victory or defeat, joy or sorrow, success or failure, and so much else, often hinges on factors that appear to be insignificant in the grand scheme of things, yet make a big difference. 

Bottom line: life is marvelously unpredictable. And, really, who would want it any other way? A game of inches is much more interesting than a game of yards.

Our 2020 Christmas letter finds some humor in Covid

This year it wasn't easy for me to write our 2020 Holiday Greetings. Usually it is.

But 2020 was such a depressing year, with 300,000 COVID-19 deaths in the United States, at first I wondered if a Christmas letter from Laurel and me was even appropriate.

Laurel convinced me that it was, after seeing a serious first draft of the letter. She argued that looking on the light side of disturbing situations helps us get through those tough times. 

OK. That was convincing. So I started over. Here's the result in both PDF and JPEG formats.
Download 2020 Christmas Letter PDF

SpeediCath Flex Coude Pro is the best male catheter

Since May 2017 I've used a catheter after having a urinary retention episode that showed my bladder had become atonic, a fancy word for not working any more as it should, likely due to my lengthy history of an enlarged prostate.

I haven't written a whole lot about my experiences with a catheter. Recently I decided I should, starting with a post that has a rather plaintive title, "I've learned a lot about using a catheter. But does anyone care?"

In that post I listed some questions that I wanted to address in other blog posts, regardless of whether anyone cares. If even one person finds what I have to say useful, that's good enough for me, even if I can't be sure that this person exists.

Question #1 was What brand of catheter is best?

That's easy to answer: the SpeediCath Flex Coudé Pro. Yes, it's more expensive than most other catheters. But you get what you pay for. And in my case, Medicare is paying for most of the cost.

At first I was given some sample catheters by the nursing staff at my urologist. I started off using the basic red catheter that has to be lubricated. I wore plastic gloves because that was advised and I didn't want to get a urinary tract infection. That catheter took considerable preparation to use and wasn't very comfortable.

Then, on a return visit, a nurse gave me a sample of the original Flex Coudé  prior to it becoming "Pro." I instantly realized how much better it was. 

After washing my hands in a sink and cleaning the end of my penis, I simply open up the sterile packaging, take out the catheter, unhook the ends that are fastened in a circle within the package, and drain the lubricant into the sink.

Then the pointy end goes into the penis. A sheath covers the plastic catheter, so I never touch the part that goes into the urethra. Thus no need for gloves.

The design of the Flex Coudé Pro just seems really well thought out. There's nothing else like it, I'm pretty sure, because I've looked for a better catheter and haven't found one.

By the way, the "Pro" designation came after a minor redesign of the tip after a competitor, I gather, complained to Medicare that supposedly it didn't have a genuine coude tip.

So now the tip is angled slightly, rather than straight as in the photo above. I didn't find much difference in how easy the catheter was to insert between the original and Pro versions.

My urologist's office suggested I use 180 Medical for catheter orders. I've been happy with their customer service.

I've learned a lot about using a catheter. But does anyone care?

In May 2017 I had a urinary retention episode while on vacation in central Oregon that kicked off my life with a catheter at age 68. Now I'm 72 -- still doing the intermittent catheterization thing five times a day.

It took me about three months before I was able to first write about my situation in "Given my peeing problem, be warned about asking 'How are things going?""

Since, I've written fifteen other posts about my life with a catheter. That's a thin (thankfully) plastic tube that is inserted into the urethra and thence into the bladder to remove the urine that, for one reason or another, isn't flowing out like it needs to. 

Those posts are in the "Living With a Catheter" category of this blog, which used to be called "My Peeing Problem." Categories are listed in the right sidebar.

I've learned a lot about how a man, me, copes with the massively life-changing event of artificially urinating on a schedule rather than just popping into the nearest bathroom, or behind the nearest tree, to take a piss. 

I try to think of using a catheter as being differently abled, peeing-wise, but that only works in my better moments.

And much of the time, I'm not having a good moment. That was true more often in the early days of my catheter use. Now I've settled into a routine that goes pretty well for me -- aside from the occasional times that it doesn't.

The question I'm grappling with now, as indicated in the title of this post, is whether any man out there who is using a catheter wants to know what I've learned about handling life with a catheter. I've only gotten a few comments on the other posts I've written, so part of me wonders if there's any purpose in writing more posts.

In case you're interested in any of the following subjects, I'd appreciate your leaving a comment on this post to that effect. Or, email me.

I'm very much willing to share what I've learned, but I'd be more eager to do this if I had a sense that there are other men wanting to know what I've experienced during the past three and a half years. Here's some of the questions I've grappled with and found personal answers to.

(1) What brand of catheter is best?
(2) What routine should I use before inserting a catheter?
(3) What to do when a catheter won't go into the bladder?
(4) How to handle anxiety, and even depression, about having to use a catheter?
(5) Can you travel when you need to use a catheter to urinate?
(6) How much to tell others about your bladder problem?
(7) How to deal with urologists who aren't very sympathetic?
(8) What's the best place to get catheters?
(9) Could diet play a role in how easy it is to insert a catheter?

There's more that I could share about my life with a catheter, but these have been some key issues for me.

I might go ahead and write about these questions, sharing the posts as links underlying each question. As noted above, I'd simply feel better if I knew that some other men were interested in the answers.

Monkii 360 is my favorite Covid-era home workout device

Here in Oregon health clubs have been closed for most of the pandemic. I'd been working out three days a week at Courthouse Club Fitness, so needed to find an alternative way of getting in my usual dose of aerobic exercise and weight training.

I've bought five devices that seemed promising. Three of them currently are sitting unused. I'll mention them briefly, then share what I like about the #1 and #2 favorite home workout devices.

(I walk two miles a day with our dog up and down some fairly steep hills, so my device focus has been on strength and core exercises.)

Early on I got a Gorilla Bow. I used it for a while, but it didn't appeal to me all that much. The Activ5 is a palm-sized gadget that lets you do isometric exercises via a smartphone app. At first I liked it, but eventually it came to seem too difficult to use correctly. The Nucleus Central Core Pro is a simple water-filled device that I'd still be using if I hadn't discovered...

Monkii 360. (Scroll down that web page to see a video and description of the device.)

As shown in the photo above, Monkii 360 consists of a cleverly-designed ball with hand grips that allow you to grasp it in different ways depending on the exercise you're doing, resistance bands ranging from 20 pounds to 45 pounds that afix to the ball via a carabiner in three possible locations, and optional weights that fit inside the ball to adjust the intensity of a workout.

The other end of a resistance band is easily tethered to a door in your house -- either at the top, side, or bottom. A well-designed smart phone app leads you through a variety of multi-day programs such as Cardio, Core, and Hybrid (mix of Cardio and Core).

I've been using the Monkii 360 every day for about five weeks.

I finished the 36 day Hybrid program a few days ago. It starts off with short easy workouts, then ramps up considerably by the end, where a heavier internal weight and stronger resistance bands made for a pleasingly sweaty 20 to 30 minute workout session. 

The smart phone workouts are a blend of timed exercises, short rest periods, and exercises with a set number of repetitions.

This makes for an enjoyable workout that is challenging, yet not excessively so. I still enjoy my Monkii 360 as much, or more, as when I first got it. Every day I look forward to heading to our utility room, which has the best door for attaching the device, and experiencing another workout on whatever program I'm using.

Bottom line for me: Monkii 360 is a fun way to exercise at home. It's a full body workout, for sure.

I've gotten considerably more fit after using it for the past five weeks, and I was in pretty good shape before. The wide variety of movements you can do with the device makes it a winner. It can be used by people of all ages and fitness levels. 

I feel good that at the age of 72 I was able to get through the entire Hybrid program with no problem. Here's a video that explains Monkii 360 nicely.

Lastly, I can also recommend the OYO Personal Gym. I use it every day after doing some physical therapy and yoga exercises in front of the TV. It's well designed and is a good substitute for lifting weights. I just can't call it fun, like Monkii 360 is. For me, at least. Your opinion may vary, naturally.

How to get MacOS Big Sur to show a flag next to emails

After installing the MacOS Big Sur upgrade, I was dismayed to find that the beloved red flags in the left column of Mail, which I'd used a lot to indicate messages I needed to do something with, had disappeared. 

When I clicked on "Flag" in the menu bar, a flag would appear in the email message itself, but not next to it as was the case before Big Sur.

Thankfully, a bit of Googling revealed a simple fix. Just right-click the "Subject" box near the top of the screen and make sure "Flags" has a check mark next to it. 

Once it does, voila, the flags appear as before. Here's a screenshot of some flag-happy messages in my inbox.