“It was the best of times, it was the worst of times, .."

We owe that unforgettable opening from Charles Dickens' "Tale Of Two Cities" which still resonates today as it had for all times past. We can expect the same for what awaits us in our future. Whether it is looking at our personal lives or that of the world around us, "the best of times and the worst of times" seem to come in equal or unequal doses. Of course, it is everybody's wish that we go through more best times than worst in our journey through life. Often, however, there is also this idea of whether one views a glass as half empty or half full.  There is no easy way to address the question, let alone use a broad brush to answer it.  Best we can do is look through different filters to address a few of them.

1. Lifespan vs. Health Span

Today, on average we are living longer through the filter of statistics. The U.S., which has kept good records show that in 1900 the average life expectancy for white men was 46.6 years, women by about two years longer.  By 2000, white men's lifespan went up to 74.4 years, while white women's went up to 79.9 years.  Minorities lagged behind but their lifespans increased as well over the same period.  World population, also on average, increased considerably.  Several countries are  actually outpacing the U.S. but third world averages are way below.

One may say, based on lifespan alone, that today we are living in "the best of times". However, we are told to recognize another measure. Along with how long our life expectancy rises, we must be cognizant of how well we are living, physiologically that is, and perhaps even emotionally, thus the term was coined,  "health span". In the early 1900s, the number one cause of death was heart attack, or more commonly, heart failure (or HF).  It still is today. However, survivors of the first incidence of HF do better now than a decade or so ago.  Modern medicine, lifestyle changes that include diet and exercise are the reasons. 

So, can we then say that lifespan and health span are what would make a glass full? On average, we can say that that full glass is what we call being 21 years old. By forty, we can only hope that from then on  a full glass would have a reasonable mix, albeit in slightly reduced strength or diluted solution of both, but still in about equal doses.  You and I would wish that to be consistently true, but then again our best times and worst of times will differ.  

2. At The Right Place, At The Right Time

Physicists would fondly call that being at the sweet spot of spacetime. You see, everyone can relate his or her good fortune by being at a favorable point anywhere at some fortuitous time. By way of example, let me relate just one particular story that would explain the heading above.

Over two years ago we hired a cleaning lady to help out for one day a week.  Hiring her was timely because shortly thereafter my wife was diagnosed with Parkinson's.  The lady was recommended by a friend.  She speaks little English but her husband and two children (who were born here) do. Soon she became like a family member who is with us every Saturday. We serve her breakfast when she arrives in the morning before she starts her chores and she joins us for lunch (typically home-cooked) and she gets to take home the leftover.  She is very thorough with her job - from helping with laundry, changing the bed's linens and, of course, the general house cleaning.

A year ago, she had a stroke.  Fortunately, she was at home with her daughter.  The response to the 911 call was quick and she was at the hospital in time for doctors to get her the immediate and proper attention. For the next 3-4 months she struggled with her balance and movement and she slurred her speech. Miraculously, she recovered in less than five months.  She regained her normal movements and shortly after, her slurred speech was gone. After another month she came back to resume her work with us.  Her daughter took a leave from her job and did the driving for her and to help her with the chore.  Later, she was driving by herself though her daughter still came with her for a bit more.  Today, it is as if she didn't have the stroke; except, of course, that she has a regimen of medicine and regular check ups.  Several months ago she ran a part of a marathon for three miles.

She is the first to admit that had this happened in Mexico where she is from where medical emergency care was inadequately timely and the nearest hospital was an hour away, she would simply have become a statistical number to succumb to stroke. 

Unlike the millions from many areas around the world with less than ideal emergency and follow up health care, from the right medicines to post illness therapy, she was at the right place, at the right time. There are innumerable stories like hers all around the world if we care to look and listen.

3. Not Too Hot, Not Too Cold

It is otherwise known as the Goldilocks zone of where earth is, relative to its location from the sun.  Venus is much too hot while Mars is way too cold. Only on earth among all the other planets that orbit the sun where water exists as a liquid naturally.  Life as we know it emerged and continues to thrive in an environment that is just right - not too hot, not too cold.

However, this Goldilocks zone is not the proverbial "Garden of Eden' all throughout every region and not consistently unchanged throughout history, from epoch to epoch.  It had gone through at least five ice ages followed by global warming over thousands of years to complete each time.  The reason: (a) The sun (one million times the size of earth) that is the source of 99.999 per cent of the heat and 100% of the gravitational force that holds the entire solar system disburses its energy irregularly at times.  It goes through tantrums as it travels through its orbit around its own master - the Milky Way galaxy that has at least two hundred billion other suns. (b) Earth's orbit around the sun is not a perfect circle. It is slightly an ellipse, thus its distance from the sun varies from slightly closer to farther away over each revolution. 

We are who we are today along with all living things because we managed to evolve to survive the many changes in our environment over long periods of adaptation. The unrelenting climate changes all organisms went through made us look different from others - for example, darker skin protected those close to the equator from the sun's damaging rays, paler skin for those closer to the poles to help absorb vitamin D from the sun; and all shades of skin color in between the equatorial and polar regions.

All throughout earth's history its inhabitants had gone through innumerable "best of times, worst of times" but here we are today - the survivors of an ever changing environment, yet life prevailed because of its indomitable ability to adapt.

4. Wars, Rumors of War And Hopes For Peace

"The history of mankind seems to be the history of war", is a quote I ran across that I cannot recall who it was attributed to for its origin.  But clearly we are used to seeing history being written predominantly by the victors of war(s).  Often, these conflicts throughout our history are romanticized where heroism and the struggles to victories, war after war, were immortalized and celebrated. Historians subdivide histories in terms of eras and changing empires along their rise and fall, despite an unchanging geographical landscape, except for the constant changes of one empire emerging after another.  Where we are today is merely a more recent makeup of where power resides but it is still the same round globe.

There is no such thing as a minor war because to those involved who perished in it, suffered from it, even for those who survived it, any war is a major war. We identify two great wars of WWI and WWII but there has not been a generation (or 25 years) in recorded history when there was no war someplace, somewhere. Between 1914 and 1939 was a mere 25 years between the start of each world war.

So, we have historians who write about wars, and there are prophets who predict upcoming wars. Neither historians nor prophets should be ignored but one thing we clearly do not do is learn from either.

For those who do not subscribe to or adhere to any kind of religious faith, you may treat the quote below not as a Biblical text but merely as a fair statement by someone watching or reading geopolitical news or analysis of the present time, instead of from several centuries or so ago, and note that only today is it possible that the world will know "of wars and rumors of wars" with the instantaneity of the internet and mass media.  At the time the original  text was written it would have been impossible for rumors of wars to spread quickly when texts were written and read  in scrolls; nor would they be conveyed speedily even on horseback as world population was a small fraction of what it is today. 

Matthew 24:6, From the New Testament, KJV

"And ye shall hear of wars and rumors of wars: see that ye be not troubled: for all these things must come to pass, but the end is not yet".

The worst of times will far exceed what will follow the rumors of war but only now since the last two great wars that a quarter of the earth's population is predicted to perish from the Four Horsemen who symbolize territorial conflict and attempts to conquer with an intensity only possible with modern weapons of war (not to exclude nuclear), worldwide famine, diseases (Covid 19 a mere preview) and death and suffering.

The good news is that peace shall come after the worst of times to be followed by the best of times.  

The reader is urged to take this for what it is worth - a commentary, but clearly no one can claim with certainty of its occurrence at a specific time and date but the trajectory is unassailable because the history of man is a history of conflict that only a supernatural intervention can assuage.

The Caregivers: The Other Side of Illness

Doctors, nurses, therapists, and all those serving in every medical and recuperative facility are all caregivers.  What they do cannot be minimized.  The significance of their roles in health care and health management serves a far greater impact in today's society despite  and apart from what technology has done to modern medicine. Having said that, it is also worth as much to say that there is one area of caregiving that is not part of the regular conversation but is becoming more and more common as the percentage of the aging population and long term survival ratios from serious ailments are increasing.  

While nursing homes and other iterations of assisted living are now integral to societies in the "First World" countries (a rarity, if non-existent, in "Third World" societies),  there is a statistical, perhaps a noticeable phenomenon of more and more folks electing to remain at their own homes. This is looking through the lens or prism that  has to do with caregiving  that involves a family member towards another who has  medical or health issues living at home.  It does not matter what kind of health problem is involved, the family member/s who take/s up the role of caregiver in the day-to-day activity within that household is what I refer to as the other side of illness.

Just last week my wife and I were in the waiting room in one area of the hospital where they do specialty scanning and other radiology testing (including the somewhat ominous sounding section - "nuclear medicine").  The DAtscan procedure that my wife was going to have was for thirty minutes but the total time we were scheduled to spend there overall was for four to five hours. There was one hour of wait time after she had a full glass of water, before a radioactive tracer can be injected intravenously. Then we had to wait for three more hours before the actual brain scan which takes about another half hour.

In the first hour of wait time another couple came in.  The wife was the patient but we at first couldn't tell  by her cheery demeanor and a smiling face as she talked.  She was scheduled for a series of tests. After a few more minutes, a mother and daughter came in. Naturally, conversation in a small confined area took on its humanly natural  spontaneous course.

The older couple - I say older but I surmised we were about their age once they revealed they had been married for 53 years!; they in 1970; my wife and I in 1971 - were the epitome, just like my wife and me, of a growing number of couples living at the same home long after it had become the proverbial "empty nest".  

The mother and daughter had a profoundly sadder story in caregiving. The daughter who has had cystic fibrosis since childhood just graduated from high school via homeschooling. Deeply heartbreaking was that the mother herself - the caregiver - was  diagnosed with muscular dystrophy (MS) not too long ago.  Needless to say, the mother intimated, both of them are frequent visitors to the diagnostic wing of the hospital. In her own words, "we know the drill" as they were ushered in and out by one technician or another to go from one test to the next.  Every time they were back at the waiting room the poor daughter would just lie down and take a nap on the couch, only to be awakened again for the next test.  One can't help but feel  for both of them. But anyone who sees them go through it will have to  be in awe of the mother.  She worries, of course, about what it would be like once MS takes its toll on her.  Her faith, she said, was what kept her going.  She is the caregiver who sooner or later will need one herself once  MS takes its inevitable progressive stage. 

Every Friday from 10-11 a.m. at the local  Baptist church I take my wife to a group exercise that is designed for those with Parkinson's under the auspices of the Houston Area Parkinson's Society (HAPS).  There's about a dozen or so who attend; naturally, each is at different stages of Parkinson's and at varying ages.  About half are men, although  men with Parkinson's outnumber women by 2:1 in the general population. A physical therapist leads the chair-bound exercises although standing up and down is part of the routine. 

Every third Friday of the month, in the adjoining room, there is a support group meeting for the caregivers while the patients are doing their exercises.  

As in every support group meeting, the seats are arranged in a circle. The moderator sits in one of the chairs and we all can see and hear everybody.  This was my first time attending. Every caregiver was a spouse - six husbands and six wives (in this particular session). 

One husband came even though his wife was not there for the exercise because their daughter took her to attend another family member's social function.  He obviously did not want to miss the support group meeting and I think I understood why from a one-on-one conversation with him later after the session was over.  He found solace and comfort from the other caregivers like him - he sort of said that much - and perhaps he simply needed a break.

In cases  when the caregiver is dealing with a significant other who has dementia or Alzheimer and other cognitive difficulties, the  emotional and stressful complexities take their toll.  It is so much tougher for the caregiver once what used to be a vibrant, conversation-filled relationship is no longer there while the afflicted partner may not be completely aware of what is going on to be emotionally or cognitively connected.

One caregiver husband is 87 years old whose wife is wheelchair-bound from a progressively advanced Parkinson's. In one of our conversations, he recalled that his friends back in the early stages of his marriage teased him about marrying someone quite a bit younger than him, a nurse at that, ensuring himself of a caregiver in his old age. Instead he became  the caregiver from the day his wife was afflicted with Parkinson's from nine years ago. At 87,  is he not one likely to have a caregiver himself soon?  Such is another side of caregiving.

It is heartening that we see couples remaining in their homes, managing and coping as best they can. But it was heartbreaking to hear one of the wives talk, "Now, I find myself the one talking to service men, repair people and handymen who come to fix things in the house.  It used to be that all I ever did with the car was put gas in it, drive and park it. Now, I'm the one talking to the mechanics and always worried about its maintenance. I am not just the primary, I am the only driver in our household".

There are obviously many more stories about caregiving, extraordinary sacrifices and the inevitable phenomenon of so called role reversals. Role reversal as in the example from the previous paragraph is also one circumstance seen where and when the children take on the role of caregiver to aging or ailing parent/s.  Usually, this role is that of a daughter taking care of a parent; but daughters do not have a statistical monopoly of that role because sons are known to assume what is now referred to as reverse parenting. The challenges associated with role reversal are not so much about taking the parent to the doctors, making sure they are taking their medication or for them to be eating properly and on time, but dealing with the emotional conflicts that accompany "parenting in reverse".

Most common in role reversal is that of simply taking on what used to be the other spouse's role.  Again, as exemplified in the paragraph earlier, there are challenges.  Obviously, not only can we not cover everything on the subject, we cannot reasonably find one common rule to apply because each situation is different from the next. There is not one particular way anyone can claim will work in one situation to apply universally.

In caregiving within a household, the greatest need is of course that of the afflicted.  That is what gives caregiving its nobility of purpose. And it is  through the caregiver's embrace of the responsibility and dedication that allows for that nobility to endure.

Why it works cannot be explained in words.  It is the summation of a shared life from the moment both promised each other, "for in sickness and in health", however many years ago that was.  Below is a quote where I end this musing.

"Love is an action, but it is also a choice.  Loving another sometimes means laying down the self and choosing the needs of another. When the rubber hits the road so to speak, it is then that these vows matter most".

----- Michele Treacy

What of my own personal perspectives, or views through the prism and lenses of my experiences?  Regular readers have had a glimpse. These  are in the Archive: 

{Parkinson And  "The Other Side of Day" 12/19/2022;  "The Other Side Of Morning" 12/28/2022;  Through The Eyes See You 07/11/2023; "For Kindness Begins Where Necessity Ends" 02/04/2022;}

What of those living alone?  {The Vigil of the Lonely  07/24/2021}