The Saga of Cement Sue

This is the special wonderful gift that my Linda gave me

I’ve often waxed poetic (or at least posted prose) about my love, Linda Herman.  I’ve worn out my list of adjectives trying to describe how wonderful she is, and how good she is for me.  This Christmas, she demonstrated her love with the best material gift I have ever received.

What could this gift be?  It is a two-foot high concrete statue of an Irish Setter.  Yes, you all know that I love Irish Setters, but that wouldn’t make this the best gift ever.  So what would?  I hope you have a few minutes as this is a convoluted answer.

The story starts with my great-grandfather Hall.  I don’t know much about the man, I don’t even know his name.  The generation before me simply referred to him as “Grandpa Hall.”  By the time I was aware enough to ask his name, my father no longer remembered it.

My great-grandfather’s property in Spring Lake

Here is what I do know about the man.  He owned a farm in Spring Lake, MI bordered on the south by modern-day M-104, on the west by Fruitport Road, on the north by the railroad tracks, and on the east by the swamp.  On this farm he raised pigs, which he smoked and sold as bacon & ham in the surrounding communities.

The other, more interesting thing, that he did on his property was breed and train what he called “Irish Bird Dogs.”  We would know them today as Irish Setters & Irish Red & White Setters.  Even then they were trying to breed the white out so that they could develop into the red dogs that we know today.

Great-grandfather Hall always kept three dogs for breeding – a male named Patrick and two bitches named Molly & Sue.  When one passed on, or retired from breeding, he would replace it with another dog with the same name.  So he always had Patrick, Sue, & Molly.  This allowed him to sell to returning satisfied clients another dog with the same parents as their previous dog.  And disgruntled customers could be offered a dog from the other mother.

My brother John & I with our dog Jojo.

My grandfather with a Sue or a Molly

This practice of Patrick, Sue, & Molly was carried on by my grandfather, Melvin Bristol Hall.  He didn’t do the dogs as a full time profession like his father did, but he kept the Patrick, Sue, & Molly tradition alive.

Now my father, Melvin Edward Hall, didn’t breed dogs.  We always had at least one dog in the house, most of them Irish Setters.  But in my little atomic family, my mother claimed naming rights for all pets.  So we had Duke, Jojo, Koof, Kerry, & Scarlet.

Then in 1992, Dad retired from teaching.  It turns out that there was an Irish Setter breeder near Coldwater, MI who had a bitch that was descended from one of my great-grandfather’s lines.  And he presented the dog to my father as a retirement gift.

This was one of the rare occasions where my father stood up to my mother.  He explained to her that the dog was a gift to him, the dog was part of his family history, and he would be naming her Molly!  My mother didn’t speak to him for weeks afterword.

My Grandmother Irene Vos Hall with a Sue or a Molly

My uncle Ken Hall (Mel’s younger brother) had a much more entertaining response.  Uncle Ken located a concrete, life-sized, concrete statue of an Irish Setter.  Since Mel had a Molly, Ken brought him a Sue – Cement Sue (you have to say it like Jed Clampett – See-Ment Sue).  And from that point on, we had Cement Sue stationed in our back yard.

The years were not kind to Cement Sue, as she stood sentry day and night in all kinds of weather.  She may have lost pieces of concrete, leaving just bits of rebar hanging out.  But she was always there, and Dad & I made a habit of saying hello to Cement Sue every time we came or went through the back door.  As time went by Dad did indeed add a Sue to go along with his Molly.  After many good years with Mel, Molly final had to go to the Rainbow Bridge.  Fortunately, he still had his Sue, who stayed by his side until his death – and Cement Sue was still on station in the backyard.

My Uncle Ken and his family

Dad with a Molly from his grandfather’s line

When the bittersweet time came for me to leave 712 Winter St., Spring Lake, MI to join my lovely Linda in Durham, NC I discovered a sad, sorry truth.  Cement Sue was so damaged, and so sunken into the very ground of the backyard that it would be impossible to move her.  So with a very heavy heart, I left her behind at 712 Winter St.

In my heart, Cement Sue not only meant Molly & Dad but also 712 Winter St., Spring Lake, Uncle Ken & a grandfather & great-grandfather that I never met.  Of course, being so sensitive, loving, caring, and attuned to me – Linda knew all of that.  So she gave me not only a brand new Cement Sue – but also all of those important things left behind when I left Michigan.  I have never received a finer gift with more love behind it.  Thank you Linda – I love you.

The Original Cement Sue (back) with Paladin

Happy Father’s Day

Friday was one of the toughest days ever.  On our way to Doggie Fun Land (the dog park in Ferrysburg) Sue got VERY excited in the car.  Now Pal is a great car rider, he just lays down and takes a nap knowing that there will be excitement when we get where we are going.  Sue on the other hand is always excited, and knows that we’d get there faster if I would just let her drive.  But on this occasion Sue was beyond excited – she was nearly out of her mind.

As we turned the corner, I saw why she was in such a state.  We pulled into traffic behind Dad’s old car and the folks who bought it from us.  Sue had heard Dad’s car and KNEW that was where her Daddy was.  Soon, they turned one way while we kept on another way.  The keening sound that Sue made cut through me like a million sharp knives.  I don’t think that anything has ever hurt me so badly as the sound that she made, knowing that she was in pain and wanted to be with her Daddy.  I was so impacted that I had to pull over and gather myself before I could drive any further.

Of course, Sue being a dog, she lives in the moment.  So by the time we got to Doggie Fun Land, she was ready to run and play.  I wish I could have recovered as quickly.

Today, Father’s Day, was the toughest holiday since Dad passed.  It was even tougher than Thanksgiving, Christmas, Dad’s birthday, or mine.  Since my younger brother

John with Barkley and Alexander

John passed away in 2004, Father’s Day has been a special occasion for Dad, Sue, & I.  This year, with just Sue, Pal, and I it seemed a very lonely day.

If you know me, then you know how dearly I loved, and still love, my father.  If you don’t know me, then words can never tell you.

But I want to share these words anyway.  In 2007 I was still working part time at WGHN– and of course I was working on Father’s Day.  Before I left for work that morning, I placed a card and a pile of gifts on the dining room table.  I also left him a note.  The note is reproduced below, without any further comment.

Mel and his first puppy Sue

Dad,

I know that I’m doing more for Father’s Day this year than what we’ve traditionally done.  Partially that’s because I’m so grateful for all that you’ve done for me, and partially because I’m a little guilty about how little I’ve done for you.  Certainly some of it is a side effect of how scared I was about losing you in February.  But mostly it is just because I love you.

You’ve always seemed superhuman to me.  The strength of your character and the gentleness of your nature still inspire awe in me.  And when I look back from the lofty heights of my 47 years (yes, you should read some sarcasm in that) at how much you had accomplished in life by age 47, and how little I have accomplished, I am humbled.

Probably the single greatest thing that you did for both John and I was that you allowed us the space to be children when we were children and that you allowed us even more space to be our own selves when we became adults.  Recently I’ve thought a lot about that, and how I haven’t really given the same back to you.  I’ve always expected perfection from you.  And while you generally deliver on that score, I let myself become frustrated and even angry when those occasions arise when you are simply a human being.  That isn’t fair, and it isn’t right.  It has been a limiting factor in our tremendous friendship, and I am sorry for all the times that I’ve allowed my attitude to impact our relationship.

I know that you aren’t some comic book superhero who always does right.  I know that you are simply a man who always tries to do right.  And that is a far more precious and valuable thing.  I know that you forgive me for this, you always do – and I appreciate your indulgence more than I’ll ever be able to say or even show.  I will try harder to allow you the space to be your own self, and a human being.  But there will always be a little corner of myself that enjoys pretending that you really are that comic book superhero.

I wrote this all down and stuck it in a card for you to read while I am at work so that we could avoid one of those awkward, mushy moments.  But that doesn’t make it any less real.  Thank you for being my father, I love you.  Happy Father’s Day!

Happy Birthday Dad

Hey Boss,

I just wanted to write you a quick note as the dogs and I wrap up the preparations for your birthday tomorrow. It sounds a bit strange to me to be celebrating your birthday more than four months after your passing, but I decided that it will make me happy to celebrate you – and the special love that we shared.

We are going to start the day with a trip to Doggie Fun Land in Ferrysburg.  After dropping the dogs at home, I’ll pop over to Orchard Market to pick-up a big old porterhouse steak and some of those little cupcakes that you always enjoyed.  I debated about baking a cake for you, as I did every year, but I’ve been doing really well with my blood sugar lately and I don’t want to mess that up.

In the afternoon, Pal has an appointment at Harborfront Hospital for Animals.  He just turned nine this month and he’s due for his annual physical.  It just seemed appropriate on your birthday to take an old man to an appointment with a doctor.  Paladin graciously offered to fill in for you.

After his visit, we’ll stop in at the City Farmer to pick up a box of peanut butter bones for the dogs.  They are still Sue’s favorite food to play with, and she teases Pal and I mercilessly when she has one in her mouth.

Then it will be home to make dinner.  I’ll grill up the steak just the way you liked it – marinated in Worcestershire sauce and seasoned with salt and pepper.  I’m going to split it three ways with Sue and Pal.  I’m also going to share the cupcakes with them.  You should see Sue and Pal on a sugar buzz!  When I came home from your memorial service, I put the leftover cake on the kitchen counter while I changed.  When I came back into the kitchen, there were two happy looking dogs laying on the kitchen floor with some cardboard and plastic wrap between them.  About half an hour later, the two of them were running around the house like young pups – playing with all of the toys, teasing each other, barking at each other, and just having a great time.

After they eat their 9:30 treats, the three of us will snuggle in together on Pal’s couch for our moment of Irish Setter Zen.  And we will sing happy birthday to you.

It won’t be the party that we’ve thrown for you the last several years.  I haven’t invited anybody over, I didn’t buy balloons, or any of that party stuff.

It is still pretty lonely in the house without you, but as I promised you, Sue, Pal and I are taking care of each other.

Happy Birthday Dad!  We will always celebrate your memory.

Mel Is Still Being Mel

Dad & I at a Piston's game

I’ve often said that you haven’t really been to a place until you’ve been there with Mel.

Dad always enjoyed going to new places – not just to see new sights, but also to meet new people.  He fully enjoyed life everywhere he was, and he shared that joy with everybody that he encountered.  It didn’t matter where or when, there were always people that he hadn’t met yet – and they would become new friends.  And more often than not, there were people there that he already knew – creating a joyful reunion of old friends.

Camden Yards

For example, in 1996 I was working on a job site near Baltimore, MD.   As I often did, I flew Dad out for a weekend visit.  We had tickets for an afternoon Orioles game at Camden Yards, where we not only had a great time watching the game, but we got to stuff ourselves on Boog Powell’s BBQ in the outfield concourse.  To fill time before the game, Dad had said that he would like to visit the grave of Edgar Allan Poe.

Edgar Allan Poe's grave

So we added a trip to the grave to our itinerary.  Since I had no idea where the grave was actually located, we left fairly early in the morning to allow ourselves time to locate the site.

We had no trouble locating the site.  We found it immediately on the first try.  It was fascinating, and we spent almost an hour there.  This still left us with several hours to kill.

Dad decided that since we had time to kill we should try to locate the old Memorial Stadium.  Dad had fond memories of watching Johnny Unitas on TV, as well as all of those old Oriole greats.  So off we went to find Memorial Stadium.

Memorial Stadium

And find it we did.  The stadium is tucked away in a residential neighborhood.  We walked the entire perimeter of the facility from across the street to get a good look at the outside of the famous horseshoe shaped building.  And it was amazing.  But since nobody was using the facility at the time, it was a bit boring.  As we stood outside the fence at the open end of the horseshoe, a security guard walked past.

Dad struck up a conversation with him, and in no time we were enjoying a private tour of the place, from the locker rooms to the press box and all stops in between!  That’s just part of the fun when you traveled someplace with Mel.

Behold, the power of the Dum Dum!

On Wednesday, I posted the eulogy that I presented at Dad’s memorial service.  Part of that eulogy included a tribute to the power of the Dum Dum sucker.  Coach Hall always used Dum Dums to recognize and reward the accomplishments of the athletes on his track and field teams.

Lo and behold, on Thursday morning I found this e-mail from Dean Spangler, the Chairman and CEO of the Spangler Candy Company, the makers of Dum Dums!

Jim:
It is apparent that your father, Mel, was a remarkable man.
Our sincere condolenses to you and your family.

Your blog popped up because of the reference to Dum Dums.

As I read your "Eulogy for My Father" I was quite moved. I
have great fondness for good teachers and people that find
the good in life.  Your father had both those traits.  While
we hear many wonderful stories about Dum Dums, I just wanted
you to know that this one probably resonated more than any 
other.

I too was blessed to have a wonderful father.  He has been 
gone 34 years now and still thoughts of him brighten my days 
and inspire me to be better.  I will try to be a little 
better person today for him, and for Mel.

Dean L. Spangler
Chairman & CEO
Spangler Candy Company
"The Dum Dums Company"

Spangler Candy - makers of Dum Dums

Even from beyond the pale, Dad is still reaching out to others.  I’m so proud that Mel is still being Mel!

A Eulogy For My Father

Melvin Edward Hall - April 1, 1932 - November 24, 2010

There are those who seek fame and fortune in life.  My father was not one of those people.

There are those who put their own interests first.  My father was not one of those people.

There are those who seek admiration, adoration, respect, sympathy, compassion, and a host of other responses from those around them.  My father was not one of those people.

My father was a teacher.

It was more than his vocation, more than a job, a profession, or a career.  It was who he was and it was what he loved.  He constantly sought knowledge and wisdom, even in the most unlikely of places – not for his own edification, but so that he could pass it along to others – human and canine.

The truth mattered to Dad.  The hopes, desires, and emotions of others mattered to Dad.  In nearly every conversation he ever had, he would tell a story from his life.  It might be a story of one of his many successes.  It might be a story of one of his many failures.  It might just be a story of everyday life.  But it was always a story that he felt would provide something useful to the listener.  It was never about him, but about how he could be of service to somebody else.

Dad smiled often.  A big, giant, authentic smile – because he found great joy in life.  Joy in his surroundings, joy in the growth and accomplishments of others, joy in the bounce of a dog’s step, joy in living life.

I was truly blessed in life to be the recipient of so much of his joy.  When ever I was down, when ever I faced a difficult decision, when ever I was not sure how to go on – I talked with Dad.  He would listen, as he was a great listener.  And then he would share a story.  As a child I was often frustrated with these stories – I just wanted him to tell me straight out what I thought I needed to hear.  As I grew and matured, I realized that he had provided the information, the knowledge, and the wisdom I needed to come to my own conclusions – to make the decisions that were right for me.  Not what he wanted me to do, not what would work out best for him, but he always gave me what I needed to advance my own way down my own path – and live my own life.

He gave this gift not only to my brother John and I, but to every one he conversed with, every student in his classroom, and every athlete he coached.  He was indeed a very generous man.

One of the things that both John and I gained from him was a love for the written word.  And it would not be a eulogy for an English teacher without a poem.  Dad taught me to enjoy the simple way of the poet Edgar Guest – the poet laureate of Michigan.  This is Guest’s “A Boy and His Dad.”

A boy and his dad on a fishing-trip—
There is a glorious fellowship!
Father and son and the open sky
And the white clouds lazily drifting by,
And the laughing stream as it runs along
With the clicking reel like a martial song,
And the father teaching the youngster gay
How to land a fish in the sportsman's way.  

I fancy I hear them talking there
In an open boat, and the speech is fair.
And the boy is learning the ways of men
From the finest man in his youthful ken.
Kings, to the youngster, cannot compare
With the gentle father who's with him there.
And the greatest mind of the human race
Not for one minute could take his place.   

Which is happier, man or boy?
The soul of the father is steeped in joy,
For he's finding out, to his heart's delight,
That his son is fit for the future fight.
He is learning the glorious depths of him,
And the thoughts he thinks and his every whim;
And he shall discover, when night comes on,
How close he has grown to his little son.   

A boy and his dad on a fishing-trip—
Builders of life's companionship!
Oh, I envy them, as I see them there
Under the sky in the open air,
For out of the old, old long-ago
Come the summer days that I used to know,
When I learned life's truths from my father's lips
As I shared the joy of his fishing-trips.

I would like to close by sharing a story of Mel – and the power of the Dum Dum sucker.  For every athlete who went out for track, he would make a sheet listing all of the possible events in a track and field meet.  On this sheet he would note the athlete’s best performance in every and any event.  Each time the athlete would post a new “best” performance in any event, that student’s name would go on the “Sucker List.”  And each week Coach Hall would read off the names on the “Sucker List” and award a Dum Dum sucker for each personal best.

Of course it wasn’t the actual Dum Dum sucker that inspired 18-year old boys to push themselves to a new achievement.  It was the public recognition, the acknowledgement that Coach noticed their efforts and wanted to celebrate their achievements with the team.

This led shot-putters to form their own “Fat Man” 440-Relay team – so that they could earn that sucker and that recognition.  The fact that the sprint work also improved their ability to turn a circle and put the shot farther was never discussed.  It was simply enough that they tried something new, or improved on a previous best.

As you leave the Sanctuary today, you will find bowls of Dum Dum suckers waiting.  Please take a sucker, on credit from Mel, and as you go through the day – do something new or better than you have ever done before.  That will be Mel’s legacy.

last hopes

My younger brother John found his way through life by writing about it.  As I was working my way through Dad’s stuff today I came across one of my favorite of John’s poems.  I’ve often taken the advice he presents here on difficult days.  I think I’ll do so tonight.

last hopes

john lee hall

the woman

i thought i’d loved

had left

me.  my rent

went

unpaid

because dear father

stopped payment

on his check

“just to show”

me.  my last

close friend

had o.d.’d

on strychnine,

and my checks

bounced higher

than a head-first

suicide

off a six-story

parking tower.

i had five

bucks

left.  the phone

was restricted

to local.

i dialed:

three

five

one, seven

one

hundred,

was put

on hold, came

off hold,

and asked

for what i needed

most —

and it came

with two

free

pepsis.

 

god

won’t answer

my prayers,

but dominoes

delivers.

I Don’t Know Why It Has To Be This Way

Last June the doctors told us that Dad wouldn’t “live to see Christmas.” At the time it seemed just plain silly to me. Sure, Dad was showing signs of what the Alzheimer’s Disease was doing to his memory. And sure, his PSA levels were ridiculously high.  He had some problems, but absolutely nothing that seemed to actually be life threatening.

We took it seriously enough to enroll him in a hospice program (for some of the trials and tribulations of that search, click here).  After a lot of researching and interviewing we selected the Big Statewide Hospice Company.  BS Hospice has not been without its challenges, but overall they have been satisfactory.  (Note that the names of all health care providers have been changed – mostly for my amusement).

Two weeks ago, things changed dramatically.  Overnight, Dad was suffering severe pain in his lower spine, left hip, and left femur.  This is potentially very bad.  It means either that the cancer has metastasized into his bones, or that we have a new problem.  If it is the cancer, then this is the beginning of the end.  He will be in constant pain until the cancer kills him.  If it is something new, then we may or may not be able to do something to help him.

The Father

BS Hospice responded admirably.  They immediately started him on a rotating program of the holy trinity – Roxanol (liquid morphine),

The Son

Vicodin, and

The Holy Spirit

Gabapentin.  While this keeps him pretty dopey, it does allow him to be much more comfortable.

After a week of this “pain management” Dad’s condition was unchanged.  BS Hospice Nurse #5 (the RN Case Managers from BS Hospice change so frequently that I haven’t named them, just numbered them) decided that she should refer Dad back to his primary care doctor (Dr. Primary) to get a bone scan done.  This is HUGE.  From all of my research, I understand that it would not be unusual for a lesser hospice company (like Dr. Asshat’s Lying Thieving Hospice Company) to simply declare that this was a symptom of the cancer and nothing was to be done.  In that case, your only options are to wait for death or to quit the hospice company.  But BS Hospice did the right thing – they decided to actually gather some evidence and make an informed decision about his care.

This may actually be Dr. Asshat

So immediately after Nurse #5’s visit on Monday I called Dr. Primary to make this happen.  Now you may not know this, but while Dr. Primary is wonderful he works in an office under the direction of Dr. Asshat.  So it was no surprise that when I called I got a bunch of bullshit about how Dr. Primary was out of the office blah blah blah blah blah blah “but if you were with [Dr. Asshat’s Lying Thieving Hospice Company], then [Dr. Asshat] could order the bone scan today.  Would you like to change hospice companies?”

I put up with this nonsense over a series of phone calls, until finally on Wednesday morning I explained to the Useless C on the phone that this was illegal, and I was certain that the state regulators would love to hear about it – and that I was going to find a new primary care doctor immediately.  And then I hung up.

In less than 10 minutes, Miss Useful (the office scheduler) called back to let me know that Dad’s bone scan was scheduled for Friday morning at 10.  Wow, isn’t that amazing?  Providing medical care for Dad is simply not possible unless they are threatened!  Who woulda thunk it?

A gait belt in use

Now, lest you think that this is simply a rant about a single bad provider (Dr. Asshat), let me continue.  As soon as Miss Useful scheduled Dad’s bone scan at North Ottawa Community Hospital I called BS Hospice to let them know that we finally had the test scheduled.  While I had them on the phone, I also let them know that Dad was getting progressively weaker and now needed assistance to get up.  I asked if they could provide me with a gait belt so that I could assist him without throwing out my back.

Keeping in mind that I was praising the BS Hospice Company only a few paragraphs back, what do you think their response was to this question?  Why, the ever so pleasant and less-than-helpful voice said to me “I don’t think that we can provide that.”

Since I was already on my last nerve for the day, I simply stated “Since Dad is 6 feet tall and weighs 270 pounds, it is dangerous for me to try and assist him unaided.  Since you can’t provide me with a simple device to assist him, I am going to be forced to call you and request a nurse visit EVERY time he needs to stand up or sit down.  Thank you.”  And then I hung up.

Wow, that hanging up thing really works!  In less than 20 minutes Nurse #5 called to let me know that she had been updated on the bone scan – AND – that she would be stopping by later in the day to deliver a gait belt!  Isn’t it amazing!

It really frightens me that Dad gets treated like this.  He has good insurance, is a compliant patient, and has a full-time in-home caregiver (me) who advocates for him.  I cannot imagine what it must be like for someone lacking these advantages to try and navigate through the system.

Every Day Is Like Christmas

This is our Charlie Brown Christmas Tree. I bought this just before Christmas last year.  It just seemed to fit our lives, our Christmas decorations, our living room, and our lives.

A Charlie Brown Christmas first aired in 1965 – I was four years old.  I can’t swear to it, but I’m pretty sure that I’ve watched it every year since.

Watching Dad’s reaction to the tree, I bought him a copy on blu-ray for Christmas last year.  We’ve probably watched it a dozen times since then.  There is just something about this classic that makes you feel good – even if it isn’t Christmas time.

When it came time to take down the Christmas decorations last season, Dad and I decided that the Charlie Brown Christmas Tree should stay up year-round.  So it became the centerpiece decoration in our living room.

Sweet Sue

With every thing that is going on with our lives and Dad’s health – we decided that we should stop for a moment each day and remember the great gifts that we have.  We have each other.  We have a roof over our heads and enough food to eat.  Dad has a tremendous insurance plan that covers whatever medical care he needs.  We have Sue – the love of Dad’s life and a tremendous blessing all by herself.

At the time, we were also fostering dogs for a rescue group – so we were sharing our gifts every day with those less fortunate.  We’ve since adopted Paladin, which put us at the limit for animals in the Village of Spring Lake and removed us from the fostering business – but we are overjoyed to be able to share our blessings every day with the most recent addition to our family.

At our house, everyday is Christmas Day – and we have the Christmas Tree to prove it!

Last June the doctor sat Dad & I down.  With a look of deep seriousness on his face he gazed deeply into Dad’s eyes and said “I very much doubt that you will live to see Christmas.”  I tried my best not to look at Dad, but I couldn’t help myself.  I looked over at him and we both started giggling like school girls.  The moment could not be contained, and soon we were both roaring with laughter!  The poor confused doctor said “That certainly is not the reaction I expected.”

As Dad & I wiped the tears of laughter away, Dad stated simply, between chuckles, “EVERY day is Christmas at our house!”

So, if you come to visit us – or even if you only visit through reading this blog – remember that EVERY day can be Christmas if you want it to be.  And please take a moment to appreciate the gifts that you have, and share them with others.

What The Hospice Companies Don’t Want You To Know

In which Dad & I continue our education regarding corporate health care.

Dad likes doctors who speak plainly to him.  It’s a big part of what he likes about Dr. Primary (his primary care doctor), Dr. Pisser (his urologist), Dr. Onco (his oncologist), Dr. Tootsie (his podiatrist), and even Dr. Twitchy (his neurologist).  In fact all of these doctors have been specifically chosen as much for their ability to communicate with Dad as for their medical skills.

Not actually Dr. Primary

So it was actually a bit of a relief to Dad when Dr. Primary told him “you probably won’t see Christmas this year.”  It can’t be put much more plainly than that.  Dr. Primary also suggested that it was time that we got Dad into a hospice program.

Now, since we’ve been through this once before with in-home care (you can read all about that thrilling episode here), we knew that Dr. Primary would refer us to Dr. Asshat’s Lying Thieving Hopsice Company.  And sure enough, as we walked out of the office Miss Useful (the scheduler) offered to set us up for an “intake visit” from Dr. Asshat’s Lying Thieving Hospice Company.  I nearly declined on the spot, since I knew that there was no way we would be using

This may actually be Dr. Asshat

Dr. Asshat’s Lying Thieving Hospice Company.  But then again I thought, why not waste some of their time – and they may provide a useful comparison point.  So we set up the visit with Dr. Asshat’s Lying Thieving Hospice Company.

As soon as we got home, I googled up other hospice companies in our area.  I decided that Happy Hospice company looked like a good candidate, so I called Miss Useful (and only had to talk to 5 of the Useless C’s before I could talk to her) and asked her to also set up an “intake visit” with Happy Hospice.

Now the fun begins!  Miss Useful informs me that it isn’t usually

The Tree of Hospice Caring

done this way.  Usually she only writes one referral and that is the company that we would use.  This of course pisses me off.  So I bluff.  I remind her that the law requires her to write the referral to whatever agency or agencies that WE choose (I have no idea if this is true or not – but it worked)!  So she backs off and does what I asked.  Score one for the home team.

The visit with the woman from Lying Thieving Hospice Co. actually goes pretty smoothly and even starts on time.  She paints a wonderful picture of the caring team of professionals who would look out for Dad’s best interest for the remainder of his life.  She assures me that that the Lying Thieving Hospice Company is nothing like those lying thieving bastards at the Lying Thieving Nursing Company.  Even though Dr. Asshat is the “Medical Director” for both firms, she assures me that they are nothing alike.  I give her all of Dad’s information, including his list of medications.  She looks it all over, declares that everything is wonderful – and if Dad will just sign on the dotted line we can start making the magic happen.

The happy picture of a caring hospice worker

Of course she is very unhappy when I tell her that we will also be hearing the sales pitch from the Happy Hospice Company and that we won’t be signing anything until after we evaluate our options.  She has “never heard of such a thing” and leaves in a bit of a huff.

The following day we get our visit from the Happy Hospice Company.  Five minutes before the scheduled time, this woman calls us and tells us that she will be running half an hour late.  She doesn’t ask if that will be O.K. with us – she just informs us that she’ll be late.  She arrives at T+30, and proceeds to spend the next 10 minutes talking on her cell phone in the driveway.  She then comes in and informs us that we’ll get started as soon as the nurse arrives.  At T+60 the nurse arrives.  I inform them that this is a bad sign, if they can’t be on time when they are trying to sell us their services, how are they going to treat us after we’ve signed up?  She informs me that this is not a sales call, it is an “intake visit” and the purpose of the visit is to sign us up and get the service started.  I’m not sure how that is actually different from a sales call, but whatever.

I’ll give the Happy Hospice Co. nurse credit.  She looks over Dad’s list of medications (the same list that I provided to the Lying Thieving Hospice Co. worker) and informs us that we will “of course have to discontinue the Zometa.”

Zometa - it builds strong bones

Zometa is a drug that Dad gets through an IV once a month.  It doesn’t actually do anything with regards to the cancer cells that are rampaging through Dad’s blood stream.  What it does is strengthen Dad’s bones so that they are better able to resist the cancer cells from eating away his bones or setting up housekeeping in his bones.  It is good to keep the cancer out of the bones, as it can be VERY painful if the cancer metastasizes in the bone.

This is a very expensive medication – about $1,200 per treatment.  But as we’ve previously covered, Dad has great insurance that pays for this treatment.  I explain to the Happy Hospice nurse that Dad’s insurance will cover the treatment, so we don’t see any need to stop it.

And this is where I get my next lesson in the business of health care.  The nurse explains to me that once Dad enters into a hospice program, Medicare picks up all of the costs.  However, any Medicare supplement that you have will no longer cover any treatment related to whatever caused you to enter hospice.

At this point I decide that we need to regroup and study the situation some more.  So I send the ladies from the Happy Hospice Company on their way (they too are disappointed that we won’t sign anything) and start researching some more.

This issue is particularly troubling to me, since the Lying Thieving Hospice Co. didn’t seem to have any issue with Dad remaining on the Zometa.  But, as their name implies, the Lying Thieving Hospice Co. isn’t exactly known for their honesty.  So I call them up and ask specifically about Dad’s Zometa treatment.  The charming and delightful person at the Lying Thieving Hospice Co. informs me that “of course he’ll have to stop the Zometa, it isn’t covered.”  Wow!  It sure would be nice of them to tell us that before they ask us to sign on the bottom line.  They decide that they should schedule Dr. Asshat himself to come to our house the next day to explain it to me.

In the meantime I do some more research.  The nurse from the Happy Hospice Company was telling the truth – as far as she went.  Of course she didn’t tell the whole truth.

Hospice Mission Statement

“Standard” hospice companies work exactly as she explained.  When you enter hospice, Medicare takes over the complete cost of hospice.  Any Medicare supplement that you happen to have is no longer in effect for the disease that caused you to enter hospice.  And since standard Medicare doesn’t cover Zometa, you can’t have it if you are in a “standard” hospice program.  Actually that isn’t entirely true – the “standard” hospice company could still let you have the treatment.  But Medicare won’t reimburse them for the cost of the treatment.  So the hospice company would have to pay for it out of the per diem that Medicare pays them for everyday that you are in the program.  But since this would cut into the profit margins, no “standard” hospice program will let you have the treatment.  Remember, it isn’t about the quality of care or quality of life – it is all about the profit margins!

But my research tells me that if you select an “open access” hospice program instead of a “standard” hospice program – you get to keep your insurance!  This sounds like what we need.  In fact, it sounds like how hospice should work.

A Common Insurance for Hospice Patients

Most people who need hospice care, I’m assuming, are on Medicare already.  And if they are smart or fortunate, they have a Medicare supplement.  So why would you not be able to use your Medicare supplement to help pay for medical care that you want or need?  Can anybody explain this?  How does this make sense?

The following day, Dr. Asshat arrives to explain things to us.  First, he explains that while Dad cannot have further Zometa treatments, there are oral medications that work “almost as well” that he could still receive from the Lying Thieving Hospice Company.  Then he proceeds to tell us that Zometa is “a bad medication for your father.”

Now hold up there a minute doc!  If Zometa is a “bad medication” then why would we want an oral substitute that works “almost as well?”  Would “almost as well” mean “not quite as bad?”  What are you talking about?  I held that thought and instead asked “Why does Dr. Onco keep him on the treatment if it is a bad medication?”

Dr. Asshat’s well thought out answer to my question was simply “I’m not going to argue the literature with you, you wouldn’t understand anyway.”  EXCUSE ME!  EXCUSE F’n ME!  Who do you think you are?

But I knew that open rage wouldn’t really help Dad, so I managed to hold my tongue for a change and instead asked about “open access hospice.”  You know, the kind of hospice where Dad could still use his insurance to pay for the Zometa treatments?  Dr. Asshat, in his eternal wisdom says “I’ve never heard of that.  I don’t believe that anybody would actually do that.  It would be illegal.”

I don't know doc, can we look here?

Now I’m not a doctor with a degree.  I probably don’t understand “the literature.”  I’m not the Medical Director of two different Lying Thieving health care companies.  But I do know how to use Google.  You, gentle reader, probably do too.  So go ahead, google up “open access hospice” and see what you can find.  That’s right, you’ll find literally hundreds of “open access” hospice companies.  Apparently they are all illegal, if you believe that Dr. Asshat has a clue.

We have since regrouped, and located three different open access hospice companies that service our area.  We have interviewed the first of the three already, and we were very impressed.  Keep your fingers crossed for us in this search.

And here are some tips and tricks if you need to find hospice care for yourself or a loved one.

* Read up on everything you can about hospice.  There are reportedly lots of good hospice companies, and I can tell you first hand that there are lots of bad ones.

* Use your yellow pages.  Google only gave me two hospice companies that serve our area – Lying Thieving Hospice & Happy Hospice.  The yellow pages gave me five companies.

* If you have a Medicare supplement, or other private insurance, you REALLY want to find an open access hospice company.  DO NOT settle for anything else.  You have insurance, you should be able to use it.

* Check, double check, and triple check EVERYTHING.  These companies will do or say anything to get your business.  Do not simply trust the referral from your doctors office.  There are lots of options – find the best one for you and your loved ones.

* Make sure that the hospice company that you select provides an emergency kit of some sort.  This emergency kit usually contains medications to ease breathing and manage pain.  They often include some form of morphine.  This kit could be a big time blessing in the case of emergency pain.  Do you really want to wait half an hour for the nurse to arrive, or do you want to (at their direction) get your loved one some relief NOW?  Believe it or not, not every hospice supplies such a kit.  Make sure that yours does, and make sure that you know what is in it.

* During the sales call (or even before if possible) provide the hospice company with a complete list of medications.  Make sure that they understand and verify YOUR desires with regards to current medications.  YOU must dictate to them, do not let them dictate to you!

* There are lots of good websites that give suggestions about choosing a hospice provider.  None of them that I’ve found mention “open access.”  But they do have lots of good ideas.  Read them all!  This is a very important decision.  Make it carefully.

As usual, the names of the health care providers & companies have been changed mostly for my amusement.  If you want to know any of their real names, e-mail me privately.

Prop It Up

Lying, Thieving, & Nursing

This is a true story, albeit one that is nearly a year old. I share it here, not so much on it’s own merit but so that I can link to it as a background item for a future post. The names of the medical providers have been changed mostly for my amusement.

For those who don’t know, I am the caregiver for my father. He is in the late stages of prostate cancer, and the middle stages of Alzheimer’s Disease. I moved in with him in December of 2005 to help him enjoy his life to the fullest in whatever time remains.

About a year ago, I had reached the end of my rope. Dad had progressed to the point where he could no longer be left alone at all. So I was “on duty” 24 x 7 x 365. And it had gotten to be too much for me.

Dad has a wonderful primary care physician, we’ll call him Dr. Primary. Dr. Primary has done a fantastic job with Dad, working to make life as good for Dad as possible. Dr. Primary is amazing, but he works out of a practice operated by Dr. Asshat. From the name I’ve chosen to use for him, you can imagine what I think of Dr. Asshat.

In an apparent effort to offset the awesomeness of Dr. Primary, Dr. Asshat has chosen to staff the office largely with a group of the most incompetent, unpleasant, uncaring, unprofessional women I have ever had the displeasure of knowing. I refer to them collectively as the Useless Cs – since they simply aren’t worth the effort required to name them individually. There are some exceptions, particularly Dr. Asshat’s Scheduler, Miss Useful.

When I reached the end of my rope, I called the office and asked to speak with Miss Useful. I had to go through three of the Useless Cs before I could speak to Miss Useful, so it was less onerous than usual. I explained my predicament to Miss Useful. She said that she knew exactly what we needed – some in-home care from LTN Co. She offered to send somebody from LTN Co. to our home to make arrangements to help me care for Dad.

The Wonderful Nurse Ratched

At 30 minutes past the appointed hour, a woman that I’ll refer to as Nurse Ratched arrived. Now I must apologize to the the more famous fictional Nurse Ratched, who by comparison is a wonderful, warm, caring, health care professional.

I explained the situation to Nurse Ratched.  She explained that she didn’t think that they could do a whole lot for us.  She also explained that whatever they could do for us, we would have to arrange for the dogs to be outside the entire time, as none of their staff would put up with dogs.  I explained that since I was looking for some way to get 3 or 4 hours away from caring for Dad at a time, that putting the dogs outside (especially in the midst of a Michigan winter) was not an option.  I was ready to dismiss Nurse Ratched and LTN Co. at that point.  But Nurse Ratched insisted that since she was there she would have to physically examine Dad for her report.  So we agreed that she could examine Dad, but of course before she could do that, she needed to see Dad’s insurance cards.

Now Dad had put in a long career as a teacher and one of the benefits of a career teaching in the State of Michigan is an exceptionally comprehensive medical plan – even in retirement.  She took one look at his insurance cards and her eyes lit up!  “Oh, we can ‘skill him up,’ we can do PT, OT, we’ll get him a bath aide, we’ll have the social worker stop by,…” she exclaimed as she ticked off every single item on her checklist of services that they could provide.  Of course the one thing that she didn’t mention was some respite for me!

But she was on a roll now!  She actually threw out the calendar page that I had printed out for her showing all of Dad’s appointments, my appointments, etc.  She started making out her own calendar for us, showing what days that Dad would be receiving physical therapy, occupational therapy, visits from the social worker, bath days, and of course “skilled nursing” visits.

Now at this point Dad did not need “skilled nursing.”  And he still doesn’t need it today.  He has some balance issues, so he needs help pulling his pants up; he uses a walker to get around so he needs help getting a glass of water to put by his chair; and his medications & chemotherapy were causing violent bouts of diarrhea – which at a minimum caused him to need help pulling his pants back up.  None of which requires “skilled nursing.”

This is what LTN Co. is all about!

But Nurse Ratched was not interested in what Dad needed.  She was solely interested in maximizing what LTN Co. could bill Dad’s insurance.  So the parade began.

PT came in to evaluate him, OT came in to evaluate him, the “skilled nurse” (Nurse Ratched herself) came in.  All of which tired Dad out and provided no benefit to either of us.

The saddest and most comical of them all was Shower Girl.  On her first visit she laid out for me the list of things that I needed to have ready for her when she arrived to give Dad a shower.  Towels, washcloths, soap, shampoo, etc, etc.  I also had to have Dad undressed and ready for the shower when she arrived.

Now we have a walk in shower for Dad and he is perfectly capable of showering himself.  Because of his balance issues he likes to have somebody around while he takes a shower, just in case he should slip in the shower.  I highly doubted that 90 lbs. of Shower Girl would help, but at this point we were clueless and just went along with the program.

When Shower Girl returned several days later for Dad’s first shower, I had everything ready as specified.  I had Dad undressed and sitting just outside the bathroom covered in a blanket to keep him warm.  When she finally arrived 45 minutes after the scheduled time, she proceeded to bitch me out about not having everything laid out for her in the bathroom.  I let her bitch and then told her that when she was done, I would appreciate it if she would walk the four steps from the bathroom and drop the towels and washcloths in the open washing machine.  She actually said to me “We’ll see if I have time for that!”  Which of course she didn’t.

Before Dad’s insurance began paying for the assistance of Shower Girl, it took me half an hour to get Dad undressed, into the shower, cleaned up, out of the shower, dried off, dressed, and the towels & washcloths into the washing machine – at Dad’s convience.  With the benefit of Shower Girl, I still spent 15 minutes getting Dad ready, 45 minutes waiting around for her to arrive, and another 15 minutes cleaning up after her.  What a deal!

The first big club over my head clue came one Tuesday morning. On Tuesday mornings, Miss Tidy comes in to do laundry, dishes, and some light housekeeping. Dad found her through the local Council On Aging.  Miss Tidy came in for about 3 hours each Tuesday morning and accomplished these tasks in a cheerful manner and Dad always enjoyed her coming.  On this particular Tuesday Nurse Ratched also arrived to “skill ‘im up.”  I decided that while Nurse Ratched was there to provide skilled nursing care, and Miss Tidy was there to show Nurse Ratched where things were located – I could get away for a quick errand.  I was gone for a grand total of 15 minutes.  When I returned home, Nurse Ratched was standing alone in the living room, on her cell phone, bitching at somebody because “he had an accident and blew my whole schedule.  I’ll have to reschedule his ‘skill’ because I can’t just stand around wasting time on him.”  Meanwhile Miss Tidy was in the bathroom helping Dad get cleaned up after his accident.  This is NOT Miss Tidy’s job.  It IS Nurse Ratched’s job.  Miss Tidy earns $10 per hour.  Dad’s insurance was being billed $55 per hour for Nurse Ratched’s “skill.”  I’ll bet that Nurse Ratched makes more than Miss Tidy’s $10 per hour out of the deal.  Yet Miss Tidy is actually HELPING Dad, while Nurse Ratched is bitching about her time being wasted.  I think I just bought a vowel.

The only useful service provided by LTN Co. was the social worker Davey.  Davey actually took the time to speak with Dad.  I explained to Davey that we really didn’t want all of this nonsensical “care” tiring Dad out and adding no benefit – all we were really looking for was somebody to provide some basic assistance so that I could get out of the house for a bit.  Davey told us that LTN Co. could provide that service at a cost of $25 per hour and that they would not bill Dad’s insurance for it.  Instead, Davey suggested that we should call the local Council On Aging.  There we could get the same “aid” to come in for $10/hour – and the aid would keep all of the $10.  If we went through LTN Co. the aid would get $9/hour while LTN Co. pocketed $16.

So now I felt like a real chump.  I had made Dad’s life miserable for nothing.  We called the Council on Aging and made arrangements for an aid – who would actually do what we wanted & needed at a bargain rate.  I made the call to Nurse Ratched and let her know that we were stopping EVERYTHING with LTN Co. immediately.  She started to go down the list with me.  The conversation went like this:

Nurse Ratched: PT?

Me: Cancel it!

Nurse Ratched: I’m sorry we can’t, Doctor ordered it.  OT?

Me: Cancel it!

Nurse Ratched: I’m sorry we can’t, Doctor ordered it.  Shower Girl?

and so on through every service on her list.  She finished the conversation by telling me that she would “have to confer with Doctor.”

The next time somebody from LTN Co. showed up at the door, I told them to go away and shut the door.  Within minutes I received a phone call from Dr. Asshat.  He was very upset that we were “non-compliant” with the therapies that he ordered.  Hold On – THE THERAPIES THAT HE ORDERED?!?!?!  WTF?

As Dr. Asshat had never actually seen or spoken to either Dad or I, I asked him on what basis he ordered anything?  And had he ever actually dealt with the slimy disgusting creatures at LTN Co?  He explained to me that he had ordered all of this crap in his role as the Medical Director of LTN Co. based on Nurse Ratched’s “work up.”  Yes, you read that correctly.  Dr. Asshat’s clinic recommended LTN Co.  LTN Co. couldn’t “do anything for us” until after they found out that Dad had Cadillac insurance.  Then magically Dr. Asshat “ordered” a bunch of therapies and skilled nursing that Dad neither wanted or needed – and that actually reduced his quality of life!  And then Dr. Asshat had the audacity to bitch me out for being “non-compliant!”

At least we got an education about how the medical racket works.  This education would become very important later when Dr. Primary recommended that it was time for Dad to enroll in Hospice – which he ordered from LTH Co. (where Dr. Asshat is also the Medical Director).  But that’s a post for another day.

Oh, and LTN Co?  Where did I come up with that name for the Lying Thieving Nursing Company?  Gee – I don’t know.

Prop It Up