Personal downsides of 2023, or why I’m a bit quieter than usual

I fear that I’ve fallen weirdly silent at times, on this blog and elsewhere, during the past year.  Some of you may be waiting for me to reply to emails you’ve sent.  Others have pinged me via LinkedIn messages, Twitter DMs, and even snail mail, and wonder where my typically garrulous self has gone.

Alas, I have a reason for being dilatory for the past half year.  While 2023 has had some high points, like the launch of my new book and the 10th anniversary of our business, it has also been pretty awful on a personal level.

Yes, this is one of those nonprofessional, personal posts.  Feel free to skip or wait for the next post.

I can sum things up as two blows.

Not sure of the year – perhaps 1980.

The first was the death of my father in Michigan.  It wasn’t unexpected.  He was 91 and had been declining steadily for decades.  Formerly a vigorous athlete, a self-styled jock, his body gradually lost strength, tissues, and functions. Cancer took a lung, then other diseases sapped his strength and cost him the ability to lift his arms above his chest. His mobility decreased until he was restricted to a wheelchair, then surgeons amputated a leg.  Affliction after affliction gnawed and reduced him.

In May he called my brother and I from yet another hospital stay, and wished us farewell.  Not a very emotional man, as per his generation, this was a brief message, but he had clearly determined that the end was near. After that stay he entered hospice care.  My wife and I visited him there and found him splendidly well cared for, but a shattered, barely living remnant of his former self.

A week later he died.  My brother, my wife, and I traveled back to take care of things.  This meant a welter of boxing, tracking down financial details, sending items away, notifying people, and many more logistical items.  It meant and still means dealing with the emotional tearing of losing a parent.  That work sprawled over the next month, intertwining with the rest of our lives.  It still continues.

From the obituary Nelson wrote, which I amended slightly:

Nelson Case, beloved father, writer, and producer, and avid tennis player, died on June 26, 2023, at the age of 91. He died of natural causes. Mr. Case retired in 2000 after a professional career spanning 50 years, chiefly in the field of entertainment, from stage managing on Broadway and acting in Hollywood and New York, to becoming one of the premier writer/producers in the field of corporate communications for over 40 years. He is survived by his sons, Kevin Case and Bryan Alexander, his daughter-in-law, Ceredwyn, Kevin’s partner, Terri van Valkinburgh, and two grandchildren, Gwynneth and Owain Alexander.

From left to right: myself, Kevin, and Nelson, during the pandemic.

I have been too busy with professional work to do the emotional work of grieving.  I know this is not good, but economic needs are paramount, at least in American culture.

Then the summer’s second blow fell, this time upon my wife, Ceredwyn.  Early this week she suddenly suffered a heart attack.

Early Monday morning chest pains appeared and worsened, then showed classic heart attack signs.  We called 911 and in a couple of minutes were surrounded by efficient, kind, and skilled EMTs, who transported her to the hospital.  Ceredwyn spent a day and night there, being tested, prodded, observed, while I stayed with her.  Tests showed that it was indeed a heart attack, as one enzyme was heightened, which is what occurs when there’s heart tissue death.  The technical term is NSTEMI, for non-ST-elevation myocardial infarction.

“Heart tissue death” is not a phrase I anticipated typing this year, especially about my splendid wife – who’s younger than me and far wiser about health than I.

That’s a pulse oximeter glowing on her fingertip. The wires below her palm lead to various spots on her body.

The next day the hospital conducted a cardiac catheterization, which astounded me as a husband and as someone who follows and thinks about technology.  The cath team inserted a probe in her right hand, then drove the thing up through an artery all the way along the inside of her arm, then across her chest and into her heart. There they found a major artery 90% blocked. The team cleaned this out then withdrew.  (I waited helplessly in her room; a kind nurse visited me to ease my dread.) Ceredwyn spent the next day recovering and being monitored, before being discharged.

Now she’s at home, resting and recovering.  We’re exploring changes to her diet and exercise, which is complicated and at times either galling or contradictory.  She’s also on a stack of medications, and here follow two observations about American health care:

1. One of the drugs cost nearly $400 US after insurance had done its thing.  Thankfully a local pharmacist spent an hour doing high level bureaucratic finagling to reduce this, but just think of what this might have meant.  I’m shameless in advocating for my family and have other advantages (age, education, extroversion, race, gender, etc) and I shudder to think about how people have to deal with this financially.  Think of how much this might have cost to someone without insurance, or whose policy didn’t do anything to help.
2. At no point until the medication did we make a rational economic choice. We did not, for example, cost out different ambulance services or sift through evaluations of hospitals. Instead we grabbed what was nearest and fast. Yet our medical system is predicated on patients and caregivers as rational economic actors.

Ceredwyn is still processing all of this. Physically, she’s still in some pain and her arms are seriously bruised at at least ten points where medical staff tried (and sometimes succeeded) in getting entrance to her veins.  Mentally she’s processing the trauma of a sudden, near death experience.  That particular artery  being blocked is nicknamed The Widowmaker (perhaps a widowermaker, to be more precise or pedantic) and it’s a radical, fundamental thing to nearly be killed by it.

Ceredwyn’s arm after the catheter invasion.  Note the hand being dark; that’s due to the tourniquet above.

My wife, my father: I can’t describe how much their respective suffering horrified and enraged me. There is so much going on here – my adoration of professionals who provided them with fine, compassionate care; endless frustration at bureaucratic strata we’re forced to tunnel through; the difficult in expressing any of this as a GenX male in American culture.  My futurist mind kept generating scenarios and outcomes from the most optimistic to the most direly pessimistic.  The planning and strategic part of my mind ceaselessly worked, developing workarounds for problems and setting priorities in careful echelons.

I want to say more, but as you might expect from the preceding, I feel awkward as hell writing this much. So I’m behind schedule and will be so for a while, as the fall semester bursts into life starting Monday (yeah) and I struggle to catch up with everything that fell by the wayside this awful year.

Please, everyone: take care of yourselves and each other.  Be safe.