Back Again...

It’s back to the table for me. That is, my back on an operating table, this coming Thursday, October 25. Before you suggest an alternative treatment, please allow me to assure you that I really have approached this as a last resort, even though I have taken this direction before.

On Thursday, August 1, 2013, persistent pain I was experiencing in my right leg was relieved when a surgeon performed a laminotomy on my fourth lumbar vertebra and cleared the stenosis being created by the disc just below it. The person performing the surgery was a celebrated professor of orthopedic spine medicine, who had conducted many such surgeries in the past but whose reputation was for spinal reconstruction – especially of children with scoliosis and other deformities. So, my surgery was without a doubt a walk in the park for him. Still, he took with me all the protocols he would have taken with a much more severe spinal problem. So I was in the hospital for four days… recovering not only from the surgery itself but also from the anesthesia, and having some pretty arduous physical therapy sessions. I was put on a walker for six weeks and strongly warned against returning to work in less than two.

That surgery was an outcome following three months of increasing symptoms that had been unresolved by chiropractic, including adjustments, acupuncture, and massage, followed by physical therapy and two injections of steroids to the affected area. The extreme solution of surgery was that to which I was resigned. But from the moment I came awake after the surgery, I could tell that my symptoms were relieved.

And I can honestly say that, since August 1, 2013, I have considered myself to be living well. The post-surgery physical therapy I was assigned put me pretty quickly back on the literal road to recovery. I was even able eventually to return to running at least ten miles a week, most weeks since.

But on August 9, this year, after the eighth mile for the week and what felt like a pretty good two-mile run, I was beginning the opening portion of strengthening exercises for the day when I noticed a slight twinge in my back on the left side, then a powerful one. I thought to myself, “OK, that’ll be all for today.”

That was all, up to now. The following weekend, I was experiencing lower back muscle spasms, making it difficult to bend. By the following weekend, getting into bed required climbing up onto the mattress on all fours and collapsing to one side or the other, to lie down. To get out of be required me to lie on my right side and ease my right foot to the floor, then prop myself up (slowly!) into a standing position. I could not comfortably sit on the edge of the bed or seat myself in a chair.

I saw my personal physician on August 16, and he prescribed anti-inflammatories including prednisone, which I tried for two weeks. These seemed to quiet the lower back pain, but now sciatica showed up in my left leg feeling very familiar to that which I had experienced in 2013.

By this time, I was more comfortably mobile, but I was visibly limping from numbness and weakness in my left leg, from the tip of my middle toe, around the outside of the foot, through the heel and ankle, and up my calf and the back of my thigh.

The doctor prescribed a different anti-inflammatory and set me up with physical therapy. After three and a half weeks of physical therapy. In the second week, it became impossible even for me to operate a stationary recumbent bicycle, and the therapist, who had at the start been confident that this was a “soft tissue issue” able to be resolved with the right application of gentle exercise, stretching, massage, and maybe a little traction, suggested that a shot of an anti-inflammatory into the affected area might prove helpful.

My physician ordered an MRI and referred me to a new orthopedic surgeon – someone, I requested, considerably less conservative than my first. This surgeon decided to follow the same measure as my physical therapist was advising, and five days later I was receiving that steroid injection (the same date two months after my initial severe symptoms).

There was no relief, and so, yesterday, ten days since the steroid injection, I sat down with the surgeon who showed me my MRI and the stenosis caused by a herniated disc at Lumbar 4 / Sacral 5 pressing against the sciatic nerve. Visual evidence says, that’s a lot of compression happening there. However, he also showed me the rest of my spine: the previous surgeon’s work is holding up very well, and the rest of my back is healthy and strong. He says, this should be it for work like this.

I think about my dad, who has had three such surgeries, including fusion at L4/L5 when he was in his late thirties and a discectomy at L5/S1 just a month after my surgery, five years ago. Now in his early eighties, Dad experiences neuropathy in his own left foot that may be related to similar circumstances as my own. Dad and I have both “enjoyed” the option of surgery to correct what appears to be due in our DNA to a predisposition toward degenerative lower discs. His grandfather walked with either crutches or a cane for all Dad’s life; and my grandfather suffered with debilitating back pain, as have Dad and his older brother Bob.

Much as I may shudder at the fact that surgery has seemed so necessary for Dad and me, it is strangely comforting to know that this option exists, since so little relief is gained from alternative treatments.

Prayers are welcome. I’ll let you know how it all goes.

Johnny pops the question (March 29, 1945 - Annex B)

I was going through my great-aunt's correspondence today, in a reverie about my grandmother's sister after uploading to YouTube some 8mm films she had made of her life and travels. The correspondence was a collection of letters from the 1940s and later, from her husband Mitch, her sister (my grandmother), and some friends. The earliest of them was a letter the text of which follows.

Aunt Lela married her sweetheart Bill Porter in 1938, but they divorced not long afterward because, as Lela put it, "he wouldn't stop running around." When the second world war came, she volunteered her services at the USO in Indianapolis, playing accordion and dancing with the military men between her sets. Her mother insisted that this was an inappropriate activity for a young woman, especially a young divorced woman. But Lela was convinced that she wasn't so young anymore (early 30s), and that she would be perceived by her audience and dance partners "like an older sister."

In January 1994, I visited Lela at her home in Palm City, Florida, and she showed me her letters for the first time then. One of them, from a soldier with whom she had danced numerous times during his term at Fort Benjamin Harrison, near Indianapolis. Johnny and she had struck up a fun acquaintance, but she was concerned that she may have given him just the impression her mother had feared she would when she received the following:

U. S. ARMY
March 29, 1945
Annex B 

My Dearest Lela:
          You probably will be shocked at my forwardness but I have tried time and time to lead up to the matter, but somehow never could.  Since it has been on my mind for several weeks, I have at last summed up enough courage to ask you.  Ever since I met you, you were very friendly, but as the weeks and months passed by, that feeling seemed to grow into something beautiful and sincere that it became practically indescribable.  I never thought, darling, that such a thought could ever enter my mind, especially at such a young and tender age, but alas here it is.  I don't know wheather (sic) it is fitting or proper to ask you such a serious question as this, for it may effect (sic) your future happiness and I would not want that.  I know, dearest, that you are much older, but you do have the mental ability.  However, I do know whatever your reply may be, that you will be true enough never to tell it to anyone.  Remember, it is just you and I.  You realize, Honey, that you are the only one in the world I would dare to ask this question.  In reply be positive, sincere and truthful, and above all dispence (sic) with all thought of tenderness, but be honest, tell me: Do you really think the Lone Ranger should sell his horse if he is drafted?
                                                                                 Johnny
P.S. -
          Hope this keeps you in good spirits for the weekend and a Happy Easter Day. Bye until I call.

The letter is written so that it breaks between the first and second page after "never to tell it to anyone." Page 2 begins, "Remember, it is just you and I." I can't help but wonder whether this letter was original to "Johnny" or if it was a meme of its day circulated from military men to their USO friends.

I imagine the latter. There's a "so" missing just before "beautiful and sincere," and other parts also make it seem copied. However, "wheather" and "effect" and "dispence" may be tell-tale indicators of an original piece, especially since the c in "dispence" is written over another letter.

Anyway, I too hope this keep you in good spirits for the weekend.

Words I said at my mother's memorial service

On Friday, May 2, family, friends, and co-workers of my mother gathered at the Little & Sons Funeral Home in Beech Grove, Indiana, to reminisce and celebrate the memory of Ione Leigh Denoon. Everyone was invited to share their memories aloud with the assembled group, and many did. Here are the words I said:

The earliest memory anyone had of my mom was a story her parents told... and Mom's aunts Rubel and Hallie.  Mom’s love of travel started early, they would say.  When Mom was 3, Hallie came to visit Mom’s little family – who lived with her grandmother.  At breakfast the morning Hallie was supposed to leave, tiny Ione arrived at the table with a suitcase without comment.  “Where do you think you’re going?” asked her mother.  “With Hallie.”

And since that day, my mother’s preparedness to go on vacation never ended.

But there were limits.  My parents were frugal.  The only exception to the rule came when my parents purchased a VW camper in order to save money on long distance vacations as a family.  Mom’s reaction was that this seemed only a little like a vacation – you were in a different place, but because you were in the camper and cooking your own food and doing your own laundry and cleaning up your own places, it was basically just like being at home... only twice as hard.

So, sometimes, the two of us stayed with Hallie and Alton and Okra, while Mom and Dad went for a brief vacation themselves.  And I came to understand why at 3 Mom wanted to go on that first vacation.  These many years later, the privy notwithstanding, those summertimes with Hallie were a wonderful gift of childhood from my mother to me and Leigh Ann.

Many of you have been reading my weblogs about Mom, including essays that she wrote while in nursing school.  And much as she loved the land of her childhood, she was certain that she would have to leave it.  She recognized the signs of the times, how the tractor was making sharecropping unnecessary.

Mom was the first in her family to attend college, but she did not consider that this fact set her apart from anyone who hadn’t gone.  She loved being with her people.  All of you who know her must have a sense of her loyalty, because when she and Dad divorced, she seized the first opportunity she could find – which also was professionally and financially prudent – to move back to Indianapolis.  And when she did, and the opportunity presented itself, she bought the house next door to her mom and dad, then sold it to her brother and his wife, and moved to Beech Grove, which not only was near work but also near another sister.

Every chance she recognized to be of help or of service to others, she seized... but especially when it came to family.

She was a strong woman, not only career-minded, but the career-mindedness certainly helped.  

She was activist in her attitudes, local and practical in her activism. She believed that radical equality ought to be applied to all - women, minorities of any kind.

She recalled to me how, one time, she lived out both career and activism (although maybe a little too locally and practically) when she took a fellow nursing student who was also a Baptist to worship with her, one Sunday morning.  Mom told me this, as if the thought of scandal or confrontation had never occurred to her.  But the year was 1958 and the place was a Baptist church full of expatriate Kentuckians in Indianapolis, and the other nursing student happened to be a black man.

I don’t think she ever tried anything like that again.  Or she never told me about it, if she did.


Mom was loyal and faithful, without exception.  These qualities never flagged in her.  There was never a relative unhoused or even uncomfortable if she had anything to do with it.  And whatever gene there may have been in her makeup to foster such dedication and devotion my sister got in spades.  Leigh Ann’s care for Mom has been dauntless, assuring that Mom could live as happily and well as possible as her dementia progressed.

But Mom’s care for us was... amazing.  Ione Leigh Hightower Denoon was a terrific mother: patient and tolerant, but insisting that I act and grow as strongly as I could intellectually and professionally.  She insisted that I attend a college prep school so that I could develop better study skills before going to college.  She made no bones about her hope that  I would become a doctor or a lawyer, but she never missed a performance I was in in theater, and she accepted not just graciously but with genuine pride my announcement that I would pursue pastoral ministry. Of course, when I announced that I was going into the ministry, she suggested chaplaincy – partly because of her admiration for the chaplains on staff at the hospitals where she had worked and partly because the hours would likely be gentler on my family than the on-call service required of a pastor.

She encouraged my sister in her own professional pursuits, blessing her on her way to Saginaw back in ’84 and welcoming her back (with rejoicing) when Leigh Ann landed back here.

From the time of Mom and Dad’s divorce until late 2006, if I wasn’t staying with her, I received a call from my mother every Saturday morning without fail... often as early as 6am... on a Saturday.  This was in the days before Indianapolis observed Daylight Time. So, for six months out of the year, Mom was phoning me at 7am.  But in November, she would be calling at 6, and I’d have to remind her to wait... please... wait.

Those Saturday morning phone calls always included a litany of the struggles and joys other family members were going through, and of the achievements of the little ones my cousins were rearing.  I sometimes had difficulty remembering who belonged to whom, but I never lacked for news.  Mom didn’t want me out of touch, even though I was far away.  Those calls are perhaps the thing I miss about her the most and their absence began my Mom’s and my long goodbye.

During seminary, when I smashed my right index finger while riding a bicycle in traffic (and a person who had just parallel parked opened her door into me), Mom did not wait to be asked but went to a friend who worked in the office of a hand surgeon and sped up to Chicago with a box full of finger splints.  Mind you, I was already wearing a splint that the surgeon at Saint Francis Hospital in Evanston had placed on my finger very ably.  But Mom wanted the RIGHT splint to be on my finger.

When Gwen was born she moved to Burlington, Wisconsin, to be closer to her new granddaughter (Coco and I aren’t fooling ourselves about that one).  By that time, her dementia had started – aphasia that was preventing her from completing sentences, and she was too easily distracted to drive safely anymore.  It was good to have her nearby, but she wasn’t a fit babysitter, and that had certainly been her fondest wish... and at 70 it doesn’t seem unreasonable to think that she should have been able to realize it.  If there is one point of anger that I experience in my relationship with God, it’s here.  I wish that Mom’s golden years could have had a good deal more shine on them.

But no matter.  I think that, despite the hardship of the last decade or so, Mom’s attitude was of happiness despite the odds or the evidence... satisfaction with who we are and how we are.  That Leigh Ann and I have come into the loves of our lives, after some initial foibles and missteps, was endlessly pleasing to her.  I have loved to watch her eyes brighten when our spouses have walked into her presence.  And the sheer delight she took in Gwen was radiant.

Letter from the Dean of Bethel College (Hopkinsville, KY) to Miss Leigh Hightower

On May 19, 1960, three short weeks after my parents were married, the Dean-Registrar of Bethel College in Hopkinsville, Kentucky, composed Mom a letter. She had been at Bethel College for her first year of study before continuing on to Marion County General Hospital Nursing School in Indianapolis (to which her family of origin moved in 1957) - making her the first member of her family to attend college.

On a pilgrimage of her past, much like the ones I myself have caused my wife to endure, Mom took Dad on a tour of places and people significant to her childhood, adolescence, and young adulthood. Bethel was one of those places, and Dean Burton and his wife were some of those people. An image of the letter follows.

Enjoy.

Address to the Soroptimist Club of Indianapolis, by Miss Leigh Hightower

Before reading this essay and seeing the accompanying photograph from the Indianapolis Star, I had never heard of the Soroptimists ("sister Optimists"). I have since learned that the Soroptimist Club of Indianapolis provided a scholarship paying largely for my mother's training as a nurse, 1957-1960.

Here is the text of an address she gave before the Club as part of her acknowledgment of their generosity. I have no information about when the speech was delivered:


Just as vividly as every small boy visualizes himself clinging to the rear of a racing, clanging firetruck, donned helmet and hatchet in hand; most little girls see themselves as nurses..... angels of mercy with light brisk steps and perpetual smiles. This dream had a part in my imaginative child-play too, but it wasn't until I was a high-school senior that a tiny baby helped me decide to become a nurse.

As I sat, night after night, beside the hospital crib of this baby, watching the nurses come and go, as guardians of the night, it seemed as if God said to me, "Leigh, you too will become a nurse." From that moment, my childhood dream began to form again. It remained with me for the next three years..... at times growing very dim, often fading almost completely from view. However, in the back of my mind there remained the memory of my promise to God, made at the bedside of my baby sister.

Upon entering nursing school, I began to fulfill that promise, and my dream has grown. I have found three words that are to me symbolic of a good nurse. They were first spoken by St. Paul, when he said, "And now abideth faith, hope, love; these three, but the greatest of these is love."

What relation do these words have for the nurse: This faith of which I speak is a complete confidence. It is faith in the medical profession.... that those who work beside you are giving their best through their knowledge to every patient. Faith in your hospital.... that inside its quiet walls new life is being created, broken bodies are being mended, and tortured minds assuaged. Faith in yourself.... that when first you felt the lightness of the cap upon your head, held high your hand, and repeated the words of the Nightingale Pledge, you did so with a heart that was sincere, hands that were capable, and a mind emotionally mature. Most important of all is faith in God..... faith that, as you walk on your ward, HE WALKS BESIDE YOU; as you speak, He speaks through you; and as you lift a glass of water to thirsty lips, you realize the meaning of "As ye have done it unto one of the least of these my brethren, ye have done it unto Me."

Secondly, there is hope... a belief obtainable. Keeping a clear mind when all about you confusion reigns; teaching the amputee that he can walk again; blinking back tears to whisper, "Rest in Peace," as you close eyes that no longer see. Then, too, it is smiling into the pink dawn of a new day after a busy night of duty.

In the last analysis, above everything else, a nurse must have a love for people, for in nursing she fulfills Christ's command, "Love ye one another." Love is evident in the whole life of a good nurse for love influences her whole manner of living. This love is not easily possessed. It cannot be taught in a classroom or demonstrated in a laboratory. It cannot be imitated, for imitation is a copy and love is genuine and honest..... recognizing the needs of the whole person, and not merely those of a broken body. It means giving more than is demanded... an extra smile of assurance or pat on a wrinkled hand; melting to the pleading eyes of an ailing child, keeping vigil while he is sinking, and crying yourself to sleep when he is taken away. Faith, Hope, and Love are to me the very heart of nursing.

In my limited experience thus far, I have no regret about the choice that I made, and if I were to choose again, without a doubt I would still select nursing because it is here that I may always keep my fingertips on the pulse of humanity.

Address by Ione Leigh Hightower (my mother) to the Miss Central District Student Nurse Contest, January 1959

Mom (lower right)
and the other competitors
from an article in the Indianapolis News

My mother, Ione Leigh Hightower Denoon, passed away on Sunday, April 27, 2014, at the age of 78 years and 9 days. By that time, she had been six years dependent upon the watchfulness of persons exhibiting the qualities she mentions below. Since 2008 she had been a resident of a Clare Bridge memory care residence.

Looking through my collection of memorabilia about her, I found the following essay (and accompanying articles and photos) which won her the Indianapolis title of Miss Student Nurse, back in January 1959. I've reproduced it with some very slight editing. Her closing paragraph seems pertinent to the season of life in which my family finds itself now.

All the world's a stage

And all the men and women merely players;

They have their exits and their entrances;

And one man in his time plays many parts.

                         (As You Like It, Act 2, Scene 2)

Article about the contest, from the Indianapolis Star.

Undoubtedly you have recognized these words by Wm. Shakespeare.

I am one woman, one of the millions of women on this great stage of life, through the field of nursing I hope to be able to make entrances and exits  into many family circles and in this minute period of time with the individual and family I hope to directly or indirectly give a small contribution that can be relayed to the family or community for healthier and happier living.

How can this be done?

An ideal nurse can be a living example of enthusiasm, energy, empathy and eagerness to help, truthfulness, trustworthiness and sincerity of purpose.

She must always display good nursing care based on the scientific principles of nursing, however she must avoid the pitfalls of too much science and too little patient care.

In addition to this she must possess charity and tact.  Charity is to love and to love is to give.  Tact is the art of being able to give and take.  To acquire this art the nurse must possess a sense of humor, patience, unselfishness and sympathy.  A nurse should portray spiritual, mental, emotional and physical health.  Patients look for the cheerfulness in the sincerity of her smile and the sparkle in her eyes.  They watch for the willingness in her response and the graciousness of her manner.  They detect the note of optimism in the words she speaks and the manner in which she speaks them.

Portrait of Miss Student Nurse 1959

She must possess faith and loyalty.  Faith refers to her belief in God and His commandments, loyalty implies trust and devotion supporting the belief in great things.  In a broader sense she displays her confidence in herself, her profession, her family, friends, and the human race.

In the eyes of a patient, who is head of the household, the mother who has left her family in the hands of another or the children from warm and loving home or the ones from a broken or unwanted family, the nurse is the provider of physical and mental care; she is kindness, understanding, strength, love, and the companion on the road back to health.

To the elderly mother or father who are nearing the end of life's journey she is the array of hope and the moment of security as they wait alone for life's final act.

To possess all of these virtues at times seems an insurmountable task, but in some small way, if it be God's plan, I hope to acquire as many of these attributes as possible and take into every patient's life a portion of those virtues.  So that when I have made my final exit from this world's stage I will be remembered for the living role of a nurse and not merely the acting of a part.

Announcement from
a Bowling Green, KY, newspaper.

Grace Lessons from My (Aphasic) Mother

Mom, and my sister Leigh (her namesake),
celebrating the 76th birthday I missed.

My mother's birthday was the other day. She was born 76 years ago, but you would imagine from seeing her today that she was much older.

Mom has dementia in the form of aphasia. The hemispheres of her brain no longer communicate. This has left her mute, with a very brief attention span and a nasty case of short term memory loss.

She first noticed the aphasia, about a decade ago, when she decided that she wanted to work part time rather than to be solely retired. Mom had been a psychiatric nurse in a locked unit at a hospital in Beech Grove, Indiana, where she lived. There was an exam she was required to take, in order to qualify for a return to work (she had been retired for two years or so). The math portion completely confused her, simple math. My mother, with multiple advanced degrees, looked at it and could not begin to respond.

Doctors visits and multiple trips to a neurologist confirmed that she had aphasia.

Mom had always been spontaneous, and we often made light of her forgetfulness and a measure of everyday disorientation that caused us to think she was just a bit dotty. She also tended to walk through life, smiling and refusing to be burdened by sadness or disappointment. "I won't dwell on the past," she would say.

A corollary to not dwelling on the past (painfully true now, since she has so little memory), was always, "I don't have time to be bothered with guilt. I forgive, ask forgiveness, or just move on." This was true in her, and, strangely, it still seems to be a conscious practice of my mother's.

I took my family to visit her, last month, and - like the last time we saw her - she was so overjoyed to see me, her face flushed with joy, and she sighed over and over again. Words were impossible, but she made it seem as though words would not have been enough anyway. The four of us stood in the middle of the hall where we'd met, in a group hug that would not stop.

My own feelings of guilt, over the length of time since I'd last been to visit, were set aside, and I received a sense of grace such as I rarely remember encountering except in prayer or on a Sunday morning.

Mom and Gwen from April 2009

She could have rightfully and justifiably expressed her anger toward me over the lack of frequency of my visits. If she recognized in that moment how happy she was to see us after so long a time, surely it could also have occurred to her how angry it made her that we had been so long away. None of us - even Gwen - would have blamed her, I am certain, if she had shouted at us instead of embraced us. This much, at least, in my mother survives the aphasia she endures.

And this fairly brief entry almost serves to remind me that the guilt that prompted it would be, in my mother's opinion, unwarranted and useless.

Bless her!