A Few Good Men

Sometimes we get ourselves in trouble, and sometimes all it takes is a few good men or women to help us get out.

Our friends from Cleveland came East for a visit last weekend. The nine of us decided to go on a booze cruise around Casco Bay. Booze and music, that is. I confirmed over the phone that the ship was wheelchair accessible, including an elevator between the two decks.

At 7:30, after a nice dinner at Sebago Brewing Company, we boarded the Bay Mist, one of the ships operated by Casco Bay Lines. We decided the best place to hang out would be on the upper deck. One of the crewmembers came by and said he would operate the wheelchair lift for me. He opened the door, and I drove in. My Permobil wheelchair barely fit. There was no room for another passenger.

I started inching up. About two feet shy of the top floor, the lift stopped. Oh crap.

The crew and Kim communicated with me through the glass window at the top door and via cell phone. Not to worry, they were working on the problem. It started to get warm in the elevator. I didn’t feel claustrophobic, per se, but I did want some fresh air.

After about ten minutes, the elevator began moving again, and I exited onto the top floor, no worse for the wear.

We had fun on the top deck — watching the sunset, sipping on cocktails, and enjoying one another’s company. Then I heard my phone ring. Who was calling? Nature, of course.

“Kim, I need to use the bathroom.”

“The only bathrooms are on the lower deck.”

We decided that, because of potential problems with the lift, when we reached the lower deck we would stay there for the rest of the three-hour cruise.

The ship’s crew helped me down to the lower deck. The lift performed well with gravity on its side. I used the bathroom, and then we surveyed our surroundings. We didn’t want to be there. I decided to take a chance with the lift and go back upstairs.

Again, things worked well until I was about two feet shy of the upper deck, at which time the lift came to a stop. On this occasion, however, the crew couldn’t get it going again. After about 20 minutes, I told Kim over the phone, “It’s getting hot in here. Let’s just have them take me back down to the lower deck.”

Nice plan Mitch, but this time the lift wouldn’t go up or down. I was stuck.

Fortunately, the crew figured out how to open the elevator door at the top and let fresh air in. I was comfortable, and not panicked at all, but I was still stuck in an elevator. My friend, Dawn, kept me lubricated with rum and cokes, and I made the best of it.

The crew was pleasant and helpful. While they kept troubleshooting the electronics, we discussed plan B. A group of four men, a.k.a. a few good men, with experience in the Armed Forces and the fire department, had volunteered to lift me out by hand if necessary. I didn’t want to be lifted out. It would probably hurt. I’m a big guy.

So, I encouraged the team to keep troubleshooting the motor and switches. After having been in the elevator for about an hour, I said, “Okay, give this one more try, and then call in the extraction team.”

My people found the few good men and asked if they were still willing to help out. “Hell yes,” they responded, ready for action.

On one of the earlier attempts, a crewmember had been able to pull up on a handle inside the elevator as we tried to run the motor, and we gained an inch or so of elevation. But this crewmember wasn’t a big man. With the few good men standing in front of the elevator waiting for their chance, I asked the strongest looking one if he would pull up on the elevator as we made this final attempt. He did, and all we gained was another inch.

“Let me try one more time,” the big guy said.

Again, we slowly gained an inch and then something happened. The muscles in his forearm rippled. His face turned red. The elevator began moving upward again, completely under his power. I rolled out onto the upper deck to the applause of my friends, the crew members, and the few good men.

Because of the change in tides, we disembarked from the top deck, and the rest of the evening was uneventful.

On Monday, when I spoke to the people at Casco Bay Lines they were very apologetic and explained that this was an old “screw type” lift, whereas all their other boats were equipped with hydraulic lifts. I will not go on the Bay Mist again unless they upgrade it. Casco Bay Lines agreed to refund the money for our entire group of nine people.

Sure, if I had been in my iBOT wheelchair, we would have used the stairs, but I certainly should have been able to enjoy this evening in my Permobil. Situations like this are completely avoidable. Lifts need to operate up to capacity, in a reliable way. That said, everyone who assisted me remained cool and calm. No tempers flared. We all worked toward the common goal of getting me out of the elevator. Thanks to a few good men, and one in particular, we succeeded.

I keep getting into trouble when I leave the safe confines of my home, but I’m not going to stop quite yet. There’s too much to see, too many fine people to meet, and too many adventures to experience.

Casco Bay Publishing

Enjoying the Ride: Two Generations of Tragedy and Triumph will be published by an upstart company called Casco Bay Publishing, LLC. Okay, this will be their first book. Okay, this may be the only book they ever publish. Okay, Casco Bay Publishing is Kim and me.

It’s something self-publishers do. It’s called an imprint, and it makes your book look more professional. It also prevents Amazon from putting their name on your book as the publisher. And finally, it's a nice way to separate the book business from your personal finances.

Casco Bay is what we call the coastline, islands, and ocean in southern Maine around Portland (see photo I took, below). It seems that half the businesses in Greater Portland are named Casco Bay This or Casco Bay That, so we were pleasantly surprised that Casco Bay Publishing was still available.

In the meantime, we inch closer to launch day.…

I plan on having two kickoff events, one near my home in South Portland, Maine and one in Lincoln, Maine where I grew up. I’ll announce those dates and locations as soon as I have them finalized — but rest assured it will be before the end of summer.

The print book will be available for sale by me personally and at Amazon. I also hope to place it at several retail locations around the state. An electronic version will be available through Amazon Kindle. Later, probably in the fall, I plan to release an audio version which I’m just beginning to record now.

Simultaneous with the book rollout, I’ll have a new website that incorporates news and information about the book along with my regular blog posts. Standby for more information on that.

A friend and prominent member of the MS community wrote a foreword for the book. Any guesses who?

I’ve gathered some endorsements along the way from authors such as Joseph Sousa and Travis Mills. Those appear on the back cover of the book.

In short, don’t worry about not knowing when the book goes on sale. I’ll be shouting it from the rooftops, and you’ll be unfriending me on social media to stop the noise. 

From the Archives (because I'm too busy with the final details of the book)

An oldie but a goodie: My Pet Peeves

Click the video below, or click here.

How are you doing?

The title question is not to be confused with the more common greeting “how are you?” Under no circumstances should you respond to "how are you?" as if the questioner gives a damn about your personal life. Acceptable responses are:

• “Good.”
• “Good, how are you?”
• “Fine, thank you.”
• or similar drivel

By adding only one word — “How are you doing?” — the innocuous greeting becomes a loaded question, especially when directed at someone with MS or an equally challenging condition. When I am asked, “How are you doing?” I have to make a decision. Do I undertake the hard work of telling the truth, or do I give a canned response? It depends.

I believe most people who ask me this question do so with sincerity. They wonder if the disease is progressing. They wonder if I’m coping well. They wonder if I’ve found an effective treatment. And I believe most people who ask me this question do so with compassion. They care about me, and they hope for good news.

Nevertheless, I reserve the right to give a canned answer such as “good” or “hanging in there” or “about the same.” I may not have the emotional energy to go any further at that moment. Just because someone invites me to delve into the gory details does not mean I am obligated to do so.

Still, if you are sincere and compassionate, here’s some advice on asking somebody like me “How are you doing?”

• Ask me "How are you doing?" if it's been a long time since you last asked me.
• Ask me if we are close friends or relatives.
• Ask me if you are similarly afflicted.
• Ask me if I am the one to raise the issue of my health (or your health for that matter).
• Ask me in a more specific manner if you can. For example, if you know that I went to the cancer center for an infusion last week, instead of asking me “how are you doing?” ask me “how did that procedure go last week?” The more specific questions require less emotional energy to answer than the more nebulous ones.
• Ask me later in the conversation, after the excitement of reconnecting with you has begun to wane. Let’s talk about the good stuff first.
• Ask me at a bar, over drinks.

Also keep in mind. When you ask someone with a progressive disease “How are you doing?” you are asking a lot. Are you ready for the answer?

Playing the Disability Card

“Playing the disability card,” is a phrase that carries a vaguely negative connotation—like I’m getting away with something. Let’s examine that.

There’s not just one disability card. There’s an entire deck of them.

The Public Access Disability Card

A couple of years ago I came up with an idea to improve wheelchair access to the bridge between South Portland, where I live, and Portland, across the Fore River. After two years of negotiating, designing, and construction, there is now an accessible pathway. I wrote about it here.

When I play the public access disability card, I certainly don’t feel like I’m getting away with something.

The Personal Safety Disability Card

We had a pitched battle in my neighborhood about parking and traffic patterns. The issues were complicated and contentious. I wrote an email to all the city counselors and the city manager, which contained this statement:

With my proposed traffic pattern, the neighborhood is much safer for me to negotiate in my wheelchair. With the alternative traffic pattern, I’ll feel like I’m risking my life every time I cross the street.

Even though I played the disability card, I lost the argument. It turns out I may have overplayed my hand. I haven’t been killed on the street, and I haven’t even had a close call.

The Convenient Excuse Disability Card

My father didn’t like to go out and socialize. My mother did. So, when they had plans, and the weather forecast called for rain, he would say something like, “Looks like we won’t be able to go out after all. Can’t get your wheelchair wet.” In fact, they could get her wheelchair wet.

Kim and I don’t play these games with one another, but we’re not above using a phrase like, “We would love to join you, but Mitch is just a little tired today.” Everybody knows I have a serious disease, and invoking said disease gives us an instant, unarguable excuse when we would rather not participate in an activity.

This disability card falls in the category of “we deserve it.” It’s a little white lie that we’ve earned the right to employ on occasion.

Note to my friends: you can’t possibly know when I’m playing this card versus when I really am too tired to go out, so you may as well give me the benefit of the doubt.

The Handicapped Parking Disability Card

To be clear, Kim would never park in a handicapped spot without me. But even with me in tow, there is a gray area. Suppose Kim and I are driving by the grocery store, and she says, “Oh, we need milk. Do you want to come in with me or wait in the van?”

I might respond coyly, “I can’t decide.” This is code for, I don’t plan on going in, but because there is technically a chance that I will change my mind, or that some sort of emergency will occur and I will need to escape the van, this qualifies you to take one of those “van only” handicapped spots near the front.

This disability card is pushing ethical limits. On the one hand, I’m technically correct to keep all my options open—to preserve the ability for me to exit the van if I want to. On the other hand, what if I’m taking the last handicapped spot, and this decision pushes another handicapped person far out into the parking lot? Then, have I overstepped my bounds? Have I played the disability card out of turn? In this instance, I feel a little bit like I’m getting away with something.

Those Times When I Don’t Play the Disability Card

I often refrain from playing the card. I belong to a neighborhood association that decided to hold a celebration at an old, inaccessible tavern. I didn’t argue against this choice of venue. In fact, I helped with the planning of the event and kicked in 20 bucks toward the food spread, even though I couldn’t attend. The event wasn’t only about having the neighborhood get together for bonding, but it was about celebrating this ancient landmark, an establishment that would be prohibitively expensive to make accessible. I’m cool with that — just as long as venues like this are the exception rather than the rule.

The disability card is such a powerful tool. I want to use it appropriately. How do you decide when to play the disability card?

Available Summer of 2018

Enjoying the Ride
Two Generations of Tragedy & Triumph
Mitch Sturgeon


Details to follow.

Optimism

    It sure seems like the world is going to hell: climate change, job insecurity, authoritarianism, racial strife, fake news, terrorism, and so much more. However, despite these issues, the human condition has never been better than it is now.

Because of my poor health, I’m not optimistic about my own situation. As I have stated here before, I suspect I will miss the cure by more than a few years. But I do harbor a general optimism about humanity. I resist falling prey to the constant barrage of bad news in the media. It’s what sells, but it’s not representative. You never see a story about how much better people’s lives are today than they were thirty or more years ago. Boring.

Am I unsophisticated, naïve, pollyannaish? Not at all. I have data to support my position (did you think for a moment that I didn’t). Steven Pinker is one of my intellectual heroes. Please take a few moments to watch his Ted talk and let me know what you think. (If you are receiving this blog post through email, click here to watch the video.)

The iBOT Lives (Again)

Looking Back

I’ve written here countless times about my stairclimbing, four-wheel-drive, balancing-on-two-wheels wheelchair, the iBOT. Here are a couple of excerpts about the iBOT from my upcoming book "ENJOYING THE RIDE: Two Generations of Tragedy and Triumph."

There is no relationship between human and machine more intimate than that between a wheelchair and its user. The chair serves not only the function of legs, but also couch, recliner, dining room chair, car seat, chaise lounge, dog walker, coat rack, drink holder, getaway vehicle, and shopping cart. It is, therefore, ironic that the customary term for such a condition is "confined to a wheelchair," when, in fact, the more accurate term is "empowered by a wheelchair."

I wrote about taking the iBOT home for the first time, after eight grueling hours of training:

On the drive home Kim and I found ourselves alone with the iBot. Our trainers were no longer there, approving or disapproving of every move. This reminded me of the drive home from the hospital so many years earlier with our first child, wondering if we were ready for the added responsibility, but excited about the future.

I received a letter, six months after purchasing my iBOT, announcing that the program had been discontinued, mostly due to the fact that Medicare would not reimburse patients:

From the time I took delivery of my iBot until the moment I read this letter, I had been an evangelist. Everywhere I went, I spread the good word about this life-changing device. Nobody with a progressive, crippling disease had ever been more delighted than me to obtain a wheelchair, not only because it improved my life, but because I became part of something bigger than myself. I felt proud to be one of several hundred people in the world to own an iBot, and I wanted anyone who needed one to have that same opportunity. Few causes come along in an individual’s life that are this deeply personal, this rewarding, this freaking awesome.
   And, poof! It was gone.

That’s where things stood for a few years. A number of us had our iBOTs, but nobody else would.

Looking Forward

The iBOT wheelchair was invented by Dean Kamen and his company, DEKA, located in Manchester, New Hampshire. Since the initial effort was shut down, Dean and his team have been working on a new iBOT.

Over the past couple of years, I, and a few other users have met with representatives from DEKA to provide feedback on their updated design. In one phone interview with representatives from DEKA, they asked me a series of questions along the lines of “would I rather have this or would I rather have that” in a wheelchair. Then they asked if I had any other suggestions for the iBOT.

I said, “Yes. I have three more pages. I just emailed them to you. Let’s go over them.” And we did. Each and every one.

Last week was something special, however. Kim and I made the 90-minute drive from South Portland to Manchester, so I could try out one of their prototypes. The new iBOT is a thing of beauty. After driving it for a couple of hours I made a few suggestions, but they were minor because DEKA has this thing well designed.

When they roll out the next generation iBOT, it won’t have many new functions compared to the old iBOT. It’s just that every function has been improved. The seat is more comfortable. The transitions between modes are quicker and smoother. Stairclimbing, balance, and four-wheel-drive work better. The controller and joystick are more ergonomic. The software is more intuitive. The chair is lighter and smarter. And the batteries? No more deep discharge required. Enhancements, such as tilt, recline, leg elevate, and automobile docking will be considered after the initial rollout.

With the redesigned iBOT, Mobius Mobility, a new company in Manchester, NH, is entirely focused on the manufacturing and distribution. Although they have obtained FDA approval, DEKA and Mobius are still working on a Medicare reimbursement strategy, and have confidence they can achieve a much better result this time around.

I wish I could answer questions like how much is it going to cost and when is it going to be available, but I don’t know those things. I do know that I saw lots of very smart people working on iBOTs last week, and these people are motivated to make the iBOT business permanent this time — permanent and better than ever. I can’t wait.

Note: Look for announcements in the coming weeks about the publish date for my book. 

The Wrong Side of History

I don’t want to die, but neither do I fear death. The reason I don’t want to die is that I hate the thought of not knowing what happens next. I want to see how this whole MS thing works out. What was the cause, and what year did they find a cure? How much did I miss it by — months or decades?

I’m also curious as to how humankind will fare. I’m optimistic. I think we’ll figure things out, and in doing so, our future selves will reveal our current selves as occasionally wise but more often woefully ignorant. One hundred years from now, I believe an enlightened society will cringe when they see how much pain and suffering people with MS endured, and will be taken aback by how much we struggled with some of the controversial issues of our day.  

Our public policy challenges fall into one of three categories: those with no answer, those that likely have answers but that we are struggling with, and those that have clear answers and should have been settled by now.

Challenges with No Answer (pendulum problems)

These are issues that, although contentious, have no clear answers and never will. Wise people, even 100 years hence, will always debate about where, on the continuum of possible choices, we should find ourselves. The pendulum will always swing back and forth on these issues, probably to a lesser extent over time, but will swing nonetheless. For example:

1. Taxation versus government spending — What role should government play in collecting taxes to support the general good versus allowing individuals to keep their hard-earned money. On one extreme are pure socialist or communist policies. On the other extreme are pure market/capitalism policies. No matter how unreasonable some of the debaters, the issue itself, where we ought to find ourselves on this continuum, will forever be a matter for reasoned debate.

2. What is the optimum amount of regulation? Without regulation, certain industries, in fulfillment of their fiduciary duties, can cause significant harm. If banks make loans to people who can’t afford to pay them back, then we place these borrowers in a difficult situation, and we destabilize the national economy. If we apply too many regulations, then we stifle commerce and unnecessarily interfere with individual and corporate autonomy. No matter how unreasonable some of the debaters, the issue itself, how much business regulation is fair and appropriate, will forever be a matter for reasoned debate.

Challenges That Likely Have an Answer, but Are Difficult to Solve

Enlightened societies in the distant future will eventually reach consensus on these issues. The problems are complex enough, however, that it is reasonable for us at this stage of our social evolution to be struggling with them. 

3. Recreational drug legalization – Would we be better off legalizing all mind-altering recreational drugs, some of them, or should we double down on the so-called war on drugs? I tend toward legalization, but that road is fraught with complications. There is no shame in us struggling with this issue for a while longer.

4. Regulation of pornography and prostitution in society — This is about an individual’s right to view pornography and/or make a living in the sex trade, versus society’s obligation to protect children from indecent images and to protect people from being in the sex trade against their will. My inner libertarian tends to think openness is the best solution, but I do worry about the over-exposure kids are already experiencing through the internet. This is the type of social problem we should be struggling with. This is a contemporary issue.

5. Euthanasia — When should physician-assisted death be legal and with what safeguards? I believe all individuals should have a right to choose their time and place of passing, but I understand some of the concerns. First, how can we be sure that individuals are not being pressured into a decision they wouldn’t otherwise make? Second, how can we be sure that we are not simply increasing the suicide rate for people who still have better alternatives than euthanasia? This is the type of social problem we should be struggling with. This is a contemporary issue.

Challenges That Should Have Been Put to Rest a Long Time Ago

Below are two issues that, in my mind, require no more debate. If you disagree with me, I think you are on the wrong side of history. I have every confidence that a more enlightened, future society will look back on these debates in much the way that we look back on debates about slavery, using leeches to cure illnesses, and whether the earth is the center of the universe.

6. LGBTQ rights — A certain percentage of people are born with or develop sexual orientations that are different from the majority. If the resulting acts occur between consenting adults, they are not unnatural, only unusual. If your reason for being discriminatory has to do with your religious doctrine, consider this. In addition to homosexuality, there are many other practices that the Bible forbids. These include eating pork, cutting your hair, and women speaking in church. Most religious people ignore these rules; why not ignore the Bible verses against homosexuality as well? If the reason that you discriminate against homosexuals is that they make you feel yucky, then you have to admit that the problem is more likely yours than it is theirs. Wrong side of history.

7. Pharmaceutical companies decide which medicines we get — Pharmaceutical companies have the resources to develop treatments, but they make their decisions based on how much money can be made rather than how many people can be helped. It’s not the fault of the individuals at these companies. They have a fiduciary duty to maximize shareholder value. The problem is, maximizing shareholder value and enhancing patient well-being are often at odds. Future societies will shake their heads when they consider how otherwise intelligent people from our time thought that the free market was the best method for developing treatments.  

There are so many subjects I could have mentioned and didn’t. There is so much more I could have said on each of the subjects I did raise, but I would’ve lost your attention, if I haven’t already. My point is, I find the exercise of imagining how we will be regarded by people 100 years from now to be enlightening.

I’m going to try not to die, so that I can see how all these things work out, whether it be MS or public policy. How do you think it will turn out?

A Letter to My Healthier Self

    I scour the earth for blog post ideas, and today I stumbled upon a good one. I like it when a person writes a letter to their younger self, and they impart wisdom learned through the travails of life. That gave me an idea for a blog post: A Letter to My Healthier Self.

I sat down to make a list of the things I would have done differently in my healthy years, knowing what I know now. Time to be profound.

The first item to pop into my head was this: make sure you run that marathon, climb that mountain, get those washboard abs. But then I thought to myself, “Self, you had other priorities in your 20s and 30s. You didn’t want to do those things because you wanted to do other things.” No, I shouldn’t advise my healthier self this way.

Then I thought: avoid all those activities that caused your MS. But wait. That won’t work. Nobody knows what caused my MS.

How about eating better. Yeah, I suppose eating better is always good advice, but there is no evidence that it would have made a difference with my MS.

Save money for a rainy day? Did that.

Make sure you have long-term disability insurance to supplement your income if you can no longer work? Check.

Life insurance? Check.

Marry someone awesome. Big check.

I thought about this all day, and I only could come up with one item for my letter:

Dear healthier self:

This is you, I mean me, I mean this is your future self writing to give you advice on how to mitigate an impending health disaster. Buy long-term care insurance. That way, when you need someone to come into your house and get you up, showered, fed, and ready for the day, or if you end up in a nursing home, these costs will be covered.
   Have a nice day.

Regards,

Mitch (2018)

Upon further reflection, that letter would freak out my younger, healthier self. What happened to being profound, anyway?
   The process of writing this blog post didn’t take me to where I thought I would go, but I think it took me to where I needed to be:

Dear healthier self:

This is advice from your future self. Keep doing what you’re doing buddy. It’s all good.

Have a nice day.

Regards,

Mitch (2018)