Sunday, 8 February 2015

Parenthood

Last week the final episode of the weekly television show Parenthood ended after 6 years.  The show depicted a family consisting of two liberal baby boomer parents who had 4 children and several grandchildren.  The show was produced by Ron Howard, who should be give props for amazing storylines, genius casting and generating superb acting performances. 

The show touched on many of the issues most of have experienced or may experience in our own lives.  There were the relationships – the patriarch and matriarch, the parents and their children, the in-laws, the ex-husband and ex-wife, the boyfriends and girlfriends, the siblings, the grandchildren, and other people who became important parts of the collective story and the individual stories.  Then there were aspects of life the show highlighted – marriage, divorce, single parenthood, interracial relationships, diversity (one of the grandkids and one of the adults had Asperger’s Syndrome), adoptions, infidelity, drug use, college dorm life, abortion, post-traumatic stress, same sex relationships, self-doubts, chasing dreams, new beginnings and losses.   The common denominator for all members of this family was their love for each other. 

Parenting has no play book.  I guess the closest thing is Dr. Spock’s Baby and Child Care book first published in 1946 which my mother used as a parental reference tool. There is no perfect way or best way to parent.  There is a tendency for us to parent as we were parented because that is what we know.  It’s generally trial and error with the first kid, and then those experiences help set the mold for parenting the kids that come along later. 

A new movie recently hit the cinema called Black or White.  The premise of this movie is a man becoming a single-parent to a mixed-race grandchild that is coupled with the challenges of race and cultural differences.  He learned raising his grandchild was nothing like raising his daughter.

On the last episode of the Parenthood show, the patriarch was reflecting on his life as a father with his daughter and asked her, “was I a good father?”  Her response with tears in her eyes was, “the best.”  What a powerful scene. 

I suppose that is the circle of life.  Most of us seek approval from our parents growing up and then as life’s clock winds down for us, we seek approval from our kids for our body of work as parents. 

I would settle for a yes to the question above while I continue to strive to be a better dad and hopefully the best grandpa. 


Sunday, 14 September 2014

The Reality of Risk


On average 1 out of every 20 people who are admitted to a hospital will incur a hospital incurred infection.  My father did, which contributed to his earlier than expected departure from this world. 

 It is estimated that 98,000 – 400,000 people die every year from preventable errors and accidents made within hospitals.  I am not sure what qualifies people to be included in these numbers, but last week I believe my mom could have been in that pool.

My mother on all accounts for her age was healthy.  Osteoarthritis in the knees, high blood pressure controlled by medication, restricted vascular flow in her lower extremities, and excess weight were the only medical conditions she had, none of which significantly impaired her daily life activities. 

On Saturday, August 23, she took a tumble which resulted in breaking her wrist and a hairline fracture of her pelvic bone.  She was admitted to the hospital on Tuesday, August 26, because she was not independently mobile.  She was put on heparin to mitigate the risk of blood clots and given pain medication for the pelvic bone injury.   She was stuck 7 times in an attempt to start an IV without success.  There was considerable bruising as a result.  A decision was made to insert a PICC line.  Surgery was performed on her wrist on Wednesday August 27, that required 3 pins to keep things together and aligned.  All seemed well post-surgery – except for her erratic blood pressure and pulse that measured from her legs.   One leg measurement consistently indicated inflated numbers, while the other leg yielded lower numbers (red flag #1).

I happened to be in Memphis during last weekend of her hospitalization. I visited her each day I was there.    On Friday, she looked pale and tired, but alert.  She had complained about not being able to urinate (red flag #2).  She was put on a medication that was to help relieve the arthritic knees.  She was concerned about the side effects of the medication.  Two weeks prior to her accident, she had received the final round of knee injections that provides lubrication for the joints.  My mom told me that medication had given her some relief.  She expressed fear about her current situation and made the comment “if I ever get out of here,” more than once.  On Saturday, she looked better and had gotten up with assistance to go to the bathroom and was able to empty her bladder.  She was looking better.  Things were looking better.  On Sunday, I went to her room before I left town and gave her a cell phone that I bought for her on Saturday.  This would enable her to get emails and re-engage with people on Facebook as well as call anyone as much as she wanted without any cost to her.  I told her my daughter would teach her how to become competent in using this device after she was discharged.  As I left, I felt a sense of fear from her, but I gave my best pitch of encouraging reassurance that all would be ok in the near term.  I had every reason to believe that she would be going to a rehab center to get her back on her feet again within the next week.

Fast forward to Tuesday.  I called her about 4 p.m. and we talked until after 5 p.m.  She sounded optimistic about being discharged to a rehab center within a mile from her home as soon as Wednesday, provided they could get her blood pressure and pulse rate under control (red flag #3).  She was apologetic for not having yet used the cell phone…that was my mom – concerned about everyone else’s feelings before her own.  She said her only concerns were being a bit short of breath and had a dizzy spell when she got up with assistance to go to the bathroom (red flag #4). 

On mid-morning Wednesday, September 3, I got a text that my mother was transferred to CV ICU because of her erratic heart rate and shortness of breath.  Throughout the day her condition rapidly declined to the point that they had to intubate her and connect her to a ventilator.  Around 6 p.m. she experienced the first of two codes and I told my sisters to forgo any more attempts since the inevitable was near.  Around 8 p.m. the priest from the parish she attended for over 40 years arrived to give the anointment of the sick (formerly, last rites) blessing and she died the moment he ended the prayer. 

In retrospect, as a non-clinician I identified 4 symptomatic red flags, all of which independently could be attributed to the stress of the injury, reaction to the new medications, pre-existing condition: vascular flow, obesity, arthritis, etc.  Together, these red flagged symptoms played a part in her overall health condition.

Could other things have been done to reduce the risk of her mortal outcome?  Certainly.  But, would the outcome have been any different?  We will never know.   In the end, is this death classified as universal fate, God’s will or a death that might have been prevented? 

Sunday, 20 July 2014

Risk and Accountability

Do no harm,” is the core conduct of civility that allows some semblance of peaceful coexistence.  This ethical tenet is foundational to the human condition.  An event in the past week has violated this often unstated, but understood code of decency.

None of us ever knows with absolute certainty what will happen from one moment to the next.  As we leave the doors of our “safe” homes, just what is in store for us?  The world is full of potential harm.  Risk is inherent in everything we do.  Harm to self, harm to others, harm by self, harm by others.  Harm can be physical, emotional, financial, or relational.  I can be intentional or unintentional. 

Every time since 9/11/2001 when I board a plan, I participate in an effort to mitigate risk of harm by terrorist activity by going through a security checkpoint.  I don’t fancy the drill, but at the same time I don’t mind knowing my flight might be a bit safer. 

This week Malaysia flight MH17 was reportedly struck by a surface to air missile in the Ukraine that killed all 298 people on board.  I would imagine these passengers probably initially felt that same aforementioned degree of safety I do when they boarded their plane.  And then the unfathomable and the unexpected happened.   

The plane was generally considered to be in a “safe” zone from risk (> 32,000 feet) along this route even though there had been two military planes shot down in that area in the past week.  This was a gross miscalculation of risk.  This is one occasion where there was not any human error by the pilots or mechanical failure of the plane.  It was a systems issue.  Why was this air space considered safe in light of what had transpired the week before?  Was it negligent or reckless behavior to believe it was safe space?

In my work, I see the risk of potential harm in healthcare too often.  The potential of the wrong patient, the wrong procedure, the medication administration error, hospital-acquired infections, etc. is alive and well in all U.S. hospitals.   I read the transcripts of congressional hearing around patient safety held last week and had correspondence with one of the presenters after the hearing.  The patient safety advocate’s position is to increase efforts to reduce the risk of harm that kills up to 400,000 patients each year.  They believe the only way to effectively mitigate this risk is to get the government involved.  The airline has a national safety board sponsored by the FAA that has proven to drastically make commercial airlines safer and healthcare should have the same type of oversight. 

There are only so many finite resources.  Choices have to be made over which values are more important than the others which compete with each other for those resources.  To date, the U.S.  has allocated much in the name of safety.  Yet, we have a constant battle of political posturing over too much government versus no government oversight.  That’s not the issue…the issue is what is the right thing to do?”  The right thing is “do no harm.”  This should be the overarching value of our civil existence and our policy.    

So this is where the accountability comes into play.  Should there be a global organization that identifies at-risk airspace and restricts commercial planes from that area?  The events that have occurred since the plane came down have been criminal. There has been blatant disrespect for people (the passengers and their surviving families) and intentional efforts to mask the truth.  The fingers are pointing at the Ukrainian separatists who are allegedly supported by Russia.  It is a diplomatic firestorm that the world is now engaged in.  Which organization or country or countries will take the lead in attempting to reconstruct what just happened and punish those found guilty of the crimes committed? 

It’s times like these where the eternal optimist becomes a bit cynical and jaded about the internal goodness of his/her fellow humans.

Friday, 29 November 2013

Taking a Peek into the Future


Death is our destiny.  None of us with any preciseness can declare when our where that time will come, but it is the byproduct of life as we know it and it is inevitable.  We can do nothing to alter this fate.   Cryogenics can put it on ice and delay it, but eventually we will succumb to it in the end.

As we live, we see others leave us long before they have lived a full life.  I ask, “why them”?  There are multiple elements and circumstances to be analyzed, and even then, it is hard to arrive at a definitive reason.  As I mentioned in a previous post, timing is everything.  Being at the wrong place at the wrong time is fraught with hazards.  Risk is everywhere all the time.  When adding human behaviour in its various forms to the mix it makes the time of our final destination much more variable.

As I move into the early autumn of my life, I wonder, “what’s ahead for me?”   It’s not that I am macabre in nature or narcissistic, but whatever happens to me also happens to other people whose life story I am a part of.  So I have made a potential life changing decision…I decided to take a glimpse in the crystal ball of my being.

I am curious to learn the most likely disease or natural cause of death I will meet up with down the road.  Based on family history, I can guess what’s in store for me, but I want more surety.  I know that the final day in inevitable, but if I am aware of what to expect, then I can come up with a game plan to prepare for and slow the speed of my demise.  I guess it’s about trying to control a piece of something that overall is uncontrollable.  So today, I am ordering a genetic marker test that will suggest my genetic predisposition for 200 common diseases / conditions that I might encounter. 

For the last few years I wanted to do this, but the cost was a prohibitive.  My wife Mary and I did a DNA test to join the National Geographic genome database to find out that our ancestral origins were in Africa and our great, great….great grandfathers migrated to Europe.  No big surprise there. 

As a natural course of studying diversity, I discovered how similar we are in regard to our genetic makeup.  Humans share 99.9% of the same 3 billion base gene pairs.  The common variances (0.1%) we see account for differences in eye colour, hair colour, skin colour, congenital conditions, etc.  Our DNA over time has altered it mutations for some people to better allow them to adapt to their environment, hence dark skin colour gives added protection to people in locales where the sun and heat are plentiful.  Interesting enough is that chimpanzees share 97% of the human genome.

Is that scary, or what? 

I am amazed at just how complex the human body is.  I am also awed by the science of it all, especially since my brain is not wired to fully understand it all.  While the science of genetics is still evolving, I believe the researchers have come far enough to where they can now make confident assertions based on DNA tests and analysis. 

DNA testing is still controversial.  It is not for everyone.  Some people do not want to know what they are most likely to see in the future.  Some people may want to know, but will constantly worry about the results from the test.  While the argument rages on about medical ethics, discrimination and privacy related to DNA testing, I am discounting that noise and taking the chance to know more about me. 

I am smart enough to know that the results will not provide me an absolute measure of what to expect.  The environment will certainly have it’s say in how long I or any of us survive.  But it does give me a glimpse of hopefully the long-term future. 

Thursday, 28 November 2013

Thankful Today and Every Day

Today in America people are celebrating Thanksgiving.  They express what they are thankful for and gather together for a festive meal.  This is one day that most people stuff their tummies with turkey and/or ham and all the trimmings that go with it.  This is also the one day nobody is counting calories nor do most people care what the scale may say the next day.   Some will trek out tonight to camp out for “Black Friday.”  Only in America.

I am thankful for countless blessings and gifts from heaven above.  I am thankful for the freedom to exercise free will in the pursuit of happiness, so long as I cause no harm to others.  I am thankful for my parents who gave me the beliefs and values that taught me right from wrong.  I am thankful for my wife who keeps me on the straight and narrow, most of the time J.  I am thankful for my children who are the light of my world.  I am thankful for my grandchildren who allow me to see the world anew.  I am thankful for all the people I have had the chance to meet and for my extended family and friends.  In short, I am thankful for all I am and all that I have.

The question that begs to be asked is, “why do we consciously have just one day that we take time off to be thankful?”  Personally, I am thankful for every day that is given to me. Truthfully,  in the busyness of life, I don’t take time every day to pause and extend gratitude for the fortunate life I have been afforded.  I do not have to look very far to find people less “lucky” than I.  Thus, being thankful should be a constant for each of us beyond the one day we designate. 

Spending time in forests, the mountains, the beaches with my thoughts and camera brings my focus toward the awe of the world about me and the thankfulness to be a part of it.   Note to self, get out and get away more often to see the beauty of where I am and give thanks every day. 
 
Happy Thanksgiving everyone!
 

Sunday, 9 June 2013

Super-Size It

It’s been a long frustrating and exhausting day at work.  It’s around 8 p.m. and I head home.  On the way home I decide I am too tired to cook dinner.  I pull into one of the two McDonald’s on my route home and order a Quarter Pounder with Cheese, French fries, and a Sweet Tea – the drink preference assumes you live in the southern U.S. and ingest it before I get home.

 I don’t take time to think about the 900 calories I just consumed.  The way I feel based on my day at work is that I don’t really care much about calorie intake at that moment.  The recommended intake of calories for the average person is 2,000 per day.  Let’s hope the breakfast, lunch and snacks throughout the day tallied to less than 1,100 calories, because it makes me even more tired just thinking about exercising to burn off anything over 2k calories. 

The Quarter Pounder at McDonald’s made its debut on the national menu in 1973.  It was a super-sized 4 oz. pre-cooked beef patty compared to the 1.2 oz. single hamburger beef patty.  I guess I can take comfort knowing it is not a true quarter pound burger after it is cooked and the grease is drained.   Because it is less than a half or a whole our psyche tends to ignore the relevance of its size. The amount of food became noticeable when a super-sized option began.  McDonald’s ended its super-sized fries and drinks in 2004 in response to a movie that demonstrated a diet of McDonald’s meals was not a healthy choice and larger portions contributed to increased girth.  We become what we eat.

Moving past McDonald’s.  Think about the last time you went to a restaurant.  What did you order?  How big was the plate that your food was on?  Even a salad can be enormous.  Were you able to eat it all?  Did you request a “doggie bag” to go?

Lessons in my early years taught me not to be wasteful, so I belong to the clean plate club.  Based on my observations where people eat, it seems there are less and less people belonging to this club. To belong to this club, you must eat everything on the plate…unless it’s green peas J.  Because I feel I am compelled to eat it all, I do not often eat out because of the portion sizes.  I can’t afford a new wardrobe with a new waist size. 

For most of us, there is the magic age somewhere between 35 and 45, when our metabolism shifts into the lower gears, and the pounds pile on which requires much more effort to trim it off.  I have access to a gym, exercise equipment and exercise DVD’s that can help me keep fit.  Truth is, I am very inconsistent about using any or all of those things.  I used to be able to cut weight quickly to stay in my weight class when I boxed many years ago.  I once could eat what I wanted, as much as I wanted, and not be concerned about packing on the pounds.  These days, nagging back aches and deteriorating painful knee joints are not real motivating factors to push myself to fitness.  And, the diets I embark on might last a week at best.  It’s really hard for me to say no to a couple of donuts when someone else brings them to the office.  My love for donuts goes back to when I was a young lad and ate a baker’s dozen in one sitting after church and this feat was acknowledged in the next Sunday sermon.  You can imagine how embarrassed my folks were.  I strike it up to belonging to the clean plate club J.  Some people concede at some point that it is an impossible task to lessen the load we carry, so the spare tire and love handles become a permanent personal accessory.  I am not quite of that mindset, yet.

I recently attended a conference on obesity.  Medical experts in the field advised that the current generation may be the first generation in our history who will not outlive the prior generation in regard to years lived.  Scary stuff.  The primary reason is due to the current rate of child obesity and the subsequent medical conditions that are associated with obesity. 

Obesity is defined as having a Body Mass Index (BMI) greater than 30. The “normal range” for the average person is 19.5 -24.9 BMI.  Between 25 and 29.9 BMI is considered overweight.  BMI is considered to be a better predictor than what scale says, because it factors in weight and height.  My gauge is the mirror, and it’s not a pretty sight.   

 In 1980, less than the 10% of the adult population were obese.  In 1995, less than 15% of adults were obese.  In 2010, 35.7% of adults are considered obese.

In 1990 the average male weighed 176 and the average female weighed 140.  In 2010, the average male and female were both 20 pounds more than they were in 1990.  A survey was done in both periods asking people whether they saw themselves as being overweight.  The perceptions for both time periods were not significantly different, which indicates we haven’t noticed we are getting bigger over the past 20 years.  I guess if I am bigger today than I was 20 years ago (which I am), and so is everyone else, then in a relative sense nothing has really changed when I compare my body size to someone else.

How did we get here?  For starters, we are taking in, on average, 300 more calories per day than we did in 1985…super-sized portions. Other contributing reasons include:

  1. Lack of sleep allows us to store fat more efficiently. And it is harder to exercise when we are tired.
  2. Stress may cause our bodies to release hormones that store more abdominal fat and slow down our metabolism, as well as create a desire for high-carbohydrate foods due to their effect on increasing serotonin.
  3. Medications.  People being treated with drugs to control depression, mood disorders, seizures, migraines, blood pressure and diabetes, among other medical conditions, have reported weight gain. The same goes for people taking steroids, hormone replacement therapy and oral contraceptives. The effects have been attributed to an increase in appetite, alteration in fat storage and changes in insulin levels, all leading to people eating more.
  4. Medical conditions: People with certain medical conditions such as hypothyroidism or Cushing’s syndrome tend to gain weight with the increase in cortical production. These maladies cause a decrease in metabolism and generalized fatigue, leading to our bodies using fewer calories from the food we eat.  Genetics have a role in the shape of our bodies, but it is the environmental and external factors that have the most impact in molding that shape.
  5. Hormonal issues: Menopause in women and the yet-to-be-officially-recognized andropause in men are blamed for weight problems. We tend to become less active, have a slower metabolism, poorer sleep and increased rates of depression, all of which affect the amount of food we are eating.
  6. When and where we eat: Skipping meals (usually breakfast), having too many snacks, eating out frequently or eating late at night have all been implicated in causing weight gain. Eating while watching TV, sitting at the computer, while reading or in the car can all contribute to weight gain due to how this mindless eating adds so many calories to our bottom line.
  7. Lack of physical activity.  Children are getting less physical activity in school, which carries over to after school.  Addiction to video games and social media contribute to sedentary lifestyles.
  8. Fatty foods, Processed foods and Additives: The easy availability of high-calorie dense processed foods, the excessive use of artificial sweeteners, high-fructose corn syrup, MSG and other food additives have all been related to weight gain.  Most North Americans consume at least 37 percent of their calories from fat (usually the wrong kind of fat such as animal fat and refined vegetable oils). This is way more than our bodies can handle.  If you have a diet that is too high in fat, it puts you at risk for obesity, adult onset diabetes, certain cancers, and arteriosclerosis (hardening and plugging up of the arteries).  One additive we often overlook is synthetic hormonal steroids given to animals that end up on our table and to cattle producing milk.  Synthetic hormones act as toxins in the body and can be difficult to get out of your system. One of the main side effects of synthetic hormones is WEIGHT GAIN, especially around the abdomen, hips and thighs.
  9. Emotional issues: The term “emotional eater” has almost become a cultural phenomenon, seemingly spreading like a virus.
  10. Our metabolism: Do you have a faulty metabolism from repetitive dieting or your yo-yoing weight due to too much fasting and feasting over the years?
The magical formula, so I am told, is to manage the portion size of your meals (downsize), regularly incorporate food into your diet that is close to its natural state (organic, fresh veggies and fruit), limit processed food to a minimum, exercise at least 3x a week for more than an hour each session and reduce high carb and sugar intake.  Sounds easy enough, right? 

The problem with that is many fold.  Poorer people have more of a challenge eating healthy which contributes to managing their weight.  The reality is that it costs more to eat healthy, unless you eat out a lot, and that can be pricy and often not a good choice on several levels.  Added to that, we are creatures of habit.  In general, we seek pleasure over pain, and food tends to bring us so much pleasure.  So many times the least healthy foods (pastries, pizza, ice cream, Quarter Pounders with Cheese, etc.) are those we interact with the most because frankly they just taste the best and satiate our craving(s).  It also is difficult to break away from cultural influences in regard to food.  Many foods in the South are fried…they even fry vegetables – fried okra, fried green tomatoes, etc.  Lard and grease galore, but it sure does taste good when it hits that palate.  And, it goes without saying, outside of Texas, barbeque is all about pork…and too much pork makes up portly. 

Another reality I recently learned is that a large number people who live in rural areas in South Carolina and are at or below the national poverty level do not have a full-service grocery store in their community that provides fresh produce or meat.  Thus, their choice is limited to largely processed foods.  Processed foods are less expensive.  For example, Raman noodles have little nutritional value and are loaded with lots of saturated fat and sodium, but it is simple to prepare, can satisfy hunger and can be gotten at a low price.  A handful of fresh peaches, especially when out of season, are more expensive than the nicely packaged single serving fruit cups that have the diced peaches swimming in high fructose corn syrup.  And, organic products are almost always more expensive than non-organic foods.   

In these same communities, it has been reported that some  individuals who were walking or riding bikes on the side of the road for exercise were struck by vehicles.  They used the roads for their exercise because their town had no sidewalks.  These realities are not an excuse for obesity, but I understand better how a person can get there.

 At the end of the day in order to lose weight you have to expend more calories than you take in.  That requires a commitment to: 1) change eating habits, 2) make better nutritional and smarter food choices, 3) start and sustain a consistent exercise regimen, and 4) say no to that Quarter Pounder and those super-sized portions.

Am I willing to sacrifice my inner desire to eat a couple donuts the next time they arrive in the break room?  Am I willing to reprogram my brain to realize that I don’t need to super-size my hamburger, when a smaller patty will be enough?  Am I willing to ask for a “doggie bag” in the restaurant?  Am I willing to say no to the stuff that tastes so good, but is killing me, literally and figuratively?  Am I willing to make time to exercise regularly?  It comes down to - how bad do I want to lose that weight and those personal physical accessories I have acquired?  I figure, if the folks on the Biggest Loser can do it, so can I. 

Saturday, 20 April 2013

Each and Every Person Has a Story

I recently attended an educational session related to grief.  Grief isn’t just about response to death, but a response to loss.  It is coping with living with loss or losses. It wears a lot of faces…despair, fear, relief, guilt, resentment, rest, peace, pain, happiness from reminiscing, etc.   

We all lose things along the way in our journey of life…family, friends, possessions, pets, etc. – all tangible things we can see and touch.  Other things that bring about changes in defining who we are as a person either in our own mind or in the mind of others creates a loss of identity and forces us to reinvent ourselves. The latter is often intangible; hard to pin down and most often not as immediate as the former.

There is a traditional model we have used in healthcare for many years that helped people understand loss and grief.  This model was introduced in 1969 by Elisabeth Kubler-Ross in her book titled On Death and Dying, who based it on her work with terminally ill patients.  This model has 5 stages:  denial, anger, bargaining, depression, and acceptance.  It is supposed that each person experiencing death or loss moves through each stage at their individual pace.  This theory and model is now being challenged and a new approach is now being used by many in the pastoral care community in healthcare.

This new model focuses on a narrative of one’s life – one’s life story.  Every story is unique.  There is a plot that explains what has happened.  There is a theme that helps tie meaning to what they live for.  There are characters, some major and some minor, who all have their own stories.  There is a time period from birth to present and there is continuity in the story because time is sequential.

Sometimes when there is a loss, the story does not make sense.  It’s like someone ripped the pages or a chapter out of the book…”I don’t know how to go forward.”  Yet, somehow most of us manage to move past that loss.  Those missing pages can never be replaced, but the story continues after the loss and the book has more chapters to add. 

Narrative and stories are connected to meaning.  A disruption in the story because of a loss may alter the meaning.  For example, if a person loses their spouse, they have a new identity (widow or widower) and with the loss of identity as a spouse there is an alteration of his/her meaning of life, i.e., purpose for existence.  It is the meaning of life in our life that truly drives us forward.  It is also one of the largest items we struggle with in loss – “What does this mean?”  “I don’t know how to make sense of it all”  “I don’t get this.”  “Why me?”  “What did I do to deserve this?” “I guess the doctors have given up on me” “Why did God allow this to happen?”

Dealing with loss is never easy.  It is most helpful when there are others to support and help the person with the loss think about their life in new ways.  The worst case scenario after a loss is arriving at a place where despair and meaningfulness dominate a person’s being.  The good news is that meanings can be reconstructed and people can have multiple meanings. Remaking meaning does not require a person to come to closure over their loss. That chapter or those chapters that have been written will remain as long as the book adds pages.  The story is not over for as long as we live. 

Nearly every weekend I spend a couple of hours logging about 5 miles on my pedometer on the soccer pitch.  Last weekend, I was walking, running and shooting on an empty field when a young boy asked if he could kick the ball at the same goal I was kicking at.  His brother was playing in a soccer match at an adjacent field.  I started talking to him and noticed he had an accent.  I asked him questions that gave me information about who he was – Thomas was 12 years old who was recently adopted and was originally from Latvia.  He told me he had not played soccer for a couple of years.  He proceeded to pull down his sock and pull off his shin guard to show me the bump from a fracture he received on his leg when he played in his native country.   He went on to tell me his family recently went to the Bahamas for spring break and found it to be hot there.  I didn’t want to tell him about the heat that was forthcoming this summer...I doubt if it ever gets over 90 degrees in Latvia.

Thomas pushed me to clock 8+ miles on my pedometer that day.    As we parted, I thought about his story, his losses and his new beginnings that bring forth new meanings.  For him, a new chapter has begun and for each of us we found common meaning on a page in our individual and collective story – football.