Life with Maris: Part 3

A very gutsy story

Throughout the 11 years, Maris was a really healthy dog that gave us no issues. Basically, she went to the vet once a year for her shots, and there were maybe four or five extra vet visits for miscellaneous ailments… for example, getting a small splinter out of her gums. We were always protective of her, though, because she was born with a heart murmur. Jeff and I made sure that she played just enough to make her happy but that she would not overdo it and overheat. For so many years, we were able to control her activity levels, but we knew that her heart would give her trouble some day. We always thought that we would lose her to heart failure or some sort of pulmonary condition. Never in our minds did we consider that she would suffer from cancer and leave us completely heartbroken.

The truth is that I am not handling her illness too well. It is hard to see her body deteriorate. Her energy level is still very high (for an 11 year old dog!), but the cutaneous lymphoma expresses itself on the outside, so I can plainly see the progression of the disease. The biggest tumor on the skin is on the left side of her snout, and it is so big that it oozes and bleeds from time to time. This means that sometimes I have to chase her around to put pressure on the tumor until the bleeding can clot, and that I now own an industrial sized carpet cleaner. She wears a big inflated donut around her neck so that she cannot scratch this tumor, and she wears a cone at night when she sleeps so that we don’t wake up in the morning to a blood bath. This is really a cruel, cruel disease, and I cannot believe my beautiful Swiss mountain dog, my Little One has to suffer from it.

Taking care of her now takes me back to the first time I was worried about her physical wellbeing. One evening in August, when Maris was only about 12 weeks old, I took her to the animal emergency room in the middle of the night. Jeff wasn’t with me because he had gone to bed early – he had gotten his first colonoscopy that day, and needless to say, it was a traumatizing two days, starting with that prep drink, yuck. So I was watching Maris alone in the living room when I saw her make a funny motion with her neck while trying to swallow something. I panicked.

“Maris, what’s wrong? Talk to me!” She wouldn’t stop this funky swallowing motion. She was wagging her tail, but to my untrained eye, it looked like she was choking and couldn’t breathe. “What did I do? What did she eat? What did I leave out?” etc. etc. etc. In the back of my mind I thought, “see, I have only had her for a few weeks, and I’ve already messed up. I can’t take care of anything. She deserves a better mom.” Funny how the mind can go somewhere dark so quickly.

It was already 10:30pm, and Jeff was in the bedroom. I decided to take Maris to the pet ER. The small puppy sat on the passenger side and looked at me, still making that weird swallowing motion. I heard myself say, “no, no, please be okay little Maris. I’m so sorry, I don’t know what I did.” We got to the ER and there was no one in the waiting room. We were taken in without much wait.

The veterinarian who examined Maris was a nice lady, whom Maris liked very much. She started to wag her tail and lick the vet’s ear, and was acting totally normally! The vet examined Maris and said that she didn’t feel anything lodged in her throat. The next thing to do is to get an x-ray. They took Maris to the back room where they took the pictures. When they got back, I saw two pictures: in the first one, Maris was spread eagle, and in the second one, it was a profile of her sitting down. The x-rays were actually quite funny (how do you get a puppy to do a spread eagle and to stay still?), and what was funnier was that Maris’s guts were completely filled with gas. “Gas? That’s what was wrong?” The vet said that over-the-counter Gas-X should do the job.

What a relief! Just gas. Six hundred dollars later (!!!), I came home late at night with the dog and a CD of the x-ray pictures. On the way home, Maris did a thing for the first time… sitting on my lap and falling asleep. I think she knew at that time that I would do anything to take care of her, that I love her, and that we are going to tackle life’s challenges together. When I got home, Jeff woke up and asked me what was going on. Boy, was he in for a story… I saved the longer version for the next day, and what I said was that it has been a day of gutsy drama in the Rathbun house, and that I expect an effervescent path toward a happy resolution.

I wish I could fix Maris’s cancer with pills as simple as Gas-X. Today, she is on steroids to help with her appetite and swelling, painkillers for comfort, blood pressure meds for her kidneys, and antibiotics to keep the tumors clean. She has sores inside her mouth, so eating is not as pleasant as it used to be, so I have been making her food to keep it soft for her mouth. I know that this cancer will take her at some point, but somewhere in the back of my mind, I can’t help thinking that maybe homemade food might help to beat the cancer. Stranger things have happened, right? Maybe there is something magical in the Costco ground beef… you never know. But I see the tumors spreading to other parts of her body; this is a very aggressive cancer with a high mitotic rate, and I can see it unfolding before my eyes. Other than the sores on her body, the lymph node on her right neck is now the size of a grapefruit. But she doesn’t yet know what is happening to her. Maris still wakes me up in the morning, more ready than I am to greet another new day, eating like a champion, and then sitting by my side because I am her best friend. We have our routine, which we keep doing because while I am neck-deep in grief, it is just another day for Maris. Maybe canine cutaneous lymphoma, this rare form of cancer, is in some way harder on the humans.

Everyone keeps telling me that she will let me know when it is time to let her go. I know that Maris will let me know anything that she is feeling. She has always been highly and clearly communicative (mostly bossing me around, haha), so I don’t doubt that she will let me know. But it is really the anticipation that is hard. I am at peace with the sacred process of knowing and accepting the moment, but the fact that I don’t know what that will look like makes me nervous. I keep imagining what her eyes will tell me, trapped inside her broken body. And then I get sad just picturing the moment in my head. So I keep looking at photos of her during her happy moments in the last 11 years because apparently, it helps to celebrate the good times that we had together. We shall see.

“What are you thinking, mommy?”
“Enough with the selfies, mom.”
“Let me teach you the proper downward facing dog.”

Life with Maris: Part 2

Living in the moment

I have been reading The Screwtape Letters by C.S. Lewis for the past several weeks. It is a book that I read when I was a wee young thing, and while I was totally enamored with the humor and creativity of it, there was no way I could fully appreciate the book at that time. Because in youth so much of life is understood in broad brush strokes, the detailed nuance of human motivations and those small branches in a decision-making tree did not speak to me then as they do to me now. In one of the chapters, Uncle Screwtape talks about the folly of dwelling in the past and the future. Past… because we can’t change it and it is useless to hang on to it, and even worse, future since it “inflames hope and fear,” (Letter #15). But present, the present “is the point at which time touches eternity.” I’ve often thought that future represents eternity or infinity… because it is yet to come! But I think Lewis is right – with hope for the future also comes fear and anxiety, and ironically, it can imprison a person in a box full of “what if’s.” Not such an eternal feeling, huh? And also strangely, it was my dog that first taught me this lesson, the freedom of the present, and it was she who first really drove home the joys of being in the moment, and how that moment can expand to fill our existence and beyond. So much more powerful than wondering about the future!

There was an incident during the first few week’s of Maris’s life with us that launched this decade long lesson about appreciating the “now.” By this time, Maris was well adjusted to me and Jeff, and she really wanted to be with me all the time. One morning, I wanted to sleep in, and so Jeff left the puppy in the bedroom with me. I am a deep sleeper, so I didn’t hear the dog until a loud ripping sound pierced through the sheathe of slumber and banged on my eardrums. Riiiiipppppp~~~~~, riiiiipppp~~~ over and over again. I sat up, put on my glasses, and to my horror saw small bits of paper strewn about the floor, and my diary torn in half with its spine completely broken. Ack!!! My first response was one of shock and anger. I can’t believe she destroyed my diary!

That diary was heavy beyond its physical weight because it represented my headspace, which at the time was filled with a lot of anxiety. I was contemplating switching careers, potentially leaving a career in classical music I had built over 10 years’ time. It was a path that I had chosen when I was still in my twenties, leaving behind a career that promised wealth and stability, status in society, and what seemed logical to the world of a person with an economics degree from an Ivy League school. I did this thing that the world does not understand, but only musicians could. But nearly 10 years later, after multiple degrees, diplomas, competitions, concerts later… I felt the need to leave the industry and didn’t fully understand why. I was lost. So my diary at that time in 2011 contained so many unanswered questions. How did I get here? What happened? Where do I go from here?

It was this diary that Maris decided to eat. This little animal found such joy in ripping it up. Some pages became tiny bits of pulp. Some pages were spectacularly torn in large chunks. The words and letters that I had so carefully crafted to reflect how I felt were decimated in seconds, so innocently tossed about without any regard to the weight those words represented. It didn’t matter that I had put in hours into those pages. Maris’s lightheartedness obliterated them between her teeth. She was in her moment! Although I yelled at the dog as a part of my reflex, my heart was calm. I was struck by the symbolic significance of the paper carnage on the bedroom floor. Maris, in her innocent exuberance, completely destroyed the baggage I was carrying from my past. All the feelings I had about the past hurts and disappointments lay destroyed before my eyes. I felt freer, as if Maris had given me permission to move on.

The practice of being in the present didn’t come automatically after what turned out to be Maris’s only book-eating incident. I had many years of learning how not to worry about the future, how not to let the past haunt me. And I’m still learning! But after 11 years with Maris, I know what to picture when I find myself anywhere other than the present moment: her floppy ears on our walks, her impenetrable focus on the impending treat, the bliss of play, and the simple but profound happiness of being together. The present is eternity, indeed.

Maris being in the moment
All that matters in this present moment… is this yummy balanced on my nose.

Resuming normal life

so, how does your wife feel about that?

It will be 3 months tomorrow since that scary day when Jeff went into emergency vascular surgery. And during those 3 months, Jeff has been able to recover at home, slowly build his strength, get his golf swing back, and regain his stamina. We both know that he is almost there – we are so thrilled, grateful… and other words that cannot possibly describe in full how we truly feel.

But the operative word for me is “almost.” Getting back to normal, the way life was for us before the incident feels like an asymptotic journey… I’m always getting closer but will I arrive at place where I don’t worry anymore? Where I don’t even think about where he is, how tired he might be, whether or not he’s been standing too long, out too long, etc. I even worry when I see him napping – did he overdo it? Why does he need a nap? Nevermind that I need naps from time to time just from the stress of living a normal life. He’s allowed to nap like a normal person!

Next weekend, on July 2nd, Jeff will play his first concert, and that will be a huge victory. It will feel like his triumphant return from battle, and I will be there celebrating it. I know that he is excited to play the oboe again, and I cannot wait to hear him spin out beautiful phrases in that tone so rich and full that it stops time for me, no matter how many times I’ve heard it. I need to make a mental note not to worry but to be in that moment, and to fill that experience with gratitude rather than my own anxiety. That first concert back will be a musical celebration of all that we have been given, the gift of life, the gift of hope and of renewed love.

Over time, I will worry less and less, and one day, I will find that I am not worried at all. I guess these first steps to doing normal things again, reclaiming the life that we had before, those are the most daunting. Once we take the first step, the subsequent steps will return like a breeze… like riding a bicycle. As the saying goes… I only know in theory because I never learned how to ride a bike, and trying to ride one is never a breeze for me! In fact, I can only make left turns on a bike. But that’s for another post, perhaps.

Just before performing Bach together at St. Paul’s for Christmas 2018

Life with Maris: Part 1

Grrr, woof woof, awoooooo!

Maris is an Entlebucher Mountain Dog, Entles for short. It is a very active breed – always moving around, extremely alert, lots of energy, simply joyful. Entles were bred to be cattle herders, like border collies, so Maris used to gently nip my heels whenever we were moving around the house. She stopped trying to physically herd me as she grew up, but she continued to herd my heart and mind for the next 11 years.

Dog owners know that their canine family members teach them many lessons while they are with us. Maris was no different for me. We got her during what is clear in hindsight to be a time of many changes in my life, and she saw me through all those years, making sure that I was trending toward self-improvement rather than spiraling into entropy :). Through our adventures together, Maris taught me many virtues, the least of which is love.

The first two weeks Maris spent with us were extremely stressful. Maris turned out to be a very headstrong, vocal, and stubborn puppy. I needed to crate-train her, but she broke down the crate we had bought for her – I had pictured a sweet puppy face instead of a real animal, haha, and I had mistakenly bought a crate made of plastic, canvas, and mesh… with a zipper opening. She tore the thing down in about 2 seconds. I got her a new large metal crate that she could grow into, but then she would cry and bark when she was in it. When she was out of the crate, and I played with her, she was so joyful and just happy to be around us. I had not had my own puppy before, so it was so fascinating just to watch her find joy in play.

I remember those first few week for something else. I knew I was now responsible for this animal, and she was such a life force that I mistook her for a child. To be specific, I saw the child that I was many years ago in this small animal. I wanted to give her the best “childhood,” perhaps one that I had always dreamed of. So the pressure was on… to do the impossible – to give this puppy the happy childhood that I didn’t have. I know… so silly. But at the end of the two weeks, my low self-esteem go the better of me and I said to Jeff, “I don’t think I can make her happy.”

Jeff asked me, “so, do you think we should take her back to the farm?” Wow, I had not considered giving her up. She had already etched a permanent place in my heart with her little paws. “No,” I replied… but I was depressed about my inability to make her happy because I was projecting my disappointments on this innocent little puppy and trying to change the course of my life by making her the happiest animal on earth. So this is how I ended up seeing Maris as an inevitable extension of me. I mean, after all, she was very headstrong, vocal, and stubborn… exactly like me! Even though she was a dog that would use the yard as her facilities and liked to eat goose poop, Maris was for me a second chance at a happy and innocent childhood… perhaps to right some of the wrongs.

Later, I happened to say the same thing to a good friend who was a dog expert/trainer: “I am worried that I’m not making her happy.” She looked at me curiously and said, “no, she’s supposed to make YOU happy.”

And that is exactly what happened. She made me happy just by being who/what she is. She showed me ways to get lost in the woods with wonder, the simple joys of togetherness, and the virtues of being a working dog. She taught me how to be in the moment instead of being haunted by the past or worrying about the future. Maris already embodied what innocence is – I didn’t have to give her the happy existence because she already owned it.

The last 11 years with Maris was a decade of many lessons. And to think that I was worried about being able to make her happy when it turned out that she was taking care of me this whole time. Oh, the irony!

Maris is soooo over everyone gushing over her
Such a rebel

Reminders of our mortality

In little existential bites

In the last twelve months, we have had our share of medical drama in the family. It began with my breast cancer scare during the summer of 2021 and the lumpectomy that followed it. It is strange to me that after that we had a string of health news and events in such a short span of time – it feels to me like someone, somewhere is poking us repeatedly… or in my case, pounding through my thick stubborn skull the fact that life is very fleeting and that we actually have little control of how it unfolds. “Hey, it’s about time you get it: you’re actually not in control over anything… except your hygiene.”

The cancer scare from last year has a happy ending – it was benign, and the lumpectomy in the fall was out of precaution. But for about six days in August, I sat around waiting for the biopsy results, and that was an interesting time. Being me, of course, I thought about how to leave my affairs in order, making sure that Jeff was taken care of (as if he needs it… he’s 19 years older than me and has more life experience!). First of all, a tad dramatic, I know. A biopsy on a 6-mm tumor led to “oh no, I’m going to die!” One does not automatically lead to the other. But my thought process was important at the time because I was forced to think about death. I thought, “so, is this how the cookie crumbles? Why so early, God?” During the wait, I was visiting my brother and his wife who welcomed their first child just two weeks before. I wondered if I would be able to see this precious boy grow up… Needless to say, it was an existential six days.

The episode of Jeff’s medical emergency was the next existential experience, and frankly, we are still processing it. It was traumatic, so I don’t like thinking about it too much, too often, and I know that Jeff is going through some surviver’s guilt – aortic dissections normally kill people… “why was I spared?” is the question he is dealing with. For me, it was another lesson that really nothing about this life is within our control. The few hours after Jeff and I parted ways in the ER were a real low point in my life – I thought Jeff might die, and I may become a widow, and how am I supposed to live the rest of my life without him?

As if that wasn’t enough dose of existential lessons, I recently had another such moment. During a fairly routine visit to the doctor, I had an EKG/ECG done. The doctor saw me afterwards and didn’t even talk about it – presumably because it looked normal. A week later, the test result appeared on my “mychart,” and boy was I shocked. It said that I had had an infarction of unknown age. A heart attack? I quickly ran through my memory bank to check if I had felt anything bad. Nope… I don’t remember having a heart attack… huh?? I was skeptical of what I was reading because I felt fine – more than fine! Of course, I consulted Dr. Google to see if you could even have a silent heart attack and be completely fine (that’s a bad idea BTW). I’m not obese, I do not have hypertension, I am not pre-diabetic, and my triglyceride levels are super low, etc… so what gives? But for the next 20 hours or so, I was so confused, and frankly, a little scared in case it meant something. Your heart is a vital organ and it is so deep within your body… and during those 20 hours, I got a small taste of what it meant to put one’s life into God’s hands. I did not even tell Jeff about it until I knew for sure. And just in case, I ordered a vegetarian meal for dinner that evening (hahaha, so unlike me). And the next day when I spoke with the doctor’s office, I found out… that this happens all the time to healthy people because those machines are so sensitive!! This is why you need humans to read the actual report.

After I knew everything was okay, I told Jeff and we had a really good laugh about it. We even laughed about that rogue vegetarian meal (which was really delicious, by the way). It was a comic episode, but I cannot help noticing the messages that are piling up before me, and they point to a singular lesson… one of human mortality and of humility that is required to accept it, to be at peace with it. When we are young, it is so difficult to imagine that our lives could end… so it is easy to focus on our own goals. Of course, our accomplishments on earth are important because we are supposed to express the potential God allowed for us… but at what point does it become purposeless? Achievement as the end in and of itself? Money for its own sake, safety out of fear, ego because we are all to some degree narcissists (while we accuse others of being full-blown narcissists)…

The awareness that we do not control or “own” the days, hours, minutes, and seconds in our lives helps us to truly embrace them and be responsible stewards of them. In recent years, I have seen stoicism make a comeback, and with it the Latin phrase “momento mori,” or “remember that you must die.” This sentiment helps us to put everything that is happening around us into a larger holistic perspective. But let’s take it one step further: We all die, but the real kicker is that none of us know when. The potential immediacy of that fateful moment is what should drive the notion that we do not actually own the next 24 hours. They are not guaranteed. Not under our control. Why? Because just maybe history, even our story, doesn’t revolve around us.

I am a fan of Bishop Robert Barron, and one of the things he says is that we in reality are all a part of “Theo-drama,” but our perspective is set on the “ego-drama.” I love this spiritual way of looking at life. I know that I have made decisions in my life based on this “ego-drama” I was writing for myself. But it is all in vain. Because no matter how spectacular and special I think this little “ego-drama” is, it is really an illusion of control and importance. The existential moments, when they come, teach us of this illusion and helps us to see the reality of the bigger drama unfolding through history. One where we have roles but the story does not revolve around us. This humbles us (there is that word, “humility”) and helps us to ask the right questions and to act with the right motives. “How can I help you?” “What can I do to make things better?”

I am so grateful that my existential lessons came in bite sizes. My cancer scare had a happy ending. My funky EKG reading was a technical glitch, and the internal Sturm und Drang only lasted less than a day. And while Jeff’s experience was traumatic for the both of us, my slice of true existential fear was a few hours… and I got him back. Not in the least, our dog Maris’s journey into “home hospice care” is the latest lesson in mortality. Okay, God. I get it. I get the picture. Nothing is under my control, and I need to put my trust in you.

Maris, having an existential moment

The other patient in the house

ever sweet, ever loving, ever ours

Through the saga of Jeff’s surprise surgery and the recovery process, something else has also been bringing us together. And that is our dog, Maris. On March 24th, just one day before Jeff’s aorta ruptured, we found out that our little furry family member has an aggressive form of cutaneous lymphoma. All of our attention was on the dog for about 24 hours until Jeff’s surprise visit to the ER on the 25th.

Maris was born on May 14, 2011 at Double Gap Farm in North Carolina. Jeff and I had been newly married and was interested in getting a dog. We really liked the Swiss German canines, especially the Greater Swiss Mountain Dog. But these dogs get to be as much as 150 pounds. I am not little, but I am 5’4″ and at a healthy weight. I told Jeff, “I will not be last in pecking order!”

One day, we were just browsing through the American Kennel Club website, and we saw a smaller version of the Greater Swiss Mountain Dog. After some research, we found out that there were four Swiss Mountain breeds: Greater Swiss, Bernese, Appenzeller, and… ah, the Entlebucher Mountain Dog. We found a breeder in North Carolina, visited the farm to “meet the parents,” and then on July 19, 2011, we traveled to the farm to pick up the 9 week old puppy named “Pink Camo” that would become Maris.

I am sure that I will reminisce about our amazing 11 years together when the time arrives for us to let her go. For now, we are focused on cherishing our time together and on trying to make her as comfortable as possible. Maris still has some energy – still likes to go on walks with us, even though the distance is much shorter than it used to be. She tires easily. She has sores on her body that make every day activities uncomfortable, I am sure. But she doesn’t complain – she just works around it. We place a cone on her at night so she doesn’t scratch her wounds while she is sleeping, and she wears a blue inflated donut around her neck during the day for the same reason. But she just accepts that she will now be wearing these things for the rest of her life and is just happy to be next to us wherever we go.

She is such a good dog.

Jeff’s medical ordeal put Maris’s health challenges into perspective, so I am at a relatively calm place. Everyone who knows me well knows how much I love my dog. And she has had a great life because of it! People used to say to me, “when I die, I want to come back as Anna’s dog!” Maris was a great friend to me when I felt the most lonely, and the combination of Jeff and Maris was the perfect healing salve because Maris was the prism that expanded Jeff’s ray of sunshine into a beautiful spectrum. Living with them, my world grew a much richer palette of colors.

But some time this year, I will have to let her go. And I think my experience volunteering with hospice patients may help me here. During these last weeks/months of her life, it will really be about her, not my grief. We will have the most fun possible, share the most love possible, and eat as well as possible. She does not know that she is dying yet. We will cherish the time we have left together, and when the time comes, Jeff and I will be grateful that we were given the opportunity to be stewards of such a magnificent animal. It was another gift that God gave us to teach us lessons in love, giving, and healing. All creatures belong to God – and how wonderful that we got to take care of one of them!

Maris is about to teach me the proper downward facing dog

What is a miracle?

is it something improbable or impossible?

My line of work is in investments. I lean into history, try to learn from it, and use it to understand probable outcomes in the future. There is no way to know for sure if there is going to be a recession or if the current state of high inflation will be persistent. We can take the variables from the past with the understanding that the current situation also has new considerations, and apply them to understand the probability of different outcomes to set reasonable expectations.

Whew, okay, done with the shop talk. Why did I just write all that? Because anticipating a range of possible outcomes and understanding their probabilities is at the core of what I do all day, every day. So when I think about what happened to Jeff, I marvel at the extremely slim probability of the final outcome. Truly a far out “tail event” in statistical speak. And I’m not just talking about that giant clot that ultimately saved his life (and yes, that in itself was a tail event!). I am talking about the probability of a string of decisions and developments that had to occur precisely in such a way that we could get Jeff the help he needed just in time for him to live. And I want to string them together to paint a picture of this unlikely outcome and why we feel that it was God’s hand guiding us, both in decisions we didn’t know we were making towards this favorable outcome, and in things that were completely out of our control, but in God’s brilliant design.

After Christmas of 2020, Jeff said to me in passing that he sometimes drives around the town of Bath (Ohio) and looks at different houses. We lived in Richfield at the time in a wonderful home that we built in 2013, and frankly, we thought we would live there for a very long time. What Jeff didn’t know was that Maris and I had also been exploring Bath while driving to and from various nature trails in Northeast Ohio. Both Jeff and I (and Maris, haha) love nature and quaint living environment. Richfield already has that (we had 2 acres of woods), but after being cooped up at home during the first year of the COVID-19 pandemic, we were ready for a change.

The problem was that there was no home that would work for us for sale in Bath. So we expanded our search to different parts of NE Ohio, actively trying to avoid the busy-ness of Cuyahoga County and the urban feel of the “East Side.” After many weeks of doing this, Jeff found something on Zillow… it was a home in the county we were actually trying to avoid, but the house was right. The design was right. the size was right. It was a model home, so after meeting with the builder, we decided to buy and finish a partially built house that was not even in the location of our original intent. What we came to realize was that our desire to live in a quaint environment spoke to our internal poets but did not jive with the busy schedules we kept. We came to love the idea. We sold our home in Richfield, finished the new house, and moved in on June 28th of 2021.

What we didn’t think significant at the time was just how close the neighborhood was to Hillcrest Hospital (the Cleveland Clinic). Eight minutes by car, if you’re just leisurely driving and hitting lights. I could shave off two minutes if I’m speeding a bit and with green lights. During the fall of 2021, I really learned the ins and outs of getting to the hospital because I had to get a lumpectomy (don’t worry, the tumor was benign and it was out of precaution), and then I had multiple appointments afterwards due to not serious but strange complications. Back and forth, back and forth. The thing is that I am really bad with roads and have no sense of direction. Now I look back and realize that God was perhaps making me practice driving the fastest route confidently for when it really came to matter.

When I think about it, that move was a crucial component to Jeff’s survival. If we had still lived in Richfield, I know that I would have probably taken him to a more remote ER. They would have had to transport him to either the Main Campus of the Cleveland Clinic or to Hillcrest anyway, and it would have just delayed everything. This was a decision made for unrelated reasons that proved to be so crucial.

There were other choices that were made for unrelated reasons that proved to be vital in the succession of events. Me working from home, randomly deciding to work in the living room instead of my home office that allowed me to notice that something was off; canceling the morning meetings because everyone was on top of things but it freed me to take Jeff to the ER; Or even taking Jeff to the ER because I thought it might be a kidney stone, but of course, it turned out to be something much more serious. These were decisions made without deep insight, and I cannot tell you that I had some sort of hunch or a feeling that I had to do these things.

And then there were things out of our control. The aneurysm had been there for many years that it grew to be the size of a baseball – it really could have burst at any time. When the aneurysm started to dissect, it didn’t happen all at once – it happened in small tears, which meant that blood started to leak out slowly, giving it time to actually clot and plug the hole. Again and again for nearly a week. And the fateful moment when the dissection became untenable, it happened during the day when I was home. If that dissection took place a few hours later in the evening, Jeff would have been driving a 3 hour road trip to Bowling Green, probably on I-90 West, alone in the car, far from the world class healthcare available at the Cleveland Clinic. That the aorta decided to rupture during that small window of time… we do not view that timing as a lucky coincidence.

When we think about how easily that clot/plug could have come undone, it sends chills down my spine. We had used a vibrating massager on Jeff’s back when we thought he twisted a muscle (yikes!)… that was a really bad thing to do to the aneurysm! What about the violent vomiting? Every time he lurched forward to throw up, the clot could have dislodged. And of course, further delay would have also meant that the outcome could be different.

All these things had to work together and with right timing. The clot itself was of course, statistically unlikely. A tail event. A black swan event (but with a positive connotation). But also at each decision point, when we thought we were making decisions that were independent of each other, it turned out that there was this beautiful design to how they were actually related… and each played a small but important role in contributing to Jeff’s survival. And in some of those decision nodes, we actually made the unlikely, less probabilistic choice based on our original intent. For those of you who have calculated the probabilities of multiple events and outcomes, you know that when you have multiple unlikely events stringed together, you end up with a really really low probability.

So, okay. Something with a low probability, even if the odds are only 0.000001% in your favor, is technically possible. So is it really a miracle? Isn’t miracle something impossible becoming possible? like turning water into wine? This is where I have to stop thinking with my head and listen with my heart. This is where I don’t want to lose perspective, the meaning of the big picture, the opportunity to experience God’s grace… all because of some technical point. When something happens, which in turn changes your perspective on life, brings more love between two people, and brings us closer to God, I consider that in itself a miracle. No matter how high the probability. And maybe it had to take such a tail event to pound through my data-driven, rational skull that only God can string events together, move hearts and minds, and put us in right places in order to bring us outcomes that are inconceivable to our human imagination. Furthermore, that we, as rational beings, would choose to accept this outcome not as low probabilistic “luck” but as God making His presence firmly known in those moments, that we should choose to see it as God’s grace, as His love, and as His gift to us… that in itself is the greatest miracle for me.

Sunrise: a daily “miracle” that lifts my spirits!
Marriage: a miracle of two very different people spending a lifetime together

A battle scar

And a reminder of grace

In order for Dr. Rizzo and his team to perform the vascular surgery, they had to create a very long incision down Jeff’s abdomen. During those first days in the Cardiac Surgery ICU, the incision was bandaged up, so we didn’t know what it actually looked like… yet. After a few days, they removed the bandage, and there it was, a 20-inch scar. I was surprised to see that they used metal staples to hold the skin together at the surface level. I don’t really know what else I was expecting.

For a long time, we had to tiptoe around it and couldn’t do normal things. At first, he couldn’t use his ab muscles at all so he couldn’t even move an inch without wincing. But he kept sliding down the hospital bed! So they had to move him around with the sheet that was underneath him. He couldn’t sleep on his side. He also couldn’t cough or sneeze – the staff gave us a firm, pillow-sized and -shaped block, which I would push against his abdomen to support and stabilize his incision. I was so scared to put any pressure on his tummy, but I quickly learned that I needed to put nearly all my weight down to counter the force as he cleared his lungs. After a while, we had a routine down: Jeff would suddenly sit up “I’m gonna cough!” and I would shoot up from the chair, run to the bed with the “pillow” and put all my weight down. But the worst of all was that Jeff couldn’t laugh very hard… at his own jokes. He was really disappointed.

The incision was healing beautifully, but the staples had to be in for about a month. It was uncomfortable for Jeff even after he came home and was able to do regular activities because the incision site was very tender (still is two months later), and the metal pieces bothered him. Wearing a seatbelt was very unpleasant because the belt would dig into the staples. Sometimes, a sheet or a blanket would get caught on the staples and cause discomfort. I examined it from time to time to make sure that there was no infection or anything suspicious, but I could tell they were really bothering him. One night, I decided, well, maybe we just need to embrace the staples – I said “they aren’t going to be in forever, so let’s get to know them before they come out. We’re counting the staples!” I counted them one by one, all the way to forty. Wow, 40 staples. “This is your battle scar.” Then Jeff opened up about it and told me that he dreaded seeing his incision for the first time. He thought “oh God, it’s going to be so ugly.” But then he said, “but I would rather have this ugly scar than the alternative.” Yes, a thousand times YES! This is his battle scar and a reminder of the grace of God that was showered on us through that most valuable clot, the temporary plug that held everything together for just the right amount of time. It represents the time when we felt God’s hand firmly in our lives.

Near the end of April, it was time to get those staples removed! While we were waiting for Dr. Rizzo, a really kind nurse came in. I remember her Russian accent and her beautiful hair… not everyone can pull off side-swept bangs! She was so seasoned – she saw that there were quite a few staples so she made small talk with Jeff. Oh, it was so easy, small movements with the staple remover. Jeff later said that it was mostly painless except for a few that felt like bug bites. And before he knew it, she looked up and said, “I am done!”

Everything looked great to Dr. Rizzo, and we were cleared to go home again. I brought a list of questions to ask, like a taskmaster. He probably found me annoying! Among a string of questions, the one that made me most happy was “Will he be able to go on TCO’s European tour late summer?” to which he replied, “oh yeah.” This made me really happy for Jeff – back to normal life if he can manage all the stresses of a European tour! The one that made Jeff most happy was “When can he play golf?” to which Dr. Rizzo said, “I’m okay with mid to late May.” We both left the doctor’s office really happy, even if for different reasons.

Removing the metal staples was a really big deal. Jeff was able to move around comfortably and not be in fear of the healing incision. That evening, I saw a familiar expression come over his face, one that I have seen thousands of times since we met in 2007. It was one of mischief – I knew that he had a joke coming, and it was going to be epic. “I had 40 staples… now I have 80 holes!” Then he went on to laugh and cackle at his own joke, just like old times.

Jeff and Maris pretending to be giants descending upon the Christmas Village people
Jeff pretending to be a freshly hatched baby dinosaur (Tucson Zoo)

An epic nosebleed

a story about ‘inflation…

I was excited to bring Jeff home because it was a vote of confidence from the hospital that he was doing well. But I was also scared to bring him home because I am not a medical professional. How do you take care of someone who has just gone through a very invasive vascular surgery?

Googling doesn’t help you here. In fact, I don’t recommend it because you might find some scary stories. I asked the hospital social worker to help us arrange home healthcare, and these people were wonderful. It was so valuable to have someone come and check Jeff’s vitals. But I was really good at preparing Jeff’s meds. I became an expert at using the pill splitter. As Jeff’s mind was still foggy from the anesthesia, I had to keep everything straight for him. I was also good at walking with him to make sure he got his exercise. For the first week or two, he had to wear a stretchy binder around his middle to keep his stitches from moving around and bothering him. So I also became an expert in putting the binder around Jeff and the use of the gigantic velcro that came with it.

Funny, the dog (Maris) quickly realized that Jeff wasn’t really the alpha dog when he came back. As much as she missed her daddy, she looked at me as the alpha dog. And when we walked together, she knew something was up. She walked gingerly beside me instead of being her normal adventurous self.

Jeff was discharged on a Tuesday, and things were improving every day. On Friday night, Jeff woke me up just after midnight. He was so gentle, his usual MO, that I didn’t realize it was an emergency. I am normally a really deep sleeper – you can carry a conversation with me, and I might even talk in my sleep, but I won’t remember it the next day! So when he woke me up, I remember seeing a flashlight and thought I was dreaming. But Jeff was holding his phone in the dark, reading up on how to stop a nosebleed. I was really groggy but sat up straight… the rate at which his nose was bleeding, and knowing that he was on a high dose of aspirin, I knew this meant another trip to the ER. I will spare you the gross details! So while we tried to stop the bleed, I told him to hold on to the tissue and stopping up his nose, I went and got dressed. After about an hour of trying, we went back to Hillcrest Hospital.

We ended up spending the whole night in the ER. Who knew a severe nosebleed was a thing that ER professionals saw all the time! I have never had a nosebleed in my life (and neither has Jeff, really), so we were discovering a whole new world. We think that the darn NG tube and the multiple efforts to get the thing down his nose caused a lot of trauma high up in his nasal cavity… the first attempt to control the bleeding did not work. It was time to use the balloon.

I am thankful that Jeff nor I suffer from nosebleeds because if you can help it, you don’t want this balloon up your nose. They inflated a balloon inside his nasal cavity at the source of the bleeding in order to create enough pressure. Jeff had a tube hanging out of his nose, which we then taped to the side of his face. It was not a pretty sight. And the pressure inside his head was causing a headache! Jeff was a good sport for putting up with it, but honestly, he was really miserable. He worried with a chuckle that one nostril might be permanently bigger than the other! When it was all said and done, the balloon was in there for five full days, and he had to see an ENT to get it removed from his nose. When the ENT pulled it out, the first thing I did was to look at Jeff’s face and said, “you’re still symmetrical!” We all had a good laugh.

The nosebleed was a setback, but honestly given all that we had just been through, it was a minor one. We were so grateful for life that we were really okay waiting those five days, no matter how uncomfortable. Jeff even went to get a haircut with the balloon up his nose and the long tail of the tube taped to the side of his face! With the balloon out, Jeff’s spirit continued to inflate (haha, sorry), and he continued on his road to recovery without any other roadblock. Soon, Jeff no longer needed the binder to walk comfortably around the neighborhood. His pace quickened daily. The dog gradually stopped walking gingerly around him and returned to her adventurous self. And full two months after that crazy day on March 25th, Jeff is getting ready to play in a golf tournament at the end of June with his best friend. Frankly, I’ve never been so happy to see him play so much golf. (Wives whose husbands are golf fanatics… you know what I’m talking about!) God is so so good.

Our first outing after the surgery
Jeff says “keep up!”
After those small steps in recovery, taking a short hike in Punderson State Park on 5/30.

Happy Graduation

from the hospital!

The day that Jeff graduated to a regular hospital room was a very happy day. It was like a pat on the back from the hospital, “good job!” We packed everything up, Jeff no longer needed oxygen nor an NG tube. His face was clear of plastic for the first time since the surgery. His multiple “central lines” were reduced to just two, and the scary one that was plugged into this carotid artery was patched up. He sat in his wheel chair ready to be transferred and gave me a huge smile.

The staff took us to the third floor of Seidman building at Hillcrest. Room number 22. It was a single room (thank goodness) and the whole wing seemed to be newly built. There was a desk, where I set up my computer to do some work while Jeff slept. There was a couch, which was a really nice for me because I was really tired. I took naps there from time to time, and the super considerate nurses worked silently on Jeff to keep from waking me up. We were so grateful for such state of the art facilities… except for the weird bed that had an alarm. Jeff’s hospital bed had an alarm that would go off like a fire alarm whenever he got out of bed. The first time it happened, we were both panicking – what did we do wrong?!! Ahhh, how do you turn this thing off? Later, I learned how to shut it off when it went off, but boy was it funny. They really want you to stay in bed, apparently!

Jeff had a few things on the checklist to accomplish. He needed to be able to tolerate oral medication, his digestive system needed to wake up (so he needed to move things along), and he needed to be able to eat a full meal before he could be discharged from the hospital. Slowly, they weaned him off of the IV meds, and eventually, he was taking his pain meds orally. But it was the second on the list that took a long time, and also prevented him from being able to eat. In fact, they had taken the NG tube out too early – they realized that they needed to put it back in. NG tube prevents the gastric juices from flooding your stomach by sucking it out – any buildup would make Jeff nauseated and would make him throw up – that would be a threat to his freshly stapled incision site. Let me tell you, putting a plastic tube up your nose and down your esophagus is not a pleasant thing. And he had to redo it twice because the second one that was put in fell out (it wasn’t taped well enough). The third and last time they tried it, I was there, and it was painful for me to watch. They were not successful and had to try later. I went home early that night because I couldn’t bare to watch it again. I figured that I would let the medical professionals get done whatever they needed to get done. When I arrived the next morning, it was in. I used a lot of medical tape to stabilize that sucker so it would never fall out by itself again! When I was done, Jeff looked like an ant-eater.

Progress on the digestive tract was slow… until it wasn’t. Suddenly, things started to move, and Jeff was able to eat a full meal. It felt like the hospital was happy to kick him out! Suddenly, on the morning of April 5th, Jeff was cleared for discharge. At this point, I was comfortable visiting him in the afternoon and being able to get some work done at home in the morning. After my early afternoon meeting, I packed a bag full of clothes, shoes, and other things, and rushed to the hospital. He looked so good for a man who had been disemboweled not two weeks earlier to get his aorta replaced!

What is really remarkable is just how quickly he was expected to get back to normal life. As the nurse read the discharge instructions, I asked if he needed to be on a special diet. Nope, can resume normal diet. Later, we had home care nurses and physical therapists come to check on Jeff at home. The nurses thought he was doing great, and the physical therapists didn’t think he needed physical therapy! And later I asked Dr. Rizzo if Jeff needed to see a cardiologist – nope! His heart is very healthy, and the ultimate stress test was the pain that he endured as his aorta was breaking apart, and the massive surgery itself. So it was this structural defect that once fixed would allow Jeff to resume normal life like before.

I am typing this in early June 2022. It has been a little over 2 months since the surgery. Jeff has been resting at home, gaining strength. It took a little over a month for him to feel like anesthesia had fully worn off so he could drive again. And since the weather has become nice in the spring months, he has been slowly playing golf, his favorite sport, starting with putting and now swinging fully. He is getting his strength back. He still gets tired, and it will probably be another month until he gets his full stamina back. And I still watch him with sheer wonder at the walking miracle that he is to me.

My little workstation in the ICU
Will never forget this room!
A slightly better working environment
Jeff, so happy to be discharged, wearing the outfit that I scrambled together for him.