An awkward visit from a colleague
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A strange encounter.
Backstory:
I first met Tom (not his name) in 1977 when I was a resident. He was an attending in my training program, doing mostly OB anesthesia. He was a good teacher. Sympathetic, understanding, and an overall good guy. A little bit “off” but I never noticed it. Hell, I was in my late 20s and a resident; what did I know.
Fast forward to 1982. Tom decided to leave the university to go into private practice. Since I was in charge of running the OR at the university, I was told to assign Tom a good variety of cases that he would encounter in private practice, not related to OB.
He left about a year later.
In 1983, he called me, telling me that there was a position available at his practice in suburban Chicago, and I should consider it. Since things were OK at the university, I declined.
In 1986, another position opened up. Since things where turning shitty at the U, I applied, but I was passed over for another guy “because we interviewed him first.” Finally, in 1988, another position opened up. It was offered to me, and I accepted, starting in 1989.
When I started, I felt, well, un-accepted.
It turns out that Tom was kind of weird guy. For lack of a better term, think “burnt out hippie.” Think toe rings and sandals. This is something I never really appreciated in my days at the university. Apparently, people thought that since I knew him, he recommended me, and we both came from the university, I must be just like him.
I wasn’t, of course, and it took me a year, or more, to escape that preconception. Once I did, the staff in the OR were asking me to take care of them.
About 3 years later, because of a change in the nature of our practice that Tom wasn’t willing to accept, he left our group. I didn’t see him again since 1993.
Now:
About 6 months ago, he called me at home. We had a nice enough conversation. He told me about his family, travels, retirement, etc. He also told me about his health - early Alzheimers. The conversation was pleasant enough, but just a bit awkward. I always felt uncomfortable that he was pushed out of our group because of his own intransigence (I'll explain later, if you're interested). I was looking forward to its conclusion.
This morning, there was a message on my answering machine from Tom, asking me to call back. He bicycles a lot, and he’s frequently in my area.
At about 3:15, there was a call from the lobby of our building. I answered, and it was Tom. Since I answered, I really couldn’t blow him off, so I invited him up. I rode down in the elevator and brought him upstairs.
He stayed for about an hour. It was most awkward. He was wearing his cycling helmet (which he never took off) and gloves (which he also never took off). He rambled on and on about memories that we shared, and also about memories that I didn’t share. He didn't remember years, people he had known and shared experiences.
I was looking forward to his leaving. When he said he was going, he started to walk toward the master bedroom, and I had to remind him that the front door was that way. As he walked out the door, he asked me if there was an elevator in the building, despite the fact that had ridden up in one about an hour beforehand.
He said he’s get in touch next time he’s in the area, but, sad to say, I really don’t want to talk to him.
Very disturbing, very sad.
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Sounds exactly how I would feel. You are not alone in that. Hell, I have "friends" more like acquaintances who think we were better friends then we really were back then wanting to re-connect. I decline most of the time very cordially by being "busy".
During the height of the COVID crap in 2020 I was warned that a person we knew back in the day who is definitely bi-polar, was running around town, telling everyone he was infected and trying to infect as many people as he could so we could all just get COVID and be done with it. He showed up at the end of my driveway in an 18 wheeler cab and I yelled at the top of my lungs from my front door to get the fuck off my property. My neighbors probably thought I was the nut. I promptly called the police non-emergency number to warn them that there was a lunatic on the lose in town.
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As Dan Quayle so eloquently stated, "what a waste it is to lose one's mind or not to have a mind is being very wasteful. How true that is."
Sad...I suspect we all fear that condition as much or more than any other, to lose the essence of one's self. My father had some mini-strokes in his last years that changed him such that when he died, I felt like I'd already lost him. Both my older brothers and I hope our end comes before such a loss of self.
In a past career, I dealt with the mentally ill - some of whom have a tortured self which can present some similar challenges. It isn't easy - as one can struggle to know where the path leads.
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So if you had to choose between a visit from this guy or the conspiracy theory surgeon, which would you go with?
The Brad
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@lufins-dad said in An awkward visit from a colleague:
So if you had to choose between a visit from this guy or the conspiracy theory surgeon, which would you go with?
The surgeon. He may be nuts, but he's not nuts nuts.
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My grandmother got Alzheimer's hard. But she hung on for a very, very long time. It was weird for me and I was pretty young at the time; it was devastating for my parents, and many of my dad's siblings.
HardImpossible to know what to do, even when it's your own family member. -
My mum had dementia. It was just awful watching her deteriorate. Truly heartbreaking. On the positive side, her music kept her going - she never lost the ability to play the piano until right at the end.
I was only joking
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@doctor-phibes said in An awkward visit from a colleague:
My mum had dementia. It was just awful watching her deteriorate. Truly heartbreaking. On the positive side, her music kept her going - she never lost the ability to play the piano until right at the end.
I hope that music gave her some consolation.
My father, and his older brother and older sister all died around 69 - 70 years old from idiopathic pulmonary fibrosis. My oldest cousin just died from IPF as well in his later 60s. They were all heavy smokers when younger. Dad's younger brother and younger sister all lived into their early 80s, but had some degree of Alzheimer -- probably more mild cases and they endured it gracefully. They weren't completely lost, and faced it well. I suspect that had my father and his older sibs lived longer, they would have had Alzheimer's as well.
I hope I can face either -- both terrible ways to go... but genetically the cards are already dealt.
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Nice to see you, IT.
“I am fond of pigs. Dogs look up to us. Cats look down on us. Pigs treat us as equals.” ~Winston S. Churchill
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@mik said in An awkward visit from a colleague:
Nice to see you, IT.
Thanks, Mik! Nicer people than Liber Faciorum.
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@mik said in An awkward visit from a colleague:
Nice to see you, IT.
Funny... I was just reading his post and thinking "great to read more from IT!"
Howdy, friend. We live in Minnesota now... I re-started my TNCR activity in the Spring of 2020 when I was forced to work remotely and had access to public internet forums again! Now I continue to work remotely from Minnesoooooooota.
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IT - IPF is less of a death sentence than it used to be. The plurality of lung transplants I saw at Duke were IPF patients.
Before 2005 they mostly died waiting on the list because organ allocation was FIFO and their disease often progressed too quickly. Since then allocation is based on disease severity/life expectancy so they get better priority.
“Don’t make me repeat myself”
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@jon-nyc said in An awkward visit from a colleague:
IT - IPF is less of a death sentence than it used to be. The plurality of lung transplants I saw at Duke were IPF patients.
Before 2005 they mostly died waiting on the list because organ allocation was FIFO and their disease often progressed too quickly. Since then allocation is based on disease severity/life expectancy so they get better priority.Yesterday my cousin died from IPF age 69-- he was twins to the cousin who passed away 6 months ag0 (middle of this thread).
So now we have a cluster -- my dad, his brother and sister, and the brother's twin sons...
I'm going to see a pulmonologist and try to get ahead of this if it happens at all -- autoimmune and pulmonary function testing, check ups every two years, hi res cat scans...
From some research by my cousin (sister to the twins), lung transplants have a 3 year waiting list, which is about the life span once IPF is diagnosed... 30,000 per year with a 100,000 waiting list; more available now due to opiod deaths... ugh.
What specifically is the medical community saying, other than it's fatal without lung transplant?
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I’m very sorry to hear about your cousin. Just curious, was he evaluated for transplant?
Waitlists vary greatly by geography. Organ availability is the whole reason I went to Duke, when Columbia was 20m from my house. Also different programs have different eligibility requirements. Many won’t touch anyone over 65. Duke transplanted a 76 year old when I was there in 2016, who I believe is still alive.
It’s true that IPF patients decline very quickly, and they used to die on the wait list almost as a matter of course when it was run on a first-in, first-out basis. The switch to a life expectancy-based lung allocation score improved their lot substantially, but that obviously didn’t help your cousin.
And then the 5.8 year median survival post lung transplant means transplant itself is no panacea.
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By the way, I know a Philly-based pulmonologist on the falculty at Penn that you should see. He was a former board member of the Pulmonary Fibrosis foundation and does a lot of research on IPF including drug trials. I can’t stress enough the difference between good but generalist pulmonologist and a key opinion leader in the specific disease.
He’s actually on our (Alpha-1 Foundation’s) Medical and Scientific Advisory Committee, we asked him to join specifically to get the viewpoint of an expert in a different disease added to our group.
“Don’t make me repeat myself”
- history
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When I was at Duke the median (not average) wait was less than a month. That means fully half the people who were listed got their transplant within 30 days.
Outliers (such as myself) either had a low lung allocation score (they weren’t as sick as the others), or they had a lot of Human Leukocyte Antigen (HLA) Antibodies, which render many donors an impossible match, or they were very tall and had trouble getting a size match. A combination of those three factors made me wait a year, which was extreme at Duke.
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@jon-nyc said in An awkward visit from a colleague:
By the way, I know a Philly-based pulmonologist on the falculty at Penn that you should see. He was a former board member of the Pulmonary Fibrosis foundation and does a lot of research on IPF including drug trials. I can’t stress enough the difference between good but generalist pulmonologist and a key opinion leader in the specific disease.
He’s actually on our (Alpha-1 Foundation’s) Medical and Scientific Advisory Committee, we asked him to join specifically to get the viewpoint of an expert in a different disease added to our group.
His name is Dr Michael F Beers and he runs the Beers Laboratory for Epithelial Cell Biology at U Penn
“Don’t make me repeat myself”
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