Monthly Archives: July 2023

Photography

A Less Expensive Way To Get Into Photography

Photography is a fantastic hobby that affords high levels of variety and creativity. There is an art to taking a good photo; some ability comes from study, but most come from practice.

Why use a separate camera in a world of good cell phone cameras? A decent dedicated camera will capture a higher-quality image than the tiny sensor on an iPhone. However, that is only part of the reason. More importantly, a high-quality camera gives the photographer control over the image. What is in focus, and what is not? What part of the image needs to be perfectly exposed? Should a fast-moving object be frozen, or is it preferred to have it show its speed by having it blur in the image? These and many more possibilities move a photograph from a snapshot to an interesting image and sometimes a work of art.

Enthusiast and professional-level cameras allow the photographer such control. However, new high-end cameras can cost thousands of dollars for the camera body and much more for a collection of lenses. Spending $2,000-$10,000 on a hobby that may not hold interest over time is not in a new photographer’s best interest. The good news is there is a solution, as older cameras are affordable and allow a new user to gain the skills necessary to take magazine-quality images.

Three years ago, I produced a YouTube video emphasizing that all semi-professional and professional cameras made in the last decade produced images that could be used for just about any current professional photo need. Some instances are so demanding that the shooter could be compelled to buy the latest and greatest. However, there have always been workarounds to get those amazing shots using a little thought and technique.

That is not to say that cameras haven’t improved over the last decade; they have improved in many ways. Newer cameras have amazing focusing, but older cameras had focusing, which was very good. Newer camera sensors have better dynamic range and low-light performance. However, those two improvements are only important in certain circumstances. Most cameras do an excellent job of capturing what the photographer intended.

Newer cameras may have convenience features, like a tilting screen which can make low-angle shooting easier, but if you don’t have one, you just have to bend down. The one central area where cameras have advanced is their ability to shoot videos in addition to stills.

The Nikon D90 was released in 2008 and was the first DSLR camera that could also shoot video. This was revolutionary at the time but primitive by today’s standards. The D90 was only able to capture 720p video in 5-minute increments. Another milestone was in November of the same year when Canon introduced the 5D Mark II, a camera capable of recording 1080p video for 12 minutes. The Canon 5D’s capabilities were so astounding that it was used to film TV shows and theatrical movies. Camera models introduced after that improved these features and were entirely capable video cameras. The one problem was that their video’s automatic focus could have been better, requiring the videographer to focus the camera manually. In 2013 Canon introduced dual pixel autofocus, which improved autofocusing of video dramatically. Other camera manufacturers have since introduced their own autofocus algorithms making focusing video as simple as pointing and recording.

Recently, many newer cameras can record video in 4K for extended times. Significantly, their ability to follow focus on their subjects has gone from abysmal to spectacular. Some newer cameras include more professional features like zebra striping and focus peaking. However, many of these features are unnecessary for the casual videographer or the individual who wants to shoot still images.

In 2008 Panasonic introduced its first large-sensor mirrorless camera, the Lumix DMC-G1. Over the last 15 years, all camera manufacturers (except Pentax) have switched to a mirrorless format. This has allowed for more computer-driven features like face detection focusing and amazing burst shooting rates.

However, all the functionality needed is present in older cameras, from excellent photo quality to enough controls to allow any level of creativity. The lack of computer-generated functions can improve the skills of a budding photographer as hands-on controls allow for the best understanding of the processes needed to obtain the best image. It is better for a photographer to understand and modify controls than expecting a computer to use some algorithm.

If you are interested in photography, knowing how to use a camera is more important than having the latest, greatest gear. Remember, digital cameras from the last decade have been good enough to take spectacular photos seen on everything from billboards to National Geographic.

If you are new to cameras, the following primer will help you understand some camera specifications:

Sensor Size

Semi-pro and professional digital cameras have image-capturing sensors much larger than your phone’s. These larger sensors are more capable of capturing an image in low-light conditions. Typically, they also have a better dynamic range. Dynamic range measures how many levels can be discerned between black and white. The greater the dynamic range, the greater the ability to see nuances in a photograph. For instance, excellent dynamic range lets you see details in shadow areas.

Sensor sizes in professional cameras come in three sizes. The sizes from smallest to largest are called Micro 43, APS-C, and full frame. There is no standardized naming convention in these three sizes.

The largest sensors (full frame) are typically the best in handling low light and have a better dynamic range. It is also easier to produce a sharp subject with a blurred background, as you may see in some portraits. The lenses of full-frame cameras have to be bigger to accommodate the larger sensor; because of this, both cameras and lenses typically cost more.

Smaller sensors (Micro 43 and APS-C) allow a smaller camera body and lenses. Lenses can cost less because they use less glass. How much a lens magnifies, an image is measured in mm. A lens with a 16mm equivalent focal length will give an ultra-wide view, while one with a 200 mm equivalent focal length will zoom into a subject. Smaller sensors have a multiplication factor when using lenses. For instance, a 200 mm lens will produce an image equivalent to a 400 mm lens on a micro 43 (2x crop) camera and 300 mm on an APS-C camera (1.5 x crop). This can be useful when you need to get maximum telephoto magnification.

All three sensor sizes can produce excellent images. I would choose a sensor size base on other qualities. For instance, if you take many flash-free images in a dark venue (like a nightclub), a full-frame camera will likely do a better job. If you want a smaller camera body and lens, buy an APS-C or Micro 43 camera. Street photographers and hikers often prefer smaller cameras, as carrying a heavy camera can be a drag.

Controls

If you want to go beyond “pointing and shooting” and become proficient with controlling your camera, you will want to have specific controls easily accessible on the camera body. I like physical controls, but some cameras have easy-to-access controls on a screen, which can also work. If the controls are hard to get at, for instance, hidden in menus, you will be less likely to use them. Having accessible controls IS THE MOST IMPORTANT FEATURE of a pro camera. Being able to control a camera quickly will give you the greatest flexibility.

The practical goal when taking a photo is properly exposing the image. There are many ways to do this, each impacting the end result differently. Becoming familiar with these ways is the most important technical thing a photographer can do.

These are controls that you will often adjust.

Shutter Speed
Cameras can expose the sensor to light for various lengths of time. A fast shutter speed freezes motion, and a slower shutter speed allows more light to hit the sensor.

Aperture
This is how wide the opening of a lens is. A narrow aperture gives a great depth of field. In other words, everything in the image is in focus. A wide aperture gives a shallow depth of field, so only the subject of interest is in focus, separating the subject from the background. A wide aperture is also helpful in dark situations when you want to have the maximum amount of light with the quickest possible shutter speed.

ISO
This refers to how sensitive the sensor reacts to light. A low ISO will give the clearest picture. Using a high ISO may introduce more noise to a photo but may allow you to capture a photo in a dark setting that you couldn’t otherwise.

These three parameters (shutter speed, aperture, and ISO) impact the amount of light hitting the sensor, and together they create what is called the “exposure triangle.” Depending on the situation, you may adjust one or another. If you adjust one setting, the camera will change the other settings automatically to achieve the correct exposure. Cameras also allow you to override all these settings by placing the camera into manual mode. This is used in certain situations but beyond the scope of this post.

Exposure Compensation
This handy feature allows you to override the camera exposure settings while still utilizing all of the camera’s automatic settings. Let’s say you photograph a person standing against a bright sunlit window. The camera’s light meter will read the entire scene, meaning that all the light from the window will cause the person to be under-exposed. You can use exposure compensation to increase the exposure so that the subject is properly exposed.

The above controls are the most important and will allow you enough control over your camera to do anything.

Extra features

Metering Modes
Multi-zone metering tells the camera that you want it to register all of the light seen by the camera and then average the metering for the entire scene. Multi-zone metering works in most situations. Sometimes you can use spot metering to register just a portion of the image you want perfectly exposed.

In most cases, I leave my camera in multi-zone metering, and if I need to compensate for the exposure, I use exposure compensation.

Focus Modes
You can have most cameras focus on a single point (let’s say a person’s face), or you can have a camera track a person or object that is moving. Different cameras have different abilities to track moving objects. Semi-pro and professional cameras from around ten years ago are very good at tracking, and newer professional cameras are excellent at tracking.

Focus Points
Some early cameras only had a single focus point in the center of the frame. Pro-level cameras may have 30 or more points that help with tracking. Some very modern cameras may have thousands. The Canon 5D Mark II (introduced in 2008) is an excellent camera with only nine focus points. The Nikon D300 was introduced in 2007; it had 51 points and is excellent at tracking subjects. Many pro photographers only use the center focus point on a camera and then shift the camera to recompose the image once they lock in the focus. A lot of focus points are good when you are trying to track a moving subject.

Burst Rate
You can set a camera to take a single shot or continuous shots as long as the shutter button is pressed. Different cameras have different burst rates. Cameras designed for sports or wildlife have very fast burst rates.

Hot Shoe
This is a mechanical attachment for an external flash. Many high-end cameras don’t have a built-in flash so that a hot shoe can be handy. Flashes (also called speedlights) are often specific to a particular camera brand. However, they can often be used manually on just about any camera in a pinch.

Eyepiece (Viewfinder)
Although not absolutely needed, an eyepiece allows you to hold the camera up to your eye when you compose your image. This lets you steady the camera and helps you see your subject on a sunny day. Some consumer cameras lack an eyepiece and only have a view screen on their backs.

Image Stabilization
Most modern cameras have a camera shake-prevention feature. Newer cameras often have it built into the camera body, whereas some designs have image stabilization built into the lens. Both work well enough for most situations.

Bonus Features
Cameras have all sorts of bonus features that may make your life easier. These features are optional for a beginning photographer.

Tilty screen
The view screen can be tilted in several directions. Different models allow different amounts of tilt. This can be useful if you take many photos from a low angle. However, you can also crouch down.

Double Card Slots
All cameras use memory cards. Some cameras have two slots, so the image is still secure on the second card if one card fails. This is great if you tend to be a worrier, but it is optional if you practice reasonable techniques. For instance, never remove a memory card while the camera writes an image to that card.

Fancy cameras have many other features that allow you to fine-tune an image. These extras are great if you know how to use them, but unnecessary in many situations. Discussing these high-end features is beyond the scope of this post. However, most are niceties and not necessities.

How Many Mega Pixels?
In most cases, this is a moot point. Don’t worry about it for your first camera. High MP cameras produce huge image files that clog up your hard drive and slow down your editing software. 16-24 MP is just fine. However, a pro camera with as little as 12 MP can take beautiful photos.

DSLR or Mirrorless?

DSLRs (Digital Single Lens Reflex) is a type of camera that was the dominant camera for professionals for many years. DSLR cameras are based on a camera design that was first introduced in the 1930s in film cameras. These cameras have a mirror system that directs some of the light to the camera’s eyepiece. When you take the photo, the mirror is moved so the light can hit the film or sensor. Although this sounds clumsy, this system has been perfected over generations of cameras.

The first digital mirrorless cameras were point-and-shoot cameras. These used tiny sensors and basic designs. These consumer cameras have almost been eliminated by smartphones that can take photos that look as good.

Enthusiast large sensor mirrorless cameras were first introduced in a Micro 43 format by Panasonic in 2008. The first mirrorless cameras could take excellent photos but had limitations in other areas. For instance, they used a focusing system called Contrast Detection Focusing, which could hunt and peck and was slower than the system used in DSLRs called Phase Detection Focusing. However, more recently (depending on the camera model), mirrorless cameras have not only gotten as good at focusing as DSLRs, but in some ways, they are better as they can detect specific things like a person’s eye to focus on.

What Camera To Buy

There are many choices. I will list some cameras offering good controls that allow new photographers to improve their skills.

These cameras are at the low end, offering a high-quality camera at a very low price. Naturally, there are more advanced cameras between these models and new camera models. I’ll give you inexpensive options, but these are only some possibilities, even within this low price range. These are cameras that I have actually used, so I have confidence in them. Use these examples as a starting point in your search.

Some of the best bargains are used DSLR-type cameras. Mirrorless cameras are all the rage, so good DSLRs are plentiful on the used market. Their lenses can also be had inexpensively. The downside is that these cameras tend to be larger and bulkier. However, they have fantastic battery life and pair well with larger lenses, as the camera and lens feel more balanced together. Pro-level DSLRs have a lot of external controls, which is a huge plus.

Older mirrorless cameras take great pictures but may focus slower or more inaccurately. Newer mirrorless cameras have fantastic focusing that goes beyond DSLRs. However, for the best features, expect to pay thousands of dollars. There are decent mirrorless cameras from a few years back that are inexpensive and do a good job.

Lenses
One of the great things about pro-level cameras is that you can change out the lenses. DSLR lenses are plentiful and less expensive than newer lenses for modern mirrorless cameras. However, there are some exceptions to this rule. For instance, you can buy older lenses for mirrorless Micro 43 cameras at reasonable prices.

Lenses come in two types, prime, and zoom. A prime lens is fixed at a particular focal length, whereas a zoom lens can “zoom” to many different focal lengths. Prime lenses can be smaller as they are simpler in design, and some consider them sharper as they are specialized to do a single job. However, many zoom lenses can be sharp too. Lenses often come in a consumer version and a pro version. A pro version may have better optics and, importantly, be built more robustly. However, consumer lenses can be much cheaper and often do a good enough job.

A decent zoom lens in the 24-70 mm or 24-150 mm range can give a photographer many options. More expensive lenses often will allow more light into them. An “F-stop” rating notes this, with lower numbers being better. For instance, a high-quality lens may have an F-stop rating of F2.8 over its entire range. In contrast, a consumer lens may have the same zoom range but an F-stop rating of 2.8-6.1, meaning that as you zoom in, the lens lets less light into the camera, and you will need to compensate by adjusting the camera’s shutter speed or ISO. However, consumer lenses may be a good choice for a new photographer as they are less expensive while still being very versatile.

There are some excellent consumer lenses in primes. Their construction may be poorer than a pro lens, but they can have low F-stop numbers and good optics. Some photographers will only use a single prime lens for their photography needs. Street photographers often like a 35 mm equivalent lens for street work; portrait photographers might use a 50 mm or 80 mm equivalent lens. Of course, others may use a zoom lens; there is no right answer. There are many specialty lenses for particular uses. For instance, macro lenses are used to photograph tiny things, and tilt-shift lenses are used in architectural photography. However, these are optional for the beginning photographer.

You will need to buy a used lens along with your camera body. Consider buying a 35 mm prime or medium-range zoom, like those above. You can always add more lenses later.

Lens mounts are specific to a camera brand and type. A Nikon-compatible lens won’t work on a Canon camera, and vice versa. Lenses for some brands that sell both APS-C and full-frame cameras can be specific to the sensor size. A mirrorless camera also uses a different mount than a DSLR camera within the same brand.

When you choose your camera, ask Google for the lens designation. You can also go to a reputable camera site like Adorama.com, type in the camera model number, and ask for compatible lenses.

What lens mounts are compatible with a Nikon D7100?

Answer: DX or FX format


What lens mounts are compatible with a Nikon D700?

Answer: FX format


What lens mounts are compatible with a Canon 60D?

Answer: EF or EF-S format


What lens mounts are compatible with a Canon 5D Mark II?

Answer: EF format


What lens mounts are compatible with an Olympus OMD-EM1?

Answer: Micro 43 format


What lens mounts are compatible with a Sony A6000?

Answer: Sony E format

Software

Almost all professional photographers use software programs to improve their photos in many ways. You don’t need expensive subscription software like Photoshop or Lightroom. It is easy to start with the free software that may be included with your computer. Apple’s photo software is surprisingly powerful for basic editing. I currently use DxO Photo Lab for most of my editing, but I could do about 90% of my photo editing using free Apple software.

Some recommendations

This list is not all-inclusive. These are starting point recommendations. Go up a newer model or two for more features and better specs. However, these cameras can still take professional-level photos in most situations. I have bought used cameras listed on eBay with good results. However, it can be risky, especially if you are unfamiliar with cameras. You may blame yourself when the camera is faulty. Therefore, sometimes it is wiser to spend a bit more and go with a reseller like KEH.com or a camera shop like Adorama.com or BHphotovideo.com when buying a used camera.

Here are some low-cost options in no particular order:

The APS-C a6000 is a very capable camera. It uses more of a menu system instead of physical controls for some settings. Introduced in 2014 at around $650.00 (Body only).
The full-frame D700 is a legend of a camera. Photographers feel that it is one of the best cameras for portrait photography. It has ample physical controls. It was introduced in 2008 for $3,300.00 (Body only).
This Micro 43 camera was introduced in 2016 for around $2000.00 (body only).
The full-frame Canon 5D Mark II was released in 2008 for $2700.00. You can pick up the newer and more advanced 5D Mark III for around $500.00.
This full-frame Nikon was introduced in 2012 for $2100.00.
This full-frame camera was released in 2012 for around $2,100.00.
This APS-C camera was designed for sports and wildlife. It was introduced in 2009 for a cost of $1700.00.
This APS-C camera is the successor to the 7D and was introduced in 2012 for around $1,700.00. It is a monster when it comes to sports and wildlife.
This APS-C camera was introduced in 2013 for around $1,200.00 It is a good all-around camera.
This APS-C camera is a classic. It was introduced in 2010 for $1,100.00.
This APS-C camera was introduced in 2007 for around $1,800.00. It is built like an absolute tank. I will never sell mine. Its successor, the D500, is an absolute sports and wildlife beast and can be had for around $700.00.
inflation stories

Dr. Mike, Escalating Inflation, And The Poor

I have been fortunate to have made a good living. I’m also a planner who saves for the future. However, the recent price increases have taken my breath away. This financial strain has been exacerbated by other factors, including Julie’s illness and inability to contribute to the household income.  

I’m not asking for sympathy; I’m confident my financial state is better than the majority. I’m able to pay my bills and still live a good lifestyle. However, I find myself cutting back and returning to how my parents lived when they raised a large family on a single income. That isn’t necessarily bad, but it is certainly different from the retirement of doctors who lived a generation earlier than me. I ask myself, “If I need to cut back, what about all those less fortunate folks than me?”

In the past we had a cleaning service, now cleaning is done “in house.” I do the heavy lifting, and the kids pitch in.

In the past, I never thought about the cost of groceries. Now, I am a careful shopper. Food items, like steak, have become a special occasion treat. I’m very aware of other cost factors, like food waste. Still, food costs continue to rise, and every product I buy seems to suffer from shrinkflation. Eight cookies are now six cookies, a loaf of bread is â…” rds its prior size, and so it goes.

I am shocked by car repair costs. I have three vehicles, one for me, one for Julie, and one for the kids. Still, we are often short of a car. Our cars range in age from 5 to 15 years old. I am not considering buying a new car as the cost of new vehicles has increased dramatically over the last four years. Inflation rose by 21% during that time, but brands like Dodge have increased their prices by almost 50%. The average cost for a new vehicle is around 60K, and many cars are loaded with extras, leaving those prices in the dust. A friend spent over 100K on a very nice pickup truck. It has many bells and whistles but is still a pickup truck.

We have decided to go the repair route with our mostly reliable cars. The repairs we have been making have not involved the engine or transmission. Instead, we replaced tires, fixed sensors, and replaced external components (like the exhaust system). I have spent nearly $7000.00 on these repairs in the last two months. Parts and labor have increased, and repair shops now charge a random service fee. Why?  Who knows.  It is cheaper to repair than buy new, but I still had to come up with 7K to complete the jobs.

Our HVAC system is old, and several weeks ago, it failed during some of the hottest days of the summer. It is getting replaced today. When I had a system installed years ago, it cost me around $4000. The system that I’m replacing it with is nothing fancy. It will do the job, but no one would consider it top-of-the-line. It will cost me $8,300, and that is with a discount. 

Gasoline prices continue to fluctuate, but they are much higher overall than in the past. Utility costs are also higher, with some, like internet service, forever creeping up.

My house insurance policy was sold to a different carrier, and the premium increased by 50% in one year. My car insurance is also on the rise.  

Going to a restaurant used to be a regular occurrence in our household. Now we go as a special treat or for a particular reason. Breakfast was always an inexpensive option, but it is now common to spend close to $50 when Julie and I go out to our monthly Sibling Breakfast. My sister went to a nicer restaurant for lunch and ordered a sandwich and coffee. Her bill (including tip) was almost $40! When she looked into the bill, she found an added hidden surcharge. Why? A friend took his wife and son to a local restaurant in a strip mall; his bill was over $150.  

Beyond actual cost, other charges are also rising. I bought five donuts from a donut shop, and the bill was almost $14. The clerk placed the donuts in a bag. He never talked to me or made eye contact with me. The “suggested tip” for this task was 25% when I checked out. Now, even buying donuts is becoming a special treat.

I have choices. If I want a donut, I will buy one. I can take my family to a restaurant. If the car needs service, I can get it fixed. Yes, I feel the pain, but I can still do it.

What about all of those people who are less fortunate than I am? Those numbers are not small.

The American dream has been to work hard and succeed. When I was growing up, it was possible to have a decent lifestyle on a single income. My father worked, and my mother stayed at home. We owned a simple house; we had a car. The seven members of our family always had food to eat. Yes, money was tight, and sacrifices were made. However, we are all able to attend university and advance ourselves.  

Now, a family can have two full-time earners and only one or two kids, and they still struggle. Expectations are high, with constant pressure to buy. Advertisers hit consumers on all levels, from formal ads to social media to psychologically targeted campaigns.  

Families use credit cards as part of their income stream because they have no choice. The average interest rate on a credit card is over 24%. I have good credit, but if I took a cash advance on my credit card, I would have to pay 30% interest. That is a juice loan. It becomes another significant burden if you rely on a credit card to live.

I sometimes hear well-off individuals complain that increasing the minimum wage will destroy the country and close small businesses. I’m sure there is some truth to this, but there is also quite a bit of exaggeration. In 2020, Illinois’s minimum wage was $9.25/hour, which was raised to $13/hour this year. If you work 40 hours a week at $13/hour, you will make approximately $26,000/year. Living on $26,000/year in 2023 would be very difficult, even if you were single. If you had other responsibilities, it would be impossible. Many minimum-wage jobs don’t include health insurance. Those that do offer health insurance sometimes limit their employees to work just under the time required to get health insurance. If you do have health insurance deductibles are on the rise, so many can’t afford to use their health insurance because they can’t afford the deductible.  

Earners in Illinois do better than their surrounding states. Wisconsin, Indiana, and Iowa all have a minimum wage of $7.25/hour, less than $15,000/year if you work 40 hours/week.

The gap between the poor and the rich widens as the middle class slowly disappears. As income differences become vast, understanding the plight of lower-income earners becomes unrelatable to the rich. I can hear this echoed in people I know with statements like the poor aren’t working hard enough, the government is too generous with social programs, or health insurance is a privilege instead of a right. The classic, “I had to earn my fortune,” doesn’t do much for a struggling single parent trying to raise a child on $10/hour. Such individuals often forget they were gifted with many benefits that may have included a higher education or various family resources.

I wasn’t raised in a wealthy family, but it was a family that strongly promoted education. Sacrifices were made so that all of us could go to college, and there were enough resources available (with struggle) to make that happen. My family is intelligent, and this also helped us achieve our goals. We all “made it.” However, what we struggled with is different from what many struggled with. What if you aren’t academic? What if you have accruing credit card debt? What if you had to drop out of school? What if the father/mother of your children abandoned you and the child? What if… There is no simple answer to equality.

I do believe that individuals should benefit from hard work, a higher education, or additional training/skills. I am delighted that I could attend medical school. But there is something wrong in a society that sees an obscene gap between the rich and the poor. How many people live from paycheck to paycheck? How many people can’t even do that? Yes, consumerism has caused people to live beyond their means, but that is only part of the problem. When individuals can no longer afford food, something is wrong. Rich people complain that homeless tent dwellers are overtaking their neighborhoods. Do they think that these people want to live in a tent? Not every tent dweller is a drug addict or a free spirit.  

My sister has a friend who lives with her husband in a gigantic home in a wealthy suburb. Her conservative friend denigrates immigrants, the poor, LGBTQ, and the like. How did her friend become so fabulously wealthy? She married the right guy, who inherited a boatload of money from his family. Good for her, now if we could all do just that.

The US introduced a Federal Income Tax at the turn of the last century. Many wealthy Americans supported this tax as they saw the social unrest caused by the inequalities of that time. The rich feared losing everything, so losing a little made sense.

Life for people experiencing poverty improved, and a sizable middle class developed. Social programs were instituted, labor laws were established, unions were formed, and opportunities expanded. Looking at my extended family of siblings and cousins, we all immensely benefited from these changes. If social changes had not happened during the first half of the last century, we would not have been afforded the opportunities that we were given. We would have become laborers, or factory workers, instead of the doctors, university professors, engineers, lawyers, teachers, and business owners we became. Think about how we contributed to society just because we were given a chance.

Such opportunities are drying up for people in the new millennium as the gap between rich and poor widens. Are we returning to the early 1900s? What will the result be? It won’t be suitable for any of us.

The RTR is a gathering of van dwellers, many of who live the vanlife due to economic hardship.
shopping secrets

Amazon Shopping Secrets From An Official Reviewer

A while back, Amazon contacted me and asked me to become an official reviewer. I like comparing things, so I agreed.  Amazon selects items that may interest me. I can select or reject these items to review.  Sometimes their selections are spot on; at other times, they are so far off that I wonder if their computer is melting down. For instance, I have been offered breast pumps and African American hair extensions.  

Third-party sellers use this review program to get high-quality reviews of their products, as a single review can mean hundreds of sales. Based on this, most officially reviewed products should be expected to be good.  Why would someone want a bad review?  Despite this, I still will get an occasional clinker. 

Getting involved with the review process has educated me about some potential review scams from third-party sellers.  Below, I’ll list some of those impressions and my personal verdict on product categories that I have had the chance to examine.

It is estimated that at least 40% of reviews on Amazon are fake.  There are many ways to get fake reviews.  One common way to pay for a fake reviewer is to write a product review.  Some folks write reviews on products as a side hustle. For a few dollars, a product can get a 5-star review on a product the reviewer has never used.

Some fake reviewers will purchase a product and write a positive review.  They use their funds to buy the item, which the seller then refunds in exchange for cash and a free product.  The seller can get a “Verified Purchase” badge on their review.

There are large overseas organizations where a seller can buy a block of reviews or even have bad reviews removed.

In the past, it was easy to spot a fake review based on a lack of details or poor grammar.  This is getting harder as scammers now use AI-generated reviews, which can seem real.

There are other ways a seller can buy a “Verified Purchase” review, but those methods are beyond the scope of this post.

Another way to scam the customer is by updating the item’s product description.  They may sell a good product at a reasonable price.  When they have gained enough positive reviews, they will use the product update function on Amazon to change the product completely.  You can tell if this is the case by reading the original reviews.  Watch out if you bought a computer, but the original reviews were for a crockpot.

Sellers will pair items under the same listing. They may sell an inexpensive but high-quality charging cable and have an additional expensive but unrelated item in the same listing. Buyers may review the charging cable at 5 stars, and the overly expensive item will also seem highly rated.

Some sellers hire groups to trash another seller’s product to gain market share.

Naturally, Amazon is trying to eliminate these problems, but it is harder than you think.  As a consumer, your best option is to read a random sampling of the reviews to see if they are legit. 

Are there a bunch of reviews that use very similar language?  Caution advised.

Are there many reviews that all highlight the exact same points? Caution advised.

Are there reviews that consistently use very bad grammar?  Cautioned advised.

Are there reviews so generic that they could describe any item? Caution advised.

Does the product page list two unrelated products?  Caution advised.

Are the reviews clumped, many written during a short time period?  Cautioned advised.

Do the reviews talk about a completely different product?  Caution advised.

I like to look at the poor reviews on a product I’m considering purchasing and compare those poor reviews with the 5-star reviews.  Sometimes it is clear that the poor review was because the customer didn’t know what they were doing. Other times there are clear indications that the 5 -Star review is fake.  

At this time, I have reviewed hundreds of Amazon products and have come up with a few conclusions.  

Clothing items:  This category has been the most variable of all product categories.  At times I have discovered bargains.  I have reviewed many products that were as advertised. However, I have found many sub-par articles of clothing.  Common problems were that they were missized or poorly constructed.  I have also reviewed clothing where the material was of very poor quality. A greater concern has been products that initially seemed to be of good value but failed after moderate use.  I reviewed a winter coat that I liked.  However, the zipper became increasingly difficult to latch within a month or two. If the manufacturer had used a quality zipper, it would have been a great coat and a good value.  However, the crappy zipper significantly downgraded the product.

Linens, etc.:  Here, you get what you pay for, and sometimes a little more.  Cheap towels are cheap. More expensive ones are decent. Bedding is often constructed OK, but check out the dimensions. I have gotten quilts and blankets advertised for a king mattress that would be more suitable for a queen.

Electronics/Computers: I have been happy with many of these items.  However, if you buy an inexpensive item, don’t expect it to be premium.  You can get a mini-computer for a couple of hundred dollars which will work for simple computing. However, it won’t do high-demand tasks like video editing or gaming.

Kitchenware: I have been satisfied with many items I have reviewed.  I have tested many small appliances and other items, from plates to cookware.  If you read the description carefully, you will likely get what you have ordered. If you buy a set of pots and pans for $20, expect to get junk.  However, I have reviewed many off-brand items that were less expensive than the brand name that were as good. Many kitchen items are made in the same factories as the more expensive branded items. Your mileage may vary.  

Tools/Outdoor stuff: Many of these items are as described.  Cheap tools won’t be as good as branded ones, but they will do the job for a DIYer like me.  I would say the same for outdoor implements. 

Camping/Fun items: Most of the things I have reviewed were good.  

Items to consider avoiding:  These are not items that I have reviewed in my official capacity. Instead, they are items that I purchased over the years. Personally, I won’t buy cologne/perfume as I have gotten counterfeit items in the past. I would say the same about other popular branded/designer items.  

Final tips: 

An identical product may be sold under several different names at vastly different price points.  

Check the color choices of a product, as some colors will be significantly less expensive than others. 

Make sure you calculate the cost per ounce when buying consumable products.  You may find that the larger container is more expensive than the smaller container (which is counterintuitive).  

Caution, when a seller uses unfamiliar measurements to describe a product.  For instance, centimeters instead of inches. At times this is an honest mistake, but at other times it is used to confuse the customer.  

Sometimes a discontinued product will be ridiculously expensive, even when the updated product is cheaper.  

Sometimes a seller will sell an item at a cost many times its MSRP.  I’m unsure why; I’m guessing they hope someone will mindlessly click and buy.

Happy shopping!

Mike

saving money

Teaching Kids About Money

Today, I’m going to blog about money. Precisely, how to be rational with it.  This is not an investment post or a guide to cryptocurrency; instead, it focuses on raising kids to view money sensibly and what happens when our emotional brain interacts with our financial brain. 

Julie and I have irrational beliefs about money, which have lessened over time.  Julie has had concerns that we will not have enough money despite evidence to the contrary.  My irrational feelings are odd.  I always panic a little when it comes to paying bills. This is despite the fact that I completely pay out bills every month. I also feel guilty when I have a large charge card statement, even if the purchases were absolutely necessary.  I experienced that phenomenon this month as my charge bill was multi-thousands of dollars.  Did I buy a super-expensive item? No.  Did I book a trip? No.  The bills centered on additional costs due to Julie’s hospitalization, various expensive car repairs, and buying items to equip our home for Julie’s disability. The only splurge was that I bought more prepared meals from Costco, as I didn’t have the emotional bandwidth to cook multiple meals from scratch this month.  FYI, I always totally pay off charge cards, including last month’s. 

We recognize that we approach money oddly and have worked to give our kids a more balanced view of spending and consumerism. It is clear that they don’t have the same hangups as we do and that they approach purchasing sensibly.

My kids don’t seem to have a strong attachment to things or status items. I can’t recall a single incident where one of them had to have something because of social pressure. They seem to make most purchases based on rational reasons. They don’t seem to need to “Keep up the Jones.”  They are secure in themselves and don’t see purchasing things as a way to prove their worth.  Of course, they have their interests, and they do purchase things.  However, they think carefully about what they buy.

Let me give you one recent example.  Son, William, loves his Airpods, which we gave him as a birthday present several years ago.  However, they are now malfunctioning and need to be replaced. He knew Prime Days was coming up, and instead of making an instant gratification purchase, he waited a few weeks for that sales event. Several different models of AirPods were available, and he evaluated value vs. features. He chose the model that best met his needs, in this case, the one at the mid-price point.

So, what did we do to raise our kids this way?  

Educating about money. We started to teach them early about money. When they would come with us to the grocer, we would compare the prices of items, sometimes using a calculator for more confusing purchases. 

Demystified advertising. We taught them that the primary purpose of advertising was to make you feel bad about yourself and to offer a solution in the form of a product or service. We looked at how advertising went well beyond commercials and could be found in everything from product placement to Instagram posts.  

Meeting needs.  If our kids needed anything, we made sure that they had it.  This was for needs, not wants. They never felt insecure about not having what they needed.

Bucking the trends. Styles, trends, and even colors frequently change to get you to buy more.  Last year’s fabulous grey is today’s cold, impersonal color. You can’t avoid trends, but you can be more sensible in how you approach them.

Delaying gratification. Does saving and buying a better product make more sense than getting a junky item now?  Can you wait until your birthday or Christmas and get the item as a gift?

Credit card sense.  No one gives you money for free.  Credit cards are traps if you don’t pay them off every month.  If you can’t do that, don’t buy the item. Who wants to pay decades of minimal payments for a nice meal that has since gone down the toilet?

Taking ownership. We are willing to buy a replacement phone for our kids, but what if they want a more expensive model?  Is it important enough for them to pay the difference?  If so, by all means, they should get it.  They were often happy to settle on the lesser model they got “free” from us. 

Buy less, but buy better.  Value is more than getting the lowest price.  A product that performs better or lasts longer is a wiser purchase than buying something that quickly breaks or doesn’t do the job.  Often the best value is a mid-tier item, although rarely it makes sense to go for a top-of-the-line item.  Designer items are almost never worth it.  

Julie gifted me a top-of-the-line Kitchen Aid mixer in 1994, which has been used constantly since then.  It was worth every penny.  However, I have a mid-tier Instant Pot.  It doesn’t have all of the programs and features that a top-tier model would have, but it is built the same and does exactly what I need it to do.  

Their money vs. our money.  When it comes to unnecessary purchases, the attitude change is amazing when it involves who is paying for it.  When kids control their money, they are much more likely to choose wisely or not buy an item. 

Emphasizing brand disloyalty.  A brand-name product may be objectively better, but a house brand may be good enough.  Humans build preferences based on familiarity rather than rationality. Heinz Catsup is a good product, but many house brands are also good; they may just have a slightly different spice formulation. Being flexible allows for getting the best value.

DIY when possible, pay when needed.  I have shown my kids how to fix stuff and make basic things. However, for some items, it makes sense to pay someone to fix them.  Always balance the repair cost with the product’s future longevity. 

Being a skilled person. One of the reasons that I have spent so much time with my kids cooking is so they would feel comfortable tackling any cooking task.  They are not forced to buy crappy fast food or go to expensive restaurants. If you have basic skills, you also have more choices.

Making rational, researched decisions. My kids are academically gifted and were accepted to top universities. However, excellent schools one tier down wanted them and were willing to pay them to attend as their test scores and grades would boost the school’s rankings.  We researched the topic and determined that attending an excellent but less prestigious school would not impact their future opportunities. They all decided to go with practical rather than expensive choices and left college debt free. We did have college funds for our kids, but they would not cover the entire cost of room and board at a prestigious university.  All of them graduated college with money left in their college funds.

Money and stuff do not equal happiness. Of course, you need money, but there is a point where additional money does not make your life better. Excessive stuff can be a burden rather than a blessing.  It is better to look for balance in life.  

Self-esteem comes from within. We focused on building their self-esteem vs. focusing them on external things (like being popular or having stuff) as the source of feeling good about themselves. 

Finding one’s style. We also had them look rationally at ways to be conservative with their cash.  Yes, some people save a lot of money by clipping coupons or spending countless hours trying to get the best deal, but is that something they want to do?  Perhaps yes, likely no.  There is an intersection between effort vs. gain.

So what is the TLDR?  Teach your kids about money.  Teach them that stuff alone does equate to happiness.  Teach them what the concept of value means.  Build self-esteem. Allow them to think differently from some of their peers. Give them appropriate control and decision-making around money issues. 

You may find the writings of U of C economist Richard Thaler interesting.  He won the Nobel Prize in Economics in 2017 based on his theory of Behavioral Economics.  Thaler’s work rebuked former theories that assumed humans were rational when making financial decisions. Most humans use shortcuts in financial decision-making, often making erroneous decisions based on emotional biases.  Here are some ways emotions get in the way of making rational money decisions.

Sunk Cost Fallacy.  People use an emotional balance sheet when making money decisions. If they have invested in something, they sometimes do irrational things to justify it.  A simple example would be paying for a movie that turns out to be terrible. The money is spent, so many will waste 2 hours of their lives to “get their money’s worth.”  Much better to get up and leave. 

This rationale can be costly.  Let’s say you buy a used car that turns out to be a lemon. It is a constant source of financial and emotional stress, but you have already invested in the purchase price and expensive repairs.  The repair bills keep coming, and now you are spending much more on the car than it is worth. Some will continue to “throw good money after bad” because of this concept.

Companies exploit Sunk Cost Fallacy to get you to buy more.  Did you pay $120 for a Costco membership?  Folks will overspend there to ensure they got their money’s worth for the membership.  

Endowment Effect.  We make financial decisions based on whether we already own something.  Let’s say you found a poster in your basement.  The poster doesn’t do much for you; you would never buy it. However, you discover that it is rare and worth $2000. You decide to hang it on your wall instead of selling it.  Your ownership of the poster changes the way you view its value. Your emotions have prevented you from selling it for  $2000 despite the fact that it doesn’t improve your life.  

Mental Accounting. Money is money; there are no different types of dollars, but we don’t see money that way.  Let’s say you get a nice cash birthday gift or you win a small Lotto prize.  People are more likely to spend that money on frivolous or unnecessary things.  Money is fungible; a dollar is a dollar.

Transaction Utility. This involves the pleasure that we gain from getting a bargain.  It is often used to manipulate someone to buy something or to buy more.  Inflated MSRPs are a good example.  You go into a store to buy something and are convinced to do so because the store’s price is much better than the item’s fake MSRP.  Some people can become addicted to getting a bargain and fill their house with items they don’t need or use because it gives them that little dopamine rush.

——

Money is something to get us what we need to survive and enjoy life.  However, we are often manipulated to see stuff as a way to achieve status or happiness.  People go into debt to keep up with the Jones with the resultant stress caused by unnecessary purchases. If we could separate our emotional and financial selves, our lives would be better.  However, many want our money and will use known manipulations to make us believe we should overspend.  In the end, those are the people laughing all the way to the bank.

Peace

Mike

Making coffee instead of buying a cup can save you significant cash over time.
Statins

My Secret Illness

Today, I am going to share with you a secret. I’m going to tell you about my secret illness.  Only a few people know about it, and now you will be one of them.

This is my story and is NOT meant to be medical advice.  If you have medical concerns, talk to your doctor. Everyone is different, don’t be foolish.

When you talk about any life-changing event, it is good to give a timeline.  However, this is one of the ways that my brain fails me.  I tend to process data a bit differently than most. I remember things in terms of how they relate to other things. This is different from the majority of folks who are more linear in their thinking. Because of this, it is hard for me to remember phone numbers, names, and birthdays, as they only connect loosely with other things. I can only approximate timelines for the same reason. Confused?  It will all make sense in the next paragraph.

A reasonable question would be, “When did your secret illness start?”  A long time ago, but I can’t give you an exact date.  However, I can tie it to an event in my life, my involvement with the Indian Princesses.  With that said, I was ill for years prior to that.

Indian Princesses was a YMCA group for dads and their grade 1-3 aged school daughters.  It has since been rebranded as the “Y Guides,” as its former title was offensive to some. Both Kathryn and Grace participated in the program.

Grace is now in graduate school. The incident happened when she was in first grade. I’ll call it the campout incident. At least once a year, tribes would participate in an overnight campout. Huge groups would gather for these events.  I recall sitting in my study, devastated that I would be attending a campout the following weekend.  

If you know me, you are probably scratching your head.  My favorite place to be is in nature, and camping is one of my favorite things.  Additionally, I love spending time with my kids. This was an extremely well-organized event.  It was meticulously planned and executed precisely.  The girls loved going as there were many fun activities for them to do.  Lastly, the dads in my tribe were nice guys.  Very welcoming and decent. 

Based on the above, the Princess campout should have been something that I was looking forward to.  So why was I nearly in tears?  I was so ill that spending 2 days camping seemed impossible.

What was this mysterious illness?  It took me decades to find out.  I’m a good physician, but I had no idea of the cause of my sickness. Did I seek medical attention?  Of course.  I would do this in waves: seeing doctors, going through tests, and trying traditional and complementary treatments.  Nothing would help.  I would abandon medical treatments only to return for another round of tests, sometimes years later.  Decades of being sick, countless treatments, and many diagnoses.  I saw multiple primary care physicians and multiple specialists.

Of course, I had all the basic tests, and their results were normal. I also had many other tests ranging from MRIs to EMGs to very exotic blood work. One doctor thought I could have MS; another felt the problem could be sleep apnea; yet another thought I was suffering from autoimmune hepatitis. I was diagnosed with a serious neurological illness, Myasthenia Gravis, and started treatment, but that turned out to be a red herring. Multiple doctors, multiple diagnoses, multiple treatments, none helped, and I was seeing my life fade away.

One true diagnosis was confirmed. I do have autoimmune neuropathy.  That impacts my balance but didn’t cause my other symptoms.

Could the problem be psychological?  I’m an expert here, but perhaps I was missing something.  I wasn’t feeling depressed, and I’m a pretty stable guy. However, I asked a friend who is a well-respected psychiatrist to evaluate me comprehensively. He concluded that my psychological state was boringly normal.

What was I experiencing?  Several symptoms, when combined, ruined my life. The first one was insomnia.  I have always been a poor sleeper, but this was exponentially different.  I was almost never able to get a whole night’s sleep.  I tried everything: behavioral techniques, over-the-counter treatments, and prescription medications.  Nothing helped.  

The second was incredible fatigue.  There is no way to describe the fatigue I was experiencing adequately.  Imagine you were recovering from a serious illness but no longer acutely sick.  You decide to do something simple, like showering or making a sandwich.  No big deal until you start the activity only to realize that it felt like you were climbing Mount Everest.  That is how I felt every single day. Resting had temporary benefits, but I would only go from 10% energy to 15%. If I did anything, I would drop below 10%.

Along with fatigue, I had shortness of breath, my third symptom.  My blood oxygen levels were fine, so I was getting enough oxygen but felt I wasn’t getting enough air.

When you are so tired, your ability to be detail-oriented is compromised. In my case, I retained the ability to think and appropriately treat my patients.  However, routine tasks were tough. I was a doctor who completed their progress notes, returned calls, and went above and beyond. I felt proud that I was responsible. However, these simple things were incredibly difficult, so I had to develop effective yet simple solutions.  I did that using a variety of techniques, some technical and other organizational.  

For example, I kept return phone call slips on a specific part of my desk.  I returned calls throughout the day so I would have the energy to do this simple task.  After I returned a call, I would mark the note with a slash and place it in a different pile.  When I documented the note in the chart, I added another slash to the note (making an “X” on it) and put it in a third pile to be filed in the chart. That way, I knew that I returned every call. Everything I did was like this to ensure that my patients got the best care possible despite my disability.  I developed a technique for every routine task.

My fourth symptom was muscle weakness. This was the symptom that impacted me the most. I felt like I was dying.  I was completely weak and incapable of doing almost anything.  I wrote in my journal, “Sitting in a chair seems like an Olympic sport.”  I recall seeing patients in a VA clinic exam room with a dirty tile floor, wishing I could lie on it as I was too weak to sit in a chair. If you understand how poorly VAs were cleaned, you will know the magnitude of this thought. A simple event like walking a block with my young children was impossible.  Just about anything normal in life was impossible. There are no words to describe how weak and sick I felt.  Yet, no one would know it by looking at me.  I looked perfectly normal and acted perfectly normal. I hid my illness from almost everyone.

I tried many behavioral things to cope, some minor and others drastic. One of the most drastic things I did was relinquish my partnerships in the successful clinic I co-founded.  Running a clinic is a tremendous amount of work, and it is also very stressful. I thought that eliminating that stress would improve my health. I continued to work at Genesis as a contractor and made more changes in my life. I remained sick.

Other dynamics were playing out in my marriage.  Julie was a stay a home mom. I’m a take-charge guy who felt my responsibility was to financially support the family at a level that they deserved.

My blue-collar background didn’t afford me a sense of financial security, sometimes to the point of craziness. Many doctors rejoice when a patient fails an appointment because they now have time to do paperwork or take a little break.  When my patients would fail an appointment, I would panic and catastrophize that I must be doing something wrong or that my very busy and successful private practice was falling apart. My private practice income allowed me to spend about half of my time elsewhere, providing care to the underserved, which was my passion. 

Combining my desire to serve the underserved with my fear that I couldn’t provide for my family, I worked a 60-plus hour week.  Every few years, I would rein in my workload and change my behaviors, but within a year, I would be where I started. 

Julie has her own financial insecurities and money fears, plus, we live in an affluent area where it is common for families to do uncommonly expensive things. Everyone was buying more or doing more than we were. Or at least that was the way it appeared on the surface. It is easy to pick a vacation from family A, add it to a new car from family B, and feel like we were not keeping up.

I had a good professional reputation and multiple board certifications, so I often got job offers, including part-time opportunities.  I would think, “Maybe I should add that new job; after all, it would only be 5 or 10 hours more a week.”  However, I couldn’t cope with what I was already doing.

I often told Julie how sick I felt, but I look normal on the surface. I would tell Julie about various work opportunities, hoping she would tell me I should not take them and instead I should cut down on what I was already doing. I was looking for permission to do less. Instead, she would say that I should consider them. I needed someone to put the brakes on me; that person should have been me, not Julie. It was not Julie’s responsibility to take care of me.  It was my responsibility. However, I was in conflict as I thought I had been given an opportunity and should not squander it. I also wanted Julie’s approval.

Finally, at age 55, I made long-term plans to save my life.  I announced in no uncertain terms that I would retire at 65, and I started to plan for that to happen.  Julie’s dad continued working into his 80s, so I don’t think she thought I was serious.  But I was.

Then something strange happened in 2015.  A variety of circumstances joined forces, and something impossible happened.  I started to lose a lot of weight. I was still feeling terrible, but I began to force myself to exercise more.  I changed my eating habits and eliminated concentrated forms of sugar. I was even able to stop prescription meds for blood pressure and cholesterol as those numbers were normalizing. Without me realizing it, I was starting to feel better.  Yes, I had the typical aches and pains for my age, and honestly, I have never been a ball of energy.  However, I could do things, walk, ride my bike, and go to the grocery store without feeling like I was about to die. In 2018 I bought a cargo van and converted it into Violet the campervan.  The thought of exploring would have been impossible years earlier but now became a perfectly reasonable idea. The world was opening up to me.  I was walking every single day, and I liked it.  I was traveling to distant towns with my camera to do architectural photography. I was driving solo to far-off National Parks, where I would hike rocky trails. I had been given my life back, but how?

It wasn’t just the weight loss, so I initially targeted stopping my excessive sugar use.  Sugar is inflammatory, so it made sense that eliminating it was why I felt better.  It turned out that sugar possibly contributed to my symptoms, but it was not the primary cause.

COVID happened, and I slowly started to regain weight.  Additionally, I fell back into the sugar trap. However, my symptoms didn’t return.  I was still walking almost every day, going on trips, and doing things.

My mildly elevated blood pressure and cholesterol returned with my increased poundage.  My doctor advised that I restart the meds that had effectively worked in the past. I complied as I wanted to continue my good health. I was on track.

At the beginning of this year, my symptoms started to return, with muscle soreness and increased stiffness.  Additionally, I had ever-increasing fatigue, and my sleep became more sporadic. I started to feel short of breath. I started to experience the extreme muscle weakness that I knew so well from the past. To say that I was devastated would have been an understatement.  I was still walking most days, but it was no longer enjoyable, and every step was an effort.  I was getting the feeling that I was too weak to even sit in a chair.  I wanted to lay on the floor again. Yes, I was eating sugar, but nothing like I had. Yes, I was stressed about Julie’s illness, but I was coping well. My life had been going so well since 2015, but now I was sick again. 

Then clarity came to me.  I had restarted Crestor (rosuvastatin), a statin drug that controls cholesterol. Statins are the most commonly prescribed drugs in the US. That was around the time that I developed sore muscles and stiffness.  I knew that these were common side effects of this medication. I road out those side effects, and they did subside.

I didn’t make the connection with my long-term returning symptoms.  But eventually, I did.  I stopped the Crestor, and slowly my weakness faded, I was less short of breath, my insomnia improved, and my fatigue returned to its prior level.  I still have symptoms on some days, but they are less severe. On other days, I’m almost symptom-free.

I’m a medical doctor who attended one of the country’s best medical schools.  Some of my friends, who are doctors, were aware of my symptoms.  I have seen numerous primary care and specialist doctors over the years.  They were all smart, competent, and dedicated to solving my mystery illness.  None of us considered that an exceptionally commonly used drug could be the cause of the debilitating problems that robbed me of my life.  But it appears that it was.  Holy crap.

Skinny Mike
Escaping poverty, Poverty

Poor People Should Pull Themselves Up By Their Bootstraps

My friend, Tom, wanted to do something nice for me while Julie was hospitalized. He surprised me by taking me to breakfast at our favorite spot in the West Loop. There was a problem on I-290, so we exited the expressway in Oak Park and treaded down Madison Avenue.

As we crossed Austin Avenue into Chicago, I was immediately struck by a drastic change. The streets were dirtier; the buildings were in poorer repair. More shocking were the types of businesses, both present and absent. Many fast food restaurants, pre-paid cell phone stores, haircare stores, and storefront churches existed. Although we were driving on a major thoroughfare, I saw no real grocery stores, hardware stores, or other typical shops that were present just west of Austin in Oak Park. The difference was very pronounced. Eventually, we arrived in the toney West Loop—a place of trendy apartments, fabulous restaurants, and well-manicured streets. I have to admit that I felt a sense of relief as I entered familiar territory. However, I also felt a sense of shame. 

I write this post from my study, a room in my house dedicated to me. Next to me is a mullioned window that overlooks a beautiful suburban street. Within a 10-minute drive from my house are at least ten different grocery stores and five gigantic hardware stores. I can access every restaurant imaginable at that same distance, from ethnic to upscale. I drive a nice car and moan that I just spent almost $2000.00 to repair it, but I could afford it. My kids got to go to some of the best schools in the country, and our town’s library is considered the best of any community of its size. Our city parks are safe and well-equipped. The sports teams have the latest gear. The schools have the best lab equipment, computers, smart boards, and teachers.  

Not bad for a once blue-collar kid who worked hard and had a dream, but hold on, that is not where I’m going.

Yes, I worked hard to get to where I am. Yes, I sacrificed a lot to get there. Yes, my current life is better than my childhood life. So that’s the answer. Poor people are poor because they are lazy, stupid, and immoral. Oh, and of course, they are all dangerous criminals. Just watch YouTube to see those scoundrels shoplifting. Stores are closing because everyone who goes into them steals something. Why don’t they work hard like I did? It is not my responsibility to help them out. I advanced my life; they should do the same. Haven’t they heard about pulling themselves up by their bootstraps? Geez!

Of course, I’m being sarcastic. Each barrier that we place takes energy and effort to overcome. Place enough obstacles, and escape is almost impossible. My blue-collar childhood was nothing like I saw in Chicago’s South Austin neighborhood. I lived in a house we owned; there was a branch library, grocery store, drugstore, and hardware store around the corner. We always had food on the table. My parents were invested in my education. I had older siblings who I would emulate. My growing up was not deluxe, but compared to someone growing up in poverty, I was living the life of a millionaire. 

What would it be like to take several buses to just buy a gallon of milk? What would it be like to live in a neighborhood ruled by gangs, where police are viewed with fear instead of welcomed as peacekeepers? What would it be like to grow up in an unstable family or with a parent working multiple jobs just to put food on the table? What would it be like to live in a neighborhood where dropping out of school was the norm? What would it be like not to know how to appropriately fill out a college application and be unaware of who to ask for help?  

These are just a few things people in poverty must deal with. My kids grew up with a highly educated stay-at-home mom. Their lives were enriched in every way possible. They were provided with experiences at every turn. Yes, they are bright and work hard. However, their energy could be devoted to academic pursuits rather than figuring out how to get food for supper. I give them total credit for their successes. However, their paths were greased by privilege.

It is easy to blame people experiencing poverty for being poor. It is easy to look at a small minority of criminals and vilify an entire group. It is easy to look the other way. But at what cost? I don’t know how to fix this problem, but I know it is a problem.  

My good friend Ralph just sent me a link to a podcast that explores some barriers to people who strive to extricate themselves from poverty. It approaches the topic in a way I had not thought of before. It is an excellent podcast and a good listen, so I am sharing the link with you. 

Peace

Mike

Link to podcast below:

https://podcasts.apple.com/us/podcast/hidden-brain/id1028908750?i=1000616725013

Uncategorized

Cancer! Part II

A family living with cancer.

In my post, Cancer Part One, I gave a timeline of our cancer journey over the last eight months. In this post, I’ll explore the journey’s psychological and emotional impact. This was the post that I wanted to write, but I had to offer the contents of Part One for others to make sense of this writing.

This post will explore the feelings of Julie, the kids, and me. However, it will emphasize my experience, not because my feelings are more important, but because it would be inaccurate to claim that I had complete knowledge of what the others are experiencing.

The genesis for today’s writings were several comments that we have heard from some individuals. Their sentiments can be summarized as follows:

“You all seem to be handling Julie’s diagnosis so well.”

“You are living in the present and seem to enjoy life.”

“You all seem to have a positive attitude.”

All of the above statements are true and accurate. However, they don’t address the entire situation. What is that whole situation? Well, that’s complicated.

As far as the above statements are concerned, they are the result of our personalities and the general way that both Julie and I approach life. Our kids had adopted many of the same characteristics.

Julie was raised in a stoic family. She is the most emotional in her family. I was raised in an emotionally huggy family; I am the most reserved member of my family. Our positions complement each other. I add the huggy quality, and she adds the sensible quality to our relationship.  

We both believe in changing what we can change and accepting what we cannot. It makes no sense to gnash our teeth over things we have no control over. It is also a massive waste of time. Every day on this earth is a gift. Each day is filled with both positive and negative events and experiences. We choose to focus on the positive things. Additionally, we do not want to waste a day worrying about inevitable or imagined events in the future. That is not to say that we ignore these things. We plan and prepare, but as a couple, we are not paralyzed by events that may or may not happen.  

As many of you know, I spent much of my career helping people recover from drug and alcohol addictions. People in recovery have many wise, if pithy, sayings. One of my favorites is, “If you have one foot in the past and one foot in the future, you are pissing on the present.” Before mindfulness became popular, I ascribed to the philosophy of living in the moment and appreciating where I was. Who knew that such thoughts would one day become trendy?

Over the last eight months, we have tried to live as normal of a life as we could as we adapted to the changing status of Julie’s health. I don’t feel that time consisted of lost months. There were good times, bad times, and a lot in between. 

I don’t think in a linear fashion, so I must digress.

Before I retired, I loved my work life and genuinely cared about many of my patients. They were people of courage and grace. However, working in my capacity also had its stresses. Let me bring that concept home to you. Let’s say you had a friend you cared about who was in crisis. You willingly gave them a call and did your absolute best to be respectful; you listened thoughtfully and offered requested advice. How would you feel after you got off the phone? I imagine you would feel good that you were there for your friend, but also emotionally and possibly physically exhausted. Imagine doing that 20 times in a single day and repeating it the next day and the day after. That was my job. Fantastically fulfilling and utterly exhausting. It isn’t easy to be responsible for the well-being of others, even if that contribution is only partial.

You may wonder about my fascination with Violet the campervan. Of course, I love being in nature, but Violet is a symbol of freedom for me. When traveling in Violet, my life is simple, and I am responsible only for myself. Violet lets me know that, on occasion, placing myself first is OK. It is OK to do something silly or something someone else may not approve of. It is OK to have fun for the sake of having fun. It is OK to explore for the sake of exploring. It is OK to be my natural self and not have to act in a certain doctorly way.  

Retirement has offered a similar experience. There is joy in learning about an irrelevant topic. There is joy for me to walk over to my friend Tom’s house for no other reason than to drink a cup of coffee and have a little conversation. There is joy in making dinner with my kids and talking about their day. There is joy in going to DQ for an ice cream run with Julie. None of these things change the world. Joy doesn’t have to change the world. When I was working two and a half jobs, there was little time for impractical joy. Every hour I was awake was parsed into 15-minute intervals.

Since Julie re-entered the paid workforce, I have taken over more and more of the necessary household tasks. I have no problem with doing what some may consider menial jobs, and I consider no necessary job as menial. However, I have worked hard to keep balance in my life as it would be easy to turn those jobs into a new career. Julie continued to do things around the house, and I involved my kids in some of the responsibilities of real life. 

I have also tried to push my own boundaries in new directions. I’m naturally shy, but I know how to be social. Despite being difficult, I have introduced myself to others and engaged with them. I feel guilty when traveling solo in Violet, but I want to explore places while I have my health. I have been open about my feelings with Julie and have been receptive to hers. I’m a lifelong learner who loves to see the similarities and differences in things. Do I really need a dozen cameras? No, but they make me happy, and I know quite a bit about cameras because of them. Over the years, I have tried to celebrate who I am. My retirement motto is, “If it is not hurting me or anyone else, it’s probably OK.”

These, and many other factors, have given me a wonderful retirement. I generally have good health and enough financial resources to do what I want. I also have enough common sense to modify, adjust, and redefine based on my current status and the needs of those close to me. Just as I communicate my feelings in this blog, I do the same with the people I love. If something pleases me, I tell them. If something bothers me, I tell them that too. How many times have I seen relationships fall apart because person A expected person B to read their mind?

However, my joyful dynamic has changed with recent events. For the moment, balance is out the window, and I have had to return my focus solely to others. This is no one’s fault; it is just how it is.  

Julie’s right leg doesn’t work very well. It has little sensation, and many of the muscles don’t function. She had great rehab at Marianjoy, but it is still common for her leg to buckle and for her to tumble. This is despite using techniques, a physical brace, and assistive devices like a walker or a wheelchair. We hope this situation will improve, but we have yet to determine.  

Julie needs assistance with activities that most of us would consider routine—taking a shower, getting something off a shelf, and using the stairs. Many of the things she has done all her adult life, like driving a car, are off-limits for now.

She is trying her best to do things and to contribute to the family, but she can only do so much. The other day she wanted to do a load of laundry. However, someone had to bring the basket down and position it. She had to use a grabber to get the clothes out of the washer, and someone had to help her get the clothes in and out of the dryer. Then someone had to carry the basket back upstairs. However, she tries even harder every day. She just informed me that she emptied the dishwasher this afternoon. And that was while she was also standing with her walker.

Julie wanted to go to the market and then to her office to check her mailbox. Simple, right? She had to ready herself. I called the store to see if they had an electric shopping cart. I was erroneously told, “No.” I had to position our car so Julie could get in. I had to collapse her wheelchair (WC) and load it (with difficulty) into the car. Julie then had to get herself and the walker into the car. At the grocer, I had to reassemble her WC (with difficulty). We then could only buy things that we could carry on her WC. Everything had to be loaded back into the car, and we drove to her office. We only used the walker there, but the path was long and complicated. Back home, I had to position the car so Julie could get out. I then had to pull the car up, get the WC out, and reassemble it. After I took the WC into the house, I had to bring in the groceries. A very simple trip turned into quite the morning, and that was with Julie trying her hardest to be as independent as possible.

Jobs like making every dinner have fallen completely on me. New jobs have been created, like ensuring no trip hazards on the floor or monitoring Julie’s shower. I’m OK visiting my friend, Tom, as he is only 5 minutes away, but I still have not worked up seeing my sisters, who live 30 minutes from me. At the moment, that is too far if Julie needs my help.

Let me emphasize that Julie is doing everything in her power to be as independent as possible. If fact, she may be doing too much. Also, my kids are very helpful and willing. They have been great.  I bought Julie an Apple Watch, so she will always have a way to call for help if needed. However, for the moment, my life is focused completely at home.

Over the next weeks and months, I’ll continue to try to find balance, but life is stressful at the moment. I am trying to do the right thing by her, but I’m not Superman. Eventually, I’ll find a way to do some exploring with Violet again, but not right now. 

An important part of what has kept Julie, the kids, and me afloat is other people. As an independent soul, this has surprised me. I wanted to share some of my feelings about this, as it may be helpful to understand those who are going through a difficult time. I’m going to be frank, as it makes no sense to couch what I’m saying. Please don’t take offense; none is intended.

I should also note that people are much more open when dealing with those who have cancer. A few decades ago, others would shun cancer victims. Not so anymore; yay for that

What is helpful:

I must offer a disclaimer here. In no way is the following a solicitation for services. We both realize that people have busy lives. No one owes us anything, and we are cool with that. However, the following things have been helpful, and some have even been wonderful.

-Letting us know that you are thinking about us, praying for us, etc. That can be via Facebook, a phone call, a text message, a card, whatever.

-A number of people have given Julie gifts, from flowers to prayer blankets. She is overwhelmed and feels loved. 

-A number of people have gifted us food in the form of snacks, cookies, dinners, meal cards, and other surprises. Personally, I have been overwhelmed by their generosity. I can’t tell you how grateful I have been not to have to make dinner or how happy the kids have been to get a treat. We feel loved.

-Don’t avoid us because Julie has cancer, but be respectful of her limitations and know that a visit or phone call may need to be shorter than usual. Call before you come over.

-If you visit, I’ll be happy to make you a cup of coffee and (if we have them) offer you a snack. It is harder for me to give you a full meal.

-Don’t be afraid to bring up the cancer topic, but it isn’t the only thing we want to discuss.

-Don’t avoid us; you can’t catch cancer.

-Don’t forget us. Kind humans tend to respond at the start of a crisis, but life goes on. Check in on us as time goes by.

What is not helpful:

-Recounting cancer horror stories from a friend of a friend.

-Offering unsolicited advice.

-Suggesting cures, “I saw a YouTube video where a medical expert cured his cancer by    drinking cat pee every day.” Crazy therapies are not helpful.

-Questioning our medical decisions because you YouTubed the topic and now consider yourself an expert. You are not.

-Not talking about cancer or talking too much about cancer. We are dealing with cancer, but we also have a life.

-Saying things like, “Call me if you need anything.” This may be sincere, but it feels disingenuous.

-Saying things like, “I wish I could help, but I’m too (whatever).” You don’t have to do anything, that’s OK. But such statements serve no purpose. I don’t want to make you feel better about your lack of involvement. 

-Visiting too long. Julie loves visitors, but she gets tired.

-Not visiting/calling because you don’t want to be a burden. Julie loves a nice visit. We want to know that you care about us.

-Assuming something without asking us. We are happy to let you know, and if we don’t want to say something, we will let you know that too.

I said at the beginning of this post that it was complicated. With that said, Julie and I have been blown away by all of the kindness that we have received. I cannot express how much it has meant to us. You have made us feel less alone. 

We often hear about the evil in the world. However, time and time again, I see the true good in people. Sometimes a tragedy brings that out even more. I am so proud to call many of you friends. What an honor for me to know you.

Peace,

Mike 

Uncategorized

Cancer! Part I

It started in London, but I was unaware.  It became obvious in Paris, and it was impossible to avoid.  I love to walk, but Julie has always been the athlete in the family.  If fact, she requested and got a Peloton for her last birthday. 

We were walking the streets of Paris, and she was lagging behind me.  Often, she would signal me to stop as she needed a break.  Naturally, I inquired why. Julie was experiencing sciatic-like pain.  However, if she rested for a bit, it would subside. I had had sciatica in the past.  It is miserable but temporary. I didn’t think much about it.  Despite her physical limitations, we had a fantastic trip.  Soon it was time to return to Naperville.

Back home and I gave Julie some standard doctor recommendations.  She found some exercises on YouTube and tried to do them, but they seemed to make her symptoms worse.  It was clear that her sciatic pain wasn’t going away.

At that time, our daughter, Grace, was applying to PA school and was having great success.  She was accepted to and considered attending a prestigious school in Washington, D.C., and wanted to visit the campus and the surroundings. Julie was born in D.C. (her father was in the CIA at the time) and went to tag along; however, her sciatica was worsening, and she wasn’t sure she could do all the walking. 

She set up an appointment with an ortho doc, who did a cursory exam and prescribed a course of oral steroids.  With pills in her purse, she went on the trip. Unfortunately, they did little to help her ever-worsening symptoms. 

Julie and I felt that her symptoms were no longer consistent with typical sciatica, and she pressed the doctor for an MRI.  However, he insisted that she complete a course of physical therapy first, which she did in December.  Her symptoms only worsened. She returned to the doctor and once again asked for an MRI. This time he agreed and ordered an MRI without contrast.

I had wanted to go the RTR (Rubber Tramp Rendevous) in Arizona for years, and I had tried to convince everyone from Julie, to Nancy and Mike, and even my friend, Tom, to accompany me.  All to no avail. It was clear that if I ever were going to do it, I would have to do it solo. I loaded Violet the campervan, plugged in the coordinates for Quartzite, Arizona, and started the long journey.  

I wrote about that experience in a previous post.  I absolutely loved being among fellow van dwellers, many of whom are on the oddball side, but in the best way possible. If you have read my previous post, you know I’m also an oddball.  Oddballs don’t fit into any category; they are a category of exclusion. I ignored my shyness and met all sorts of folks on my adventure.  The RTR attracts individuals without a lot of resources.  However, they are amazingly clever and make the most of what they have.  Everyone that I met was incredibly nice.  The RTR isn’t about competition; it is about cooperation.  I loved camping in the desert and meeting these folks.  

The RTR runs for about a week.  I was planning on staying for six days of the meet-up. However, around day four, I got a text from Julie.  “Can you call me?”  I did.

Julie wanted to read me the results of her MRI.  There were quite a few anomalies, but most were minor—bulged discs and a small descending aneurysm.  I translated my medical knowledge into non-medical lingo as she read them off.  Then, she read the last impression. “A large solid mass in the right pelvic region in proximity of the L5 nerve root.”  “What?” I said.  Can you read that back to me again?”  She did. “Take a screenshot and send it to me.” She did. We discussed the implication of this finding, and our conversation ended with me saying, “I’m leaving for home.”  I drove back to Arizona to Naperville in two days.  

Oddly, the ortho doc never called us with the findings.  We eventually called him.  By then, we were both on high alert.  Being a doctor for decades, I know how the system works, what buzzwords to use, and how to get past the red tape.  The ortho doctor never had a follow-up visit; he just left a message that Julie needed to see a gynecologist. I wasn’t impressed.

She was able to make an appointment with a gynecologist fairly rapidly and reported that the doctor was kind. He looked at the MRI and advised that Julie see a gyne oncologist. Julie had to go to our group’s website, make random phone calls, and plead her case to be seen sooner rather than later.  It was all very stressful for her and for me too. I think we should have contacted our PCP to assist us, but no one suggested that, and our mutual state of mind was in crisis mode, not logical thinking mode.

The gyne/onc appointment was three weeks out, and I suggested that Julie call to see if they could order any additional tests in the interim, as this could save time in a process that already seemed to be taking too long. She did, and an MRI with contrast was ordered.  The results came back, and they weren’t good. This wasn’t a gynecological finding; it clearly involved the important L5 nerve root, which offers sensory and motor activity to much of the leg. Once again, we didn’t hear from the doctor, and we wound up contacting him.  In fairness, it is possible that he would have called on his own if we had given him enough time.

I already knew the answer, but he confirmed that Julie needed to see a neurosurgeon.  Our group did not have a neurosurgeon, and once again, we were left to fend for ourselves. I could coach Julie, but she had to do the legwork.  She was working full-time, and only she knew her schedule and symptoms. Hours on the computer, endless phone calls.  This was one of the most stressful times as we didn’t have the familiarity of our medical group; Julie was calling phone numbers with the hope that someone could see her quickly. It was really terrible. By then, it was clear that this was a tumor, and there was a strong likelihood that it was cancerous based on its size and strange location.  Beyond that, I could glean no further information from the limited data available. We felt like we were blowing in the wind. Yes, I’m a physician, and Julie is a psychologist.  We understand the medical system, but we were a family in crisis, not clinicians. We didn’t have a logical separation between treatment needs and personal boundaries.

Through her persistence, she set up two appointments with neurosurgeons.  One doctor was at our local Edward Hospital, and the other was downtown at my alma mater, Northwestern. She sent them both a copy of the MRI with contrast, and both places quickly shifted her to different neurosurgeons based on the unusual qualities of those findings.  We felt a sense of relief when she had finally secured the appointments.  

We first met with the Edward neurosurgeon.  He was incredibly nice and had recently relocated from Northwestern to build the neurosurgery program at Edward.  He informed us that the tumor was extremely rare and that surgery would be incredibly complex.  He had the expertise to do the surgery, but his team at Edward was still being developed and was not yet ready for such a difficult operation. He knew our Northwestern doctor and thought highly of him.  He also suggested the head of the department at Northwestern; both doctors were experts in tumors of the spine. He would call them with his impression. Now more waiting, but we had a sense that there was communication and a plan of some sort was developing.  We were relieved.

I honestly don’t remember how long we waited for the Northwestern appointment; I’m guessing weeks.  I’m not a big fan of driving downtown; I’m a bit phobic about it. However, it had to be done, and I was going to do it.  By then, Julie was having escalating symptoms, and it was becoming increasingly difficult for her to do the most basic things like standing or walking a short distance. She was incapable of driving all the way downtown, so I had to figure out a way to do it.

For me, knowledge is power, and I spent an afternoon studying maps, looking at satellite images, and plotting various routes using Google Map’s ability to predict traffic patterns based on the time of day.  I also have a thing about being late, as I think that it is both selfish and rude to think that my time is more important than someone else’s.  Julie gets this about me, so she was willing to leave generously early for the appointment. We set out for our appointment and got about halfway there when the doctor called to say that he had been exposed to COVID and had to reschedule the appointment.  Gasp!  More delays. 

Finally, we drove downtown.  I concentrated on the road, breathing, and I tried not to grind my teeth. Yes, driving downtown is not easy for me, but everything in life doesn’t have to be easy.  Recognizing a weakness and then figuring out a solution is more important.  Knowledge of the route and ample transit time was what I came up with.  Hardly a perfect solution, but good enough.  We made it to Northwestern.

The neurosurgeon there was also incredibly nice and spent a lot of time with us.  Like the Edward Hospital doctor, he informed us that surgical removal of the tumor would be extremely complicated and difficult.  It would involve multiple teams from various disciplines. It would be a big deal. Northwestern operates on a team model, where cases are presented to a committee of doctors from various disciplines.  He would discuss the case at the next appropriate tumor board and inform us of their recommendations. More waiting.  He also wanted us to see a neuro-oncologist at NMH, another doctor, but luckily the appointment wasn’t weeks away. 

That doctor was also really caring.  He said Julie needed a biopsy, which would be difficult to obtain due to the tumor’s location.  We voiced our concern that everything has taken so long that it was now months since we started our journey.  The doctor picked up the phone and called in a favor.  The biopsy would be the following week.

Another trip to NMH, a biopsy, and then waiting for results. The results were unusual, to say the least.  This tumor was a sarcoma, which are rare tumors.  However, it was also a rare type of sarcoma. Further, parts of the tumor appeared benign and other parts were cancerous. It was possible that it could respond to novel monoclonal chemotherapy used for blood cancers, and we were sent to a heme-oncologist doctor—more waiting.

That doctor concurred that chemotherapy MIGHT work, but there wasn’t a lot of research data on using that agent with this cancer.  This somewhat experimental use would require additional permission from our insurance company.  He would work on getting that permission and bringing the case to another tumor board at the hospital. More waiting

He did get approval for the novel chemotherapy, but we found out that its impact, if any, would take 6 months or more to work. The chairman of the Department of Neurosurgery was at that tumor board meeting and wanted to meet with us.  He thought the tumor should be removed, and peeling it from the nerve may be possible.  Otherwise, they would have to remove not only L5 but the L4-S3 nerve roots with devastating consequences.

During these months, Julie’s pain did not remain static.  It was significantly worsening every few days. Work was becoming impossible.  She couldn’t stand for more than a minute or two; she couldn’t sit in hard chairs, then any chair. Sleeping became difficult, with her waking up in pain every few hours.  She had trouble walking very short distances.  She was seeing a pain doctor and was up to the maximum dose of a nerve pain medication, and she was also taking the maximum dose of an NSAID as well as a powerful opiate at bedtime.  All of this wasn’t touching her pain, but it was making her mentally cloudy-a no-go for someone who makes their living with their brain. A steroid epidural was recommended, with the hope that it would provide a few months of relief.  It helped for less than a week.

We met with neurosurgeon #3, the chairman of the department.  He said he would work with neurosurgeon #2 and the chief resident of neurosurgery in the surgery.  In addition, the head of plastic surgery would be there as additional reconstruction work needed to be done. There would also be a general surgery team present, plus a variety of anesthesiologists. They would book the operating suite for 8 hours, and the minimum time in the hospital would be 5 days. When you have no options, the best is the only one given.  We took it.

We also needed to get a PET scan, a test that looks at metabolic activity and is very sensitive at locating additional tumors.  This was another struggle, but this time we had the foresight of contacting our PCP and asking him for help.  Although he was far removed from the case by that point, he got us an appointment.  Thank you, Dr. Lee-you are a peach. However, in the end, we had to go back to Northwestern for the PET scan, but it felt good that we had a doctor who was not only concerned but also willing to extend himself when he technically didn’t have to. 

Now all we had to do was to schedule the operation.  That meant scheduling the head of neurosurgery, his second in command, the chief resident of neurosurgery, the head of plastics, a general surgeon, and several anesthesiologists for the same 8-hour block. That should be easy-not.

Finally, all was scheduled for June 8th.  Remember that our first doctor’s appointment was in early November.  

For some reason, I thought I should go to the surgery solo.  I didn’t want to disturb the kids’ lives.  Crazy, I know-and they thought likewise. They would hear none of it; they were all going. 

In the wee hours on January 8th, we assembled.  In my compulsive way, I told the kids to bring things to occupy themselves.  This was a silly thing to do as they are all competent people who had already planned for the day. I believe that I also reminded them to bring their phone chargers… as if they would forget such things.

Each of us brought stuff, from schoolwork to novels.  The hours ticked on with an automatic text message every two hours to say, “The operating is proceeding as expected.”

First, I got a call from Dr. Wolinsky (head of neurosurgery) saying that his portion of the operation was complete.  He was able to peel off the tumor, which was the size of a peach. However, it was unclear how L5 would respond.  Hours later, I got a call from the head of plastics saying that his portion of the operation had been completed and that they were closing Julie up.  The operation took 7 hours, and she was in recovery for over 3 hours.  Julie lost so much blood that her hemoglobin dropped to 7, with the normal range for women being between 12-16.  The 7 was after getting blood transfusions.

Julie spent 4 days in the ICU, then a number of days on a med/surg floor before being transferred to Marianjoy Rehab Hospital.  Her total time in the hospital was nearly a month. Naturally, we visited her every day.  She has worked hard, but at present, she has very limited use of her right leg.  She is learning ways to ambulate with a walker and is using assistive devices now that she is home.  We are hopeful that L5 might wake up or at least return in some partial form, but that is uncertain.

Although she still has pain, it seems to be more from the recruitment of new muscles.  The horrific debilitating pain in her lower back and leg seems absent.  Her numbness continues.  Every day I see improvement in her ability to adapt.  I encourage this but don’t want to push her too far.  She is working hard.

Many have told us how surprised they were to see the way that we coped with the diagnosis. Their observations have truth.

However, the journey has been horrific, and some of that could have been avoided.  Yes, the very long wait (8 months between first contact and surgery) was terrible as Julie continued to suffer.  However, we used that time to learn more about her diagnosis and how to prepare for the future.  The biggest trauma was feeling like we had to do so much of the work on our own.  We are medical professionals, but that only goes so far. We were in crisis and just trying to function. I believe that we should have contacted our PCP earlier on.  He is a great guy, but no one told us to do this; the specialist doctors just gave random commands like, “You need to see a gynecologist,” or “You should find a neurosurgeon, but we don’t have one on staff.”  Often we never even heard from the doctors; we reviewed the test results and called them. We would then get a message back or possibly a call from one of their underlings. No one said, “Come in and let’s talk about it,” or “Our office will arrange for you to see Dr. … ASAP.”  We were just left to blow in the wind as we were dealing with terrifying news. For me, the worst time was when we were told to find a neurosurgeon but given no additional information.  Where should we go?  What kinds of neurosurgeons were we looking for?  What should we tell them?  How quickly did we have to see them?  None of this information was provided.  It was by the grace of God that Julie was not only able to make appointments but that we got the doctors that we did.  

The first neurosurgeon (Dr. Jones) couldn’t do the operation but gave us information and called Northwestern to inform the doctors there.  The second neurosurgeon (Dr. Swong) was nice, respectful, and encouraging, as was the third neurosurgeon (Dr. Wolinsky). In fact, all of the NMH docs were wonderful, except the pain doc.  He was OK but treated Julie like she was a drug addict because his methods weren’t working. Even so, he did his job and wasn’t too bad. However, it does bug me when a doctor blames a patient because he can’t remedy their problem.

There is likely more to come, radiation, possible proton therapy, and who knows what else. We have been cared for since we plugged into the Northwestern system.  There was a plan, although it changed from week to week.  However, we knew it was changing because the team was getting more information and opinions and thinking about more options.  You can’t fault them for that.

We also had excellent care at both hospitals.  I was proud that I went to Northwestern for med school and my residency.  Marianjoy was… well, a joy.  

You may ask why our family will stay with the extremely large medical group that we currently use.  Honestly, it is because of our PCP, Dr. John Lee.  He is smart, respectful, compassionate, responds to inquiries, and is a good guy.  I like to think of him as an Asian Dr. Welby. Most of our medical needs are typical, and Julie is already plugged into the Northwestern system for her cancer treatment.  However, she will continue with Dr. Lee for her regular medical stuff.

We have a long way to go—Julie as an individual and our family.  But we are on our way. In the next post, I’ll talk a bit about our emotional journey.  In that post, I’ll emphasize my feelings.  I don’t think they are any more important than Julie’s or the kids’.  Rather, I know what is going on with me more than I know what is going on with the others.

Peace

Mike

We all waited during the surgery, each with our own distraction.
Forcing a smile in the ICU.
Visiting mom post-surgery. Julie had a fantastic view; too bad she couldn’t enjoy it.
Learning how to walk again. Marianjoy has a practice apartment where patients can re-develop necessary life skills.
Practicing walking with William as her assistant.
Getting ready to go home. Wonderful and terrifying.
Tom helped me install this grab bar.
Our shower now has more of a “hospital look.”
We went on a little 4th of July walk. Julie made it 3 blocks but paid for it the next day.
family, Family relationships, family traditions, spending time with family

On Ed And Anne Kuna

My cousin, Ken, kindly commented on my last post and mentioned that I should write about my mom, Annie.  I thought about it, and it sounded like a good idea.  This post will also give me the opportunity to write a more balanced remembrance of my dad.

I write these posts for my kids and try to be honest and transparent. When I mention my dad, it is often in a less-than-positive light.  However, that doesn’t mean that he didn’t have positive qualities. Additionally, he was a product of his environment.  Roles for men and women were rigid for someone born in 1910.  This was compounded by his 1st generation status, which dictated its own behavioral compliance. In addition, my dad was raised in a large family that in itself was controlled by rigid rules of conduct.  

I can’t say I knew my dad’s dad, although I saw him a hundred times.  My grandparents only spoke Slovak, a language that I didn’t speak. Interestingly,  I eventually learned that my grandfather was fluent in English. His pride demanded that everyone address him in Slovak; there was no flexibility.  I remember my grandpa as a frail old man who spent most of his time in bed. However, when I see photographs of him from his younger days, he appeared very differently.  In those images, he is tall, strong, and very good-looking. Apparently, he was also very strong-willed. My father would tell stories where my grandfather would remember some transgression that my father committed weeks earlier.  He would then wake up my father and beat him.  My dad said he frequently didn’t even know the reason why.

My dad left school after the 8th grade.  He was a bright guy, and it was common for students to continue on to high school, but he had to support his brother, who was attending college.  His matriculation into the workforce was at his parent’s insistence; my father said he was happy to do it for the family.  My uncle was on track to become a priest, and in the Slovak circles of the day, there was no higher honor that a family could obtain. No family sacrifice was too great.  Eventually, my uncle decided that religious life was not for him and married my Aunt Rose.  I am grateful that union produced some of my wonderful cousins. My grandparent’s disappointment became my blessing.

My dad was also a product of the Great Depression and the deprivation and stress that era created. As an interesting aside, he had a secret weapon; apparently, he was so good-looking in his youth that girls would swoon over him (reported by multiple sources). 

Despite his difficulties, he eventually became the Chief Operating Engineer of one of the largest high schools in Chicago. He consistently worked and supported his family.  He was a handy guy who could fix many things.  He took care of my mother when her health failed.  He supported my educational efforts.   

I recognize the traumas that he overcame, and I respect his efforts to succeed.  As I said in previous posts, he was not an evil person.  The two of us didn’t gel.  He needed a standard issue, son, and that wasn’t me.  Yet, his disappointment paradoxically impacted me and played a key role in my development. I became self-reliant, an excellent problem solver, responsible, and independent.  Those qualities have served me well throughout my life.  Every coin has two sides. 

My dad was just half of my parental equation; the other half was my mom, Annie. Just like my dad, she had her flaws.  However, that is not the purpose of today’s writing.

My mom was also raised in a very large Slovak family, where the last three children were girls.  She was sandwiched between my Aunt Mary and my Aunt Lill. My mother admitted that her father was an alcoholic, something shocking to say in the day.  She noted that he was nicest when he was drunk and meanest when sober.  He worked as a maintenance man for a book binding company. My mom’s mom was very gentle and loving. Both were deceased long before I was born.

Despite being an immigrant family, her siblings became very successful.  One started profitable savings and loan; another owned a factory, one was a professional baseball player, and several others became engineers. I remember going to the home of one uncle.  We lived in a run-down Chicago bungalow.  His family lived in an actual mansion in Riverside—a giant house with a book-lined library and an elevator. I recall going to other relatives on my mom’s side; that were also impressive.

Cultural limitations bound her life. Women were regarded as second-class citizens.  If her brothers saw her on the street, they would ignore her as she wasn’t worth their time.  In those days, there were two types of high school certificates, a 2-year and a 4-year diploma. She graduated from the two-year program, which completed her education. She was then expected to work, which she did in a variety of menial jobs.  This was not unusual, except for one thing, my mother was one of the most intelligent people that I ever knew. I know a lot of very smart people, but her intelligence was global.  

My sister has a diary that my mom wrote that recalls her graduation.  In attendance was her family.  The principal stood at the podium and announced that an award was to be given to the most outstanding student.  The principal talked about all of the student’s academic talents and amazing creative abilities. That student was a superstar with a bright future. My mother was curious to discover which boy won the award.  Then the principal announced the name “Anne Skriba” (my mom).  Her brothers were shocked that their stupid sister wasn’t stupid after all.

Edit: My sister has my mom’s diary, which is the primary source for the above paragraph. She has offered the following corrections: My mom received specific awards for her creative activities, which ranged from writing poetry to authoring a play. The school also had an award that was given out to the best academic student in a class. Their name would be engraved on a plaque. My mother was awarded that honor and consistently scored the highest among her peers academically. When the principal gave her the academic award, they referred to all the other awards she received. Last correction, the principal identified her as Anna Skriba, not Anne Skriba.

Did my mother build a space shuttle or write a best-selling novel?  No, she married my father and raised a family.  I believe that few people who met her knew how intelligent she was; she was hampered by low self-confidence, anxiety, and the locked-in role women of the day were expected to conform to. 

I mentioned that my mother also had her flaws, and that was undoubtedly true.  However, I felt that she loved me unconditionally.  Some may say she was co-dependent.  However, she was generous to a fault and constantly worked to keep the family together.

Here are a couple of simple examples from my experiences with her.

When I was in primary school, I had a project to create a castle. This was one of those assignments where the kid was supposed to do it, but the parents completed 90% of the build.  My mom gathered junk from around the house with my sister Carol’s assistance. Some empty oatmeal containers, a broken mirror, a bit of old house paint, some cardboard boxes, etc.  In one evening, they build me a castle that could have been used as a prop on a TV set.  It was fabulous. 

My mom did typical mending jobs, but I didn’t realize how talented a seamstress she was until one Halloween.  My sister Nancy asked her to make cat costumes for her and her boyfriend for a party that evening.  My mom was not a hobbyist sewer; she sewed because she had to repair clothes.  She thought about it for a moment and reached into her bag of scrap material and found a beat-up pair of black pants.  She disassembled the pants and pulled out her sewing machine, a gadget that never worked well.  In short order, she made both of them cat costumes, complete with ears and tails.  They looked great, despite the fact that she made their costumes with only scraps and imagination. 

My mom was an excellent writer,  something my procrastinating brother, Dave, took advantage of.  Like most college students, Dave would be given 20-30 page term paper assignments at the beginning of the term. However, he didn’t start the paper until the night before it was due. That evening, he would appear with a stack of books in his hand.  Dave didn’t type and asked my mother to do this task for him. Their efforts started after dinner, usually around 6 or 7 PM.  Dave would start by describing what he wanted to say and pulled some references from the books he brought. My mom would start typing on our old Royal Upright.  This would continue through the night, and I remember waking up at 2 and 3 AM to the sound of her typing. At some point, my mother would take over the composition.  By 7 the next morning, the paper would be complete.  I’m sure that my mom deserved the first author title on these endeavors. 

My friends always wanted to eat at my house, and I couldn’t understand why, as I assumed that all moms were great cooks.  However, I learned differently.  My mother was an effortless cook who made most foods from memory.  She would bake something every single day. She did this in our crappy kitchen with a broken stove and mismatched pots and pans.  She had a Sunbeam Mixmaster from the 1950s that was so used that my father would have to change out the motor’s brushes every year or two. Her bakery was fantastic. She didn’t teach me how to cook, but I often observed her cooking.  She had such confidence in her cooking that it gave me confidence when I started to cook.  One of her favorite TV shows was “The French Chef.”  I watched so many episodes with her that I joke that Julia Child taught me how to cook.  

My mom had a broad understanding of alternative medicine at a time when such things were uncommon.  She had a strong interest in the paranormal.  She and my dad had an actual close encounter, but that is a story for another time.

She was very gifted psychologically and had an intuitive understanding of others. Friends and family sought her advice which was both compassionate and logical.

Lastly, she had genuine psychic abilities.  I’ll give you two examples.

When I was 5, my aunt and uncle generously took me with their family to Rainbow Beach, which was a large beach/park on Lake Michigan. Those were different times, and kids weren’t tightly managed. My uncle and aunt set up a blanket, and I went off into the waves with my cousin Bob and (I think) my cousin Kris. After splashing about for a bit, I looked up and couldn’t find either of them.  I was in a panic. I decided to go back to the family blanket, but it had disappeared.  My uncle had moved the blanket to a better site.  It seemed like there were a million people, but I recognized none of them.  I decided the best way to find my relatives was to break the beach into quadrants and methodically search each one.  I did this twice but to no avail.  By now, my anxiety and fear were out of control.

At home, my mother sensed something.  She told my dad, “We must go to the beach right now; something is wrong with Michael.”  My father tried to dismiss her concerns, but she was beyond insistent. In fact, she dragged along my sister, Carol. As they pulled into the parking lot, they heard an announcement on a loudspeaker, “Still missing 5-year-old Michael Kuna.”  My mother almost fainted.  Of course, my relatives were also looking for me, but we didn’t connect. I knew my strategy wasn’t working, so I devised a plan B.  I returned to the parking lot and found my uncle’s old Packard car. There I sat and started to cry. A kind man saw this, asked me what was wrong, and took me to the beach’s office.  My mother knew that I needed help from miles away.

I was 7 or 8 at the time and frequently played with Mike Z, a boy 1 year older than me but light years more street-smart. One day my mother said she was going to take me to the local theater.  This was extremely unusual; it was the only time she did this. Not only did she take me to the movies, but she also bought me ice cream afterward.  I was over the moon.  We walked back from 59th and Kedzie to our home at 55th and Francisco.  On the way home, I thank her for the wonderful adventure. She looked at me and said, “I had a strong feeling that if you stayed home today, something terrible would happen to you.”  We turned the corner to our block and saw an ambulance in front of Mike Z’s house. He had been spraying lighter fluid into an open flame that traveled up the can and exploded.  He was street-smart enough to roll himself in a blanket, but despite that, he had significant burns over most of his body and spent weeks in the hospital. He would likely have had me do the “experiment,” and I would have been the burn victim.  However, it is less likely that I would have had the common sense to roll myself in a carpet.  It is more likely that I would have been disfigured or dead.

We are all products of our genes and our environment.  We all have positives and negatives.  We all have strengths and weaknesses.  Today, I wanted to give you additional insight into my family of origin. There are two sides to every coin.

Peace