The Love Of Money

"A billion here, a billion there, pretty soon, you're talking real money." [Or words to that effect.]
-- Senator Everett Dirksen (R-Ill)

This is pretty personal. I almost got killed off last Sunday. No exaggeration, I'm serious.

I have a condition called COPD, which is the new designer acronym for emphysema. I take several medications like Advair and Spriva, and I've also used an Albuterol inhaler for some time. My condition worsened late last Summer, and I was being prescribed combinations of prednisone (steroids) and antibiotics. The first antibiotic used was labeled SMZ/TMP (short for sulfamethoxazole/trimethoprim, or something like that), but I had a bad reaction. Apparently, I'm allergic to sulfa-based drugs. We tried other antibiotics, with little effect, and I kept getting worse. In December, I had to switch doctors because the one I'd been seeing left private practice, and the new doctor prescribed the Nebulizer for an Albuterol vapor therapy. Initially, when I tried this, I started feeling better, sort of, and mentioned the Nebulizer in my New Year's Day blog. But wait! There's more!

The full name for Albuterol is Albuterol Sulfate. Sulfate, get it? Sulfa-based. Uh-oh! Gradually, my system's intolerance for sulfa drugs began to take over. I'd been having enough physical problems anyway, it was hard to sort out what was going on. I was thinking more that my health was deteriorating badly, and was becoming concerned that I might soon become unable to care for myself. As far back as Christmas, I'd had such difficulty getting around that I whimpered about it a little bit to my therapist (yes, I have a therapist. Surprised?). By last Sunday, January 13th, I was in a pretty bad state.

I was in between NFL playoff games, and I needed food. Going to the super market had begun to be a rather harrowing adventure. I'd become so short of breath that I could only go so far through the grocery aisles without having to find somewhere to pause and catch my breath. By the time I got back to the car, I would be exhausted. Sunday, however, was much worse. I started out by hitting the shower, but I really couldn't breathe at all. I hung to the shower rod a while, lifting my arms to try and provide extra leverage for air to come in, but I was losing ground. Afterward, I lunged into the bedroom and fell backwards onto the (unmade) bed. The coverlets bunched at the bottom of the bed raised my buttocks above my head, and I felt as if I were being waterboarded. My bronchial tubes had slammed entirely shut, and only sheer force sent any air through my system at all. The position I was in wasn't helping, and I was starting to lose it. I was able to force myself to a more level situation, fortunately, and felt marginally better after another twenty minutes or so. If I'd passed out a few minutes earlier, I might not be writing this now.

I went ahead to the grocery store. Basically, I was just crazed at this point. I was already straining badly just to get inside the store, and by that point I knew I was in trouble. I clung to a display as inconspicuously as possible, and looked around. The inside of the store might as well have been the Grand Canyon, it seemed so vast to me, but somehow I made it through and paid for my items. It must have taken forty-five minutes, all for a small hand basket of things. After paying, and having to acknowledge my difficulties with the cashier who couldn't avoid noticing, I grabbed one of the chairs at the pharmacy and sat for a while trying to collect myself and get back to the car. Again someone checked on me, but I assured them I just needed to "catch my breath." The truth was, my bronchial tubes still weren't working at all, and I actually started to worry about the oxygen supply to my brain. I think that part's ok, as I still appear able to solve relatively complex equations (2+2=5, right? I remember reading that in a book last week.).

Long story short, I got back to the car, finally. There were more struggles, and a couple more inquiries about my health just outside the store when I had to pause yet again, but I made it. The experience was oddly like one of those nightmares, when you discover you've been going around unclothed, because I felt so exposed. Things were so obviously bad, I realized I needed to analyze this situation further, and I decided that since the Albuterol Nebulizer treatment had been the most recent change in my routine, it had to go. For the remainder of the day, about all I could do was veg out, and make sure at least some air was working its way through my dysfunctional pulmonary system, and I called the doctor's office on Monday to request changes in my medication.

I'm feeling a whole lot better. I'm not ready for cartwheels, but my bronchial tubes are almost working again. They're not wide-open superhighways, but they're somewhat flexible and yielding, almost like what you'd expect in a living system. I had an extreme reaction to the sulfa-based medication, one that really might have been the last reaction I would have to anything. How does that sort of thing happen? When I switched doctors, I noted on the first papers I filled out for them that I had a probable allergy to sulfa-based stuff, and I probably should have checked out the Nebulizer setup more carefully myself, but hey, I'm the patient, they're supposed to know what they're doing, right?

So, was this malpractice? Oh, I don't know. I don't think the Seattle area is overrun with pulmonologists, so I kind of need these people. I can burn bridges with these doctors, but that may not be the best idea. Did I get superior quality treatment? I will leave the answer to that as an exercise for the reader. I mean, me and the tobacco companies have worked very hard together for many years to get me to this point, and by the time I come to the pulmonologists, it might be understandable if they just throw up their hands and ask what on earth I expect them to do. In a way, in a kind of abstract sense, I can see that. Of course, if it's the very last thing I see, that colors my perspective a little.

So, we've really gotten autobiographical here, but hey, how many more chances might I have to talk about me just a little bit? If I actually should kick off sometime soon here, I'd want to have made this entry in the blog, just for the record. But this ties into a lot of themes, and there's nothing like a stark encounter with mortality to sharpen the focus. My preferred exit would be at the age of ninety while in mid-tryst with a beautiful woman, but my bad habits are going to seriously truncate such expectations. Nonetheless, I'm not ready to go just today, or tomorrow either. I want to see the Cleveland Browns win the Super Bowl, and to see George Bush leave the White House voluntarily to be replaced by a truly progressive leader. I want to learn more about how to live a more enlightened life, and maybe to have some effect on the dialogue we're having now. I want us to think just a little about the basic premises we want to live by, while we still can. I want to be around you folks just a little while longer.

Most of the goods and services we have available now don't really reflect the spirit of craftsmanship that's been so highly valued throughout history. The mechanization of society has placed us on an assembly line on a global scale. Medicine is certainly all about the profit margin, and those in the medical profession are mostly swept along in a direction they might not have chosen for themselves. Even at Microsoft, where craftsmanship is often so very good, I had difficulties maintaining my own standards in that area due to the pace and the volume of what was expected. We're so tilted toward production that we've lost sight of too much of the process, I suspect, and we've lost some appreciation for each little step along the way. Our perceptions are skewed, and I still think it's causing more problems than we've come to accept.

I can breathe a little bit easier now, and each breath is a little more special. If I think about how many breaths I've got left, I'll get in too much of a hurry again. I look around, and I think we've really gone through the looking glass. We know that we have to change things, but we cling to the coattails of anyone who promises to keep us safe. I hate to tell you this, but it's not you they're going to be looking out for when the stuff starts flying. You're going to have to learn to deal with some of these problems yourselves.

We have so much unreasoning fear. In my years in New York theater, and in software development in Columbus, Chicago, and Redmond, I've existed in an exuberantly global environment, filled with talented people from literally all over the world. I've argued world problems over lunch with Jews, Muslims, Buddhists and Christians all at once, and I've come to know just how deeply alike people are the world over. There's a whole lot of globalization I'm not only not afraid of, but look forward to with eager anticipation. I like the people of this world, and while there is certainly plenty to fear, by and large, it's not the people. FDR was right, you know, that fear is still the only thing worth fearing. When we're afraid, we look for protectors and shrink from contact; when we're brave, we speak up for ourselves, and reach out to others. I say, be brave!

In our heart of hearts, we know the right path to take. If we can stay calm, and keep that path in sight, we'll know how to proceed. We'll understand how we need to compromise, how to bridge the divide between one way of doing things and another. It's when we lose sight of the basic values, the essential craftsmanship of our efforts, that we start to flail.

You want to find the truth of Zen to help you go forward? Go out to a lovely spot in the woods, or a peak that overlooks a beautiful vista, and sit quietly for just a moment. The thing you first felt in that first brief moment of silence is all there is of Zen. There is nothing else, except to try and gauge your behavior in the world to be more in line with the simple truth of such moments. It's in that spirit, and with that knowledge of the truth in all our hearts, that I say go forward. Let's see what happens next.