The Jehovah's Witness Protection Program

Saturday

http://jwpp.bandcamp.com/

My first clue that 'something was up' lay in the fact that it was 7 am in the Intensive Care Unit and getting to my patient was a challenge for all of his visitors in his room.

My second clue that 'something was up' lay in the fact that my patient was African-American and all of his visitors were white.

Now before we get all racially sensitive, I am very aware that many families are blended in many ways and many of us are close friends with people of all races. As well it should be. However, in the hospital where I work, it is an uncommon sight to see a room full of white people at the bedside of a black man at seven in the morning. Just sayin'.

My patient was a Jehovah's Witness and was losing a great deal of blood. He chose not to receive a blood transfusion. Fair enough. I respect his decision. But I had work to do, so I asked that only two visitors remain in the room. Three men remained.

The oldest of the three, a diminutive man dressed in a white shirt, beige trench coat and glasses with 'flip-up' sunglass lenses stood staidly at my patient's bedside and without introduction said, "I would like to speak to the doctor". I asked my patient if it would be OK for the man to speak with the doctor on his behalf. He consented.

When the doctor arrived, the little guy in the trench coat said "We want EPO and Iron only. No blood products. Fingerstick blood samples only".

The plot thickened. I suspect that these men were from the "Jehovah's Witness Hospital Liaison Committee". or what I referred to as the "Jehovah's Witness Protection Program". Although they never did introduce themselves or state their relationship to my patient it was clear that they were at his bedside to advocate for his choice not to receive blood.

My problem was not with my patient's choice.

My problem was with the fact that the JWPP guys came off all self-righteous and pushy. No "please's" or "thank you's". It was clear that they considered us, the health care team, to be the enemy. At one point, another JWPP rep abrasively questioned, "Why is it taking so long to give the EPO and Iron? Didn't the doctor order it?" Sucking it up, I chose not to say "It's been 15 minutes."EPO" and Iron are not going to save this guy." But instead, I gently informed them that "these medicines would be given in a timely manner, but that they were not considered 'emergent' at this time."

My JWPP team seemed sadly misinformed.

Explaining that "fingersticks" are a great alternative to classic blood draws if you haven't already lost 3/4 of your circulating blood supply was received with incredulity. I had to show them my patient's white, almost translucent fingertips in order to prove the point. I still don't think they believed me.

"EPO" (as they referred to it) is actually "Erythropoetin" a building block of red blood cells that is normally manufactured in our bone marrow. My patient had no difficulty in manufacturing red blood cells. He was just losing them at a rapid rate. "EPO" may not hurt - but in the immediate treatment of profound blood loss, it was not going to help.

Iron is a component of our blood that helps carry hemoglobin (oxygenated blood). Again, without an adequate supply of blood, giving Iron is somewhat moot.

An incredibly courageous choice. My patient knew that receiving blood would save his life and that we were ready to give it to him but he chose not to receive it. Was it his strong faith? Was it his fear of being shunned? Was it the fact that he was not strong enough to change his mind? I will never know.

I do know that his decision was respected by all members of his health care team. I also know that the JWPP could have chosen to sit with him and hold his hand throughout the night while he lay dying in a hospital bed, but instead he was left alone, holding the hand of a health care worker, a nurse he had just met a few hours earlier.


New York City...The Macy's Experience

Thursday

I had always heard going to NYC around Christmas-time was a very cool thing to do. I had no idea.
A sucker for sappy, tear-jerking Christmas movies with deep messaging, one of my all-time favorites is the original "Miracle on 34th Street" with Natalie Wood...
The movie was all about Macy's Department Store and its Santa. You probably know the rest, but if not - do yourself a favor and rent/borrow/download it - you'll be glad you did.
 They had me with ..."Believe".
I'm not a shopaholic. Never have been. 

That being said, walking into Macy's at Christmas-time was as close to a religious experience as I have had in a while.

Was it the colors? Or maybe the messaging? I don't know.

But after taking a moment to pause, breathe and get all misty eyed while standing in the middle of  Macy's Main Floor corridor - I realized that I too, drank the Macy's Kool-Aid.


And then there were the window displays...

My one-dimensional photos are a far cry from the magic of the window displays. While looking at them, think 'movement', 'music' and 'sparkles'.

As I was leaving Macy's ... The Salvation Army... ringing their bells to the rhythm of the Christmas beat...
I love New York.

Spain: Seville

Friday


Barcelona or Seville? Doing both was not logistically feasible for us, so the historic value of Seville won out in our decision-making and was only 2.5 hours by Renfe AVE train (high-speed) from Madrid (Renfe is the national train system).


Located in the Andalucian region of Spain, Seville (Sevilla) is known for its Tapas, Paella and Flamenco.

Tapas is everywhere. Small servings of food normally ordered at bars way before the 9 pm dinner hour. We frequently had tapas at 6 (as 9 pm conflicted with our bedtime). Here's an idea of what we ordered....
Tapas

Tortiilla Espana = Potato Quiche
Tortilla Paisana = Veggie Quiche
Aceitunas = Olives
Alioli = Garlic and Oil
Calamare = Fried Squid (not necessarily battered)
Boquerones = Anchovies (quite popular)
Patatas Bravas = Small diced potatoes
Pulpo al gallega = Octopus
Pan = Bread

On the occasional days we could hold out until 9pm to eat dinner...this was our favorite...
Paella
Many years ago, I read a book written by Erma Bombeck called "When You Look Like Your Passport Photo... It's Time to Go Home". She described how young people would regale their friends with stories of the architecture, artworks and culture when they returned home from their travels abroad. Old people talk about the food. OMG. I have arrived.

Travel tip: Re: Train travel in Spain. Save money. Go Tourist Class. We traveled Renfe '1st Class' (to Seville) and 'Tourist Class' (from Seville). There was very little difference in service or comfort between the 'class' structures. 1st Class offered a small complimentary snack and wine.

 Flamenco
Our 14th Anniversary was celebrated over dinner and a Flamenco Show at El Palacio Andaluz.

My knowledge of dance is lacking. That being said, the long faces and apparent bad attitudes of the Flamenco dancers was getting to me. In fact,  they were looking downright pissed off. 

Later, I learned that's the way it's supposed to be. Flamenco's roots are from many years ago where it was a secretive dance to express passion and frustration of poor, disenfranchised Spaniards.

There you have it.

Seville was lovely. All tiny alleyways and flying buttresses.
The Seville Cathedral (circa 1100) is an architectural miracle and is the final resting place of Christopher Columbus.
Seville Cathedral
Seville Cathedral - Flying Buttresses

Spain: Toledo

Thursday

About 30 minutes by train from Madrid, the ancient city of Toledo was a cool day trip to a way-old city known for Muslim, Christian and Jewish peaceful co-existence. How refreshing. As odd as it was to see a nun selling Christian trinkets and religious artwork in an ancient Mosque, it was equally civilized.

Toledo is a UNESCO designated World Heritage site.According to Wikipedia..."The (UNESCO) program catalogues, names, and conserves sites of outstanding cultural or natural importance to the common heritage of humanity."

And rightly so - Toledo is so incredibly rich in culture and beauty...





Spain: Madrid

Wednesday

Our Madrid experience began at 0300 Dallas-time and our first stop was the Tourist Info kiosk where we were to pick up our pre-purchased train passes.

Spotting the Tourist Info booth was not a problem as Madrid's Barajas Airport is largely constructed of walls made of clear glass. The problem was in actually getting there. After riding the glass elevator to nowhere a few times, we eventually changed our strategy by using the escalator.

Travel tip: When in Madrid's Airport...consider using the escalators. The elevators bypass certain floors.

After an uneventful train trip from the Terminal 4 at the airport to Atocha Station, we walked a couple of blocks to our hotel and despite mind-numbing sleepiness, sucked it up and started out on our tour of Madrid...
The Rose Garden in Parque del Retiro
Parque del Retiro
A view from our hotel room
We weren't quite certain of what we ordered but we think it was ham.
Yup. 100% Iberian "Jamon"
Served on bread with a very generous drizzling (1/4 cup) of Olive Oil

Plaza Mayor
Typical Street signage
He had no choice, really
 FYI: Our tour of Madrid did not include attending a bullfight.
  • Palacio Real
  • Museo del Prado
  • Plaza Mayor
  • El Rastro
  • Museo Thyssen-Bomemisza
  • Parque del Retiro
  • El Escorial
  • San Francisco el Grande


Free Advice

When you are going someplace that you know very little about and have a limited amount of time at your disposal, pick up an "DK Eyewitness Top Ten" guide to help you navigate your trip before you go.

They're inexpensive, little handbooks that include train, city and road maps, points of interest with corresponding addresses, opening and closing times.

For example, let's say that you are going to Paris...

There are a ton of things to see in Paris, the 'Top Ten' guide gives you a list of the 'Top Ten' Paris highlights. Let's say 'The Louvre' is listed in the 'Top Ten" Paris highlights. This is where the dirt meets the road. There are tons of things to see in 'The Louvre', so the 'Top Ten' guide then gives you a suggested listed list of the 'Top Ten' works of art within 'The Louvre'.

Nice, clean and neat.

I am not being compensated  for my DK Top Ten endorsement...I just really like them. 

Paranoid in South America

Anticipating travel to South America was both exciting and scary. Admittedly, reports of muggings, kidnappings and police corruption go...