Dr. Ryan Pfannenstein DPM is a phenomenal human being. Although I met Dr. Pfannenstein on one of the last days of my hospitalization, I didn’t know of his generosity until my follow-up appointments with him. Dr. Pfannenstein is knowledgeable, capable, and professional. He has such an enthusiasm for his profession. He is so generous with his time. No appointment is hurried. No question is unanswered. No fear belittled. No ignorance uneducated. All of his attributes are the cornerstones of a fantastic physician.

Yet Dr. Pfannenstein has something far more precious than these attributes. Once during an examination I had taken off my shoe and my sock and placed them on the floor. While talking to me Dr. Pfannenstein casually reached down and rolled my sock into a proper ball, placed it inside my shoe, and placed shoe and sock on a chair. This attention to detail seems superfluous but it is indicative of his manner. Dr. Pfannenstein reminded me of my innate dignity. I feel confident in his abilities. I feel assured of his compassion. I feel surety in his judgments. He has a fundamental decency that is exceedingly rare. Dr. Pfannenstein is the finest physician I’ve ever met. I am blessed to be his patient.

Whenever I feel the stress of life or the pressure of perseverance and I’m tempted to smoke - I remember Dr. Pfannenstein. It would be so unjust to waste all his work.

February 16, 2007

 

Three years ago on a Saturday in August I walked into the trauma center at Regions Hospital. I had spent the night before on the floor of my living room in a ball. I knew I was seriously ill. I knew I had no insurance. I knew I couldn’t afford the medical bills. I knew I couldn’t afford not to go. I had accepted death. I had not accepted defeat. I wasn’t suicidal. I went to the ER.

It would make for better reading to say the rest is a blur and that I woke to find a kindly doctor standing above my head gently waking me with the good news that he had saved my leg. Yet the truth is that I remember all of it. I remembered every goddamned terrifying and traumatic moment of it. I remember Karen’s eyes as they took me into surgery. I remember that Mike took residence beside me as they wheeled me down the hall.

Three years later I remember the people who were so kind and I recall the nobility of their actions. I remembered to seek each of them so I could offer my gratitude in person. And I have. Every. One. Of. Them. I spoke profusely because I knew their humility would discount my proportion. I wanted them to know they mattered. I wanted them to know there was one man in this world who knew who they were and who remembered what they did and who cared that they existed. I know. I care.

Three years later I remember the kindness of Jennifer. I remember Sandy’s smile. I remember Amy’s enthusiasm and her green shoes. I remember Luke’s humor. I remember Lee’s stories. I remember Brendan taking the x-rays. I remember Jerry wheeling me down the hall. I remember Francis putting in the pic line. I remember Brian’s kindness as I went into surgery. I remember Matt’s eyes as he put me to sleep. I remember Marie and her graciousness. I remember Dr. Mateo and his humor. I remember Ryan’s confidence and assuredness as he shook my hand before surgery and put me at ease. I remember Donna as she patiently taught me to wrap my foot. I remember Christine wiping my forehead. I remember Dorthea holding my hand. I remember Derek reminding me that humor is the best medicine in the hall. And God remembers them too. I remind Him everyday.

Three years later I remember to check my blood sugars in the morning. This morning it was 76. Three years later I remember to hold a mirror in my hand as I check my feet for wounds or infections. Three years later I remember to measure my Wheaties and curb my appetite to remain thin. I eat my cereal from a cup- not a bowl. 3/4 of a cup isn’t a meal but it’s maintenance. I have two feet. I have two legs. We earned them.

I listen to the lamentations concerning the cost of healthcare. Yes. It is expensive. But what is just compensation for someone who has prepared all his life for the critical moments in ours? How is compensation measured? Healthcare is a partnership of people. Who shouldn’t be paid? Jealousy and coveting prevents an unencumbered reply. Yet gratefully we have a just God who compensates with compassion.

I’m a man of meager means. I offer my gratitude, I offered my talents, and I offered my service. I followed up with every department that participated in my care. I offered each department my encouragement and my gratitude. I offered each department my talents. Whether they accepted my endowment or scoffed at my gift isn’t my concern. I sit on a stool in the hospital twice a week so that I can offer support, cheer, hope, and humor to everyone that passes. People ask me, “How are you today?” and I reply “I’m cheerful.” And it’s true. I sit there and I am full of cheer as I cheer them along their way. Empty hands could be thought of as useless. Or they can be accepted as available to offer a shake or a clap.

Last week I walked a man and his child to the fifth floor of the hospital. I had spent a week on the fifth floor. And for a moment the memories flooded my mind. I steeled my mettle and I walked down the hall as I remembered the kindness of the staff. Later - I sat in the hall and I heard a woman talking to her companion. And I recognized her voice. She had spent many nights comforting me and consoling me during my hospitalization. And I started to cry without tears. Margaret. I had forgotten Margaret. I told her of my remembrance. I offered her my gratitude.

I remember.
I’m grateful.
I’m humbled by your nobility.
I thank God for all of you everyday.

August 11, 2007

I set a few ground rules for myself when I began these confessions. Although I didn’t anticipate the breadth of this blog - I did envision writing about my journey. Yet I was adamant that this would not be a journal. I’m not going to write about the books I read, and I’m not going to write about the films I see or the concerts I attend or the friends I visit or the women I know or the daily doings of my family. I’m not interested in evolving this into a diary.

I write about God because we’re all thirsty. Whether it be water or wine, we all search for the quench. I write about the wells of water I see, the wetness I taste, and the dank that sometimes drowns.

I write about relationships because we all experience encounters that are rarely unique yet are never so opaque that we can’t see a lesson or share a laugh.

I write about the hospital because it’s where I encounter the greatest variety of people. An employee of the hospital told me that she felt it was a great experience to work at the hospital because she was able to see people at their best and at their worst. I think that’s true.

I’m self-employed so I spend hours a day writing words and working with words and yet not speaking a word. Today I shared three conversations with three doctors that altered the way I saw my world. And although those conversations are private, my new visions will indirectly be reflected in snippets of my posts. I think that’s of greater interest than whether or not I think Britney Spears will be able to make a comeback. There’s enough verbiage devoted to societal garbage.

I’m at an amazing crossroads of the evolution of my existence. I am privileged to meet, to admire, and to befriend an amazing group of people doing an amazing volume of work with an amazing degree of integrity. Doctor’s privileges: I never knew it meant the privilege to be privy to the profundity of their work.

I’m blessed to have the opportunity to reciprocate for their kindness by providing a chronicle of their achievements, a memorandum of my observations, and a record of my enlightenment. And I’m quite grateful that you read my observations and share my journey.

August 21, 2007

Ok … I listen to my doctors. I do. I’m a diabetic and I was told to maintain my weight. And I do. I was told to examine my feet. And I do. I was told that I need a flu shot each autumn. And I get one. As a diabetic who used to be on insulin, I’m not afraid of a needle.

So I went to my local Walgreens today to get a flu shot. I paid my $24.99 and I waited in a line with the elderly. I can honestly report that I didn’t witness any older men or any older women burst into tears and scream from pain. They set the standard so I knew I had to maintain my dignity. There was a very attractive young woman administering the shot. So I slipped a cheerful smile on my face and I sat down. She asked the rote; she made a note. And then she stabbed me.

Oh no. I didn’t select the wrong verb. She stabbed me. It’s a wonder I can type with the wound. I’m not the type to complain so I stood up and sucked up my screams and I flew out the store. I wasn’t aware of what would be in store for me. I’m in pain. I ache. And no, I’m not just bellyaching over something quite minor.

I’m just in the state of shock. I’m wondering if she committed a misdemeanor in this state. I know it’s a misnomer to call her a nurse since I’m the one who is going to have to nurse myself back to health. I told my tale to one of my best friends. He’s a doctor and I sought a little sympathy. Well he laughed. Health care? I don’t think he cared at all. He just rolled his eyes. I pointed at him and told him that’s exactly what my eyes did when I was stabbed. Ok. I exaggerated. He still didn’t care. What the hell - I took a shot.

October 10, 2007

Lately I’ve had a number of diabetes complications. I’m very disconcerted. I don’t know – I thought that if I kept on an even and disciplined course – I’d lull it to sleep. I quit smoking three years ago. I’ve maintained my weight loss. Although I don’t count carbs anymore, I do count portions. I spend a portion of my day monitoring my blood sugars. I limit the work of my feet and I check their underside each morning with a mirror. But recently I’ve learned there is no upside to diabetes. So, I was either naïve or just goddamned stupid because I felt quite surprised and very disappointed when the complications popped up like a pimple on a prom day.

I try to be realistic about my future. A couple of years ago, I sat in an emergency room with my feet dangled while an emergency room doctor examined me. I asked him a question. I said that I wanted to avoid being “whittled.” Well, he looked at me and laughed. My bluntness stunned him. I said, “Well isn’t that exactly what we’re talking about here?” And he said it was exactly the right word. He told me he was also a diabetic and he wanted to avoid being “whittled” too. We shook hands as partners with the same problems. Fortunately a recent podiatric problem was quite minor and with a tweak from the formidable Dr. Ryan Pfannenstein, I’ve avoided any slice/chop/whittle for now.

I’m dealing with my other complications as they emerge. Last night I sat at a bar with my buddy. He’s an internist. He had arrived a bit ahead of me so I found him in a booth with his beer. I took off my jacket and sat down. He looked up and said, “what’s up with you?”

“Nothing,” I replied, “what’s up with you?”

“No,” he said. “You look like shit. What’s going on?”

“Nothing,” I said as I reached for a menu.

“How’s the diabetes going? Tell me,” he commanded. He’s older than I am so he feels he can boss me around.

“Oh am I paying you?” I said as I looked at a page of the menu. “Oh that’s right. I’m not.” He’s my friend; he’s not my doctor. I volunteered for a couple of years at a hospital. I have buddies in all the departments. I don’t whore my friends. I don’t discuss any medical conditions with anyone I don’t see in a professional capacity. My friends know I’m firm.

“Shut up and talk to me,” he admonished.

“How can I shut up and talk to you?” I chided.

“Mark, I’m serious. Talk to me.” I looked up at him and talked; he listened. “Write this down,” he said. “Here’s what you want to ask Bob.” He knows my doctor. I quietly listened and wrote down his words.

Sometimes you don’t even know what to ask. Sometimes you don’t know you should ask. Yet sometimes God puts you in the right place at the right time with the man who knows the right questions. And then I don’t question my response. I recognize the synchronicity of Divinity. The only thing I have to do is feel grateful.

March 5, 2008

His feet dangled in the water and waved as she sliced the lengths of her pool. She mesmerized him. Her movements were hypnotic. Her kicks were methodic and measured. She silently swooshed with her limbs. Her strokes severed her path.

His mind didn’t lapse into daydreams. The heat from the sun paled under the warmth of his desire for her. His arms steadied his weight as he waited for her to bob up at the end of her swim.

Her head cleaved the water as she bounced to a halt. “Hey you,” she burbled as her hand whooshed the wet from her face. She pressed herself against his legs. Her breasts brushed his feet. He bristled at their touch. His legs waved wide as he wrapped them around her back. He pulled her near and bent for her kiss.

“Don’t,” she whispered.

“You don’t want me to kiss you?” he pulled his head back and waved his legs away from her waist.

She ran her hands down the length of his limbs and felt his shins shake until she handled his heels in her hands. “Hey, don’t do that to me,” she shushed. She inched her lips against his chest as she guided her hands down the length of his feet. He yanked them away before she touched his toes.

“Goddamn you! Stop it!” he withdrew his legs and whisked them against the pool wall.

She took a step closer and touched his instep. “Come on baby, it’s nothing,” she soothed. She palmed the place where his toes used to be.

He reclined against his arms and tried to drag his legs out of the pool. He smashed his ass into the shale as he freed his feet from her fingers. She grabbed his ankles as soon as his feet hit the deck. “Let go of me!” He jerked his knees to his chest and toppled on his back. His skin scraped against the stones.

She climbed out of the pool, pulled her suit straps up her shoulders, and walked over to a bar near her seat. She picked up her pack, placed a cigarette between her lips, and lit it. Two puffs and she was ready to speak. “You’ve got to get over it,” she exhaled. She grabbed her towel and dabbed the damp.

“There’s nothing to get over,” he stumbled to his feet and straightened his skewed trunks. He frantically searched for his shoes.

“They’re right behind you,” she exhaled.

He grabbed his shoes. “Why do you have to do this shit to me?” he pulled on his shoes. “Huh? This is the first time in years that I’ve gone barefoot outside and you have to make something out of it. Jesus Christ you’re cruel!”

“I’m not being mean,” she picked up her glass of tea and took a sip. “I just wanted you to know it didn’t bother me.”

He tied the last shoelace and straightened his legs. He stood up and walked over to his chair. He picked up his bottle. “Well it bothers me!” he guzzled a gulp. “You should have considered that it bothers me!”

“Well it shouldn’t,” she pulled her wrap from her chair, twirled it around her hips, and wasted no time tying the knot. “You need to get over it Mark,” she sat back into a seat and swung her legs up onto the lounge. “You’re taking everything too far.”

“What? What am I taking too far? That I don’t want you to touch my foot?” he pitched his empty bottle into the trash. “Shit, it’s the only part of me I don’t like touched. Why is that so weird? Huh?”

“It’s not just that honey,” she flicked her cigarette into the metal ashtray on the side table. “Look at you. You’re too thin. You’ve lost too much weight.” She shifted in her seat and picked up the sunscreen. She squirted a glob into her palm. “You’ve taken everything to the extreme.” She rubbed the lotion into each of her limbs.

She rubbed him the wrong way. “Hey! Just because I don’t want you to touch my foot doesn’t make it a character flaw.” He grabbed another soda and backed onto his chair. “Christ! Talk about extreme! Did it ever occur to you that I’m humiliated?” he twisted the top off of the bottle and threw it into the bin.

“Over what? You’ve lost a couple of toes. So what? You’re a diabetic. It happens.” She leaned back into her lounge and tilted her face to the shine. “But you’re gaunt now. It’s not a good look for you. You’re not good looking enough to be gaunt.”

“Well Jesus Christ, you’re a fun party aren’t you?” He put his soda to his lips and slopped it down his chest toward his trunks.

“Oh hush,” she turned her head toward his face and shaded her eyes with the shield of her hand, “it’s just the God’s truth. You should be glad I love you enough to tell you the truth. The biking is good but you need to find a balance about your weight. You’re too thin.”

“No one else thinks I’m too thin,” he closed his eyes and sunk into the sun.

“They don’t see you without your clothes on,” she drew her legs up and angled them with her feet on the seat. “I can see all the bones in your back.”

“Oh Christ get off me please,” he said with his forearm over his brows.

“Baby, what are you so afraid of?” she swung her feet over the side and sat on the edge of her seat.

He took his thumb and forefinger and whisked the sweat from his eyes. “Irresponsibility,” he said. “I’m afraid of irresponsibility.”

She stood up and walked to his side. She bent and sat beside him. He shifted his ass in his seat and made room for her. She put her palm on his thigh. “But you’re not being irresponsible Mark,” she soothed. “You said your podiatrist said your foot never looked better. Right? Your blood sugars are all good. Right?” She patted his leg. “It’s gonna be good sweetheart.”

He shifted his body to the edge and made more room at his side. She sank to his side and put her head alongside his. He cradled her in his arm. “I’m not afraid I’ll be irresponsible. I won’t be. I know me. I know who I am. I know how to maintain. I refuse to lose my legs or my feet.” He kissed her forehead before he went ahead with the conversation. “And I’m not going to disappoint them.”

“Who? Your doctors?” she seemed puzzled.

“Yeah, to a degree,” he admitted. “I mean I know they aren’t even paying attention. I haven’t lost my sense of proportion. But when I volunteered at the hospital I used to talk to all of them. The residents were so full of hope. They had read all these theories and had all these plans and hopes. But the doctors were so weary. They knew they weren’t going to make that much of a difference. A lot of them were so brokenhearted,” his hand lazily stroked her arm. “And I used to say, ‘count of me. I’ll do it. I’ll show you that medicine works. I’ll prove it to you. Watch me man.’ And they would laugh at me. Not in a mean way. They’d laugh like I was this simpleminded dolt who didn’t quite get how the world worked.” He closed his mouth and echoed its action with his eyes.

“It’s noble,” her hand brushed against his hip. “It’s a little unrealistic though - don’t ya think?”

“Nope,” he reached over her to grab his glasses from the table.

“You should maybe get contacts,” she studied his face. “You’re better looking without glasses.”

“Can’t,” he rubbed the sweat off of the top of his head. “I can’t risk the infections.” Their breaths matched as they soaked in the sun. “Don’t you see kid,” he began, “all my life I’ve been so disappointed. People always told me there wasn’t a God. People laughed because I carried a Rosary. You know, like I lacked the intelligence to see the folly of faith.” He took his hands and wiped the sweat off his chest. “And I’d say, come on man - I’ll prove it. Tell me what you need and I’ll get it for you. And they laughed and then I’d pray my ass off. And He’d give it to them. And then they’d avoid me because they were afraid. So when I ran into them again, they’d stand and explain to me how it wasn’t God. They told me it had all just worked out.” He stretched his legs and arched his back to get a better position. “And never once did anyone ever say to me, ‘you’re right. Prayer worked.’ But I know it did. I know it does. So. Medicine works. I don‘t want them to think they did it all for nothing. I don‘t want them not to have hope.” He reached for his bottle but it was beyond his grasp. “Hey baby, will ya hand me my soda?”

She handed him the bottle and then stretched out along his side. Her hand touched his belly; his hand caressed her arm. “So you want them to know the work was worth it,” she sighed. “Hey, you’re getting sunburned. Turn over.” She reached for the sunscreen.

“No, I want them to know it’s possible,” he flipped on his stomach. “I want them to know it’s not all just a theory. Just once I want them to see it in the flesh. I want them to see the possible one time.” She rubbed the lotion into his shoulders as she straddled his legs. “And then when people tell them it can’t be done, they’ll know it has been done. And they can grab that fact and hold on to it when things feel hopeless.” He tipped a sip of his soda. “Hey, diet soda sucks in the summer,” he assessed.

“We should try making lemonade with Splenda,” she grabbed him around the waist and gave him a squeeze. “Don’t get too thin on me,” she nuzzled into his neck.

“Ok, I’m getting in the mood to get touched,” he whispered as he flipped between her knees and landed on his back. “We could work up to my foot.”

“Oh you’re all worked up,” she giggled. “That’s obvious. You want to go inside?”

“No, let’s swim a couple of laps before we do,” he pulled away and sat upright. “I’m all sticky from sweat.“ He untied his laces, removed his shoes and handed them to her. He stood up and walked barefooted toward the pool. She couldn’t see him wince. But she knew it was possible.

 
 
July 16, 2008
© 2007-2008 Mark R Trost

Today is the fourth anniversary of my trauma with my diabetes and my foot.

I’m in a melancholy mood. In some ways - my life is drastically better. I’m thinner. I’m healthier. I’m happier. I’ve met the greatest friends. They know who they are. Anyone who reads this blog - knows who they are.

I realized this morning that most people will never take the time to start at the beginning and read my evolutions, my revolutions, and my revelations. I’m sorry they won’t because I wanted these people and their moments marked. But I’ve marked them. I’ve mentioned them. I remember them. They’re marked on my heart. They are remarkable human beings.

I thought about them this morning. I thought about my life this morning. I thought about this blog. This blog is the account of my life. It’s the chronicle of my search for enlightenment and my struggles for sanctity. It’s all here: my heroes, my heartaches, my loves, my losses, and my triumphs.

What is not here is my defeat. I have not been defeated. I sit here with both of feet resting on the floor beneath me. But it’s not beneath me to offer those who know - my gratitude, my friendship, and my affection.

I do not walk alone. And neither do you.

 

 

 

August 14, 2008
© 2007-2008 Mark R Trost