RIVERSIDE

One of the fixtures in family life on the upper west side is the Riverside, funeral home that is.  We have all been there, touched by the sadness and the formality and the dark suits and black hearses and limousines.

When my father died in 1970 I was not quite 21 and dealt with tragedy as a smart ass kid.  Riverside was the place to go and I went with my father’s cousin Richard (Dick) who was now the father figure.  Richard would later become my father-in-law but in 1970 he was cousin Richard.

The picture below is of the two of them as children in their world war one costumes.  It is a treasured family memento.

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At Riverside we met with someone and then rode an elevator to the basement which housed the coffin displays.  On the elevator I recall asking the operator if I could drive; it was just like the one at 222 and I knew what to do.  He said no.  

When we exited the elevator we were confronted with Riverside’s most expensive offerings.  Here again, the smart ass emerged and asked where are the cheaper ones?  We wended our way through several rooms and the boxes got less and less fancy and, of course, less expensive.

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In the last room, in the back of the room, stood the plain pine box.  It is a Jewish tradition to go with the pine.  I could not do it.  My dad deserved better I thought.  Next up was a beautiful pine box with some curves and a Star of  David on the lid.  That was it.  Done.

Well, not quite.  Now there was the choosing of the room for the service.  Here, I was not a smart ass; I knew what I wanted, the biggest room they had.  Richard and the Riverside guy tried to talk me out of it.  It’s August they said, so many people out of town; a waste of money.  I insisted.

There was an obituary in the NYTimes, it was way too small for a man of such accomplishment but it was the NYTimes. 

As was the custom, the attendees were in the chapel and the family, what there was, came in last.  At first, I was afraid to look but after we were seated I turned and found a standing room only crowd.  Heat of August be damned, vacation season be damned; my dad was honored and remembered by many.

As I wrote that last paragraph I teared up again, as I did then, and as I have whenever I think of that room and all those people who had come to remember who and what my dad had been.  The bad stuff was put aside. He was a good man, an accomplished man.  

The Rabbi who officiated at his funeral was Ira Eisenstein.  He had performed the wedding of my parents.  In a manner of speaking the circle of life was completed when, many years later, Ira died in the hospital at which my sister was Chaplain.  

Sports in 9E

We were big baseball fans in apartment 9E; the NY Giants to be precise.  My hero was  Willie Mays (centerfielder), my sister if I recall correctly liked Whitey Lockman (first baseman).  We all thought the world of Alvin Dark (shortstop).  These were exciting times.  New York City had three baseball teams, our beloved Giants, the National League enemy Brooklyn Dodgers and the American League enemy the New York Yankees.

One of the saddest days in my life before the age of ten was learning that the Giants would be taking Willie Mays to San Francisco.  The owners voted in May 1957 and the team moved from the POLO Grounds in 1958.

Willie Mays was an amazing athlete, famous for his basket catch among other things. I knew him not only for his stardom but for the season he played with a fracture of the glove hand.  (Today, a twisted pinky puts a player on the disabled list).  I also remember reading about the gold hardware supposedly to be found in his bathroom in California. 

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I only saw the amazing Willie play live one more time after the NY departure.  In 1958 or 1959 they came east to play the Philadelphia Phillies in a weekend doubleheader (either Saturday or Sunday).  We went on the train.  I don’t remember if it was all of us or some of us, but dad and I were there at the Connie Mack Stadium.*  

Baseball was by far the favorite sport in our apartment but not the only one followed.  The NY Giants was also the name of our professional football team.  I say professional because we rooted for Navy every year; big fans of Joe Bellino, 1960 Heisman Trophy winner, an extraordinary halfback.

The football Giants gave our family Y.A.Tittle who was also a star in the early 60’s leading the Giants to three NFL titles.

It was the loss of the baseball Giants that resulted in my loss of interest in professional baseball and eventually other professional sports as well.  Years later I would follow the NY Apples Tennis Team and eventually World Cup Soccer.  

* Cornelius McGillicuddy, better known as Connie Mack, was an American professional baseball catcher, manager, and team owner. The longest-serving manager in Major League Baseball history, he holds records for wins, losses, and games managed, with his victory total being almost 1,000 more than any other manager.

A New Journey Three

When mom died I had not lived at 222 for fifteen years.  When dad passed at the age of 60 I was almost 21 and still on 83rd Street.  Dad died in a hospital, returning there after some time being miserable at home.  Mom died in a nursing home after a considerable and unhappy stay.  She died in an accident when someone left the bedrail down.  The details are horrifying and will not be exposited here.

Mom’s death, I did not realize until my hospitalization and my confinement at rehab, left me with a sensitivity to bedrails and their use for my own safety.

 

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The trip to rehab was carried out in a crappy old ambulance from a private company.  Jean had worked for this company for many years on Sundays and one of the emts remembered her.  So, when we arrived at the skilled nursing facility (SNF) that specialized in short term rehabilitation and Jean was waiting for me, there was a reunion of sorts.

The rehab experience was mixed.  My first night, a Monday, I was pretty miserable but the wonderful night shift RN spent an hour with me and got me calm enough to sleep.  The rehab professionals, OT and PT showed the next morning to conduct initial assessments. 

The medical doctor was a consultant and finally appeared late on Wednesday afternoon after much consternation and family intervention.  It was later explained that the consultant model was in use and that an institution such as this had days to evaluate medically.

My only problem with this was that the MD was relying on the medicine orders from the hospital which were wrong.  He also had to order lab work because none was shared for the transfer.  How dumb is that?

My roomy and I could not have been more different.  He was older, Italian and Catholic.  I, well you readers know. We did not discuss politics. My liberal west side of manhattan political leanings and his conservative trump liking inclination did not mix and we agreed not to examine our differences.  To say we took care of each other would be an understatement.  Louis constantly encouraging me, his wife getting things, and me calling the front desk on my cell phone for help when he was ignored for so long that he was yelling “help”.  

The OT and PT services varied by assigned worker.  But they were helpful no matter who delivered them.  

Nursing services were different.  In the SNF like the hospital, staffing was spread very thin and assigned inconsistently as to patients;  the CNA that worked with Louis and I one day, would be across the hall the next. We were also living in a place were medications were “passed” by LPNs (Licensed Practical Nurses) for whom you waited for a considerable amount of time if you wanted something outside of their medication administering schedule.  So, for pain medicine you could wait.

The regulations permit very few RNs.  This is unfortunate in many ways, particularly because in the late afternoon, through the night and weekends they are in charge and there are at most two for a 100 bed facility.  Complaints were handled at this level.

I was trouble.  Besides making a scene about not seeing the doctor who was writing orders for my care, I experienced numerous medication “near misses” as they were called and one medication error I was sure occurred.  These troubles upset me not only for myself but for the numerous other “residents” who did not have my experience in health care or were unable to speak for themselves.  

I do have to mention the food.  They had a new food service director I was told more than once.  But just like in the hospital the food was institutional and errors were frequent.

The focus was rehab and as I said above it was good.  They wanted me to stay longer but my mental state was deteriorating and we believed I could continue to improve with home based services.  The care plan/discharge meeting was not going the way I wanted it to go until Jean called in.  She helped make it very clear that I needed to go home and in the end the family rules.  The irony was that medicare cut me off the day I was to leave.

I’m still using a walker but moving toward the cane.  It’s hard.

There is more of course, but, dear readers, I owe those of you who stuck with me a return to stories of growing up on the west side.  Thanks for reading.

A New Journey Two

In Part One you read about my ambulance and emergency department experiences.  I look upon the next chapter as my going beyond the healthcare experiences of my youth.  My pediatrician is the only medical doctor I recall from my childhood.  It was the era of awe and house calls.  Everybody respected the doctor and when he arrived in Apt. 9E we were no different.  My mother and father tripped over each other making sure Dr. E was comfortable and we always followed his instructions to the letter.

NYPresbyterian Queens is a teaching hospital, that is always interesting. Difficult to adapt to is the replacement of doctors with physician’s assistants (PAs) to make moment to moment decisions and pop in like they own place.  Some of the interactions with PAs were great. And then there is also the arrogance of the PAs who are actually doctors from other countries who either chose to not do what was necessary or were unable to complete the requirements.

One PA in particular, a young woman, came to my bedside more than once to find out what was going on or explain things.  Unfortunately, she was atypical.

Staffing was a significant issue.  There was a day when RNs had ten patients each on a post op unit.  There was a day Nursing Assistants had 12.  Professionals and Paraprofessionals cannot provide good care under these conditions.  At one point I complained to my surgeon’s partner about the nursing staffing and he acknowledged it and said he had written about it.  The next day, the RNs had six patients.

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What struck me as troubling and fixable was the assignment of nurses and certified nursing assistants (CNAs) to patients.  Part of the problem is the three twelve hour shifts the RNs work.  It would be nice if nurses were assigned for their three shifts to the same patients.  A reduction in errors would no doubt be accompanied by more comfortable patients.  Consistent assignment of CNAs who do the most intimate things to and with patients would also be of comfort to patients.

Nursing is a profession with which I am quite familiar.  My professional career brought me in contact with “staff nurses,” nursing supervisors and nurse managers.  Some of my best friends were the latter over 12 years in one hospital.  To say the job is difficult in an inner city hospital is an understatement. In addition to the staffing issues the work requires focus and precision when passing meds, compassion when speaking to and listening to patients, and decision making prowess when squeezed between patients and PAs and doctors.  These men and women, on the frontlines, truly carry lives in their hands.

While the times have changed the medical profession has been slow to move forward.  Patients’ privacy seems more of a concern (there is law) than listening to what they say.  If I answered the question about back pain once, it must have been at least 25 times in 10 days.  My answer was always the same, “I don’t have back pain, I never did, the pain was in my legs, that’s why I couldn’t walk.”  

The biggest exception to this difficulty was the surgeon I chose; calm, soft spoken, patient, attentive and skilled, this physician was not at all like any surgeon I have ever encountered.  It was wonderful to be heard.  He was kind like Dr. E the pediatrician had been.  He exuded an air of confidence and one of kindness that was of inexplicable value to this patient.

The anesthesiologist, the person whose job it was to keep me alive during surgery, was another kind person He was concerned about my wellbeing and was able to smile and laugh and give me confidence in a total stranger in minutes.

When they got me up the morning after my surgery, barely 16 hours later, I stood without any pain for the first time in so many months; I mean no pain.

Walking in a walker was not how I saw myself but the PT and my supportive family got me going in spite of my fear.

So now it was on to rehab. 

A New Journey

In ninth grade I had scarlet fever and missed two weeks of school.  My absence caused me to lose five points on my algebra grade from Miss D.  I loved algebra.  I had other childhood diseases and gave up my tonsils for ice cream.  I had bypass surgery in 2002 and two cancer surgeries since but nothing prepared me for the ordeal which I just endured.  

It all started with an increasing inability to walk until I ended up sitting on the floor in my tiny kitchen waiting for an FDNY ambulance to take me to a hospital.  

When the EMTs arrived, two big guys, they could not have been more wonderful.  Helped me figure out a hospital in the right network (a chapter to come) and much more.  Turned out one was also a rigger and one was a volunteer firefighter who built dioramas of NYCity fire houses.

The rigger rode in the back with me and we talked the whole way. He had worked in theatre and at the top of the Chrysler Building (showed me pictures of himself up there). The firefighter drove and we got a chance to chat and share some things at the hospital.

Both took copies of the children’s book I wrote over 25 years ago, Volunteer Firefighter.  This was about as good as getting taken to a hospital can be.  The connection to FDNY and theatre and the kindness of these two big guys was a credit to the service.

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The fact that they are the lowest paid uniformed service in NYC is an embarrassment which should be felt by all New Yorkers. The average salary for a NYC EMT is $16.61 an hour.  That’s for men and women who come to help and have a life saving skill set.

Embarrassing! 

The hospital chosen, out of the immediate zone, was selected because it was a NYPresby institution like the one with which almost all of my doctors are connected. Sadly, I learned that all that was expected from decades old federal requirements for records that are shared does not even exist in this hospital network.  

It was in this emergency department that the journey continued with orders that were not explained, a physician who apologized for not informing me about the head CT they tried to give me without explanation, and the usual wait for a room.

This will not continue as a litany of complaints in part two but I hope it provides you with lessons that might be useful in your own journey into the depths of the healthcare system.  I brought to this the independence of a man raised on the West Side, educated exclusively in NY public schools through an advanced degree, many years of service to the people of the state of NY in several of its psychiatric hospitals, and support of friends and family, particularly the mother of my children.

Photo by Benjamin Voros on Unsplash

WALKING

Today, I know that walking is good exercise.  When I am able, I do.  In my days on the West Side there were many opportunities but I would not have called them exercise.

Most of my West Side life was confined to the area bounded by Riverside Drive, 76th Street, Central Park West and 86th Street.  My independent walking began with going to school, PS9, on West End Avenue and 82nd Street.  I only had to cross one street, Broadway, which as I’ve said before was often guarded at 82nd by Sam the cop with the size 13 shoe.

First, of course, there was navigating the halls and elevators of 222.  Not a lot of walking involved here; to the elevator, sometimes across the lobby and from the elevator.  

In those days, all lobby and elevator personnel were men; doormen and elevator operators.  At 222 there were among them Big Eddie and Little Eddie.  The two Eddies did everything in the building that was not the work of the handyman.  They were doormen, elevator operators and garbage collectors.  Every member of the building staff was male.  Today, in my queens building there is often a woman covering the door duties.  The first one was a notable addition, since then I barely notice.

On my side of the building there were apartment E, F, G & H.  One had no backdoor.  It was next to the service elevator which was used to move furniture and garbage and operated by the aforementioned men and the superintendent.  On the other side of the building were A, B, C & D and a different arrangement of  back doors and service elevator.  Apartment living meant you did not have to walk far to put out the garbage.  On Long Island it was different, depending upon where you lived.

Student Walking Clip Art | Clipart Panda - Free Clipart Images intended for Students Walking Clipart

When we weren’t indoors or playing in the street immediately adjacent to 222 we would walk.  By the time we got to junior high I was walking about 8 blocks to school every day.  There was always plenty to see, people and stores along the way and of course the friends. And, we all carried brief cases, no backpacks in the 50s and 60s.

For play there was walking to friends’ homes along West End and the side streets and there was the two block walk to Riverside Park.  Walking to Central Park required an adult for many years; there were tough kids between Amsterdam and Columbus.

In Riverside Park we were pretty free to roam, just not too far, until we were teens.

My longest and most regular walking began in late high school and continued well into college.  It was the stroll from 222 to 72nd and Broadway and back.  This was the thinking walk.  When there was something wrong I was having trouble working out I went for this walk.  The process was to list everything I could think of that could be the source of my discomfort and wait for the stomach to start hurting.  That was the issue that needed addressing.  It worked for me.

My longest regular walk was my first real job on 61st and Broadway.  Every morning in August 1972 I would start out walking South on Broadway and stop at Irving’s for my NY Times.  Although Mrs. Miller had taught me the correct way to fold the paper I often walked all the way with it spread in front of me.  I rarely looked up at corners.  The NY kid in me had the hearing in those days to know when to stop at the corner and wait for traffic pass.  Although I started on the East Side of Broadway, I spent most of the walk on the West Side.

I guess I never really appreciated the ability to walk briskly and anywhere until recently when problems have developed.  But I have now been reminded of the little pleasures walking brings and will work to get them back.

Mischief

They say “kids will be kids”.  Mine certainly were and when I look back so was I.

Living at 222 amidst its 108 apartments afforded us many opportunities to do mischief.  Some of us looked out on Broadway and some of us looked out on West 83rd Street.  There were, I believe, 8 boys all within about 18 months of each other.  So there was great potential for the seizing of opportunities to make mischief.

Hitler’s house was a favorite of mine.  And with two parents who smoked, there were plenty of matches around to play with.  Imagine a matchbook standing up like an A frame house. It had to be a full book of course; and then the delight as a match was struck and placed under the A and the anticipation as we waited for the whole book to go up as we would want his house to have burned. {Don’t try this at home)

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Of course, this was performed in the bathtub; not very dangerous because of the siting but a heck of a lot of fun.

The bathroom in my apartment faced West 83rd Street and therefore provided a chance to try to make mayhem below with toilet paper bombs.  These were wads of toilet paper soaked with plain water in the sink and then tossed out the 9th story window.  As I recall we were trying to land them in front of people not hit them (we were good boys).

One mischief maker who did not live in our building was heralded for some time after he dropped an M80 firecracker in the toilet at his house to see if it would go out; it didn’t and the reported mess was the thing that legends are made of.

And of course there was the time in 222 when I didn’t do it but was accused. (In fact I still am accused of the dastardly deed.)  Someone carved the initials MK on the metal intercom box in the elevator.  Those are mine backwards and belong to another former resident in that order.  

Most of the stuff we did at 222 was relatively harmless.  Ringing doorbells and heading for the stairs was a big one.  Calling for the elevator (in the days of a human operator) and heading for the stairs was another one.

We could be very annoying. 

 

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