I fear that I’ve fallen weirdly silent at times, on this blog and elsewhere, during the past year. Some of you may be waiting for me to reply to emails you’ve sent. Others have pinged me via LinkedIn messages, Twitter DMs, and even snail mail, and wonder where my typically garrulous self has gone.
Alas, I have a reason for being dilatory for the past half year. While 2023 has had some high points, like the launch of my new book and the 10th anniversary of our business, it has also been pretty awful on a personal level.
Yes, this is one of those nonprofessional, personal posts. Feel free to skip or wait for the next post.
I can sum things up as two blows.
Not sure of the year – perhaps 1980.
The first was the death of my father in Michigan. It wasn’t unexpected. He was 91 and had been declining steadily for decades. Formerly a vigorous athlete, a self-styled jock, his body gradually lost strength, tissues, and functions. Cancer took a lung, then other diseases sapped his strength and cost him the ability to lift his arms above his chest. His mobility decreased until he was restricted to a wheelchair, then surgeons amputated a leg. Affliction after affliction gnawed and reduced him.
In May he called my brother and I from yet another hospital stay, and wished us farewell. Not a very emotional man, as per his generation, this was a brief message, but he had clearly determined that the end was near. After that stay he entered hospice care. My wife and I visited him there and found him splendidly well cared for, but a shattered, barely living remnant of his former self.
A week later he died. My brother, my wife, and I traveled back to take care of things. This meant a welter of boxing, tracking down financial details, sending items away, notifying people, and many more logistical items. It meant and still means dealing with the emotional tearing of losing a parent. That work sprawled over the next month, intertwining with the rest of our lives. It still continues.
From the obituary Nelson wrote, which I amended slightly:
Nelson Case, beloved father, writer, and producer, and avid tennis player, died on June 26, 2023, at the age of 91. He died of natural causes. Mr. Case retired in 2000 after a professional career spanning 50 years, chiefly in the field of entertainment, from stage managing on Broadway and acting in Hollywood and New York, to becoming one of the premier writer/producers in the field of corporate communications for over 40 years. He is survived by his sons, Kevin Case and Bryan Alexander, his daughter-in-law, Ceredwyn, Kevin’s partner, Terri van Valkinburgh, and two grandchildren, Gwynneth and Owain Alexander.
From left to right: myself, Kevin, and Nelson, during the pandemic.
I have been too busy with professional work to do the emotional work of grieving. I know this is not good, but economic needs are paramount, at least in American culture.
Then the summer’s second blow fell, this time upon my wife, Ceredwyn. Early this week she suddenly suffered a heart attack.
Early Monday morning chest pains appeared and worsened, then showed classic heart attack signs. We called 911 and in a couple of minutes were surrounded by efficient, kind, and skilled EMTs, who transported her to the hospital. Ceredwyn spent a day and night there, being tested, prodded, observed, while I stayed with her. Tests showed that it was indeed a heart attack, as one enzyme was heightened, which is what occurs when there’s heart tissue death. The technical term is NSTEMI, for non-ST-elevation myocardial infarction.
“Heart tissue death” is not a phrase I anticipated typing this year, especially about my splendid wife – who’s younger than me and far wiser about health than I.
That’s a pulse oximeter glowing on her fingertip. The wires below her palm lead to various spots on her body.
The next day the hospital conducted a cardiac catheterization, which astounded me as a husband and as someone who follows and thinks about technology. The cath team inserted a probe in her right hand, then drove the thing up through an artery all the way along the inside of her arm, then across her chest and into her heart. There they found a major artery 90% blocked. The team cleaned this out then withdrew. (I waited helplessly in her room; a kind nurse visited me to ease my dread.) Ceredwyn spent the next day recovering and being monitored, before being discharged.
Now she’s at home, resting and recovering. We’re exploring changes to her diet and exercise, which is complicated and at times either galling or contradictory. She’s also on a stack of medications, and here follow two observations about American health care:
- One of the drugs cost nearly $400 US after insurance had done its thing. Thankfully a local pharmacist spent an hour doing high level bureaucratic finagling to reduce this, but just think of what this might have meant. I’m shameless in advocating for my family and have other advantages (age, education, extroversion, race, gender, etc) and I shudder to think about how people have to deal with this financially. Think of how much this might have cost to someone without insurance, or whose policy didn’t do anything to help.
- At no point until the medication did we make a rational economic choice. We did not, for example, cost out different ambulance services or sift through evaluations of hospitals. Instead we grabbed what was nearest and fast. Yet our medical system is predicated on patients and caregivers as rational economic actors.
Ceredwyn is still processing all of this. Physically, she’s still in some pain and her arms are seriously bruised at at least ten points where medical staff tried (and sometimes succeeded) in getting entrance to her veins. Mentally she’s processing the trauma of a sudden, near death experience. That particular artery being blocked is nicknamed The Widowmaker (perhaps a widowermaker, to be more precise or pedantic) and it’s a radical, fundamental thing to nearly be killed by it.
Ceredwyn’s arm after the catheter invasion. Note the hand being dark; that’s due to the tourniquet above.
My wife, my father: I can’t describe how much their respective suffering horrified and enraged me. There is so much going on here – my adoration of professionals who provided them with fine, compassionate care; endless frustration at bureaucratic strata we’re forced to tunnel through; the difficult in expressing any of this as a GenX male in American culture. My futurist mind kept generating scenarios and outcomes from the most optimistic to the most direly pessimistic. The planning and strategic part of my mind ceaselessly worked, developing workarounds for problems and setting priorities in careful echelons.
I want to say more, but as you might expect from the preceding, I feel awkward as hell writing this much. So I’m behind schedule and will be so for a while, as the fall semester bursts into life starting Monday (yeah) and I struggle to catch up with everything that fell by the wayside this awful year.
Please, everyone: take care of yourselves and each other. Be safe.
Thanks Bryan, these are vicissitudes of life, I’d not call them as “downsides”, these are what make us humans. All the best to Ceredwyn, as we say in down under, Kia Kaha, stay strong. Things happen. All the best and love to you Bryan, we will wait for your messages, as and when you can. Take care of yourself mate.
Thank you, Arin. I appreciate the wish and perspective.
Bryan – So sorry to hear this. Sending wishes for recovery for your wife and some strength and peace for you.
Thank you, Denis.
Oh Bryan. You very briefly shared the death of your dad a few months ago and I noticed you immediately “got back to work”. Now this traumatic health issue with your dear wife.
Please know that you have a caring community all over the world!!!
Look after yourself and your family. Sending deep care for you.
Vivian
Thank you so much, Vivian. This virtual community of care means the world to me.
You have maintained your optimism and belief in the well-meaning of others. That is in character and will help you feel better eventually.
That is a very kind and wise thing to say, Ellen. Thank you.
Bryan—I am so very sorry—for all of what you and your family have and are going through.
Thank you, Catherine.
Tami and I have you and your family in our constant thoughts. Hang in there old friend!
Thank you, kind Gregory.
Bryan, my thoughts & prayers for you & your wife. This too shall pass
Thank you, dear Gisele.
Wish you the best. Your life and family are more important.
Thank you, Mohammed.
I just retired from my teaching job in Boston. My landlord wanted me out so he could quickly slap some paint on my apartment and rent it out by September for twice what I was paying him. In a matter of weeks, I had to both move out of my classroom and apartment of many years and lug it all to my house in Vermont. My husband and I bought this fixer upper in 2008 for too much money. Then the pipes burst and he came down with Parkinson’s. I moved up to a money pit that has been waiting for me for years, in an economy that’s mercilessly sucking everything I’ve ever done sway. I know just where you’re at. Just two busy to be overwhelmed, or so overwhelmed you are just living in the moment and staying on top of everything like medical personnel doing triage. I’ve never gone through anything like this before. And you are the same. We don’t know how it will all turn out. But are you feeling the same as I? That you are stronger than you ever realized? That you have talents that you didn’t know you had until circumstances made you use them. There’s always that silver lining. At least you have a forum where you can unload your experience and know that people will hear and care for you. Be grateful that you have that.
How terrible American life is — is there any country in the world that allows the rapacity of capitalists everywhere (including for medicine) like the US?
When will it end?
I don’t know. I fear we will lose our democracy and then all hell will break loose.
There is also a burgeoning left movement within the United States, with people like Bernie Sanders and AOC.
My dear Teresa, how horrible! I am so sorry, especially as this all happened after your retirement.
Is there anything we can do to help?
I’ve had four heart attacks in five years so I’ve had many caths and pills. I learned from the last one my heart grew new arteries to replace the blocked ones. I had to retire but your shows are one contact with the field of education. Keep on
Ye gods, Joel! That is definitely too many.
Besides retirement, how else did you change your lifestyle?
So many life episodes so close together…I appreciate your sharing such a personal story. Please take care of yourself too as you support your wife and children.
Thank you, Lynne. This is hard to write about. And harder to care for myself.
You are an open and sharing person from who we all learn. Our hearts are with you.
Thank you, my friend. I believe in connections.
Bryan, I’m sorry to hear all of this but I appreciate the raw honesty in this post. My dad also had a “widowmaker” heart attack about 12 yrs ago. Luckily, he’s had a clean bill of heart health since if that’s any condolence.
After meeting you in-person for the first time at SCUP, I walked away thinking how kind and patient you were. Your joy in being around others and learning w others radiated. I’m glad you’ve had some ups alongside all the downs. Take care of your family, we will still be here when life calms down. But put your sweet Ceredwyn and yourself first.
My dear Shannon, you are so kind. Thank you for the very sweet words and thoughts.
All I can offer you is my care, appreciation, admiration, and empathy.
Vivian Forssman phased it better than I can.
Hope your wife make a full recovery soon.
I am grateful to you for all of that, Carl.
Bryan,
You are so brave!! You are realizing the strength hidden in you for just such tragic times.
Having been through tragedy myself 4 years ago when my 43-year-old son died suddenly, I have realized just how strong I am!
One very important thing I learned was to never stop hoping! Hope is air!
Another thing I realized is that my connection to others is vital. Knowing I’m not the only one to suffer is helpful to me.
I’m sending you a big hug and lots of love,
Judy
xxoo
I remember your tragedy, Judith, and its horrors.
You, my dear, are always so strong!
Bryan, as usual, you are soldiering through with considerable grace. I’m sorry this year has been so hard. I hope you can give yourself some time to reflect, and heal, soon. You are worth it. And there is no time that it feels convenient for the body and mind to say “enough” and force that rest upon us! Perhaps you can join your lovely wife in some of the rest she needs for her own recovery?
Thank you, Val, for your hard-earned wisdom.
Please take care of yourself, Bryan. This is a lot, esp. in this summer where so much feels on fire in truth and metaphorically in climate, politics, and academia. Blessings and prayers. So appreciate your focus on issues of the future but we can wait a bit if you need a break.
Thank you, Deborah. Not sure when a break will be possible.
Sending love and best wishes ❤️
Thank you for sharing.
Kathy Bakhit
Thank you, Kathy.
Prayers for your wife and peace of mind for you.
Thank you, Stephen.
When major life events stack up like that it definitely takes a toll. Thank you for sharing it here. I’m wishing Ceredwyn a good recovery, and hope you find a way of giving yourself the time you need for yourself in this.
Thank you, Ton.
As an American I think it’s unlikely I’ll find such recovery time for a while.
Bryan, you have nailed something I’ve tried to put words to – the tension between gratitude for our healthcare people vs. utter frustration at a health care system. I know we can do better as a people and country, but fear it will take longer than my time here. I’m so grateful Ceredwyn is on the mend, I didn’t realize that a heart attack preceded the catheterization. Healing vibes to you & Ceredwyn, Gwynneth and Owain… that’s a lot of trauma in a short time!
A heart catheterization can be done before or after symptoms and event. If symptoms build up slowly, the cardiology team has time to help the patient through testing and a diagnostic, sometimes interventional catheterization. But when blockages build up and then a piece of plaque falls off, clogging an artery downstream, the even happens first and you pray the patient gets to the cath lab with enough time that the interventional cardiologist and or surgical team can find and fix the blockage before permanent damage occurs. btw, that’s why statin meds are used – they stabilize the plaque and make the heart attack less likely
Well said, my experienced and knowledgeable friend Briget.
Ceredwyn’s now on a statin and two blood thinners.
Thank you, Lisa. Quite a tension indeed.
Challenging times for you and your family~ sending best wishes from Australia
Thank you, Charmayne.
Powerful
Thank you, David.
Tears in my eyes reading this … you have been through so much.
God be with you and your wife and family
Glen
You are very sympathetic and kind, Glen. Thank you.
Bryan, I cannot even imagine this and really should be better at preparing for these events that are sure to come one day (my dad now 80 and in great health and my mom as well at one year younger) but we never get around to preparing for these events for one reason or another.
Sending a big bear hug to you from México.
I am so glad to learn about your parents, Ken, and also grateful for your kind thoughts.
Y ahora estudio espanol!
My deepest and sincerest condolences.
Sheila Aird
Thank you, kind Sheila.
My condolences. I’m not sure you chose when to grieve. Important that you do. Every day is precious.
Indeed, you are wise, Stan.
Bryan, you have my sincere sympathies, and too much empathy too – like you, I’ve seen an astounding number of close family members hospitalized this year for a whole range of health concerns. It’s as though the pandemic’s aftermath has unleashed pent-up diagnoses for warning signs that were going unheeded, while front line healthcare workers are overwhelmed and exhausted. UNlike you, though, the personal upsets have definitely impacted my productivity. I don’t know HOW you do it, maintaining so much activity, writing and publication despite the personal trials. All the best, Ken
Ah, I’m so sorry to hear that, Ken. I think you’re right about post-COVID illness.
Please take care.
My condolences. Hang in there, best you can. And do take your time, at the times when you need to take it.
Thank you, kind Elena.
Sending love, care, healing vibes, and good energy.
Take the time you need to take care of you and your family…
and also f*&% capitalism and the need for productivity (though yes, very real especially if self-employed in gig economy).
Self-employed I am, so yeah, must feed that need.
Thank you for the kind thoughts, Sara.
Sending strength to you and your wife for her healing and peace for the entire family. I’m sorry for the loss of your father, May his memory be a blessing. . . .
Thank you, Sarah. My wife is very strong.
Thanks for sharing this, Bryan. I am so sorry to hear about the loss of your dad, and Ceredwyn’s health issues. I hope that you can take some time to care for yourself as generously as you care for those around you. Sending you and your family best wishes…
Thank you, Jason. Good to hear from you again.
I knew your father for over 40 years, having met in NYC while we negotiated the SAG contract and he traveled back and forth from MI.
I hope you know that even with the complicated relationship you had, he was EXTREMELY PROUD of you and Kevin and he loved you both.
He spoke very highly of each of you. And yes, his generation loved different, but it doesn’t make it less.
I wish good health to your bride, and please know I am sending you love and healing vibes.
My dear Angelia, how awesome to hear from you. Thank you for sharing those memories. That means a great deal to me.
This sounds like a harrowing year indeed. I am so glad Ceredwyn got the care she needed quickly! Please (both of you) take care of yourselves. The world would be a poorer place if you were to retire.
On a more optimistic note (for me and others in the healthcare industry) if you would put your INCREDIBLE TALENTS into improving the healthcare system I would truly appreciate your efforts and the improved system you would undoubtedly come up with.
You are so kind, my friend.
I have been researching health care as a system, in part because there are interesting parallels in higher ed. Hmmm!