Two weeks ago today I lost my lovely wife.  Coronary atherosclerosis. That is what the death certificate says. My family and I have received an outpouring of love and heartfelt sympathy from our community of twenty-five years. We will never be able to repay their kindness.

Danielle was a craftsperson when it came to her writing. She would work for hours (or days) to express a thought or concept in just the right way. Medical writing was a mystery to her with its passive voice and weasel words. Early in my career I tried to enlist her help with one of my “scholarly” articles. We soon reached an agreement that I would write what I needed and she would pretend to read it once published and say “that’s nice dear.”

This blog was a collaboration and was different. Our attempt was to write it for a layperson with an interest in health care, a passion for doing the right thing, and a desire to connect the dots regarding the flaws in our care delivery system. If we succeeded it was because of her. If we failed, I take the blame. I only hope I can continue and not embarrass myself too much without her contributions.

Danielle was a healthy, fit, active women who unfortunately had a terrible predisposition to cardiac disease and no sensation of cardiac pain. In other words, no “warning signs.” She did not smoke, was not overweight, and ate mostly vegan. Her “coronary atherosclerosis” would have been as much of a surprise to her as it was to the rest of us. Here are my thoughts, at two weeks out:

  • Disease occurs randomly. Being adopted, she had limited knowledge of her family history.Had she known that that was a possibility, there are only a couple of things she could have done to change the outcome.This is true for many people who suffer from illness and disability. Victim blaming serves no purpose and is an incorrect response. This we all need to stop.
  • That being said, risk factor mitigation only makes good sense. Eat right (a diet low in fats and animal protein, high in fiber, and minimize processed components), exercise daily, avoid cigarette  smoke and alcohol in excess. While it didn’t save her life (nor any of us eventually) this type of living likely gave her 10-15 years she would not have had. And gave us that time as well. We all need to try and live in harmony with our bodies.  As a community we need to provide these opportunities.  Farmers’ markets, community gardens, and bike paths all contribute and should be supported.
  • Human connections are very important. What I learned of Danielle after her death was how important her friendship was to many people. I cannot count the number of people who have come up to me to say that at a vulnerable time she reached out and help him or her through the rough patches. As a primary care physician I am brought in at times of crisis. We need people like Danielle who will take an interest and have a serious discussion about concerns with folks who are vulnerable. Things like this prevent crisis. Please reach out to someone who seems distress and ask them what can be done to help them. While churches can serve that purpose, activities involving the arts, informal interactions within the community at open air markets and dog parks, for example, are where such interactions take place. As a community we need to build in these opportunities for casual interaction.
  • Illness, random or otherwise, in America is expensive with insurance and cost-prohibitive without it. We are very fortunate that we had health insurance through my employer and enough money to cover incidental costs.  Without insurance, the hospital would be able to put a lien on my house if I didn’t have the money. While the ACA is not perfect, it is what we have at this time. President Obama has made it so that, at least in those states that have expanded Medicaid, bankruptcy for medical bills is much less common. Please support the Medicaid expansion.

Enough rationality. For those who know us, I miss her every day in ways both big and small and I know you do as well. For those who did not have the opportunity, hug someone and go back to helping us continue the fight.

Aloha, Danielle.

 

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