My LVAD lifeat9200rpms: Eleven days at the head of the transplant list and counting

     I have been on the 1-A list for a heart transplant since July 20.  That is 11 days into a 30 day span that all persons listed for a heart transplant can avail themselves of.

     From my perspective, my LVAD is working quite well.  I don't wheeze, I can walk a couple of miles at a time, I can climb stairs.  My CHF is under control thanks to my pump.

     When I had my normal 90 day followup yesterday at the U of MN, my cardiologist and LVAD coordinator gave me positive reinforcement for my time as a 1-A.  Both said that while they could not predict what will happen, their experience tells them that  my time for a matching donor is fast approaching.

      The prospect of actually receiving the gift of a transplant is difficult to comprehend.  It is at once scary and there is an emotional elation aspect to the notion.  Hard to describe. 

      I've only been listed for transplant since last Halloween, a relatively period.  Even former VP Chaney was listed for more than 20 months before he received a heart.  There is no standardized measuring unit for average time on the list.

      I am not complaining.  I am content where I am.  I feel my attitude is good.  What will be, will be. But I am keeping my fingers crossed.



     

     I

     

My LVAD lifeat9200rpms: Early AUSA days and The Usual Motion

    This post is courtesy of my heart pump, a HeartMate II LVAD, which has supported me for nearly 28 months since I succumbed to end stage heart failure.  I was a goner but because of the LVAD, I'm still going.  My advice: never quit.

     I made a career change from reporter to lawyer in 1978.  I found that all the same skills I used in newspaper work transferred to legal and trial work.

     The U.S. Attorney for the Northern District of Illinois in 1978 was Thomas P. Sullivan.  Tom was always a criminal defense lawyer in Chicago and had a first rate reputation among lawyers and judges for three decades.  Somehow U.S. Sen. Adlai Stevenson convinced Sullivan to accept President Carter's nomination for the position of the top federal law enforcement officer for the eight million people in Chicago and the northern third of the state.

     I applied to the U.S. Attorney's Office in my last semester of law school at Loyola University of Chicago.  I was covering the federal beat for The Chicago Sun-Times newspaper at the time.  I covered that beat since 1972.  The federal beat, which many colleagues and I considered to be a plum assignment involved daily reporting on federal agencies, the trial and appellate courts and the U.S. Attorney's office.  I worked as the federal beat reporter during the administration of three U.S. Attorneys: Jim Thompson, Sam Skinner, and Tom Sullivan.   Thompson went on to be Illinois' governor, Skinner became U.S. Transportation Secretary, and Sullivan returned to his lucrative law practice as a partner at Jenner and Block.

   When it came time to decide what to do with my newly minted law degree, my choices were to wait in line and hope to eventually be assigned to Washington to cover the U.S. Supreme Court or to present cases in federal court as a prosecutor.  The line to cover the high court was long and unrealistic.  Equally unrealistic was the notion that I could become an assistant U.S. attorney.  I applied anyway and went through dozens of interviews with members of Sullivan's staff, knowing full well that one negative vote of the hiring team would likely be a death knell to my application.

     Eventually, I got a face to face meeting with Sullivan and his First Assistant, Greg Jones.  The conversation took an adversarial tone when Tom asked me whether I would tell my friends and colleagues in the media about cases in the USA's office.  "Can you keep your mouth shut," he asked.  My reply was succinct.  I said no.  I told him my clearance as a Naval Officer was likely higher than his, and that I was not applying to become a federal prosecutor to make it a revolving door.  My friends and colleagues had the integrity not to ask me for privileged information and I believed I had the integrity not to share it, I said.

     Sullivan asked me if I had talked to my wife about the job and its demands.  I said I had.  Sullivan said I would be making 20 to 25 per cent less as a new assistant U.S. attorney than I was as a reporter.  Could I accept that?  Yes I said.

    The office was about to undergo a hiring freeze, Sullivan said, so I had to start before the end of the fiscal year, which ended September 30, 1978.

     I talked to my wife and accepted the offer.  I had yet to take and pass the Illinois Bar Examination.  No matter, Sullivan said, I would start as a Department of Justice law clerk and await the results of the bar exam.

     TPS, as he was referred to, hired me and five other 1978 law graduates without any of us having a law license.  We were all awaiting bar results, which were not due until late October.  We all passed and were sworn in as new lawyers in early November at McCormick Place on the Lakefront.  Tom orchestrated a swearing in for all six of us before the Chief Judge of the District Court, James Parsons.  Tom commented on the record during the swearing in oath of office proceeding that he would never again hire any lawyer who hadn't been admitted to practice. Too risky given the hiring freeze. He said he breathed a heavy sigh when he got word that all of us had passed the bar exam.

     In the weeks between starting as a clerk and being sworn in as an AUSA, all of us prepared briefs of cases on appeal to the Seventh Circuit U.S. Court of Appeals.  The Seventh Circuit was housed on the 27th floor of the Dirksen Federal Building and Court  House, 12 floors above the U.S. Attorney's Office.  None of the six prospective AUSAs had a case load and none of us could appear in court.  But we did have the chance to argue before the Appeals Court the cases we'd briefed, if we passed the bar and were admitted to practice before oral arguments were scheduled to take place.

     Once I was "legal" so to speak as an AUSA, I received a case load in the Criminal Receiving and Appellate Division.  One of the  assignments was covering rotating duty days, processing new cases, arrests, and search warrants for the federal law enforcement agencies:  FBI, Secret Service, Postal Inspectors, and the DEA among others.

     On my first duty day I handled the case of two men charged by Postal Inspectors with stealing mail from a letter carrier.  For some reason, the two accused were given summonses to appear before a federal magistrate.  At the scheduled time, I appeared before U.S. Magistrate James Balog.  Two lawyers, appointed by the court to represent the accused, appeared as well. But the accused were absent.

     I had been in Balog's court as a reporter for many cases over six years in the federal building.  We knew each other at work and had been together a few times socially.

     Balog saved my bacon that day.  His clerk called the case of the accused mail thieves and the lawyers stepped up and introduced themselves.  Their clients were absent.  The defense lawyers said they had spoken with their clients earlier that day and reminded them that it was important to be prompt for their court appearance.

     The magistrate looked over at me and I suddenly was struck dumb.  What I should have said was, "Your Honor, I move for the court to issue bench warrants for the arrest of the defendants."  Instead I stood for a very long minute.

     At last I got my mind in gear enough to say:  "The usual motion, Your Honor."

     Bang bang went his gavel as though he were awaiting any small hint from me of what the usual procedure should be. "The usual motion, your Honor" was enough for Balog to launch into a litany of the facts leading to this point and the issuance of bench warrants for the arrest of the no shows.

     I waited for the courtroom to clear and left.  I entered Balog's outer office and spoke with his secretary who ushered me into chambers.  There I thanked Balog for his quickness in covering for my rookie memory failure.  "No thanks necessary," he said, "it happens to all of us.  I'm glad I was there to help."





     

My LVAD lifeat9200rpms: Paying forward, Emergency Medical Technicians and LVADs

       I got the chance to be a "show and tell" exhibit for 60 plus EMTs at F-M Ambulance, the ambulance service in the Fargo-Moorhead area.  It was a work day for most of those attending because most were in uniform.

     The topic for the day was me and my LVAD, a left ventricular assist device, #8358 installed April 2, 2010 at Mayo Clinic.  The LVAD saved my life.

     I sought out F-M Ambulance to show and tell about my experience with my LVAD, a HeartMate II.  EMTs likely have heard of them but probably haven't responded to a 911 call involving a person with a heart pump.

     The uniforms of the EMTs were recognizable by their utility appearance: pockets everywhere, badges and patches of office. My uniform that day, like most days, consisted of an untucked long sleeve shirt.  The shirt covers the fanny pack-like pouch that carries my two-pound system controller.  I wear the controller at about belt level in front.  There are three electric leads in the controller; one each for the two batteries and the third connects the controller with the pump inside me.  The leads, I told the gathering, should not be disturbed on the 911 call or in the transportation process.

     Here is more of the show and tell:  I wear a shirt designed for undercover policemen to carry handguns concealed in velcro closed chest pockets.  The pockets for me are filled with batteries, one in each pocket, that allow the batteries to nestle under my arms.  They are out of the way.  The batteries are handgun sized and the pockets provide a secure carrying device. The shirts are made by 5.1.1 Tactical, a police type outfitter.

     Under the tactical shirt, I wear an elastic binder that is about eight inches wide.  The object of wearing the binder is to securely hold the lead that goes to the pump.  Injuries and infections to the site on the abdomen of LVADs are the main cause of serious problems for those with implanted heart pumps.  The site is treated like a wound and is dressed daily or every other day using sterile conditions: gloves, masks, surgical cleaning products, and sterile dressings.

     Once the new dressing is applied, Thoratec, makers of the LVAD I own, urge owners to make the so-called "drive line" as tight to the binder as possible.  The idea is to keep the drive line site from being disturbed, yanked, twisted by an LVAD owner's snagging a lead or dropping batteries or controller, which would tug on the site.

     These issues were part of the subject matter of my discussion and the Q and A with the EMTs.

      My HeartMate II is one of several LVADs that they may run across in their emergency service work. 

     Essentially, I told the group that just because I have an LVAD the EMTs in attendance on a 911 call should follow their own procedures.

     My best advice was to talk to the LVAD owner, if conscious obviously, or his caregiver.  They are the knowledgable ones.  They are the ones with information about how to assess any alarms the system may be displaying.   I told them to contact the individuals LVAD coordinator by phone.  Usually, the phone number is attached to the controller with a sticker, on a medical dog tag or bracelet and may be displayed on the LVAD's cell phone or luggage tag on his "go bag."

     Our vital signs may not be displayed on standard devices like other patients.  I happen to have an audible blood pressure with a standard B/P cuff and a stethoscope.  It registers best on my right arm.  My radial pulse can be felt but the ulnar pulse is weaker.

     One sure way to obtain a one number (mean) B/P is by using a Doppler (sound powered) measuring device.  Most EMT ambulances do not carry them.

     I told them that my LVAD is a continuous flow pump that supplements my normal heart function.  The VAD is a mechanical pump that supports my heart function and makes blood flow in people like me with congestive heart failure.

     The point is that because an EMT cannot get a blood pressure or pulse does not mean blood isn't flowing.  The opposite is true for me and likely other LVADs.

     Do chest compressions and follow CPR procedures as a last resort.  If I am breathing with no pulse or blood pressure, do not use chest compressions.  The pump is attached to my heart and could be dislodged or disturbed during chest compression. 

     The LVAD coordinator on call at the hospital is the best sounding board.  The contact numbers for my LVAD coordinator is on my medical dog tag, on my controllers, and on my phone.  Call the coordinator and confer.

      Take care not to twist any of the three power leads.  Do not disconnect any of them.  If batteries need to be changed, that is a simple task. One battery at a time.  Disconnecting both batteries stops the pump.

     I reminded the group that if the pump is disconnected for more than 15 to 20 minutes, it should not be restarted because of the danger of clotting inside the pump.

     During the Q and A, a couple of the EMTs wanted to listen to the pump sounds using a stethoscope.  I obliged.   I could not answer some technical questions and referred them to my LVAD coordinator. 

     Our local hospital, Sanford, does not currently implant LVADs but some of the cardiologists are familiar with patients with pumps.  I know of about a dozen LVADs in the Fargo area.  We are rare.

      So here we are some 250 miles from a VAD center.  There are three VAD centers in Minnesota: the University of Minnesota Fairview, Minneapolis,  Abbott Northwestern Hospital, also in Minneapolis, and Mayo Clinic's St. Marys Hospital, Rochester.

     If the EMTs and the LVAD coordinator determine that the LVAD must be transported to the emergency room or prepped for a life flight air ambulance trip, remember to take all the gear.  Specifically, they should make sure that all of the VAD gear:  power module and cords and display monitor and the battery charger, cord and batteries, and the "go bag" with back up controller and a set of batteries accompanies the LVAD.

     Next, I want to talk to the emergency responders at the local fire departments.  Talking to local police may come later.

     Thank you Thoratec for making possible my life post April 2, 2010.





     

My LVAD lifeat9200rpms: To be (a transplant recipient) or not to be...the wait continues

     I was minding my own business driving, yes LVADs drive, back from the cardio-rehab gym today when the Heart Transplant Coordinator from the U of MN called.  In brief I was told that a possible donor heart was available.  The coordinator reviewed my body mass statistics, changes in health since April, hospitalizations, blood transfusions.  I had none of the latter three.

     I was told to pack my gear (LVAD gear) and await a call from the people at life flight air ambulance service to fly to the Twin Cities.

     My wife couldn't believe it at first, but sprang into action alerting our grown son and daughters and dusted off and put into play our tentative plan for our kennel of pups.

     Within 30 minutes as I had my gear ready to go from home, the coordinator called back to tell me to stand down.  The surgeon said the donor's body mass was not calculated correctly because of massive swelling.  In short the heart would not work for me. 

     "Dry runs" are common, I'm told.  What this experience offered me was a chance to make the decision to go forward or to back out.  I was ready.

     Meanwhile, my HeartMate II continuous flow left ventricular assist device stands me in good stead at 9200 rpm's.  It's what keeps me ready, and I am grateful for it.

My LVAD lifeat9200rpms: Dr. King and hate in Chicago's Marquette Park

     This post is brought to you courtesy of those wonderful people at Thoratec Corporation, who have successfully assisted in the implantation of 10,000 HeartMate II LVADs, preserving so many  lives.  That includes me, LVAD #8358, which has been on-line and  performing as designed since April 2, 2010.  I am no longer wheezing, fatigued, unable to climb stairs, sit or lay sleepless and uncomfortable in the extreme.

     As a graduate student at Northwestern University's Medill School of Journalism in the summer of 1966, I was reporting from the Criminal Courts Building at 26th and California, looking for interesting trials.  I learned from the beat reporter for the Chicago Sun-Times that Dr. Martin Luther King Jr., who was living in Chicago at the time, would be leading a demonstration in the white Southwest Side neighborhood known as Marquette Park.  Since it was a slow day at the courthouse, I and other Medill student reporters headed for the site of the march.

      It was a hot, humid Friday afternoon in early August.  Dr. King came to Chicago to conduct non-violent demonstrations for open housing as part of the Chicago Freedom Movement.  Dr. King and his wife moved into a north Lawndale apartment the prior January, 1966, and from that base he and the organization, of which he was co-chairman, conducted demonstrations for integration of Chicago's notoriously racially segregated housing system.

     The Marquette Park area surrounded a park of the same name and that was to be the location of the open housing march to protest segregated real estate and rental policies.  It was one of many marches held by King's movement in the summer of '66. Eventually, the demonstrations and King's negotiations pressured the city's white leaders into making real commitments to open housing for all. The Chicago Real Estate Board finally agreed to open-housing laws in exchange for ending the demonstrations.

     It was stifling, in the mid-90s with a similar humidity.  A mostly young, jeering, all white crowd that numbered in the thousands confronted Dr. King and about 700 or so followers.  The anti-King demonstrators carried home made signs with provocative, racially charged sayings printed on them. "King would good with a knife in his back," one sign said. 

     The scene was volatile and ominous.  The taunting and jeering and racial comments were impossible to ignore.  The crowd threw rocks, bottles, and assorted other things including lots of firecrackers.

     As King marched, Chicago Police in riot gear walked between the anti-King demonstrators and King's group.  I and the other male reporters stuck out because we were in coats and neckties. The few female reporters were overdressed and easily identifiable by the mob.  As wave after wave of missiles flew, we all were targets.  

      Suddenly one of the missiles, a piece of a brick, struck King on the head, stunning him.  He went down to one knee and stayed there for a few seconds while his bodyguards and supporters surrounded him like a Secret Service protective detail.  But instead of hustling King from the area like the President's protectors, King continued to march.

      Thirty or so others were injured in the melee and 40  were arrested.  The demonstration concluded and Dr. King survived without further personal harm.  

     As a young reporter,  the brick throwing that felled Dr. King  made a significant impression. Insular and racist Marquette Park   is the same southwest side park where Frank Collin and his band of neo-Nazis held rallies and demonstrations in the 1970s. (See previous post on Collin).

      After the march, Dr. King told reporters why he marched.  "I have to do this--to expose myself--to bring this hate into the open." He was no stranger to such demonstrations but said there was a difference in Chicago.  

     "I have seen many demonstrations in the South, but I have never seen anything so hostile and so hateful as I've seen here today," he said.

     As he was about to leave the city in late 1966 after the Chicago Real Estate Board conceded, Dr. King called the open housing agreement and his efforts in Chicago a first step in a thousand mile march.

    My youngest daughter later saw an AP photo of Dr. King being hit in the head and asked me about it.  I felt like Bill Mooney (previous post about Stalag 17, the movie) and said "I was there."

My LVAD lifeat9200rpms: Oz, the Tin Man, and a new heart

Going to 1-A status on the UNOS transplant list gives me the willies.  As of Friday evening, July 20, 2012, the pre-transplant coordinator at the U of Minnesota confirmed that I'm now in 1-A status for the next 30 days.  I am using the term "the willies" as a substitute for saying I'm terrified.  

The words to the popular song that Oz never gave nothin' to the Tin Man that he didn't already have are very stubborn right now.  The lyrics and tune are running around in my head.  Thanks America.  

I've gotten this far, 27 months and 19 days downrange from my LVAD implant surgery, and I would not be here without old pump Number 8358 HeartMate II.  Do I really want to give up something that has given me back my life?  Or do I want to exercise the option of going through with a heart transplant?

If, successful, the transplant requires a completely new regimen of anti-rejection drugs for life.  I know there will be side effects from the drug therapy and those are not pleasant to contemplate.

So what makes a person like me, your ordinary 68 year old with a perfectly good heart pump, want to go for a transplant?  I've been asking myself that from day one on the transplant list.  The only answer I have is that I want to be around for as long as possible to interact with and to help my family:  partner, daughters, son, their families and our grandchild. 

The U surgeons transplanted two hearts Friday.  Is that a good omen?  It is good for the recipients but as I understand the situation it doesn't mean anything to my 1-A status.  If a matching donor heart is found, I'm told I get a call.

There are hiccups in the process.  The call comes to the 1-A person when UNOS's computers and statisticians declare a match for transplant.  At the same time a heart transplant team is dispatched to obtain the donated heart, assess it in person, and return with it to the U of MN hospital in Minneapolis.  The 1-A beats feet for the hospital.  Since I live in Fargo, 240 miles from Minneapolis, the air ambulance service is pre-arranged as my transport mode. It will be me my LVAD equipment and my wife.

Because the transplant isn't a go until the heart transplant recovery team obtains the donated heart and I am prepped for surgery, the operation could be scrubbed at any time until the heart surgeon begins opening my chest.  When a transplant operation is scrubbed, it gets chalked up to experience as a dry run.

Having been in the military, I accept the notion of "hurry up and wait."   

My LVAD lifeat9200rpms: Going to status 1-A on the heart transplant list

       The University of Minnesota heart transplant coordinator called today to say that I could spend the next 30 days, probably beginning tomorrow, on the U's heart transplant list in category 1-A. 

     That makes me ready, willing, and able to receive a donated heart, should one become available.

     The categories were developed by the United Network for Organ Sharing, UNOS (www.unos.org).  I am aware of the category I'm in now, 1-B, 1-A for those in greater need of a transplant, and category 7.  The latter category is for those who must travel more than four hours from their transplantation center. 

     It is usually a temporary reassignment to Category 7 for most LVAD's.  Some one who develops an infection, non-VAD related, or has a stroke, could be listed for transplant but in Category 7.  Cat. 7 is kind of a holding pattern.

    The notion of being bumped up to Category 1-A is at once scary and promising. I have been listed as a Category 1-B for transplant since last Halloween.  So far this year there have been 13 heart transplants at the U.   No guarantees, of course. None expected.

     I am, by most measurements, doing quite well with my LVAD.  My quality of life is quite good.  Every day is a gift.  I entered the transplant list as a category 1-B.  As I understand it that means that I have end stage heart failure but am being supported by a mechanical circulatory device.  

     Not all LVAD recipients are as healthy as I currently appear to be.   If an LVAD's pump fails, causes life deteriorating issues, or he/she returns to end stage heart failure despite the pump, that individual is likely to be placed in category 1-A.  That category has the top priority for an available organ donation.

     By UNOS rules, every Category 1-B listed can be temporarily placed in Category 1-A for a maximum of 30 days.  If no matching organ is available within that time, the individual reverts to Category 1-B.  I am told that most heart transplants occur while a listee is in Category 1-B.

    The categories are governed by UNOS, a private organization under contract with the federal government that manages the national organ transplant waiting list for all organs, heart, lungs, kidneys, liver, and pancreas.  

     UNOS maintains data bases and staff to determine matches of donors to recipients and an equitable distribution of available organs throughout 11 geographic regions of the United States.  Minnesota is in Region 7, along with North and South Dakota, Wisconsin and Illinois. 

     The UNOS staff is at it 24/7, 365 days a year. They match tissue compatibility by blood type, antibodies, body size/weight, and age.

     If a heart becomes available, the U of M sends a transplant team of doctors and surgeons to the place where the donor is located. That team makes an assessment of the organ as well.  Meanwhile, since I live in Fargo, I'll travel to the U of MN by air ambulance to await final word on whether a transplant is a "go".

    

Lifeat9200rpms: Renault Robinson, Mayor Daley, and U.S. District Court Judge Prentice Marshall

     
     This is another in an occasional series of entries made possible by my mechanical circulatory support system, an LVAD.  LVAD stands for left ventricular assist device.  My LVAD was perfected and manufactured to relieve symptoms of end stage congestive heart failure.  My thanks again to Thoratec Corp. for my HeartMate II.  I have owned mine, number 8358, since April 2, 2010.  So far, 10,000 HeartMate II's have been implanted.  

     As background, I worked at the Chicago Sun-Times newspaper beginning in 1963, first as a copy boy and later as an editorial assistant.  I was in college at the time and finished a degree in English literature in 1966.  My intention was to teach high school English.

     As graduation approached, I changed paths and decided I wanted to be a newspaper reporter.  Jim Hoge, the paper's editor said I had two choices:  get some experience on a smaller paper for several years or pursue a master's in journalism.  

      I chose the latter path and applied to Northwestern University's Medill School of Journalism.  I began work on the degree in 1966 and with interruptions obtained an Master of Science in Journalism in 1968.  But half way through I launched as a general assignment reporter in June, 1967.  

     Among my first assignments was to attach myself to beat reporters around the city:  federal building, city hall, criminal courts, State of Illinois building and the like.  I landed first in the press room of City Hall, in the hay days of the first Mayor Daley, Richard J. Daley.

     The Hall was covered for The Sun-Times by Harry Golden Jr.  Golden came from a Detroit paper as the replacement for Frank Sullivan, whom Mayor Daley made into his press agent.  Golden was a colorful (meaning irreverent among other things), experienced reporter with a distinctive New York accent, and two closets full of sport coats.  

      He must have owned more than a hundred coats, ranging from standard Navy blazers to brightly colored numbers that you might see at the race track. He could dress in a different outfit every day for at least six months.  And, while he was small in stature, he strutted like he owned the place.

     From my perspective, Harry was a throwback to the Front Page days of rough and tumble Chicago style reporting of the 1920's.  He was fast, accurate, and always had a story that he held back to blow the competition out of the water.  "Always keep a story in your back pocket," he advised, "for a rainy day." 

     Harry eventually became the dean of the City Hall press room.  When he started, the Hall was covered by the City News Bureau, Chicago Tribune, Chicago Daily News, and Chicago American which was later changed to Chicago Today.   During Harry's tenure some of the faces changed and the Mayor remained the same until he died in 1977.

     I showed up in the Hall press room and listened to the reporters banter for an hour before the Mayor's press conference.  We attended the gathering.  I took notes and Harry asked questions. 

      We returned to the press room and Harry called the city desk to  alert the assistant city editor that he had a Daley story.  Harry used an old Underwood manual typewriter all the time I knew him.  He never transitioned to a computer.  He generally lit a Lucky Strike, inhaled deeply, made a couple of sarcastic comments and poised to write his story, usually the lead paragraph and an outline of the rest of the piece that he would dictate.  His typing style was animated to say the least.  He pounded the typewriter, hands held high, and used a finger or two from each hand.  He talked as he typed.  If it didn't sound right, he kept at it until it sounded right.

    Golden talked as he wrote, sounding out his words, emphasizing some and striking through others that did not have the snap he wanted.  Typically he wrapped one leg around the other and his typing style was two fingered, using his index fingers.  He squinted through a cloud of smoke as he typed.

       He told me that the lead paragraph had to have a teaser that hooked the reader into the story.  "Keep it short--2 1/2 lines--or no more than 20 words," he said more than once during my internship at the Hall.

     This day he finished his Lucky and lit another as he reached back over his shoulder to a lower desk drawer and drew out a brown paper bag containing a pint of whiskey, Jim Beam.  Still talking to himself, he uncapped the bottle and poured a good shot into his coffee cup.  

     Harry was not paying close attention when he returned the bottle to the drawer.  It slipped from his hand and you could hear the bottle breaking inside the brown bag as it hit the tile floor. It was a muffled but unmistakable sound.

     He knew immediately his predicament.  "Goddamn," he said, "shot my dog."

     Without missing a beat he pulled a couple of bills out of his pocket and sent me across the street to a liquor store to replenish his "dog."

      Harry and the other regulars did a story, actually it was a continuing series, on Mayor Daley giving the city's significant insurance business to an Evanston insurance firm that just happened to employ his sons, Bill and the future mayor, Richard M. Daley.  "What's a man to do if he can't help his family?" the Mayor told reporters.

      At one point, in exasperation, the Mayor said that he would make his explanation at "the appropriate time."   

     "Meanwhile, if you don't like it, you can kiss the mistletoe hanging beneath my coat tails,"  his honor said.

     Golden relentlessly pressed the Mayor every chance he got to explain how the millions of dollars in city business went to Heil and Heil in Evanston.   No explanation was ever made.

     After Mayor Daley died of a heart attack, his body was laid out in an open casket in the area of the ground floor of the combined City Hall and Cook County Building.  Tens of thousands of Chicagoans passed by to pay their last respects to Daley.

     The press room crew of reporters came as a group.  My friend, Bob Davis, a Tribune reporter recounted Harry's next steps. Harry, who was Jewish, approached the casket, he knelt, made the sign of the cross and in a stage whisper said, "Is it time Mr. Mayor?  Is it time now?"



  

     

Lifeat9200rpms: How Harry Golden Jr. "shot his dog"

       
     This is another in an occasional series of entries made possible by my mechanical circulatory support system, an LVAD.  LVAD stands for left ventricular assist device.  My LVAD was perfected and manufactured to relieve symptoms of end stage congestive heart failure.  My thanks again to Thoratec Corp. for my HeartMate II.  I have owned mine, number 8358, since April 2, 2010.  So far, 10,000 HeartMate II's have been implanted.  

     As background, I worked at the Chicago Sun-Times newspaper beginning in 1963, first as a copy boy and later as an editorial assistant.  I was in college at the time and finished a degree in English literature in 1966.  My intention was to teach high school English.

     As graduation approached, I changed paths and decided I wanted to be a newspaper reporter.  Jim Hoge, the paper's editor said I had two choices:  get some experience on a smaller paper for several years or pursue a master's in journalism.  

      I chose the latter path and applied to Northwestern University's Medill School of Journalism.  I began work on the degree in 1966 and with interruptions obtained an Master of Science in Journalism in 1968.  But half way through I launched as a general assignment reporter in June, 1967.  

     Among my first assignments was to attach myself to beat reporters around the city:  federal building, city hall, criminal courts, State of Illinois building and the like.  I landed first in the press room of City Hall, in the hay days of the first Mayor Daley, Richard J. Daley.

     The Hall was covered for The Sun-Times by Harry Golden Jr.  Golden came from a Detroit paper as the replacement for Frank Sullivan, whom Mayor Daley made into his press agent.  Golden was a colorful (meaning irreverent among other things), experienced reporter with a distinctive New York accent, and two closets full of sport coats.  

      He must have owned more than a hundred coats, ranging from standard Navy blazers to brightly colored numbers that you might see at the race track. He could dress in a different outfit every day for at least six months.  And, while he was small in stature, he strutted like he owned the place.

     From my perspective, Harry was a throwback to the Front Page days of rough and tumble Chicago style reporting of the 1920's.  He was fast, accurate, and always had a story that he held back to blow the competition out of the water.  "Always keep a story in your back pocket," he advised, "for a rainy day." 

     Harry eventually became the dean of the City Hall press room.  When he started, the Hall was covered by the City News Bureau, Chicago Tribune, Chicago Daily News, and Chicago American which was later changed to Chicago Today.   During Harry's tenure some of the faces changed and the Mayor remained the same until he died in 1977.

     I showed up in the Hall press room and listened to the reporters banter for an hour before the Mayor's press conference.  We attended the gathering.  I took notes and Harry asked questions. 

      We returned to the press room and Harry called the city desk to  alert the assistant city editor that he had a Daley story.  Harry used an old Underwood manual typewriter all the time I knew him.  He never transitioned to a computer.  He generally lit a Lucky Strike, inhaled deeply, made a couple of sarcastic comments and poised to write his story, usually the lead paragraph and an outline of the rest of the piece that he would dictate.  His typing style was animated to say the least.  He pounded the typewriter, hands held high, and used a finger or two from each hand.  He talked as he typed.  If it didn't sound right, he kept at it until it sounded right.

    Golden talked as he wrote, sounding out his words, emphasizing some and striking through others that did not have the snap he wanted.  Typically he wrapped one leg around the other and his typing style was two fingered, using his index fingers.  He squinted through a cloud of smoke as he typed.

       He told me that the lead paragraph had to have a teaser that hooked the reader into the story.  "Keep it short--2 1/2 lines--or no more than 20 words," he said more than once during my internship at the Hall.

     This day he finished his Lucky and lit another as he reached back over his shoulder to a lower desk drawer and drew out a brown paper bag containing a pint of whiskey, Jim Beam.  Still talking to himself, he uncapped the bottle and poured a good shot into his coffee cup.  

     Harry was not paying close attention when he returned the bottle to the drawer.  It slipped from his hand and you could hear the bottle breaking inside the brown bag as it hit the tile floor. It was a muffled but unmistakable sound.

     He knew immediately his predicament.  "Goddamn," he said, "shot my dog."

     Without missing a beat he pulled a couple of bills out of his pocket and sent me across the street to a liquor store to replenish his "dog."

      Harry and the other regulars did a story, actually it was a continuing series, on Mayor Daley giving the city's significant insurance business to an Evanston insurance firm that just happened to employ his sons, Bill and the future mayor, Richard M. Daley.  "What's a man to do if he can't help his family?" the Mayor told reporters.

      At one point, in exasperation, the Mayor said that he would make his explanation at "the appropriate time."   

     "Meanwhile, if you don't like it, you can kiss the mistletoe hanging beneath my coat tails,"  his honor said.

     Golden relentlessly pressed the Mayor every chance he got to explain how the millions of dollars in city business went to Heil and Heil in Evanston.   No explanation was ever made.

     After Mayor Daley died of a heart attack, his body was laid out in an open casket in the area of the ground floor of the combined City Hall and Cook County Building.  Tens of thousands of Chicagoans passed by to pay their last respects to Daley.

     The press room crew of reporters came as a group.  My friend, Bob Davis, a Tribune reporter recounted Harry's next steps. Harry, who was Jewish, approached the casket, he knelt, made the sign of the cross and in a stage whisper said, "Is it time Mr. Mayor?  Is it time now?"



  





     

Lifeat9200rpms: Illinois Central Train Crash

     This reminiscence is made possible by my 27 month old HeartMate II LVAD, without which I would not be alive.

     At the time of this account, October, 1972, I had been the federal building beat reporter for the Chicago Sun-Times newspaper for about a month.  When I walked into the federal building press room, I turned on a radio I kept to catch the 8 a.m. news summary. 

     Instead of a news briefing, I heard a report on a commuter rail crash with many injured and killed.  It developed that this crash, which was the worst in Chicago’s history, occurred during the morning "rush hour" on October 30, 1972.

     It was early morning and I called the city desk to volunteer to go to the scene.  Basil Talbot, an assistant city editor, was in the slot and told me to go ahead to the scene.  I did not know that I would be the only Sun-Times reporter covering the crash for the rest of the morning. Another reporter, Paul Galloway, was sent out about noon. 

     I took a cab to the closest IC station, which was at 27^th Street, and went down to the platform. Chaos ensued.  Illinois Central Gulf commuter train 416, composed of newly purchased double decked passenger cars called Highliners, overshot the IC station at  on 27th Street between the Lake Shore Drive roughly Cottage Grove.  

     There are many rail tracks in the two block wide area.  Commuter tracks were on the western side. Later the Illinois Central Gulf commuter trains became what is now known as Metra.


     Train 416's engineer followed protocol and the chain of command and asked and received permission from the 416's conductor to back the 416 to the platform. This move was the made without the flag protection required by the railroad's rules.


     Unfortunately, Train 416 had cleared automatic block signals, which are intended to alert following trains that the coast is clear. Because Train 416 overshot the station platform and cleared the block signals, the way was "cleared" for an express train, Train 720 to move through the station without slowing.  

     Train 720 was composed of more heavily constructed single level cars, which would rip through Train 416's thin metal skin.  Train 720's engineer was unaware of the dilemma 416 presented and 720 continued at full speed on the same track. 

     The engineer of the express train did not see the bilevel train backing until it was too late. When the trains collided, the front car of the express train demolished the rear car of the bilevel train.  Train 720 sheared the last car of Train 416 and did not come to rest until it plowed through successive cars.

     In all 45 people were killed and 332 persons were injured.  After the accident, the ends of all commuter rail cars and locomotives in the Chicago area were painted with orange and  white stripes for better visibility.  But that day the rear of  Train 416 was unmarked.

     I arrived on at the 27th Street station on Chicago's near south side. There were many firemen and police present.  In addition there were teams of doctors and nurses from Michael Reese Hospital and Mercy Hospital, which are both within a few blocks of the crash site.

    The scene was chaotic.  I found the highest ranking fireman, a division chief, and stuck to his side until I could grasp the scope of the disaster.  No one knew how many were dead or injured. There was no central place to get solid information.  

     No one was overall in charge that I could see but the Chief was making his best effort.  Meanwhile, the medical teams began moving through the cars of both Train 416 and Train 720.

    I got in line behind one of the medical teams from Michael Reese and went through one of the 416 cars.  It looked like a slaughterhouse scene: moaning, bloody, unfathomable.  In my time as a reporter I never saw anything like it and hope I never will.  The teams were going through a triage assessment of the injured and inert bodies, some of which were alive but unconscious. Some of the team started IV drips in the injured.  Others ran back to the hospital ER for supplies.  Communications were non-existent among the medical staff.  They didn't have radios and cell phones were some years away.

     Triage, as I understood it, was the method of determining who needed medical help immediately to safe a life, who was next most seriously injured, and who was either dead or so close to dying that they were listed as hopeless. I had no practical experience with a tragedy of this proportion and had no experience with the concept of triage.

     About 10 a.m. the Tribune's mobile city desk arrived at track level.  The mobile city desk was housed in a bus with writing and phone accommodations for 15 to 20 reporters.  It had a teletype link to the actual city desk.  A marvel to behold.  The problem was that I was doing pretty well surrounding the story solo and the 20 Trib reporters began stumbling over each other and duplicating each other's work.  

     A mobile city desk is a good idea, but someone needs to be in charge to divvy up the story.  My solo reporting had me overwhelmed with what to do next so I did a sample of every facet I could think of.  I called the city desk immediately after I arrived.  There were still pay telephones at the time. I had to go a block of so to find one.  My communications with the paper were stretched to an hour.  When I finally  saw Galloway, I got to a phone and unloaded all the information I had gathered to two rewrite men.

   Then I went back to work.  By this time, just after the lunch hour, the medical people and fire department had run out of body bags.  Plastic bag substitutes were used, including zip lock type bags for body parts.  As gross as that sounds, it was necessary under the circumstances.  I have to admit, I lost my lunch a couple of times that day.

     The last person rescued was the engineer of the following train, number 720.  He was trapped in the operating compartment of his train and had to be helped with the aid of metal saws, jacks, and a cutting torch.  The jaws of life were in development.

      

Lifeat9200rpms: Skokie, Frank Collin-Cohen and the ACLU

      This is another in an occasional series of entries made possible by my mechanical circulatory support system, my LVAD, without which I would have been toast by now. 

     As I was about to finish law school at Loyola in Chicago, I worked days as a newspaper reporter covering the federal courts and agencies for the Chicago Sun-Times.  The year was 1977.

     Frank Collin, who was 33 at the time, was the leader of the National Socialist Party of America, formerly the American Nazi Party.  I was surprised to learn that Collin is still around. He is an author and self proclaimed witch, who served three years of a seven year Illinois prison sentence for child molesting. The criminal charges led to his ouster as head of the NSPA Collin was born Francis Joseph Cohen in November, 1944. 

     No one knew he was Jewish when he made his Nazi speeches, or led the NSPA.  That information was not something he willingly shared. In fact, Collin called his father a liar, when the elder Collin talked to a United Press International reporter about being Jewish and a Dachau death camp survivor, originally named Cohen.  Information suggesting Collin's Jewish ancestry was first published in 1970.  

     Collin gave a series of neo-Nazi "political" speeches in Chicago area parks and led demonstrations, including one in suburban Riverside. The creed he espoused was anti-black, antisemitic and anti-just about everything.  Chicago banned him from its parks.  He looked for another target.  

     He wanted to make a statement with his swastika bearing, brown shirted, jack booted, rag-tag irregular band of misfits and drew a bead on Skokie, Illinois.  Skokie is a near north suburb of Chicago that was home to the largest population of Nazi death camp survivors. Collin wanted to hold his demonstration on July 4, 1978.

     There were about 70,000 residents in the suburb in 1974, about 45,000 of them were Holocaust survivors or descendants of those sent to the camps.  You can imagine the intensity of the emotional climate surrounding a neo-Nazi demonstration under such circumstances.

     Skokie leaders refused to go quietly about their business and let Collin and his neo-Nazi band parade in their quiet village.  City leaders adopted several ordinances, essentially banning the Nazis from marching.  The laws were couched in the form of a parade permit ordinance, no parading in uniform bearing swastikas, and requiring a bond to indemnify the village against property damage.

     Collin and his Nazis could not get a permit and could not buy insurance.  In essence, Skokie had stalemated them. But would the village's ordinances withstand First Amendment analysis?

     Enter the American Civil Liberties Union and its main lawyer in Chicago, David Goldberger, himself Jewish.  The ACLU took on Collin's case because Skokie's anti-Nazi laws were an affront to the First Amendment of the U.S. Constitution.  

     Goldberger was criticized by the Jewish Defense League and Jewish War Veterans among other groups.  The ACLU in Chicago reportedly lost financial support and members as a result of the representation of Collin.  Two years after the neo-Nazi case, Goldberger became a professor of law at the Ohio State University's Moritz School of Law.

     Francis Joseph Cohen, then known as Frank Collin, came to the attention of the federal building press corps when he decided to lead a demonstration in Skokie, Illinois.  He threatened to march with or without a permit.  The ACLU filed suit against Skokie claiming violations of the First Amendment's guarantee of free speech and the right to assemble as applied to the state's through the Fourteenth Amendment.

     The case was one of those that underscores the need to protect the rights of us all whether we like those asserting the right or their message.  Justice Oliver Wendell Holmes maintained that we must defend "even the thought we hate." 

     U.S. District Court Judge Bernard M. Decker held a trial on the lawsuit December 2, 1977.  The following February, Judge Decker issued his opinion, holding all of Skokie's anti-parade laws unconstitutional. 

     Decker said, "The ability of American society to tolerate the advocacy even of the hateful doctrines espoused by the plaintiffs without abandoning its commitment to freedom of speech and assembly is perhaps the best protection we have against the establishment of any Nazi‑type regime in this country."  He was affirmed on appeal up to the Supreme Court of the United States.

      In the end, after some negotiations with the U.S. Department of Justice and Chicago and Skokie leaders, Collin and his motley crew abandoned the Skokie demonstration and instead marched on the federal post office plaza below an Alexander Calder sculpture,  entitled Flamingo, 53 feet high, some 60 feet long and some 20 feet wide, that dominated the plaza.  Pyrotechnics with no flash and no bang but a whimper under a flamingo. The compromise was good because it saved injuries, if not lives.  Skokie's anxiety was normalized.  I attended the Collin demonstration. There were about a dozen demonstrators, no counter demonstrators, no violence, and police made no arrests.  The First Amendment lives.


   

Lifeat9200rpms: Stroke SITREP

     Support groups for LVADs are important, in my view, because they give the pump owner a chance to compare notes, get answers, and share practical experience.

     My LVAD support group in Fargo meets monthly at Sanford Clinic and Hospital.  It is for those with LVADs and those with heart transplants, some of whom have had an LVAD before receiving a heart.

     At our meeting this week, a compatriot LVAD, who has had his pump since December, 2009, four months before I got mine, came to our meeting using a cane.  Something was up.  He never used a cane before.

     I learned that he had a stroke recently and had to be hospitalized.  Strokes are generally of two types: bleeding and clotting.  His stroke resulted from clotting.  He was told that his continuous flow LVAD damaged blood platelets. I have the same pump and have been fortunate so far not to have a stroke. Platelets are the clear cell fragments carried in the human blood stream that aid in clotting.  Apparently when they are damaged, platelets start the clotting process. And that can cause problems, including a stroke.

      He was told that his pump speed of 9,000 rpm's combined with his low INR (the International Normalized Ratio for clotting) caused the platelets to break up, leading to his stroke.  Once hospitalized, his HeartMate II pump speed was reduced to 8,800 rpm 's and his INR was increased.  The INR of a normal healthy person is about 0.5. The INR target range for most LVADs is 2.5 to 3.5. 

     The point is that since continuous flow pumps are machines, significant variations in clotting capability combined with pump speed can cause problems.  My pump speed is the working title of this journal: 9,200 rpm's. My INR range is 2.0 to 2.5.  I check it almost weekly.  All LVADs follow an anti-coagulation or anti-clotting regimen using Coumadin/Warfarin and some also use aspirin. 

     As a result of his stroke, my compatriot can no longer drive a car, because the drivers licensing authority suspended his license because of the stroke.

     He is recovering relatively well.  His speech is somewhat impaired but getting better.  He hasn't lost his sense of humor.

     Being on the list for a heart transplant is another issue.  The heart transplant listing authority, UNOS (United Network of Organ Sharing) rules require that those LVADs who suffer a stroke be downgraded from category 1-B to category 7.  Essentially, those in Category 7 are temporarily out of consideration for a donated heart, should one become available.

     There are many aspects to medical and self-management after an LVAD is implanted.  Despite all of that, my quality of life is excellent.  My wife and I just hosted our 18-month old granddaughter and her parents, which I would not have been able to do without the miracle that is my pump.