CHAPTER FOUR



I HAVE LOST THE LOVE OF MY LIFE
CHAPTER  FOUR


🌹  THE BEGINNING 2003

It started with a pain and a follow up by her primary physician.  Sometime in APRIL 2003, the diagnose, tests, work-ups, x-rays etc. determined Ovarian Type 3c of the Cancer and finally the operation.  I feel like I am on a fast track. I’m watching days meld together. 

It’s been five days since the three surgeons, and a very long operation took place of 8.5 hours and she's doing as well as can be expected.  She's got color back, being weaned off the drugs and they'll try to get her up walking. 

And I suspect trying to throw her out, you know insurance companies. I guessed right.  No fooling around here. Drains out, some walking, some easy food and guess what, you go home or a rehab joint!  On the sixth day she came home, my choice. 

The good old mil-spec training kicked in.  We take care of our own, checking vitals, cooking and the occasional dressing change. My wife won't be going to rehab, I won't let her.  It had to be a miracle, all the prayers and well wishes do make a difference and being home with great friends and neighbors put a smile on her face all day and she feels better already. 


🌹FIVE YEARS LATER  -  MY WIFE OF THIRTY ONE YEARS, DOLLY...
She was my companion, confidant, support team, friend, sunshine, smiles and all the good things that life together offers.  It came quick, Ovarian Cancer 3/C is quick but not without a fight and the tools we had to work with at that time.  The first surgery supposedly took carE with removal of most of the cancer in organs and walls.  Four and a half years later it returned.

I asked her on a scale of 1-10  how she felt?   She replied: "an 11". I took her to the ER at Morton Plant at Midnight.  She beat Ovarian Cancer,  aka “ the silent killer”, the last time (almost four years ago) in 2003 and it has reared its ugly head again.  

My worst fears, and four hours after arriving at the hospital, we had the news. The doctor in the ER said the CT scan showed additional masses and spots again, had re-established themselves, good sized masses into the lungs. They admitted her immediately and her  surgeon showed up the next day.  This type is called the silent killer and she made it five years after the first surgery.  

NOTE:   Thats about average for this type.  They never get it all, minute cells left missed by the surgery and chemo or radiation can miss, the tests were inaccurate... the outcome predictable.


🌹 OVARIAN CANCER AND THE CA-125 TEST
Doctors are the eternal optimists, they have to be.  Or they couldn't do their job.  But some of the things they are told by the clinical results, modern medicine and chemistry just don’t go far enough.  It seems that a day doesn’t go by on TV that some lawyer group is challenging some medicine praised as the second coming.   And some of these medical wonder drugs have side effects worse than the condition they are treating.

Ovarian Cancer the "Silent Killer" doesn't come with instructions and doctors don’t have the time to train you.  That doesn’t stop me.  I aggressively went after the information because my life was in her.  She was my soul mate, she had my heart, nothing will ever replace that and as a writer and researcher, it was what I could do.

What failed? I asked her attending physician what happened.   All of her screenings over the past three and a half years based on the CA-125 tests showed no signs of any problems. But the test itself proved to be inaccurate.

He disclosed CA-125 testing has limitations, cancer antigen-125, is a protein that is found at levels in most ovarian cancer cells that are elevated compared to normal cells. CA-125 is produced on the surface of cells and is released in the blood stream.  It’s a simple blood test from a sample that assesses the concentration of CA-125 in the blood. 

Here’s the problem: The CA-125 test only returns a true positive result for about 50% of Stage I Ovarian cancer patients. The CA-125 test is not an adequate early detection tool when used alone, and the test has an 80% chance of returning true positive results from stage II, III, and IV ovarian cancer patients.  


🌹 He scheduled surgery after a week of needed fluids, a little building up and pre-care, plus our surgeon had a loaded schedule, they finally wheeled her into surgery. It was Good Friday and even this Jewish husband, liked the name of the day. But a tough tribulation to go through as this was her second operation. 

Hopefully, it really could be good this time.   But time and length of time tells you things, like complexity.  She went into a marathon eight hour operation to remove the Ovarian C cancer that had infiltrated south to north. They took out a lot. This is called “de-bulking”, a second time.

It’s a cold harsh word, but needed for this is a nasty, virulent monster that has difficult attributes that defy some convention. Only surgery allows accurate appraisal of the tumor, an accurate diagnosis, and remove or de-bulk as much tumor mass as possible leaving less for the chemotherapy. Aggressive removal of cancerous tissue is associated with improved chances of survival.  Sometimes, it’s a crap shoot. 


THE ENEMY

OVARIAN CANCER IS THE MOST FATAL OF ALL CANCERS INVOLVING A WOMAN'S REPRODUCTIVE TRACT

🏥   Most ovarian cancer develops after menopause; half of ovarian cancers are found in women older than age 63.
🏥   Only 19 percent of ovarian cancers are diagnosed at an early stage, when the disease is confined to the ovary and is most easily treated. 
🏥   Women diagnosed in the early stages have a 90-95 percent chance of surviving at least five years.
🏥   About 76 percent of women with ovarian cancer survive one year after diagnosis, and 45 percent survive five years after being diagnosed. The survival rate drops as the stage of the cancer increases, with a less than 14 percent five-year survival rate in women whose cancer has spread beyond the abdomen. 
🏥   Younger women (below age 65) have a better five-year survival rate than older women.
🏥   An estimated 20,180 American women will be diagnosed with ovarian cancer in 2006, according to the American Cancer Society, and about 15,310 will die of the disease. Ovarian Cancer Whispers - so listen...


THE SIGNS

🏥   Watch for Pelvic or Abdominal pain or discomfort.
🏥   Vague but persistent gastrointestinal upsets such as gas, nausea, and indigestion
🏥   Frequency and or urgency of urination in the absence of an infection
🏥   Unexplained weight gain or weight loss.
🏥   Pelvic or abdominal swelling, bloating or feeling of fullness.
🏥   Ongoing unusual fatigue; or unexplained changes in bowel habits.
🏥   Pain during intercourse.
🏥  If symptoms persist for more than 2 weeks, ask, no better yet, demand your doctor do a...  Combination pelvic-rectal exam, CA-125 blood test, Trans-vaginal ultrasound, Pap Test, but does not  detect ovarian cancer.
🏥  Two other factors might add probability to this occurrence.  Some doctors are looking at women who have not had children, and approaching menopause.  
🏥  Another factor might be the frequency of hormonal migraines. Those migraines that might arise days before the menstrual cycle. Back then this was not addressed, today it is.
🌹 Dolly had a history of hormonal migraines which were dismissed and treated with the usual take two, go into a dark room and sleep it off.   We never had children. Two strikes, two was enough. 


THE HOSPITALS

🏥  NOT ALL HOSPITALS OR PERSONNEL ARE THE SAME
Reality, set in and  I'll jump around a bit but I would be remiss if I didn't share things I have learned about this situation.  I may jump around at times.

😇  MORTON PLANT HOSPITAL, CLEARWATER
The finest group of Doctors, Nurses and Technicians I have ever met with a true Empathic Patient Care Philosophy (EPCP). We had the fortune of being close to Morton Plant and there was incredible communication between Dr’s, Nurses and Patients.  It differed from my last visit to another hospital.  Bayfront and Largo Medical are not on my favored list.

👿  NOT ALL DOCTORS ARE THE SAME
I was fortunate to have had one of the finest OB-GYN/ONCO teams in the country who now recommend and enforce your insurance for CT scans and or PET scans in addition to the Markers.  

You cannot, cannot, rely on Marker CA-125’s alone.  If you have little confidence with your primary physician,  get out now...   Good doctors have good doctors for associates.  Bad doctors have many outside interests.  Golf, country clubs, fancy cars, nice suits.  Interrelationships amongst Doctors is crucial as a good doctor will never send you to a bad doctor or specialist.  They stick with professionals on their level of expertise and thats a good thing. 


👿TOUGH LOVE IN THE HOSPITAL
The entire team that treated Dolly was exceptional till she was taken to another facility and it became hell.  Tell the nurses, to cut off the phone, mail and visitors. I know this sounds harsh.  Imagine lying in bed with tubes dangling exhausted by the constant interruptions and procedures by the staff, then six people come into see you and you put your best face forward and answer the same questions over and over again like  “How do you feel and what happened?”                       

Not in my world.  I took the mail away, got rid of the flowers ( allergies), the balloons that get in the way of the nurses, the dose of perfume by visitors, screaming kids visiting, double rooms are small enough.

😇 It worked. They said no reason to keep her there.  She’s about three days ahead of schedule and they attributed most of it to rest and not being bothered. 

It was tough love on some things on some it hurt me to tell people they stay away from the hospital, but they could come to the house.  But it was the best thing for her and get her home.

Make things easy on yourself:  Patients are not big eaters I am chef trained and can make good food from around the world. 

But I also had a stack of simple Lean Cuisine, Stouffer’s and other brands for the meals perfectly suited, and needed immediately for a smaller appetite recovering from the surgery and the use of paper plates, plastic knives and spoons, paper cups really make it easier on the caretaker and a spare garbage can for medicals.  

It gives them variety, choice, and fast cooking, throw away trays and the microwave needs no cleaning. It’s also safer for the patient, lower calories and lowered chance of contamination.  Till you can get them on a heathy recovery diet I created for other cancer patients I work with.  


🌹 HISTORY REPEATS ITSELF
2008 - 2013 - In 2008 I got a call from an old friend, we had known for twenty five years.  She disclosed she had been a cancer survivor and had heard about Dolly.  I had lost dolly and her other half left her.  Just walked out, couldn’t handle it.   We were friends before and after these tragedies    

In 2013 - A couple of years later she told me, her cancer had returned.   I met with my soon to be latest patient, actually a long lost friend of Dolly and myself who has survived from two times Multiple Myeloma ( Bone and Marrow) and came out of the hospital at 98 pounds after three weeks of a new type stem-cell transplantation at Moffitt Cancer Research Hospital.  

She had been given six months if this procedure failed.  We got her to off-site rehab, got her home two weeks early, laid down the rules, with no immune system, no playing with her orchid plants, ( a mold could be deadly)  no pets, in too close a situation, we had some do the litter boxes,  meds on time and put twenty plus pounds back on her with my recovery diet.  In August 2019 she will celebrate six years since the end of her chemo trip. 


👿  BLESS THE CAREGIVERS WHO CARE,  NOT THE ONES THEY SENT!
The good ones are a blessing.  But they are few and far between but the best care is love based.  Many home health care providers really need to look themselves in the mirror.  They were hours late, sometimes failing to show, failing to call, forgetful, and incompetent.  

Another spent one hour of questions, all related to “ How they were to get paid".  She took vitals which I was doing anyway.  Vitals and a 200.00 dollar bill, for two hours of nothing, enough...  My temper exploded, we went solo I told her to tell her boss you and her are fired.   

The second company the Dr. ordered was no better.  I had lots of first aid training on higher levels, many times with different organizations and felt I could do it better.  One time their "nurse" came finally, albeit totally unprepared and I had to supply her with the wound dressings and gloves. When I saw they were doing nothing, I dismissed them and told them not to come back. I reported them to the hospital who sent the from an agency who should of been shut down

Again read the parts about paper plates, cups and "Lean Cuisine", lots of juice, and pain killers. A large garbage can double lined and sealable. Tylenol PM helps too. I took a few myself. It got ME a few hours sleep too.  Nights of worry and anguish vanish with this over the counter drug and got her off the Vicodin the third day, faster.  And gradually getting her to real food, not the quickie stuff, a noticeable change as soon as the real food went in.  After a few weeks we are looking forward to the Chemotherapy as another stage in the recovery and to get it over as quick as possible. 


WE BOTH LOVED FLYING AND I WAS TEACHING HER, MY CO-PILOT


🏥  CHEMOTHERAPY
This is about her second operation for the removal of Cancer.  Sometime in May-June, it all seems to meld together but my baby takes it in stride and doesn’t complain. After what seemed like days of Dr. visits and tests, the Chemotherapy started.  I failed chemistry twice but I got a brush-up course on the web. Yes, everything you heard about it is true; basically a chemical dose of poisons. Some feel the cure is as bad as the ailment. Nausea, body aches, pain in joints etc. 

Chemotherapy destroys cancer cells by preventing them from growing and dividing rapidly. Many normal cells also divide rapidly and are damaged by Chemotherapy. These include but not limited to:  Hair follicles; Red and white blood cells; Platelets for blood clotting; Mucous cells in the gastrointestinal tract; Side effects are anemia fatigue, dizziness, shortness of breath, Nausea, vomiting, diarrhea, low white cell blood count resulting in infection

But it sometimes saves lives. It's simple enough, drugs like TAXOL, are slow dripped into the body and they go after the rogue cells that the surgeon can't possibly see or locate. It's sort of like DNA matching; the drug looks for anomalies in cells. These usually are the rogue loose cancer cells. (This is a simplified explanation) 

Like I said the cure may be painful. Dolly was given Taxol since it worked before and Carbo-Platen plus blood monitoring utilizing injections of Neulasta for the white cells and Aranesp for the red cells. The method of insertion selected by our doctor was intravenous injection (IV). It can also be administered directly into the abdominal cavity, orally and intramuscular. 


TAXOL,  PRAISED AS A WONDER DRUG… FAILED  Is an incredible story in it's own right as it represents all that is good about NOT killing the rain forest. It's made from the bark of a tree discovered in the 60's and finally was chemically synthesized just a few years ago.  Like in any scenario, what works in one case may not work in another. Just recently an intensive study indicated Taxol does not work as well for the most common form of breast cancer.  It helped far fewer patients with breast Cancer than has been believed. 


ALWAYS THE PARTNER AND SHE LOVED COLLECTING LEAFS
The nurses at the Cancer Center always ask the patients how they feel, the standard answer nausea and some pain and their answer is... “ I understand, it comes with the territory, the stuffs doing its job". 

You saw it on TV, the new drug Neulasta: Since Chemotherapy works by killing fast-growing cancer cells, there is a downside. Chemotherapy can’t tell the difference between cancer cells and fast-growing healthy cells, including red and white blood cells. 

As a result, one of the most serious potential side effects of many types of chemotherapy is a low white blood cell count. The fewer number of white blood cells you have and the longer you remain without enough, the more at risk you become for developing a potentially life-threatening infection. This is the reason for Neulasta. It keeps the white blood cell count growing from the bone marrow, on the other hand causes bone joint pain.  When they needed more cells, the Neulasta worked incredibly well.


 👿  A KNOCKDOWN 

She has pain in the groin and a discharge. I tell the Chemotherapist about the symptoms and he orders a CT scan as usual Friday late. Why does everything go wrong on Friday? The Chemotherapist meets her Internist in the hospital on the weekend doing rounds and they go over the scan. 

We get a call Monday at 11:AM and our Internist tells us one of her body cavities has developed an abscess. The Internist gets on the horn, I mean this Internist is fast, and takes a personal interest within minutes we are scheduled to see a surgeon from our team who is familiar with the case. 

The thoracic surgeon who assisted our two oncologists during her marathon operation. Our appointment was at 2:PM but he had a heavy patient load that day and finally he got to see us at 4:PM. We were grateful he got us in on short notice. Also this was part of the Morton Plant - Mease group so he had access to all her files by computer.

The rest of the month we had a long session with keeping the wound open to drain. Finally after much frustration I threw out the home health care people.  Dolly's surgeon OK'd and arranged a short course at the Morton Plant Hospital Wound Unit where I was shown how to do the procedure watching a wonderfully skilled and empathetic nurse do the packing procedures.  I passed the test and took over.

I knew the vitals, anti-contamination procedures, graduated and after that I am once again her caregiver. After four weeks the wound has healed and the Dr. said I did a great job. We beat the bad guys again...


👿  TEN SECONDS LEFT IN THE ROUND

Dolly complains to me and the Chemo RN that she been experiencing shortness of breath. Part of the de-bulking was in an area under the right breast in the diaphragm.  After a hastily ordered PET scan of the chest the scan showed Cancer has peppered the inner wall of the chest and the Taxol, Carboplatin combo was not working.  A Chemo called Topotecan was to be substituted. 

The first week goes Ok but the breathing is getting more difficult. This regimen requires twelve weeks of treatment and her breathing is getting worse plus she's getting a yellow jaundiced look. Chemo blood work basically aims at the white blood count, the red blood or hemoglobin. Hemoglobin is a protein in red blood cells that carries oxygen. A blood test can tell how much hemoglobin you have in your blood.  


🌹The SECOND WEEK - ARANESP SHIPMENT LOST

Dolly had Chemo on Friday after an extremely irritating morning because her medications scheduled to arrive by 11 am via UPS did not arrive. This was because they failed to ship on Wednesday, and then the shipping department failed to mark the package “before 11:00AM” on the next day service. It was marked wrong by the Aranesp supplier. 

At her exam before getting the Chemo her red blood count was down to 7.9, as it was brought up again, it had been diminishing each week, 8.9, 8.4, 7.9. That explained her yellow jaundiced coloring, so they scheduled her for a transfusion on Monday morning.  

Dolly had once said that I am an empath. I see and hear things others don’t.  Its like what folks call a "sixth sense".   After flying for thirty years, I call it situational awareness. This is no good, I had bad vibes… I tried to get her type-matched on Friday but we could not get her to the hospital and they do not type-match after 3:30 pm. 

I was ten miles away in FRI afternoon traffic and Dolly is a very nervous person in traffic, she is an ardent back-seat driver...we got her out of Chemo at 3:13. 17 minutes, too far, too much traffic and an accident certainly wouldn't help things. 

We decided she had enough for one day and she wanted to just go home. After repeated Chemotherapy, the red blood cells lose their ability to reproduce even with the kicker Aranesp. She needed a transfusion. 

Saturday she acted strange, very up and down, told me one minute she was better and yet didn't want to be alone. She actually went for a ride with me in the car to pick up some parts. She insisted on going and she soon fell asleep in the car. Then she awoke, then asleep and I said to her: “I told you this was too much and she would of been better off home with the sitter I had arranged”. 

No she said," I wanted to be with you". She nodded off again, I cancelled the second half of the trip, turned around. "She said it again, she wanted to be with me and didn’t want to be alone".


🌹  THE LAST DAY
I got up Sun AM and surprisingly she had gotten up ahead of me and she made breakfast which is unusual because she doesn't function well when she gets up due to her condition. She's zooming around the house which really startled me. She said she was going to take a shower. Fifteen minutes later, I checked up on her. 

She didn't come out so I went in to check on her. After her dose of drugs at Chemotherapy on Friday she was never the same, four people who live in our condo saw us coming and going and later commented about her "look , reaction, composure, etc." Something went wrong and I didn’t catch it soon enough. 

I called to her in the shower and she didn’t respond. I grabbed the door open and she was laying on the shower floor in a pool of blood, delirious, partially coherent, but definitely not in her mind and saying she can't take it anymore.  I called the Paramedics and screamed for my next door neighbor and she and her husband rushed right over. She spoke with the paramedics with directions I applied first aid, all that I could…  

The paramedics showed up and transported her to the TRAUMA center at BAY FRONT HOSPITAL, a LEVEL TWO TRAUMA center. Twice as far away as Morton Plant. I objected I knew that place, I flew enough patients on flight missions.  Pardon me more “ F*cking contracts based on money and not the best care”.

 

🏥  THE WORST POSSIBLE SCENARIO    HOGAN
The trauma surgeon operated from sometime around 9:00 or 10:00, I could not see her till 3:00 PM. The trauma Dr. removed three additional masses (Cancer) from the abdomen. Dolly in addition had a herniated twisted colon and other complications. Dolly received two pints of blood. There were peppered masses throughout the lung cavity in the inner walls which showed on the last PET scan. The Chemo is not working at this point. We are done with Chemo.  Enough Chemo to stop this onslaught would also stop an elephant. This was not good and I knew she was not coming home this time.   It was time for hospice.


By a chance of fate, or bad karma,  Hulk Hogan (the Professional? Wrestler and Sports Actor Fake Entertainer) was in the hospitals trauma section with his son and a young Marine who were both in a hopped up Supra that landed in the top of a Palm tree after going street racing and airborne.  Young Nick Hogan on something will survive but the young Marine will be in severe physical and mental incapacitation for the rest of his life.  The young and stupid Hogan was not that critically injured but not so good for the passenger.

The LegaL Statement:  In 2007, John Graziano,  a decorated Marine, was critically injured in a crash on Clearwater’s Gulf-to-Bay Blvd. while a passenger in a car driving by, Nick Bollea, son of famed professional wrestler Hulk Hogan (Terry Bollea), lost control on the rain-slicked street and hit a palm tree.

I almost went off the rails.  My problem was with the Hospital and only grace prevented me from going ballistic. I couldn’t even get close to Dolly because the waiting rooms were filled with all of the TV reporters, big jerk-offs fans and fellow Hulkster idiots. 

I went down to the office and demanded to see the Administrator.  I think the jerk was trying to get an autograph.  By agreement the rest is unimportant, I did not get arrested and he is still claiming ownership of his head.

 

🏥   NOTHING IS WORKING
Adding things up there was a total of 32 hours under the knife in the past four years…too much for anyone… I saw her after surgery last night in the ICU and she is quite well drugged because of the severity of the operation and the fact she has sustained a lot of damage.  

Three of the Physicians attending to her are not affiliated with this particular hospital.   More frickin politics.  And one of the problems is once again I have to change doctors. I believe they call this switching horses mid-stream and it serves no good. Nevertheless her Internist, the Trauma doctor and her Chemo doctor all with privy to the CT and PET scans have counseled me on the next step...... I know what it is and it is in the best interests for Dolly.

Please, God, just let me do what I have to do in peace, this is not easy and if I could take her place, in a heartbeat, she is the only thing in this world I have deeply loved more than life itself. She taught me the meaning of the word...

 

🌹 HOSPICE
She could not speak because of all the tubes and she circled the air with her finger, she wanted to write something. She wrote: "I love you and all those helping me". Then she wrote, "the Chemo and all the drugs are killing me". I fell apart, I couldn't handle it anymore.  She can't breath without the re-breather. Several attempts were made to help her breathe and failed. The cancer was in the lungs.  

Her Dr. thought it was the proper time for her to go, as did most who were aware of her extended condition fighting Cancer for better than four years. The hospital Psychiatrist, the Chaplain, actually three of them tended to her, a Baptist, a Methodist, a Jewish Rabbi, and the Dr. of Palliative Medicine were involved. Professional medical care was given, and sophisticated symptom relief provided. 

The patient and family are both included in the care plan and emotional, spiritual and practical support is given based on the patient’s wishes and family’s needs. Those involved in the process of dying have a variety of physical, spiritual, emotional and social needs. The nature of dying is so unique that the goal of the team is to be sensitive and responsive to the special requirements of each individual and family. 

Nothing is more important to me now, I have to do what's right for Dolly. I can't be that selfish in trying to hold on. It's not about fighting. In a war you see someone go down, you fight harder because you could be next. With cancer you fight as long as the quality of life, the only reward is still in sight. Take it away and there is nothing but pain and sorrow to live with. Dolly told me she had enough... she knew the time... 

I have copy of her Living Will and was asked to sign the form called a DNR. (DO NOT RESUSCITATE). It was just about five O clock. People were going home to loved ones. I was going home to an empty home and a torn heart. I kissed her good-by, told her I loved her, promised no one would ever hurt her again, closed her eyes and I will hear her labored breathing the rest of my life. She got the scheduled pain relief and four hours later... It was over.   Dolly passed at 9:18. The hospital called my cell at 10:30.  I went home, alone.


👮🏼 THE MEDICAL MACHINE AND THE LAW

At 12:30 in the middle of the night, the Medical examiners office called me to tell me they were taking her body for examination. It seems she came in through the TRAUMA side of the hospital and was listed as having a wound. That was where the stoma was from the colon bypass. She had caused a wound in the area of her STOMA.  She was fixing her attaching point for the bag when she passed out.  Thus the scissor was in the shower.


🏛FLORIDA HAS STRICT LAWS

That one minute that Dolly succumbed to hopelessness, deprived oxygen, resulting in her mental state not being right means they have to do a complete autopsy.  

As if five major and two minor surgical operations and procedures, (one less than five days ago) tearing her body apart over thirty two combined hours of surgery, office and hospital visits too numerous to count, and very taxing Chemo, almost twenty weeks of poison, exams, and check-ups weren't enough to kill her. They have to hurt her again.  Not over my dead body 

They made the call from information given from the paramedics.  The medics had found a scissor in the shower.  The Medical examiner told me they had not contacted any of the Drs. that had seen Dolly or knew of the condition of lowered blood levels , reduced hemoglobin, severe shortness of breath and knowing the drugs weren’t working.  

With her dying hand Dolly wrote about her love and how the drugs were killing her. She had to give up, there was no fight left in her. In her mind there was nothing left to look forward to except maybe a little peace.

The Cancer won and the law part of the medical machine took the wrong corner in the battle. 12:30 at night I made my case to the examiner. I got nowhere. This is a travesty beyond anything I have witnessed in my life.  There is no dignity left here; no compassion; nothing to learn medically; her organs will never go to another because the Cancer had spread. I screamed, because no one had paid attention to what I tried to tell them when she was admitted? 

I had all her medical records and history and would bring them down to them. I was told they would solicit them on their own.  In all my years covering stories and seeing how people react to things, I never understood what it took to go off the deep end.  

I am wounded, deeply hurt, dangerous and the war fighter in me starts to come out. I will admit I even went as far as to grab my assault weapon, two clips and a sidearm, and wanted to take things into my own hand. I wasn’t going to let them hurt her again even if it meant doing something I might regret the rest of my life. "I had told her  no one would ever hurt her again" and even if it meant my life I didn't care.  It was both irrational and painful.


🔫  I WENT TO WAR

There is no logical or compassionate reason to hurt two people anymore, people who loved each other and one decided enough is enough and the other agrees.  So I get on the phone in the middle of the night and call her doctors.  I called my attorney, I called the board members of the hospital where I had done stories about, anyone I thought would intervene, like the admin of the hospital board and two judges I know... I got through to a few...

Then, my anger kicked in, I did something stupid, I locked and loaded, added a shotgun and I was going to stop the autopsy one way or the other. I made a promise no one would hurt her anymore even if it meant me being in trouble.   Almost walking out the door locked and loaded, the phone rang and it was the Coroner or his assistant.

He advised me there was a 24 hour hold for evidence on Dolly and who was I?  He said I don’t know who you are but we got calls from everybody but the governor,  I said calmly and plainly her situation, gave him the info and added I am the Grim Reaper if anyone touches her... before the medical papers arrive, have a gurney ready.

They, many  (no one would ever tell me ) contacted the examiner and got a 24 hour hold pending medical records. By morning all her records will be checked and if the information is correct and verified the examiner will cancel the autopsy.  I pray the people at the hospital do what is needed and get the records to the examiner on time. They certainly didn’t impress me while I was there.  My blood was boiling, I planned to intervene and stupidly I meant it.  Now they were on a clock.  

Trauma departments are independent of the hospital. Trauma doctors are as one non-trauma Dr. described it 'adrenaline junkies". Their work is always on the edge and prioritized. The day drags on and I have a house full of friends, and my neighbors who were there when she fell in the shower and dialed the 911 while I held her,  the doorbell rings. 


🚔  THE POLICE
A knock on the door, and it is a Police Detective from my district. He is following up on a request from the Examiner to interview the household.  It’s because again of the trauma side and policy.  Possibly my act or threat of taking the Coroner to the point of him needing a Coroner life might have prompted it too.

This too is routine.  Like on COPS they have to visit the scene. My neighbors who witnessed the entire event, the scream while we were having coffee,  the 911 call,  and helped me in the shower with her and Dolly’s friends all answered the questions. They were there, first hand witnesses and my neighbor is a retired Irish SAS cop and expressed grief at her loss and total disgust at the treatment we were receiving.  He was carrying the ball for me.

The officer/detective from the Largo Police Department was the first to show humanity.  He apologized for the intrusion, he was kind, understanding and compassionate.  He carefully explained this step was part of the law.  He found absolutely nothing wrong, as there were two witnesses at the time she went down, and he immediately contacted the Examiner that this was not anything that needed this attention, and drop the issue. 

Before noon, within a couple hours, the State Asst. Examiner called and said Dolly was ready to be picked up by the funeral home.  They had held off on the autopsy, no autopsy and a genuine graceful apology for any hurting that may have occurred, I thanked them profusely and smiled and broke down, I had kept my word to her. “  

No one will hurt you anymore, baby”.    

To this day, I still feel the same,  when asked would I have done something, the answer is yes, she was more than my life.  I had the tools and I have enough training... love and anger, I would have done something stupid but it didn’t matter... If it meant anything I would have died for her, and to keep her from more trauma, yes I would have and could have.  


⚱BY THE ROCKS IN THE STREAM, OUR SECRET PLACE LIES IN THE FORREST
I loved my wife and when more decisions had to be made:  We did them together:  It’s a simple choice, cremation or burial. We had decided jointly we both wanted cremation because of her debilitated physical condition with more deep scars than anyone I have seen, the loss of all her hair, and her further denigration by the Colostomy warranted this type of closure.

I could see her hurting every day and still smiling though the frustration in her life getting dressed day after day to see Drs. and getting poked, prodded, and scared.   She always had a smiling face for the Dr’s, nurses, neighbors and friends. She wanted to be cremated so that it would kill every Cancer cell and hide the scars they made on her body and soul. 

I will take her to the secret place we loved and visited in the National Park between Gatlinburg and Cherokee when the trees turn colors and a cool breeze floats through the mountains. 

I will intern her in a place where twenty-five or thirty years ago, in a late winter snowstorm, I told her I loved her in this spot and she affirmed her love for me. I have the pictures of that day and that place. I will bring her home soon...   

This is what she loved and missed seeing the past five years while not feeling well. This was the promise I had made. I will bring you home and I will always love you baby…. 


💝   HER LEGACY WAS HELPING OTHERS 
Tradition, Jewish tradition sometimes involved burning the deceased shoes so that no one shall walk over another's path.  Dolly always had the heart to help others.  Just plain old love for those who need a helping hand, warranted the next move.  So I combined my tradition and her help for others, it would be the Dolly way.

All of her clothing, shoes and handbags were donated to CASA house for Abused Women and Children.  With help from Billy, a friend.   We delivered them within in 48 hours. She was a major supporter and fundraiser for CASA House and never mentioned her name.

For those who do not know this charity, it provides a temporary safe housing for women and children who have been abused and in many cases have escaped an environment with just the clothes on their back and an abuser right behind them. Her work clothes like pantsuits and dresses will hopefully help another soul get started back in life. 

That was Dolly's legacy, always thinking of others.  Her doll collection, nothing fancy but LOTS of THEM, like Baby Beanies over 60 and stuff were carefully delivered to the All-Children’s Hospital in St. Petersburg so that no child shall be without, there were between fifty-five to sixty plus all new, all in plastic and some individual dolls.

The armed guards (some kids are there because of abuse) asked me what I was delivering.  I told him I'm the "Jewish Santa Claus".  That didn’t fly when two guys,  me and my friend billy who is black carrying black leaf bags at 9: 00 P.M. walked into the Children’s Hospital.

Fortunately he was smart enough to know that there is no such thing as a Jewish Santa Claus.  I had to explain to him I worked the other shift, the 364 other days of the year when kids needed a little love too.   He asked what was in the bags and I told him.  I showed him ID, and asked if he would get the charge nurse.

My 2nd mission objective accomplished, the bags were inspected, toy’s delivered when the nurse supervisor on the night shift and a doctor came forward and the one knew me... worked in personnel ( a friend) told them I was coming.  Lots of kids woke up and got Beanie Babies that night in their beds and cribs.  It was the best thing for Dolly, Me and the Kids.

The Fruit, Food and Flowers, More than I could ever use or eat and would of gone to spoil. So I dropped them off at the Nurses stations that took care of Dolly both at Morton Plant and Bay Front. The staff at both hospitals did their best. They asked, "what patient was it for"?  And I said,  “it doesn’t matter, it was for the staff to enjoy for helping my wife”.


🛫  CLOSURE 
It's time to bring her home: It started by air from St. Petersburg, Florida to Chattanooga Tennessee via Allegiant Air.  Nice small airline, so small they charge large for peanuts!  Four dollars a bag! 

Had Dolly and I been together she would of had a purse full of goodies for us.  Beautiful day for flying and things went smooth. Its tough for me, I owned my own plane, and being a pilot stuck in the back is uncomfortable for me. 

We landed in Chattanooga and I headed for the reserved rental car which was not there. So they bumped and upgraded me to a larger car which they did have after I threatened to seek another supplier of fine automobiles.  I headed toward the mountains and then I noticed the sun was leaving and clouds had started rolling in. 

Six hours later it was rain, some sleet and snow depending on the elevation. So much for my friends advice about the summer like conditions.  Things change very fast this time of the year in the mountains. I changed my itinerary and took the back door into Pigeon Forge since the gap route was closed by the snow.  It added fifty miles but the Gap was closed.

I called friends and changed days and times to meet.  Going solo with some adverse advise from local friends I trekked in the snow dust not as far as I wanted, but found the path we knew to a familiar fast moving creek alive with power and movement, unusual since the drought has effected this area too.  I knew this path, I had told her I loved her in this spot. It is the place in the picture above. The exact spot.

This spot was OK because of the weather closing in and because it was a spot Dolly and I had visited before. In this comparable pristine park, I released the knot holding the contents of the bag, smashed the urn, and as they say “ashes to ashes, dust to dust”. I returned her to her  “Earth Mother” though the water...


 
Life is just a series of events some planned and
some coincidence, the rest unexplained...

⛪️  I watched her ashes divide and take their own path in the stream as it rambled downhill. It was mixing the spirit with the power of the mountain.  

⛄️ It was snowing, raining and drizzling with flurries just as it was almost thirty years ago when I told her I loved her, uncanny but the same day Nov 5th. I planned that, The circle was complete with time and weather. 

🏃  I slipped and landed on my bottom, hand and feet up to wrists and calf’s in the frigid water.  She was telling me to go now, the job was done...  My feet and hands were freezing. 

I got to the car and turned the heat up and used the vents to thaw myself. I had completed my walk-a-about or personal journey, the Native Americans spoke about and so do the Australian Aborigines.  The rest of the trip was uneventful, actually ahead of schedule trying to hook up with friends and always seeming to be on the wrong side of the mountains and the weather from them. The passes were closed and it’s a hundred miles around, the long way it seems.  

😇  I did reach and managed to spend time with a really great human being and fellow photographer Mark Alexander.  He showed me beautiful parts of Chattanooga which is a great little developing city.  Later that night his wife joined us for a nice dinner. But the emotions and events caught up with me and I needed to be alone Sunday AM until I hopped on the bird to return home.   I dropped into my seat on the big bird and ordered a Bloody Mary and a Beef Jerky snack, the Jerky of all things which I used to eat on the trails, I hate peanuts. Then reality set in... thirteen dollars!  Peanuts were cheaper. 



NATIVE AMERICAN THEOLOGY

Dolly was born into a Methodist family, and survived being married to me (I'm Jewish) for thirty plus years. Both of us were not religionists, those who profess too much.  We dealt in actions not words.  Not for one-second in any way did the difference of Christian and Jew ever enter into our relationship.  We did things together.  Love that’s pure isn’t polluted by human weaknesses and the demands of controlled religionism.  But the two of us though my writing casually researched into other cultures, not to change or adapt but to understand.   Because knowledge is understanding. 

There are those those who believe in the true miracles of Gods rationalism and the beautiful world he created. We read about and looked into the other beliefs, not searching for an act of conversion but just to understand literally "how the other half lives".  

The basic tenants of most Native American philosophy is very similar to basic Jewish philosophy, simply put  "the Art of Living".  Follow the traditions.  It is  respect for the land and many books have been written on the subject about these ancient and aboriginal similarities from the various regions of the world.  Traditions , customs, whats the difference. 

It paralleled the work I have done with Asian peoples and other indigenous groups from Alaska to South America.  You just have to dig.  It’s more about the strength of the big mountains than the big bang and pillars of salt.   Not the man made hypocrisy of the artificial story tellers, secret rituals, Swiss bank accounts, fancy DVD's and printed matter, slick coiffures, bottles of holy water from the city tap, mumbled false pretense and superficial enhancement, guilt and fear motivation, golden TV studios, Rolex's, and strange headdress or is that a hairdo? 

Add a few Gulfstream G4’s, now 65 million dollar G650’S, A GIFT FROM TAX EVASION, pedophilia, abuse and the latest incantations, Prosperity Divinity.  I believe one day GOD will deny hiring any of these folks as his spokesperson since he did mention a rule that states "NO FALSE GODS NEED APPLY” and he will refer them to Mr. Mestophilies who is always recruiting.  ( And doing a bigly, incredible, great, wonderful job, just ask T-RUMP, his main supporter)


THE EARTH MOTHER
It was the Algonquin's who said,  "That beneath the clouds lives the Earth-Mother from whom is derived the Water of Life, who at her bosom feeds plants, animals and men”. 

We spent many vacations on the trails there and my wife's last wishes were to be returned to the mountains, a place we always spoke about and the place I told her I loved her. And that place was one that he created that enriched the soul by it's sheer majesty and beauty. 

The Smoky mountains and the closeness and spiritual history of the Cherokee Nation was such a place. And I found the water of life.  The picture of her by the rocks is that place.  It was a gnarly day, getting worse and I told her we need to start heading down and back to the hotel. We had a three mile hike downhill in snow.   She wanted to hug the tree you see in the background. I asked why?

She said that tree was a survivor, its still here even though they had a blight.  It’s growing sideways out of the mountain at the top.  It’s a special tree that God cared for.  All the other trees fell before it.  And being at the top put us closer to God.

The plains Indians, the Lakota, Nakota and Dakota also known as the Great Sioux Nation are descendents of the original inhabitants of North America. The Sioux were against placing the deceased in the ground. It would trap their souls forever. At first they used trees or scaffolds to elevate their dead, then they used above ground boxes, later adapting to the white way of burial. That's why I didn't bury the ashes..... They have a story... 

THE DREAM CATCHER STORY - WE CAN LEARN FROM THIS ANCIENT STORY

Long ago when the world was young, an old Lakota spiritual leader was on a high mountain and had a vision. In his vision, Iktomi, the great trickster and teacher of wisdom, appeared in the form of a spider. Iktomi spoke to him in a sacred language that only the spiritual leaders of the Lakota could understand. As he spoke Iktomi, the spider, took the elder's willow hoop which had feathers, horse hair, beads and offerings on it and began to spin a web. 

NOTE: In Lakota mythogy Iktomi is a spider-trickster spirit, and a culture hero for the Lakota people. Alternate names for Iktomi include Ikto, Ictinike, Inktomi,Unktome, and Unktomi. These names are due to the differences in tribal languages, as this spider deity was known throughout many of North America's tribes.

He spoke to the elder about the cycles of life ... and how we begin our lives as infants and we move on to childhood, and then to adulthood. Finally, we go to old age where we must be taken care of as infants, completing the cycle. 

"But," Iktomi said as he continued to spin his web, "in each time of life there are many forces -- some good and some bad. If you listen to the good forces, they will steer you in the right direction. But if you listen to the bad forces, they will hurt you and steer you in the wrong direction." 

He continued, "There are many forces and different directions that can help or interfere with the harmony of nature, and also with the great spirit and-all of his wonderful teachings." All the while the spider spoke, he continued to weave his web starting from the outside and working toward the center. When Iktomi finished speaking, he gave the Lakota elder the web and said...

"See, the web is a perfect circle but there is a hole in the center of the circle." He said, "Use the web to help yourself and your people to reach your goals and make good use of your people's ideas, dreams and visions. "If you believe in the great spirit, the web will catch your good ideas -- and the bad ones will go through the hole." 

The Lakota elder passed on his vision to his people and now the Sioux Indians use the dream catcher as the web of their life. It is hung above their beds or in their home to sift their dreams and visions. The good in their dreams are captured in the web of life and carried with them...but the evil in their dreams escapes through the hole in the center of the web and are no longer a part of them. They believe that the dream catcher holds the destiny of their future. 

When seeing old photographs of the Sioux, notably you will see very serious expressions on the faces. It is not solely to the seriousness of the times but also to the feelings that photography was a serious matter.  To be photographed was an awesome experience, and demanded dignity. They knew about the power of capturing a moment of time. 

I have been blessed as a photographer to share many moments of time and keep those images alive in my mind. Thank you all for all your support, the cards and e-mails have been a great help. I apologize if the injection of humor here and there might offend some folks in what should be a very solemn part of my life, but for thirty plus years a bright smile and face has been laughing at my jokes both good and bad and that’s what's kept me going. 

I love you baby, rest in peace....

Al Jacobson 

AUTHOR and PHOTOGRAPHER: 
Al Jacobson, photographs and writes in the Tampa Bay area on a myriad of subjects. He is from NY and occasionally speaks English, preferring Brooklyn based meta-phonetic syllabication (aka Street Engleesh).

His high school English teacher, once commented to his parents, "He should try learning a foreign language like English... in a foreign country".  He retorted, "Shakespeare doth not a genius make, for he spake in terms reminiscent of a flake".  She threw him out of the class.  He made the Deans list, not the one you want your kids on. 

I am not a writer I am a story teller, and this is Dolly’s story.  I documented lived, part of me died, and approved every word of this page.  This was the toughest assignment of my life... most of these photos came from the little APS camera I gave her for her birthday.


CHAPTER FIVE

                  

--------*02-18-2019 aljacobsladder.com