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".

    

Life at 9200 rpms: Looking tanned and fit

     I recall the following as if it were yesterday.  My LVAD makes these occasional musings possible.

     Fred Hubbard was a Chicago Alderman from the 2nd Ward.  His day job put him in charge of funds from the federally funded Chicago Plan, which was aimed at job training for minorities.

     Sometime in early 1972, Ald. Hubbard disappeared from Chicago.  He took with him about $100,000 in federal funds that was taken from the U.S. Department of Labor program grant.  It turned out that Hubbard gambled with the money in Las Vegas.  He lived the good life for some six months.

      Eventually Hubbard was indicted on fraud charges, and was tracked by the U.S. Marshals Service to Las Vegas.  As a fugitive from justice, Hubbard was returned in custody sans stolen funds in the custody of U.S. Marshals and appeared in U.S. District Court in Chicago with his attorney wife, Arnette Hubbard.  

     Bob Davis, the Chicago Tribune reporter in the federal building, grabbed me by the arm and said to follow him.  Davis got advance notice of Hubbard’s appearance and I was the new guy for the Sun-Times in the building.  We developed a strong professional relationship and were good friends.  I learned much from Davis and prized his friendship.

     At any rate the appearance was short.  The courtroom was crowded.  It was good that Davis took me under his wing because I would not have known Hubbard on sight and likely would have missed the story.  His case was called by the deputy clerk of court and up stepped a black couple, Fred and Arnette Hubbard.  The brief appearance disclosed none of the background information.  Davis had it all.  The whole hearing start to finish lasted less than five minutes.

     Back in the pressroom on the 21st floor of the Dirksen federal building, Davis and I called our city desks to report the story.  Davis was given a rewrite man to take dictation. The rewrite man was apparently asleep or did not know that Hubbard was black.

      Trying to be funny, Davis dictated his lead paragraph with a straight face and tone:  Ald. Fred Hubbard (2nd), looking tanned and fit, pleaded not guilty to federal charges that he embezzled $100,000 from a federally funded jobs program and spent the money on a Las Vegas gambling spree.

      Clearly, the “looking tanned and fit” was not intended to get into the newspaper. But it did.  The phrase ran in the first edition.  It got past the city desk review, the copy editor who wrote the headline, the news editor who was in charge of getting the story set in type, and other layers of review.

      I did not have either temerity or the courage to be flip about the story.  I played it straight.  In this case, straight was good.

      Davis was called about the phrase by the night shift assistant city editor.  It was intended as a flip remark, Bob said, not for publication.  The phrase was axed from the story.  Davis kept his job. If anyone complained, it was explained away. 

More from my life at 9200 rpms: for tonight you'll be guests of the Queen

     Here is another of my occasional musings made possible by my LVAD.

     During a pre-trial hearing in U.S. District Court, the federal prosecutor was defending the arrest and detention of two U.S. citizens accused of stealing $4.3 million about Halloween of 1973 from Purolator Courier Inc.  It was touted as the largest cash heist in the U.S. up to that time.  

     I was a reporter for The Chicago Sun-Times newspaper covering the federal building, which included the U.S. District Courts and the U.S. Attorney’s Office. 

   The two accused thieves,  Luigi DiFonzo and Paul Marzano, were detained on the runway of Grand Cayman Island as the plane they had boarded was about to take off for Costa Rica. The detaining officer was the head of the The Cayman Islands constabulary. The Caymans are a British Overseas Territory.  

     Costa Rica does not have an extradition treaty with the U.S. If DiFonzo and his cohort left the Caymans, they would likely have been untouchable. Ironically, DiFonzo was acquitted at a trial, while his confederate Paul Marzano was convicted. 

     The plane was delayed for takeoff on the orders of Detective Superintendent Derrick Tricker of the Cayman Islands Police.  Tricker made it clear during his testimony that his police force had no relationship to Scotland Yard and implied that any confusion to the contrary would be slanderous of his department.

     Tricker was testifying before U.S. District Court Judge William J. Bauer.  Tricker kept trying to standup in the witness stand as is customary in British courtrooms. The chair in the witness stand would swivel  but it was bolted to the floor and would not allow Tricker to standup straight.  He called the judge “your Lordship,” which Bauer relished.

     Tricker described the event.  He had received information from the FBI that DiFonzo and Marzano were on Grand Cayman, that they were suspected of robbing Purolator in Chicago, and that they were preparing to leave for Costa Rica.  The information was reliable, Tricker concluded, and he agreed to question the pair on the aircraft as it prepared to taxi for takeoff.

     The Detective Superintendent related how he walked onto the aircraft ahead of two FBI agents from Chicago, apparently youthful types who did not know the powers of a Cayman Islands police superintendent.  The FBI agents were crowding Tricker.  The agents apparently wanted Tricker to rush up to the pair and arrest them with gusto. Tricker said he told them to stand pat near the forward door of the aircraft and that he would handle the task at hand.  

      He walked up to the seat where DiFonzo and Marzano sat.
He asked them to identify themselves.  It is a crime under Cayman and British law not to identify yourself to a policeman. The pair used false names in identifying themselves. Det. Supt. Tricker asked the men for identification.  DiFonzo produced his plane ticket and boarding pass.  Marzano, it turned out, had eaten his ticket once on board.

     Tricker said little else. He turned on his heel and walked back down the center aisle and away from DiFonzo and Marzano, much to the consternation of the two hovering FBI agents.  He started back up the aisle of the aircraft toward the waiting agents. Over his shoulder in a loud clear voice, Tricker said: “Gentlemen, please follow me for tonight you’ll be guests of the Queen.” 

      FBI agents are imbued with the notion that they should  take charge or at least to do something. After all they were with the FBI and not some rink dink local law enforcement agency.  The rivalry between the FBI and any local police usually has the FBI considering itself superior to all others.  It was a legacy of the Hoover years.  These two young agents were no different.  They were anxious to get on with the case.

     The two bureau men didn't seem to get that the bad guys weren’t going anywhere.  Tricker was in charge, not them.  The aircraft was grounded by Tricker, pending DiFonzo and Marzano’s detention on Grand Cayman.  

     The next day the pair was accompanied by Grand Cayman police to Miami, where, at last, the FBI agents, which has no extra territorial jurisdiction, took them into custody.

     

Musings At 9200 RPMs: William Mooney and the "snot nosed kid"

     My LVAD has allowed me some time to reflect about things that  randomly leap out at me from years ago. Before I was a lawyer, I was a  reporter for The Chicago Sun-Times newspaper. One of my friends worked for the sister newspaper of the Sun-Times, the Chicago Daily News.  William Francis Mooney, whose father and son were both named William Francis Mooney, was a genuine old school reporter out of The Front Page.   

     The Front Page was a play by Ben Hecht. Ben Hecht lived the stories behind the play as a Chicago journalist. Essentially, it is the story of rough and tumble Chicago  journalism in the 20s.  Mooney would have fit in well.  He was a fast talking, hard drinking, chain smoking, fast walking, fast working, dedicated newsman.  His politics were clear:  He was 51 per cent against all politicians before they opened their mouths.

     I first met Bill Mooney in the middle sixties, when we would cross paths on assignment. I was a newly minted reporter in 1967 and fellows like Mooney were legendary.  He was in his middle 40s and I was a "snot nosed kid" of 22.  He liked the term snot nosed kid and he used it a lot.  To him it was a descriptive term and not one of pure derision, although to the uninitiated, it seemed to be a put down.  In truth, when you begin as a reporter you have no experience and are "a snot nosed kid," like it or not. He was simply telling it like it was.

     I got to know him well when he was covering the income tax fraud trial of former Illinois Governor Otto Kerner.  At the time, Kerner was an active judge on the U.S. Court of Appeals for the Seventh Circuit, a seat Kerner's father held before him. The IRS agents proved to a federal jury's satisfaction that then Gov. Kerner and his state revenue director, Theodore Isaacs, took bribes from the horse racing industry in Illinois in exchange for favorable racing dates.  In the end, the testimony and eventual verdict showed the crassness of Kerner and Isaacs.  

     Kerner went through a withering cross examination by the lead prosecutor, U.S. Attorney James R. Thompson. By the end of the second day of cross, Kerner was sullied and bowed. In fact, he said at one point something to the effect of Mr. Thompson, I'll bet you were going to ask me...

     Thompson said, "No governor I wasn't going to ask you that but go ahead and answer the question." Mooney knew the jig was up for Kerner.

     The next morning before the trial resumed, Mooney typed out a mock news story lead and posted it on the press room bulletin board.  It said: Former Governor Otto Kerner threatened to pay back the bribe money during the third day of cross examination in his tax fraud trial.

     Mooney was a wisecracking, no nonsense personality. He started at City News Bureau in the mid-30s.  Typical of his zeal for  a cause, he couldn't wait for the United States to get into the war, so he joined the Canadian infantry in 1940 and when the U.S. entered the war, he transferred to the U.S. Army Air Corps. 

     In all he spent about four and a half years in Europe, almost two years of that time as a German prisoner of war in the infamous Stalag 17.  He joined the war effort and eventually the bomber he crewed in was shot down over German held territory and he and surviving crew members were imprisoned as POWs. 

     After the war he joined the Daily News and stayed at the paper until the paper stopped publishing in 1978. During those 30 years, Bill was an intrepid investigator. He led the Daily News to a Pulitzer Prize in the investigation of Illinois State Auditor Orville Hodge in the '50s.  Hodge was indicted, tried, convicted, and sentenced to prison for financial fraud.

     By the time of the Kerner trial, Mooney had been a reporter for more than 35 years.  His war years were not usually a subject of discussion. His prison camp was Stalag 17.  As he lived it for those war years, Stalag 17 was not a pleasant memory for Mooney.  And he did not know that it would become the title of a Hollywood production, and could have cared less.

      But Stalag 17 became the title of a 1953 feature length movie written and directed by Billy Wilder starring William Holden among others.

     Mooney told the story about a young Mike Royko, a "snot nosed kid" who'd just gone to work for the Daily News when the movie was released. Mike Royko, is the same Royko, who was a thorn in the side of the first Mayor Daley, won his own Pulitizer for commentary in 1972, and rose to be a well respected daily columnist for the Daily News.  But at the time Royko had just seen the movie and to say he was enamored of it was an understatement, Mooney told me.  Mooney and Royko got on well in later years and Bill told the story out of fondness.

     At any rate, as the story goes, Bill was working the middle watch slot at the paper, preparing copy for the next day's first edition as an assistant city editor.  The middle watch is a time when the afternoon papers had put their final edition to bed. The middle watch was mostly dead because there was no staff, no writers, one editor, no printers, no copy boys, and no paper to publish anything in.  Bill was editing stories for the morning edition and was concentrating on his work, when Royko rushed into the city room to tell Mooney about the movie he had just seen.

     Bill continued to mark and edit copy while Royko tried to interrupt him and engage Mooney in conversation. Royko didn't know about Mooney's connection to Stalag 17 and said, "Mr. Mooney, I just saw the best World War II movie,  Stalag 17."

     Mooney never looked up and replied, "Kid, I was there," in a conversational low tone. It was a factual statement but Royko wouldn't quit.

     Undeterred by Mooney's comment, Royko, who could not contain his excitement, said, "No, Mr. Mooney, you don't understand this movie is about a German prison camp for American and British flyers in WW II."

     "Yeah, kid,"  Mooney said,  "I was there." 

     "No. Mr. Mooney, I mean William Holden is the main character in this one.  He does a good job." 

     "Kid," Mooney said, "I was there.  Holden wasn't.  I don't need to see the movie.  I lived it for 22 months."

     Royko slunk away.  Royko usually sauntered.  I never saw him slink. Mooney made him slink.

    In the 70s just after the trial of former Gov. Kerner, Bill was part of a team of reporters who uncovered a bribery scheme in the Metropolitan Sanitary District, that led to the indictment and conviction of Sanitary District officials and officers of Ingram Barge Co. of Nashville.  Bill covered that trial for the Daily News and I covered it for the Sun-Times. 

     In 1978, when Mooney was 60, the Daily News stopped publishing.  Many reporters were absorbed by the Sun-Times and many others, including Mooney, were terminated.  They got retirement packages but were out of a job.  

    Knowing Mooney's situation, I talked to him and to some friends at the Illinois Bureau of Investigation about him.  In short, Bill was hired as a special investigator for the IBI and worked their until he died in 1984. He learned of my good words about him and thanked me.  I occasionally ran into him in the hallways of the Chicago U.S. Attorney's office where I was an AUSA. The IBI sometimes brought cases to the federal prosecutors. He was only 66 but he had a serious heart condition and only one lung at the end.  I think he  liked snot nosed kids.

Ripeness is all.

     "Ripeness is all."  It's a line from Shakespeare's King Lear.  A father, who has suffered and persevered, is about to give up on life and die in hiding.  His son urges him not to give up, and to endure life through all the obstacles, setbacks, and disabling events that all of us must face.  

     Man must endure.  It is part of the human condition.  Hence, "Ripeness is all."  Don't give up before you're done.  Keep on fighting.  It is not your time.

     The line capsulizes for me what having an LVAD means.  I'm not done yet just because I'm battery operated. There is more to come.  Embrace the whole catastrophe as Zorba the Greek said in a memorable line. 

     This week Dolly's and my granddaughter, Aria, (she's on my lap in the photo accompanying this narrative) came to visit us in North Dakota.  It is her longest road trip yet.  A darling at 18 months going on 30:  determined, inquisitive, skeptical, accepting and much more.  She walks, she talks, she smiles, she cries. 

     Without the mechanical circulatory support device called an LVAD, I would likely have missed meeting her by about nine months.  With an LVAD, I can be Gramps.

     I remember my granddads with fondness.  I'd like to be around to watch her grow up.  This heart pump has given me that chance.  I am thankful more than I can say.  Life is good at 9200 rpm's.

     "Ripeness is all," for me means facing what comes and doing the best I can.  Last night about 1:30, my neighborhood in Fargo had a brief power outage. Of course, I did not know it was a power outage until morning when I saw the clock on the microwave in the kitchen was flashing, begging to be set. 

     As one who depends on a consistent flow of electricity through being plugged into a machine or by battery operation, power outages are serious.  I came awake to multiple alarms audible on my various systems. I flipped on the light, coming out of the fog of sleep.  I looked at all my warning lights.  No power to the pump.  Not good. I reached for a pair of charged batteries and was about to switch to battery power, when the audible alarms silenced and normalcy returned.

     Further sleep eluded me as I dozed with an eye and ear open for  another alarm.  No further alarms occurred.  No life lesson here only a hint at the philosophy side of things: yesterday is the only easy day.

Lost and Found, Mostly Found

      Have you ever lost something and fretted about it to the point of distraction?  I'm sure we all have.  Then, if you find the thing you lost, you tend to feel whole again. 

     But when something is lost and gone forever you tend to think about what you took for granted all this time. That point in life can be very distressing. Now it's gone and not coming back.  Part of this human condition has to do with the glass half full or half empty notion.  I'm not sure one is a pessimist when the glass is seen as half empty.  There was a loss, after all, and it is not coming back.  The question for me became ok so I've lost a lot of my heart function, but I have an LVAD so what do I do now.  I chose to accept my condition and move on.  In Jesse Ventura's memorable movie line as he is wounded in the jungle by hostile forces but continues to do battle:  I ain't got time to bleed.

    Some 500,000 persons develop congestive heart failure each year.  Many with the condition do not survive or survive for long. Even fewer survived a short 20 years ago.  A few fortunate CHF sufferers are diagnosed  and some of those can be treated.  Few can be cured.  For most it is a permanent condition.

     Among the few who can be treated, an LVAD may be just what was needed. An LVAD is mechanical circulatory support for an ailing heart.

      I took for granted the condition of my Chevrolet heart, as the cardiologist called it.  Over a short time, the Chevy heart deteriorated and became suitable only for the junk yard.  The the left ventricular assist device happened and I got back much of what I lost.

      It took more than a year to regain endurance and some strength.  I lost 50 pounds or more in the hospital and literally had to learn to walk again. My balance was shot, I had an unsteady gait, and stairs were a significant challenge.

     Now, with the help of cardio-rehab specialists I use the treadmill and other equipment for 45 or more minutes a day, five days a week. I haven't reached my limit but I do not expect to run a marathon or even a 5K.  I feel about as whole as I will feel under the circumstances.  I lost a lot but found more than enough to live my life.  For me that is a win and I'm grateful each day.  Life is not a destination.  It's a journey.  The journey continues.