death – Go Retire Psychiatrist

Slow Down, Tithonus

What I sometimes don’t like about the X-Files episodes were the esoteric titles. One of them was “Tithonus.” I watched it again last night. It’s about a police photographer named Fellig who claimed to be about 150 years old because he cheated death sometime during the days of Yellow Fever in the U.S. in the 18^th through the 20^th centuries. He was in a hospital sick from Yellow Fever but didn’t look at Death, which was some kind of entity taking those who were dying from Yellow Fever. Death took his nurse instead because she looked at him.

Ever since then, he’s been trying to catch a glimpse of Death mainly by following people around who he somehow knew were about to die. I think the idea was that if he caught up with Death and stared at it, then he could finally die, because by this time he’s so tired of living that he’s attempted suicide several times. He often acts like he’s in a hurry to catch a glimpse of Death.

The main way Fellig knows who is about to die is because they look black and white instead of in living color. Agent Scully is working with another investigator who believes Fellig is a serial killer. Fellig looks at Scully and she’s monochromatic (black and white) which means she’s about to die. So, he tries to stick close to her so he can get a look at Death. The other investigator shoots Fellig and the bullet also hits Scully. Fellig tells her to close her eyes and he finally gets his chance to look at Death and dies. Scully survives.

So, that preamble leads me to talk about the title “Tithonus” a little. Tithonus in Greek mythology was this rich mortal with whom Eos, the goddess of dawn, fell in love. She made him immortal but forgot to give him eternal youth so he gradually because a shriveled up, demented old fart. This led to some pretty intense arguments between them:

Tithonus: So, here I am, senile because you neglected to give me eternal youth when you gave me immortality. This is just like the time you made me a Braunschweiger sandwich, but instead of using my favorite spread, Miracle Whip, you used mayonnaise!

Eos: How does that even make sense? I try my best! You should use your walker more often; then you wouldn’t trip and fall so much.

Tithonus: Excuses! And you hide my Geritol!

So, Eos turned him into a cricket to interrupt his constant babbling.

Anyway, occasionally I think about my mortality because I’m not getting any younger. I’m more forgetful. I can’t walk as far as I used to. I can still juggle, but I’m beginning to accept the fact that I may never be able to do the shower pattern or the off the head trick. Sena and I still play cribbage, but I’m starting to notice that I make certain mistakes in counting that I didn’t make in the past. I can’t stay up as late as I once did.

On the other hand, I can get along without certain things like TV, mainly because I notice I enjoy reading more. I ignore the news a lot more than I formerly did. I would rather listen to music or watch the birds. I admire Sena’s garden from our back windows, where I can watch the dawn arise.

I’m in no hurry.

Hickory Hill Park Ramble

We visited Hickory Hill Park today in Iowa City. We’ve lived in this area for 30 years and have been near it but never walked a trail until now. It’s full of trees, birds, and other wildlife, including deer, which seemed to pose for the camera.

I say we’ve been near it because we have visited Oakland Cemetery, where the famous Black Angel monument is. At least one of the trails leads to one end of the cemetery—which we discovered today.

There are many legends about the Black Angel, most of which are in the vein of various curses and some of which claim that the curses can kill visitors—not true, of course. Many take selfies in front of the Black Angel and toss coins in the base (probably to ward off any curses, just in case).

I was feeling pretty reckless on the day Sena took a snapshot of me in front of the Black Angel. I left a little pocket change. That was a few years ago. The object of the visit was not to visit the Oakland Cemetery but to take part in the picnic and Psychiatry Department Matball Challenge game, Faculty vs Residents at Happy Hollow Park about a block away from the cemetery.

Anyway, it was pretty hot today, in excess of 100 degrees with the heat index. We kept the walk short for that reason. It was warm, but the tree canopy kept the heat down a little. There’s something about walking through a thickly wooded area in which most of the sounds you hear are of nature. It tends to make me a little reflective.

Because I’m in my last year of a phased retirement contract and will fully retire next year, I’ve been thinking about transitions, the end of one era of my life and the unknowns about the beginning of another. There are a lot of unknowns. Sometimes I feel a little lost.

Retirement tends to lead me to think about death, which is pretty morbid, I know. I don’t ruminate about it, but walking past some of the park benches, some of which are memorialized to certain persons, got me to wondering about the next bend in the path. On one of them was a small plaque bearing a quote,

“Not all those who wander are lost.”
JRR Tolkien

There was a baseball on the bench.

And not long before we got to that bench, we saw a shoe, apparently lost by someone—who might have been lost. Hickory Hill Park is big. A person could get lost in there.

We followed a path that others seemed to be taking. It led to the back of Oakland Cemetery where we saw a couple of headstones which puzzled us. The names were very familiar; man and wife, with only the birth years carved in them. But the strange thing was—as far as we knew they were still very much alive! The man had been the closest thing to a mentor that I could remember ever having.

Naturally, later I realized that it was just that they had thought through their own transitions a lot farther than many of us do. They had planned not only for retirement. They had planned for their own deaths. But until I finally got it, I actually searched on the web for obituaries.

Strange, I actually found a pdf file posted that sort of sounded like one—an exquisitely written letter from a relative who described the person we knew in enough detail that it seemed to identify him beyond much doubt. Why would such a beautiful and presumably private remembrance be posted on the web?

Maybe because the relative wanted the world to know how deeply loved this person is—while he is still alive.

I Wonder

There are now 3 eggs in the robins’ nest. I saw a big turkey vulture soaring close by. I wonder if that’s what got the House Finch chicks. The bird that made a noise with it’s wings that was as loud as a big sheet flapping on a line in the wind, and looked too big to be a crow or even a raven–I wonder.

I wonder if I somehow was partly to blame for the murder of the baby birds, always messing around the tree. Still, I take pictures–and maybe draw death nearer.

And that leads to other strange thoughts. It’s odd that the nearer I get to retirement, the more I think about my life way before I ever even thought about medical school.

I remember the first time I ever heard about death was when I was in kindergarten. My mother woke me up early one morning to tell me that Steven, one of my schoolmates, was killed the evening before. He was playing around the railroad yard just a few blocks from our house. A train ran over him.

I remember my mother talking about it but I didn’t make any sense out of it. I was too young. I only wondered what it meant.

When I was a difficult teenager and made a conscious effort not to smile for pictures, I remember hitchhiking along a lonely highway in a bad rainstorm. I was glad when the man pulled over. I was not glad when he began to rub the back of my neck and asked, “How about a ride for trade?” I was not too young to know what he meant. When I said, “Let me out,” he did. I was too young to know that was miraculous.

I sometimes catch myself wondering if my life has been a grand illusion since then, only to protect my fragile soul from knowing the true horror. Maybe the driver really didn’t let me out. Why should I wonder that?

I remember a man who taught me how to do the work of a land surveyor. I looked up to him. He committed suicide by shooting himself in the chest over a failed relationship. I couldn’t help wondering why.

Of course, death visited me several times after I became a physician. They sometimes led to decisions I would rather I had not made about the direction of my career. I always wonder.

My Brother

Sometimes I think about my brother Randy, who died 19 years ago. His last days were made immeasurably easier by the caring staff at Hospice of North Iowa. He worked at a local artificial ice company for many years. He died when he was 43 of cancer, before either of our parents died.

Jim Amos
Randy Amos

He will always be remembered for his generosity, kindness, and infectious sense of humor. A sense of humor ran in the family, despite hardships. He had a raw, honest, and often boisterous passion. We treasure everything he gave us.

Even the courageous way he let go of his life was a gift. He died as he lived, in the arms and in the hearts of the people who loved him.

I learned a valuable lesson about that. On his last day in the hospice, I was determined to be with him up to the moment he died, staring down death in his face. I’m still not sure why I wanted to do that.

Then a couple of his long-time friends stopped by to see him. Death watch was interrupted as we visited in his room. I faced them, reluctantly taking my eyes off him. They talked to me, sharing their memories of him while he was alive. I soon became painfully aware that there were many who knew Randy in ways that I did not know. He was a dear friend and even a surrogate father to many.

They talked; I listened and learned. I lost track of the time. When there was a break in their discourse, I quickly turned back to Randy. He was already gone. He had slipped away while his friends, his other family, were sharing something with me far more important than my death watch. I learned more about humility that day than I can recall learning ever since. There is a brick in the driveway of Hospice of North Iowa on which is etched the message, “He ran his race.”

Randy was a track man in school. He could outrun just about anyone. He was also pretty fast on his gold flake Schwinn Stingray bicycle. I notice there are vintage Stingrays going for thousands of dollars these days. He could fishtail and wheelie like nobody’s business.

My father used to say that the only difference between me and Randy was that he could cook and I couldn’t. There were a few other differences.

Through an unfortunate circumstance that I still don’t understand, Randy was my patient on our Medical-Psychiatry Unit in the late 1990s, shortly after he was diagnosed with cancer. I would never have done this by choice, but it seemed there was no one else to cover the unit at the time.

He was delirious, probably from an accidental overdose on opioid pain medicines during a difficult stage in his cancer treatment. It’s really not possible to describe the conflict I had about being both his brother and his doctor. It should not have happened—but it did. He didn’t recognize me. He mumbled. He twitched. He drifted in and out of awareness. I knew all the signs; I saw delirium every day in the hospital.

But this was different because this patient was my brother. I will never forget. After that, I had a much better understanding of what families goes through when they witness delirium in a loved one. I will not miss this part of my job when I retire.

Randy was my best man at my wedding in 1977. I bought him a nice pocket watch, which was buried with him. I do not visit his grave not because I don’t love him, but because I would rather remember him as he was.