Trauma, Death, And A Summer Paint Job in December: A Year In Review

It’s a quiet morning caused by an unexpected snowstorm.  I’d like to be full throttle in renovating my home, but scheduled workers didn’t show.  It’s the perfect moment for the quiet introspection I’ve been dreaming of.

Max New Year;s Day last year.

Last December at this time, my dog, Max was in a doggie wheelchair and the vet told me he would never walk again.  The family holiday powwow was to schedule one sibling to be with Mom 24/7 because she had just completed her cancer surgery and needed round the clock assistance.  Mom and I were debating the value of life at 4 AM on a regular basis.

The surgery to remove the tumor from under her right cheekbone meant removing her right cheekbone, her right eye which had been invaded by cancer, and, well let me explain it this way. If you put your finger touching the middle of the roof of your mouth, everything to the right had to go.

Shortly after the surgery, they put in a very refined denture that mimicked the roof of mom’s mouth.  Without that, she couldn’t talk or eat.  She was trying to figure out the care of it, she was exhausted and beat up from the surgery.  The surgery impacted her hearing.  She was completely deaf without her hearing aide and the hearing aide was working inconsistently.  Her sight was much worse.  She had trouble breathing and frequent nightmares.

I spent nights with her at the hospital and she would wake from nightmares at 2 or 4 AM.  She would say how if she knew it was going to be this bad, she would rather die.  We would debate the merits of living and dying.  I would interject Emotional Freedom Technique (EFT) to release some of the emotion, much of it, fear.

Surgery can result in a form of post traumatic stress disorder (PTSD).  The patient’s subconscious feels it is being attacked and doesn’t recognize this is a life-saving measure.  Mom’s nightmares were part of that syndrome.  Fortunately, I was able to get in there quickly with EFT.

When we got home, Mom slept for a while sitting up in a chair in the living room.  It was hard for her to breathe lying down.  By then we took turns staying with her.  During my turns, we often had those 4 AM discussions and EFT.

I briefly mentioned that my dog was in a wheelchair.  Just as my mom’s surgery was scheduled, my dog, Max, became paralyzed.  It was just before Thanksgiving.  He’s a little Bichon and the vet said a lumbar disc had dislocated.  The vet also said, after a couple weeks went by & Max didn’t show improvement, that he would never walk again.

I have to thank my good buddy, Steve Kowalczyk, for nursing Max.  I was pretty full time taking care of Mom.  So Max went to Steve’s house and got excellent nursing.  It was a lot to ask of anyone.  Max couldn’t get up at all on his back legs, so he had to be cleaned up several times a day and carried outside to relieve himself and held.

So in the back of my mind were life and death questions about Max as well.  I didn’t entertain them much, though.  Somehow I knew Max would be well and Mom would, too.

Maybe I felt that way because I was able to help them.  Mom would never take my USANA vitamins before.  But in her helpless state, I drowned her in them the best I could!  I ground them up and put them in her food, her drinks, her deserts.  I did the same for Max.

And I was able to do EFT, CranioSacral Therapy, Lymph Drainage Therapy, and Liss Stimulation, every skill I knew from my work I employed for both of them.

Around this time last year, we took Max to get his wheelchair.  As soon as he stood in it, he was so happy.  Since there was no weight on his back legs, he began moving them.  The woman at the custom wheelchair shop said that indicated that he would probably recover.

Max recovered and he’s still recovering.  At Thanksgiving, my daughter and I took a long hike in the woods.  I debated with myself whether to take him, as he hadn’t done any really long walks.  It was one of our favorite places we used to walk.  So I took him and he kept up and enjoyed it.

Our walk with Max, Nov 2009

Mom is back to her energetic self that our family really hadn’t seen in over 10 years.  She had gotten really overweight and was on medications for high blood pressure and cholesterol.  For about the last 6 years, she had lost her ability to walk any distance at all.  She had gone from a person who wore all her children out shopping, to someone who couldn’t make it across a parking lot.

After the surgery, she got her energy back better than ever.  She lost about 70 lbs and she did it healthy, not losing muscle.  She ran around taking everyone shopping and running the show this Christmas.  She’s still taking her vitamins on her own, just in case they have something to do with her anti-aging energy boost.

Mom clowning around in the kitchen Christmas day.
Max as Santa
Max as Santa 12/25/09

The only crazy thing was, well, actually there were 2 crazy things.  My ex-husband, the composer, Michael Galasso, died on September 9 and my brother, the cardiologist, Michael Pasquale, died September 17.

Mike Galasso had been struggling with his health for years and died of a heart atack while my daughter, Catherine was visiting him at his home in Paris. She had 5 weeks with him and he died the day before she was to fly back to NY.  They were very close and it’s been very tough for her.

She’s a choreographer and she’s been able to channel her grief in very interesting ways through performances she’s given in both NY and San Francisco.  It’s been both tough and inspiring watching her.

Out of the blue, while Mom was in recovery mode in the spring, my brother, Mike got diagnosed with cancer and died in September.  My brother, Tony, and I were together at Mom and Dad’s when Mike died and we gave them the news.  It could be the hardest thing I’ve ever done.

Summer paint job in the snow. It’s all done & ready to go!

So here I am.  The snow is on the ground and on the scaffolding that stands in front of my house.  I live and have an office in a 3 story brick & cast iron building that dates from 1876.  Painting the cast iron and pointing the bricks, sprucing up the rusting facade, was supposed to be a summer job.  The summer job turned into a winter job, the contractor just finished yesterday, after many delays.  The scaffolding is supposed to come down the first clear day we get in the new year.

I’m deep into interior renovations of my home & office.  It’s planned to be a winter job and be done by March, in time for Chinese New Year!  I’ll keep you posted.

Happy New Year!

Behind The Curtain: Helping a Parent Though Cancer Part 16

Pasquale family at the dedication of the echolab at Christiana Hospital.  I’m at the bottom right and Mom is over my right shoulder.  Dad is standing behind Eileen’s mom to my left.

It’s holiday time and many of us are thinking about the ones who are not here to share it with us.  As I was washing the dishes this morning, I was crying at the loss of my brother, Mike, who died in September, not of the cancer he had, but of the opportunistic infections he couldn’t beat.

At the same time that I was crying, I was marveling how my body could automatically be washing the dishes.

Then I thought, didn’t I dream of Mike last night? Yes I did.  In the dream, I asked him, “Why did you leave us?” I couldn’t remember the answer. so  asked out loud, “What was your answer, in my dream?  What was it you said, Mike?  Why did you leave us?”

All I could remember was that the dream was comforting and I intended  to tell my sister-in-law, Mike’s wife, Eileen about it.   In the wee hours of the night, it seemed like a revelation.  Now I couldn’t remember.

At the sink, as I washed the dishes, I saw Mike clearly, laughing.  He said, “I told you that I haven’t left you.  I’m with you.  Just think of me as behind a curtain.” He had that bemused look on his face, smiling, as he so often did.

Behind a curtain.  Like the wizard of OZ?  In the light of day, with water splashing in the sink, it wasn’t nearly as satisfying an answer as it had been earlier.

The Center for Heart & Vascular Health at Christiana Hospital in Wilmington, Delaware dedicated its echocardiography laboratory to my brother on Monday, December 7, 2009 calling it the Michael J. Pasquale, M.D. Echocardiography Laboratory.

The dedication was to be at 3 PM, so at 10 AM, I picked up my parents in New Jersey and we met up with the family at Eileen and Mike’s  house outside of Wilmington.  My brother, John, had come with his wife, Patty, and their 2 boys, Sean and Andrew, twins about 12 years old, and their oldest daughter, Amanda, 25.

My brother, Mike’s, children were all there–Chris, 27, Kimberly, 25, and Nicole, 22.  Carolann, 25, my sister, Ann’s daughter, and her boyfriend, Kyle, were there, too.  Eileen’s 92 year old mother completed the group.

It’s hard to describe the feeling’s in Eileen’s kitchen that morning.  We were cheerful.  The underlying strain of grief was also present.

We were met at the hospital by an auditorium full of Mike’s colleagues, hospital administrators, cardiology fellows, nurses, friends and patients.  Dr. Timothy Gardner, the medical director, spoke first. Then Dr. William Weintraub, the cardiology chair and my brother’s partner.

My brother had been a cardiologist, hired 20 years earlier, and these 2 men spoke about how Mike had left his mark at Christiana Hospital.  Besides being an excellent doctor that was the “go to” guy in the department, he was adamant about introducing the new technologies of cardiac care into Christiana.  But where he really shown, was teaching the new cardiology fellows.

My family sat in the reserved first row of seats, filling both sides of the aisles.  We listened as each speaker spoke with enthusiasm about Mike’s contribution to the hospital.  Of course, we were grateful and happy.  At the same time, the tears were streaming down my cheeks and when I turned to look at my brother, John, beside me, his eyes were drowning , too.  My parents and Eileen and the kids were on the other side of the aisle.  I could only imagine the tug of war going on in their hearts.

The speech that moved me most was the one from my nephew, Chris.  I was so grateful for his words, his acceptance of this honor on the part of my family.  He said

“I’d like to start by thanking Dr. Gardner, Dr. Weintraub, and everyone else who helped to make today happen on behalf of my family. It means so much to us to have my dad honored in this way.

You all knew my father as a colleague and it’s that professional aspect of his life that we’re here today to celebrate. Many of you also knew him as a friend. My relationship with him was obviously from a different perspective.

However, if there is one thing I’ve come to realize about my dad over the past few months, it’s that he approached every aspect of his life in a similar way. And so I think that there is likely some common ground in what we each took from the relationship.

Many of my memories of my father growing up were also from working with him. Although, for me, it was working in the garden or around the house on Saturday mornings.

My dad was a do-it yourself kind of guy. No task was too daunting and I think he made my mom nervous on more than one occasion with the projects we attempted.

He was also a do-it the right way kind of guy. “Good enough” never was. And although I didn’t always share his zeal for perfection at the time, especially as Saturday morning turned into Saturday afternoon, he taught me what it meant to take pride in your work, to strive for excellence, and to make going above and beyond normal operating procedure.

He applied this philosophy to everything he did, whether it was running guys half his age ragged on the tennis court, growing baseball bat sized zucchinis in his vegetable garden, or even something as simple as putting up the Christmas lights, which always had to go in the back yard as well as the front even if only our neighbors would see them.

As we’ve heard today, he brought this drive to his profession as well. He was passionate about helping patients, passionate about honing the skills of his craft, and passionate about passing on his knowledge to others.

And although he didn’t talk much about his work when he came home, the outpouring of sympathy and respect from his colleagues, fellows, and patients over the past few months has been truly humbling and a testament to how successfully he achieved these objectives.

I can think of no better way to commemorate my father’s life than to continue to pursue these ideals. Having met many of you here at Christiana and the Echo Lab in particular, I’m confident that you share his passion and I couldn’t be more proud to have his name associated with the outstanding work you do here.

Thank you again.”

There was a beautiful luncheon served and we as a family were taken right away on a tour of the echocardiology lab.  As we walked down the hall, Dr. Gardner told me that after Mike died, there had been a ground swell of support to name the new lab after Mike.  It came on behalf of Mike’s colleagues who worked there.  He had left his hand in it so prominently, his striving for excellence for everyone who worked there, his insistence on the latest technology and finest care for the patients.

Michelle Marstom, RDCS, Supervisor of Echocardiography Lab, in the break room. Notice Mike’s picture top left above the family photos.

When we toured the lab, I poked my head around the corner where the nurses were hiding in the break room.  On the back of the door were pictures of their kids, and at the top was a picture of Mike, whom they called “Dr. P”.  Michelle Marston, RDCS, the supervisor of the lab, said they keep his picture there to remind them of his presence in the lab.

Below his smiling face in script it said, “Quality is job one!”  Michelle said each week they change the picture and put it up with a  different “Dr. P’ism”.

“He always used to say these things and he was always right,”  Michelle said.

I was touched to see 3 months after his death, they had incorporated a ritual to remember him.

Dr. Vinay Hosmane was one the first graduating cardiology fellows trained by Mike.  He told me the following “Dr. P’ism”.

Dr. Hosmane said when they were learning to read the echocardiograms, in the beginning, the echos all looked like indecipherable clouds of black and gray.  Mike would say to them, “Be a man. Take a stand.  Make a call.”

It seems many cardiologists will hem and haw.  Mike demanded those under his tutelage, as well as colleagues, call the echo, normal or abnormal, without beating around the bush to protect themselves for fear of being wrong.

I thought how profound this was for life outside cardiology.

Another fellow said on his first days as Mike’s student, he was given what seemed to him a huge amount of work to do for day one, Monday.  There were these plastic partitions dividing the office where they met.  The fellow was frantically checking the books, reading, and making last minute changes.

He heard Mike calling his name, his voice booming, “Reading is on your own time!”  Even though Mike couldn’t see what he was doing, he knew, and he was calling him on it.  He was a tough taskmaster and they appreciated it and it made them chuckle.  They all remarked how Mike did it with a big heart and was always fair.

Through all this, I have come to know that there were so many things I didn’t know about my brother.  I look at the others in my family and I think, “What don’t I know about each one of them?  How do I find out, while they are still alive, and I can tell them how much I appreciate them?”

Do you want to know something really odd?  After we had returned to Mike and Eileen’s house, I was sitting with her mom.  And she told me about how her husband had died at age 54 of cancer, the same age as Mike.  She said that he began to go to the doctor for treatments in the spring of that year.  He never told her what the treatments were for.  Then she took him to the doctor after Thanksgiving because he was having trouble walking.  The doctor told her he was being admitted to the hospital and would be dead in a couple of weeks.

That was the first she heard about cancer.  Her husband was dead before Christmas.

“So,” she said, “I know how hard it is to have this happen.  I know how hard the holidays are.”

I don’t believe in coincidence.  I believe in synchronicity.  I can explain it as energy patterns that spin around us, directing us to certain people, we become actors in this play of life, as hokey as it sounds.  At the end of it all, we get to read the entire script as well as our part in it, and it will make sense.

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