by Ed Evans, MGySgt., USMC (Ret.)
April 11, 2011
It was the first warm Monday of a late spring in Nashville, and I was scheduled for an early morning stress test at the VA Hospital. My new doctor, a very conscientious young man, was attempting to determine the cause of my shortness of breath and sometimes loss of equilibrium. I tried to tell him the cause was 'cause I'm 70 years old.
The VA Hospital here in Nashville, Tennessee, is much improved -- from services to attitudes -- from what it was 20 years ago when I first began going there for treatment of my Graves Disease related lack of adrenaline and the after affects of a Vietnam-era gunshot wound to my lower left leg. And it should be one of the best in the nation, since an agreement with Vanderbilt Hospital makes it part of Vandy's teaching experience for new doctors. But to be truthful, at my elder age I'm skeptical of all doctors. My experiences lead me to remind everyone that doctor's are only guessing when they diagnose, and that's why they call it a medical "practice."
When I was in VA Hospital a few weeks ago, I had four doctors attempting to determine why I came into the hospital emergency ward on a Friday night in extreme pain and sickness. My symptoms were a feeling that something was eating my gut, with a steel band of pain across my upper chest. When I had left the house so my wife could drive me to the hospital, I had dry heaved in the bushes, a reaction to the pain in my gut.
When I got to the emergency ward, they determined my blood pressure and temperature was up, they needed to keep me in the hospital, but no diagnosis as to why the pain. It stayed that way all Friday night until Saturday afternoon when I passed the gall stone that I had said I thought was the source of my pain. Meanwhile they had taken x-rays, CAT scans, poked, prodded, taken blood, given me intravenous solutions and even insulin shots in the stomach since my aggravated pancreas had stopped making insulin. I don't know that they ever actually agreed on a diagnosis, after all, where was the evidence? But I'm satisfied that what they could not determine, the Divine Healer handled. For, being a retired preacher as well as a retired Marine, I was surrounded in prayer by a great company of prayer warriors.
Thirty years ago, when my Graves Disease first attacked my thyroid, dropping me in weight from my customary 160-lbs to 95-lbs, and robbing me of any ability to think ahead, the medical community told me I was depressed about my pending military retirement. It was only when I insisted they at least do a simple blood test that I was diagnosed with Graves Disease.
So you can see why I approach the medical craft as a necessity in our lives, but I tend to take their assurances and sureties with a smile and a wink. I feel certain they are well-trained and serious about their craft, but I probably know my body better than they do, and I know the Great Healer.
Now, I will admit to being a bit sensitive about my age. I hate when the young girls at the grocery store insist they should help me carry my groceries to the car. And i guess I should be pleased when clerks want to give me a senior discount. After all, this old face does show its age, a fact I'm not unhappy about. It's been a rough ride, and some of those roads weren't paved.
But getting back to my Stress Test this past Monday, once again my age led them to treat me with concern. And that was understandable. I have no complaints there. But I had my own agenda.
The doctor was a young lady of about 25, the friendly technician was about the same age. They probably each asked me at least five times, "Do you have any questions?" They were so thorough in their explanations about what was to happen there was no need of further questions.
They had given me some sort of intravenous radioactive material, then performed a 15-minute CAT scan of my upper torso, then I was to perform the treadmill exercise, then they would follow up immediately with another CAT scan. Actually, I had a choice of the treadmill physical event, or they would give me an intravenous medication that would artificially stress my heart. Perhaps you can understand why I chose the treadmill. I wasn't sure they could. They kept asking me if I was sure that's what I wanted to do. I assured them it was.
The technician fitted my left arm with an intravenous device into which he could fit a syringe that would be used during the treadmill test. He explained that when I reached the right heart rate, and when I was about at the end of my ability to keep on, they would pump a certain liquid into me that would help them determine the condition of my heart.
They told me my resting heart rate was around 80, and they would need to get it up to 128 beats per minute for a good test. Could I do that? At least three times I assured them I felt I could. As they rigged me with heart monitors and other wires and connections, the technician talked about the good weather we were having and how he looked forward to getting into the great outdoors. He had not heard about Tennessee's best kept secret, Big South Fork, a National Park in middle Tennessee near Jamestown, and I shared with him the joys of having such a wonderful wild area so near Nashville, full of natural arches, hiking and riding paths, and the abundance of wild deer, birds and other animals along the trails by spring-fed waterways. It was once a private hunting preserve, but now the beautiful ridges and waterfalls are open to everyone, and much closer and less crowded than the Great Smoky Mountains.
Finally they were ready. The treadmill had a bar across the front with which to steady yourself, and bars on either side to keep one from falling off. The technician told me how some people had never used a treadmill and what some of the dangers were. I assured him I was familiar with the equipment.
They started out with a gentle walk, the doctor and the technician watching a bank of blinking monitors, glancing at me now and then. She pushed a button and the speed increased. I walked faster and fell into a rhythmic breathing pattern. My heart rate increased dramatically as the speed increased again, reaching 128 and continuing to climb. Now they glanced at me more often. I was enjoying the exercise.
"When you feel you can only go for one more minute," the doctor advised, "let us know so we can put this liquid into your blood stream."
"Okay," I said as I huffed and puffed. I was almost running now.
A few more minutes and my heart rate was at 154. Now it was the technician telling me to let them know when I was about out of steam.
I told them to go ahead and choose when they wanted to put the syringe in, because I could keep going.
The technician looked at the doctor, she looked at him, he said, "Well, okay, you've impressed us!"
At that he leaned over me, attached the syringe and emptied the liquid into my vein. After a few more minutes of them watching the monitors, they began to slow the treadmill until it finally stopped and I stepped off. Since they had not slowed it to a walk for a few minutes, but stopped it rather quickly, I was still breathing heavily. They asked if I was okay.
I replied, "I don't recover as fast as I used to, but I'll be fine in a few moments," and even as I spoke my breathing began to return to normal.
That exercise was then followed by another CAT scan of my upper torso, then I was finished. They told me I would hear from my doctor at some later date concerning the results. As I walked down the halls of the VA toward the garage where I had parked my green van, covered with Marine Corps stickers, I almost felt like I was walking a little taller, even with my customary left leg limp. The words were echoing in my ears, "Well, okay, you've impressed us!"
Small victory, but a great moment when you're 70 years old. Now, if I can only still do that when I'm 80!
Postscript.....How It's Done
I'll share a secret that I learned in the Marine Corps for going beyond "what you can do." First, this "secret" is fifty years old, and it's not all that secret. It is simply "continuing to march" when you think you can't. How? You change your thinking.
It's a fact of life that when faith leads, courage will follow. And sometimes, even in something as simple as pushing your body beyond what you think you can do, it takes an element of courage. But if faith leads, courage will follow.
It's something I have practiced all my life. There was a time when three of my four sons were teenagers, while I was still in the Marine Corps, and they would go running with me. Obviously, being younger, they challenged me. My number two son, Michael, used to taunt me on the run by running backwards in front of me. "C'mon, old man, is that the best you can do?"
Michael seemed to be a natural athlete, and he could always outrun me. He told me one day he had learned the secret to running. "You just run until it hurts, Dad," Michael explained, "then you keep going." True. Different people have different ways for making that happen. Some concentrate on their breathing, some repeat a mantra in their mind, some pick out a target in the distance and run to it, then select another target ahead.
For me, it was always the story of Gunnery Sergeant Hartman. When I was stationed at Marine Corps Air Station, Cherry Point, N.C., about the time my boys would run with me, we had a base commander who was a spirited runner. He liked to go on runs, would do that every noon hour, and he wanted his Marines to be as enthusiastic about running and staying in shape as he was. So he arranged to have a formal three-mile cinder track built on the base. I was about 35 at the time, and my left leg gunshot wound from Vietnam was only about five years old. Running was difficult for me at that point in my life, but I had been promoted to the highest enlisted rank, Master Gunnery Sergeant, and led of team of about 20 enlisted Marines. Marines always lead from the front, so I had to make running work for me.
When I would go running, I would often see GySgt. Hartman out there. He always looked like he was in deep physical distress, but he kept on running. Always. He never fell out, never slowed, never walked. He ran.
One day I had the opportunity to sit and talk with him, and I asked him point blank, "You look like you're about to fall over out there. How do you keep going?"
That's when he told me about Hue, South Vietnam. I was in Vietnam when the enemy attacked the beautiful city of Hue during the 1968 Tet Offensive, and I knew the Marines sent a relief column of tanks and infantry to help the outnumbered Vietnamese soldiers.
Hartman told me he was in one of those relief columns to Hue, about an hour's drive north from the 3rd Marine Division headquarters at Phu Bai Combat Base.
"We knew the best warriors in the city, the Hoc Bao (Black Panthers) had left the city and come south to assist our Marines along Highway One, our small teams of Marines within the villages who were being overrun by the North Vietnamese Army. So while they had a few South Vietnamese Army troops there, still the Hoc Bao's families and all of the Catholics there would be at the mercy of a merciless enemy. Other Marines were there ahead of us, and they needed our support. We had to get there.
"But our unit," he continued," had to go by shanks mare (by foot). All the mechanized traffic was busy elsewhere. We started out marching, then, as the Battalion Commander began to get updates on Hue, we realized the situation was desperate. At some point the command was given, "Double time, march!", and we began to run, still in ranks, our weapons before us at port arms, we ran toward Hue.
As Hartman paused, I thought I saw a misty look in his eyes.
"It was too far to run," he said. "But we ran. Women and children, the families of the Hoc Bao were being slaughtered. They were finding mass graves of priests and villagers. We had to get there. So we ran."
"Now," he said, "when I'm out here running, and there's just nothing left, I start running for Hue. I run to Hue. And I don't stop."
It's been about 21 years since I've seen Gunny Hartman, but I can remember every word. And like him, when the body wants to quit, when you just run out of gas, I run to Hue, the adrenalin flows, I run to Hue, and I don't stop.
That's the Marine Corps way ... improvise, adapt and overcome. Semper Fidelis.