Wednesday, July 08, 2020

The Sound of a Bee in a Bottle

I grew up in the '60s and '70s when the advertising prowess of the '50s still held sway over people's habits and preferences.  And as a result, pretty much every waking moment of every day was filled with the sight, smell and sound of cigarettes.

Seeing people smoking and smelling the stink of cigarettes are both fairly obvious.  But do cigarettes have a sound?

Well, maybe not... but the smokers sure do. 

When I was a kid, I knew which of my parent's friends were smokers; not from seeing them smoking, but from the sound of their voices.  Especially women.   If a teacher, telephone operator or waitress had a voice that sounded like a bee in a bottle, it was a pretty sure thing that she was a smoker. 

For that matter there were many actors and singers whose voices gave away their heavy smoking habit even if they were rarely (if ever), seen in public with a cigarette.

As smoking declined in popularity in the late '70s and '80s, so did the ubiquitousness of that 'smoker's voice'. 

But for all the good those health awareness and anti-smoking campaigns did, something happened in the '90s and early '00s.  Young people started taking up the habit in staggering numbers.  And despite legislation that prohibits smoking just about anywhere in shared public spaces, I'm again hearing 'smoker's voices' just about everywhere I go.   

And the truly head-shaking part is that these voices don't belong just to middle-aged people anymore.  I'm hearing twenty-somethings who sound like they belong in a 1940s film noir.

Tragic!

 

Posted by David Bogner on July 8, 2020 | Permalink | Comments (0)

Monday, July 06, 2020

So, about that whole kidney donation thing... (Part 3)

[Read Part 1 and Part 2 first for context]

If you've finished reading the two previous installments, you now have a vague understanding of what put the idea into my head.  But everyone who donates a kidney comes to the decision by a different road.  Always keep that in mind.

Today's installment is about that critical stage where thoughts are translated into actions.  And here, pretty much everyone travels the same road.  

To be clear, one doesn't go from idly thinking that kidney donation might be a neat idea, to checking into the hospital and letting the surgeons remove the organ. 

Oh my, no... that's how altruistic financial donations work.   In fact, most charities count on hooking you with a compelling pitch at an impulsive moment, so that you'll whip out your credit card before you have a chance to think about all the other things you could do with the money you're about to hand over.  After all, you can always make more money.

That is the very antithesis of the process of considering living organ donation!  You have only two kidneys, and even under ideal conditions you can only give one away.

Obviously the the organizations that manage the stream of potential kidney donors (not to mention the potential recipients), are very anxious for as many people as possible to sign up for altruistic donation.  But there are two main hurdles that must be cleared in order for the donation to go ahead: 

1. Medical

2. Psychological / ethical 

Today I'll be discussing both. 

As an aside, for many people, there is a step before this which deals with the question of who you actually want to receive your kidney.  But I'll leave that for the next chapter. 

The Medical Hurdle:

In order to be able to donate a kidney, a person must be healthy enough that the surgery to remove the organ, and the future lived (to 120!), with only one kidney, do not present unreasonable medical risks.  After all, aside from the whole 'do no harm' thing that the transplant surgeons are bound by, the math falls apart if by removing one person from the list of sick people waiting for kidneys, they end up adding someone new to the list by allowing an unsuitable candidate to go under the knife.

Not only that, but there are a bunch of medical conditions ranging from weight to cardio fitness that can influence your chances of tolerating/surviving the surgery and loss of a kidney  

The kidneys are responsible for a whole range of essential functions in the human body.  The most obvious is removing waste and excess fluid from the body.  That's why people in kidney failure are dependent on ongoing dialysis to stay alive. 

But the kidneys are also responsible for regulating blood pressure, making red blood cells, keeping bones healthy, and controlling the body's PH levels.  If your body is struggling with any of these things with two kidneys, chances are you aren't a good candidate to give one away.

[More about what kidneys do here

That means that the first thing you are going to be asked to do when you make contact with a kidney donation organization or hospital transplant center, is to go to your family doc and get a complete physical exam (including a bunch of basic blood tests).  If you're a grown-up, you should be getting an annual physical anyway, so this might be just the kick-in-the-pants you needed to get into the habit.  

Bottom line, in order to be considered seriously - from a medical standpoint - as a potential donor, you need to make sure your body can survive the surgery and carry on comfortably with only one kidney.

Once you pass that hurdle, buckle up for a long journey of self-discovery.  You are going to find out more about your physical health than most people care to know.  I personally found this process reassuring.  But others take an 'ignorance is bliss' approach to knowing what is going on under the hood. 

I would also add that it is really important to have access to one or more people who have already donated a kidney.  Hearing the perspective of a layman is incredibly helpful to sort the wheat from the chaff.  I was blessed to have several friends who had previously donated, offer insight, advice and guidance during my journey.  If you don't know someone, the hospital and/or donation organization will certainly have a list of people who have offered to have potential donors contact them.

The actual time-frame for this screening process is not set in stone.  If, G-d forbid, you have a critically ill family member waiting for your organ, that might fast-track the screening process to a couple of months or even weeks.  But for most people, you're looking at a minimum of 6-8 months of testing before you get the 'Good Housekeeping Seal of Approval' to don the backless gown and surf into an OR on a gurney.

The Psychological / Ethical Hurdles:

Once you've gotten acceptable results from your basic blood work and physical exam, you will begin a long, two-pronged, path of testing designed to establish your suitability for living organ donation.  I've already talked a bit about the medical side.  Now for the psychological and ethical side.  Even though these two criteria are mostly unrelated, I've decided to address them together since neither can be determined using blood tests or other 'hard' medical exams.

From an ethical standpoint, they are going to want to make sure you aren't being pressured, or paid, to donate a kidney.  As hard as it is to imagine, there are deals being made with the devil every day where the imbalance of wealth is leveraged to essentially extort a kidney from someone in financial need.

I'm not talking about someone waking up in a bathtub full of ice in Tijuana after being rolled in some back-alley cantina. That kind of thing may happen occasionally in the third world... but is mostly the stuff of fiction.

But if someone has a pressing financial need (say, a wedding, college tuition or an expensive medical procedure in the family), 'selling' a kidney might seem like a quick and viable solution.  Sadly, there are doctors and middle-men around the world who profit from this imbalance of organs and resources... and it is as unethical as it is dangerous.  The screening process you are about to undergo is designed to prevent even the appearance of anything of the kind.

You will also be screened several times by a psychologist and/or social worker to determine if you are mentally fit to undergo the organ donation process, as well as to make sure you aren't volunteering to give away a healthy organ for unhealthy reasons (feelings of guilt, inadequacy, desire for accolades, extreme risk-taking behavior, surgery-fetish, etc.).   They will also ask a question that caught me off-guard:  How will you feel if the transplant is unsuccessful (meaning you gave away a kidney for nothing)?  It gets kinda real when you think about such things.

Many potential donors are focused solely on the act of donating.  But they aren't prepared for the day after, and the return to normalcy (and relative obscurity), that invariably occurs weeks, months and years after they've recovered.  That's a topic for another day, but it is worth mentioning that the psychological screening is meant to force a potential donor to take a brutally hard look at what is driving the decision process, and how it might all play out before, during and especially after the kidney donation is completed.

I'll be happy to answer any specific questions about MY screening process (your mileage may vary), in the comments or private email.  But assuming you successfully pass all the screening hurdles, you will find yourself with an appointment to sit before a multi-disciplinary committee tasked with giving final approval to you as a potential donor.  At least this is how it is done in Israel... I assume most developed countries have similar approval committees in place.

The committee is made up of medical doctors, mental health workers, attorneys and a civilian advocate.  They will be given your entire file of screening tests / reports to review in advance.  Their job is to determine - objectively - if you are a suitable candidate for living kidney donation.

What does 'objectivity' have to do with anything'?  Isn't the hospital that did all the tests objective?  Aren't they staffed by physicians bound by the Hippocratic oath to 'do no harm'? 

Yes.  But they are also an interested party.  In fact they are one of many interested parties involved in the process!

Your motivations may be ethically and psychologically correct/healthy, but the fact that you want to donate a kidney makes you an interested party.

The recipient needs a new kidney.  They would never want to do anyone else harm, but the fact that they have a need colors their objectivity.  So they too, are an interested party.

Even the hospital doing the transplant is an interested party, albeit their interests are confusing and often conflicting: 

On the one hand, they genuinely want to 'do no harm'.  Add to that, they are like a baseball player whose future prospects depend heavily on maintaining good 'stats'.  A ball player needs to keep their batting average or ERA at optimal levels.  A hospital has its own set of stats by which it is ranked locally and internationally; particularly in the realm of transplant surgeries.  A hospital with a strong transplant program wants to have a statistically 'all-star' success rate (for both surgical outcomes and long-term donor and recipient health).  Accepting bad candidates means increased risks... which translate into bad 'stats'. 

On the other hand, there are far fewer potential kidney donors than there are people waiting (desperately), for viable transplant organs.  Even if everyone signed their donor cards, and every fatal accident and illness ended with two viable kidneys entering the transplant pool, cadaver kidneys don't last nearly as long as organs taken from a living donor.  The difference can be the difference between a donor kidney lasting 5-8 years in the recipient's body... and lasting 15-20 years! 

So hospitals have an interest/stake in qualifying as many living donors as possible.  I don't believe they would deliberately qualify an unsuitable candidate for kidney donation.  But I could certainly see how they might qualify a borderline candidate with rationalizations and statistics to back up their decision.

So, standing in the way of all these interested parties is this final committee whose job it is to objectively determine if the person in front of them is medically, ethically, and psychologically suited to take the fairly drastic step of allowing the removal of a healthy organ from their body.

This committee is not a rubber stamp.  They will ask hard questions, And as adversarial as they may seem during what may feel like an interrogation... they are actually the only party in the entire process that is completely uninterested.  Their interest is protecting the health and welfare of the donor, and ensuring that the entire process is transparent and adheres to international medical and ethical standards.

If / when you receive the formal approval of this committee, you are free to commit to donate your kidney and schedule the transplantation surgery with your hospital team.

But (and this is a huuuuge but), at any point up to the point when you are rolled into the OR and put under general anesthesia, you can change your mind and decide not to go through with it.  The recipient will only be told that it turned out you weren't a suitable donor, and nobody will hold it against you.  At every stage of the process it is important to keep this in mind.  At no point while you are still conscious are you committed to the point where you can't change your mind.  This harks back to the previous installment when I explained why its best not to tell too many people in advance.  Leaving yourself the ability to back out gracefully is important to decision-making process and your long-term mental health.

Stay tuned for the next installment which will deal with the issue of who actually winds up with your kidney, should you decide to give one away.

As always, if you want to be informed of new posts, follow me in twitter @treppenwitz

Posted by David Bogner on July 6, 2020 | Permalink | Comments (2)

Friday, July 03, 2020

Photo Friday

It's that time again...

Just click on the thumbnail to view the full size image:

 

As always, if you want to be informed of new posts, follow me in twitter @treppenwitz

Posted by David Bogner on July 3, 2020 | Permalink | Comments (3)

Monday, June 29, 2020

So, about that whole kidney donation thing... (Part 2)

[Part 1 of this series can be found here]

Zeus was a bit of an asshole.  For a god who was supposed to be the king of all the other gods on Mount Olympus, he sure seemed to display a streak of insecurity when it came to mortals challenging his authority.   

Look what he did to Sisyphus: For the ‘crime’ of being clever and upsetting the established order of life and death, Zeus sentenced Sisyphus to repeatedly roll a huge boulder uphill, only to have it roll back down again and again. 

Or Prometheus, who pissed off Zeus by stealing fire back for humanity, and who was punished by being chained and having an eagle eat his liver every day; only to have it grow back every night.

Being the son of an educator, I grew up with Greek mythology.  So much so, that in 1st grade I didn’t find it the least bit odd that we had cats named Dido and Aeneas.    

So, how did Greek mythology influence my decision to donate a kidney?

Here’s the thing… the problem with teaching kids about mythology is that they are very literal.  They try to apply modern logic to whatever they encounter… and it usually doesn’t work.

I remember my dad explaining that mythology was basically just a bunch of made up stories to explain natural events, or to offer morality lessons about human behavior.   

I asked him about the whole ‘liver regeneration’ thing.  He told me that it wasn’t real.  It was just a story describing the most painful punishment the author could imagine.

But it bothered me.  That story seemed oddly specific, yet didn’t relate to anything the ancient Greeks would have encountered.

And even as I completed my undergraduate degree in English Literature, I kept running into endless references to mythological figures/events.  All fine and good.  Dad was right, those myth-writers were just explaining observed natural events and human inclinations. 

Except for that liver regeneration thing.  There’s no way the Greeks created the story of Prometheus’ punishment and randomly chose that specific organ!

Then, one day while I was in college, I read a news report about liver transplantation from a living donor; made possible because a liver lobe that is surgically removed will completely regenerate itself within a very short time. 

[[[!!!]]]

Turns out the surgical technique for safely removing (and transplanting) a lobe of a living person’s liver - knowing that it would grow back - wasn’t pioneered until the second half of the 20th century!

So, how the hell did the ancient Greeks know that the human liver could regenerate itself?! 

That question bothered me for years.  Each time I stumbled on a report of live liver transplantation (and thanks to the ‘Baader-Meinhof phenomenon’, I stumbled on it a lot!), I would read the article carefully for any mention of Prometheus or some ancient knowledge of liver regeneration.  Nada.  Zip!

The more I read about living liver donation, the more I became fascinated by the idea.  I was a habitual blood donor, and was an early adapter to signing an organ donor card (despite Judaism’s early hostility to the idea).  So the idea of saving a life by donating something that would miraculously grow back, seemed a no-brainer.

Except that the more I read about living liver lobe donation, the more I discovered that it is a fairly risky and painful surgery, and they usually only allow immediate family members to donate in order to save a loved-one’s life.

Scratch that off the list. 

Forget the fact that everyone in my family has healthy livers (tfu, tfu, tfu).  As soon as the concept went from blood donation safe/painless, to life-threateningly dangerous (with a long, painful recovery period), it lost a lot of its charm.  Apparently altruism has its limits with this boy.

But in the course of educating myself about the stark realities of liver donation, I naturally came across a bunch of articles about a parallel living organ procedure that had been practiced and perfected to the point of becoming almost routine:  Living kidney donation.

I don’t know the exact date I began idly toying with the idea of kidney donation, but it was sometime around the time that the reality of middle age began to creep into my contemplation of my own mortality.  I spent almost a decade assessing and addressing creeping health issues; losing weight, getting myself fitter and taking my blood chemistry reports seriously (for the first time), etc.. 

And once I felt I had my own health somewhat under control, I began thinking about the feasibility of repairing someone else’s health.  What do they say, "there's none so zealous as a recent convert, nor so carnal as a recent virgin'.  Once anyone gets healthy, it's somewhat inevitable that they want to make others healthy.

That's enough for one day.

Everyone who donates a kidney comes to the idea from a unique starting point.  This was the story of mine.

[The next installment will get into the nitty-gritty of the screening and decision process]

As always, to be notified of new posts, follow me on twitter @treppenwitz.

[Read Part 1,  and Part 3 ]

Posted by David Bogner on June 29, 2020 | Permalink | Comments (5)

Friday, June 26, 2020

Photo Friday

In place of the usual Friday meme dump on FB (and in light of my having been declared persona non grata there ), I've decided to try it here to see if is less disruptive for people.

Just click on the thumbnail image to view the full size image:

 

Posted by David Bogner on June 26, 2020 | Permalink | Comments (2)

Thursday, June 25, 2020

Birthdays Are Complicated (for me)

When you're a kid, birthdays are the cat's ass; the absolute pinnacle of your existence.  You literally spend your entire year - every waking moment - either looking forward to it with eager anticipation, or looking back on it with a bitter-sweet longing that you won't recognize as nostalgia until you hit middle age.  

I'm not sure when it happened, but at some point, for me, birthdays acquired an ominous pong... like a Tupperware in a hard-to-reach corner of the fridge containing a left-over science project that was once part of a delicious, festive meal.

Anybody who sent me birthday wishes this year received the following upbeat reply from me:

Thanks for the birthday wishes. 

Birthdays seem like a silly thing to get emotional about; like Steve Martin in ‘The Jerk’, when he gets all excited about the arrival of the new phone book.

Everyone gets one.  Everyone is listed.  What’s the big deal, right?!

Except that’s not really true, is it?  A lot of people don’t get a next birthday.  The book comes out, but their name isn’t in it. 

So yeah, it *is* a big deal, and I’m deeply grateful for another year... and for my wonderful family and friends.

And I mean/meant every word of it, from the bottom of my heart.

But birthdays are complicated.  And there's such a thing as 'a lie of omission'... where the moment the words leave your lips, your cheeks glow crimson with guilty knowledge of the rest of the story you just bit down on to keep if from spilling out.  That's what I felt sending out that cheery, upbeat thank-you note.

In general terms, I think some of my problem with birthdays come from secret feelings of inadequacy or unworthiness.

Some people lose their house in a fire or get cancer in the prime of life, and as they watch helplessly as the gleaming, scheduled express train of their life jumps the tracks and goes plunging into the ravine below, they demand explanations from G-d by bleating "Why Me?... what did I do to deserve this?!"   

My wiring seems to be screwed up somehow, because each time something has gone right in my life, I've found myself standing in the shuddering wake of a car that just missed me... standing under the chuppah next to the woman of my dreams... walking around a hospital delivery room holding my perfect newborn child... surveying my new, well appointed office... a small, inner child behind my eyes bleats, "Why me?... what did I do to deserve this?!"

As the years have passed, its only gotten worse. 

Friends who did everything right; studied hard in school, made responsible life decisions, chose practical careers... got 'put out' in the cruel, seemingly random game of dodge-ball that we're all forced to play.  

I took an unusual route home from work the other day; one that took me to a cemetery where a shocking number of people I've known and loved are buried.  I parked the shiny new car that my company just gave me and walked between the dusty rows until I came to the grave of a friend who had lived a charmed, magical life.  He was the smartest, most talented person I've ever known.  Everything seemed to come easily to him, and everything he touched turned to shining gold. 

Yet there I was, sobbing next to his grave... not because I missed him (I do), but because I can't seem to come to terms with why things work out for some people, but not others.  I sat there with the line from Billy Joel's 'Allentown' running in a loop in my head, "...For the promises our teachers gave, If we worked hard, If we behaved...". 

I never really worked that hard, and often didn't behave.  Yet I'm still here... amazed and confused to still be in the game.... screaming silently with a deep, maudlin sense of inadequacy, 'why me?!', when any sane person would be looking at my wonderful life, and celebrating every moment.

Posted by David Bogner on June 25, 2020 | Permalink | Comments (8)

Tuesday, June 23, 2020

Devolving

I recently read something that was, in equal parts, fascinating and scary:

"Years ago, the anthropologist Margaret Mead was asked by a student what she considered to be the first sign of civilization in a culture. The student expected Mead to talk about clay pots, tools for hunting, grinding-stones, or religious artifacts.

But no. Mead said that the first evidence of civilization was a 15,000 years old fractured femur found in an archaeological site. A femur is the longest bone in the body, linking hip to knee. In societies without the benefits of modern medicine, it takes about six weeks of rest for a fractured femur to heal. This particular bone had been broken and had healed.

Mead explained that in the animal kingdom, if you break your leg, you die. You cannot run from danger, you cannot drink or hunt for food. Wounded in this way, you are meat for your predators. No creature survives a broken leg long enough for the bone to heal. You are eaten first.

A broken femur that has healed is evidence that another person has taken time to stay with the fallen, has bound up the wound, has carried the person to safety and has tended them through recovery. A healed femur indicates that someone has helped a fellow human, rather than abandoning them to save their own life."

    [Source: Remy Blumenfeld - Forbes]

So why is this scary?  Because I couldn't help contrasting Dr. Mead's description of the rise of society, to irrefutable evidence that we as a society seem to be devolving; figuratively coming apart at the seams.

Think about it; if inconveniencing/endangering oneself for one's fellow man is a sign of society forming, what does it say about us that in the face of a serious external threat, where our best and only way to protect our fellow humans from infection, illness and potential death is to inconvenience ourselves (in a minor way), by wearing a tiny cloth or paper mask, we, as a society, are prioritizing our convenience and comfort over the safety, health and lives of our neighbors?

That long ago human's fossilized femur gave evidence of the empathy of an adjacent human.  Yet today, even as scientific evidence conclusively proves the efficacy of cloth and paper masks to lower the chance of spreading infection to low single digits (thus preventing serious illness and death), I see people walking around with no masks... or with masks slumped ineffectively below their nose (bad) or chin (the same as not wearing a mask at all).

In a society where we are finally being conditioned (in a good way), to be protective of the cultural, sexual and racial sensitivities (e.g. protecting people's feelings) of our fellow man, how has protecting their lives fallen so far out of fashion?!

 

[If you want to be notified of future posts here, please follow me on twitter: @treppenwitz ]

Posted by David Bogner on June 23, 2020 | Permalink | Comments (7)

Monday, June 22, 2020

So, about that whole kidney donation thing... (Part 1)

I thought about discussing the science and potential risks of being a kidney donor, but that has already been done quite nicely by the organization that shepherded me through the entire process: Matnat Chaim.  They have a Hebrew site as well, but if you follow that link... the information is pretty well organized, and will have enough for someone who is at the 'kicking the idea around' stage.

What I will do is tell the story - in installments - about my personal journey that lead to my decision to donate a kidney.  This will be 'Part 1'.

Aside from the sidelong looks/whispering (yes, I see/hear you), and the excruciatingly embarrassing compliments (which I honestly don't know how to deal with), being a kidney donor - despite how noble and selfless it may seem from the outside - can be fraught with complex personal feelings unrelated to altruism.

Although the reasons for donating a kidney are probably as numerous as there are people willing to consider it... there are a few common milestones that are likely shared by a large proportion of people who start the screening process. 

The entire process - from first toying with the strange idea of letting someone remove a perfectly good part of you, to finding yourself on the operating table - can be a journey of anywhere from a few months to several years; depending on how enthusiastically one embraces the idea. 

Some people jump into the process head-first because a close friend or relative is in urgent need of a transplant.  Others [*raises hand sheepishly*], start with the germ of an idea, and spend several years slowly working up the nerve to even begin the medical screening. 

It's probably not really relevant to anyone else why I, personally, first started thinking about kidney donation.  But I'll talk about it in a bit because it seems to be one of the first questions people ask. 

Before I get to that, though, I want to say that what is hugely important is to get 'buy in' from your spouse / partner (or immediate family if you are single), early in the process.  I'm thankful that I did, because I can honestly say that nobody, even the most supportive person, will fully understand why you want to do this. The best you can hope for is that they don't feel like they've been sandbagged at the last minute to give their okay (which means that you've been planning this for a long time without consulting with the person/people who will have to deal with the consequences if anything goes wrong).

Think about it... if you wait until you are already approved and matched with a recipient, and your husband/wife gives anything but an unconditional, enthusiastic 'yes', it is as though they are saying they're not in favor of saving an actual person's life!  That's a lot to lay on someone who is hearing the idea for the first time. 

Better to talk to them as soon as you start to think about it seriously, so they feel that they've been part of the decision-making process from the get-go.

So... how did I get to the point where I found myself, a person in very good health (it turns out!), in the operating room watching an anesthesiologist with smiling eyes lower a mask onto my nose and mouth?  How does one even begin to contemplate such a monumental decision?!

Like many difficult decisions, I opted to use the 'swimming pool' method in my deliberations over whether to donate a kidney. 

For those not familiar with it, this method is the same used in the difficult process of getting into a very cold pool.  Yes, there are always a few foolhardy souls who jump in all at once.  Most of us first test the waters by putting a toe in... then a foot.. and so on, until we either decide it's too uncomfortable (and we back out), or we find ourselves far enough into the process with manageable discomfort to justify taking the rest of the plunge.

I've described it this way, because I can honestly say that there was never an 'aha' moment when a light-bulb went on and I felt that I could walk around to the diving board and simply jump in head-first.  I always felt that I could allow myself to back out gracefully at any point; and that was crucial!

One of the key factors that allowed me the luxury of knowing I could stop (chicken out of), the process at any time was that I didn't make a big announcement to the world that I was planning on 'going swimming'.  I kept the circle of people who knew about my deliberations to an absolute minimum until I was literally at the point of booking the date for the transplant surgery. 

The reason for this should be obvious.  If you tell everyone you know that you are going to do something difficult (think skydiving or running a marathon), their expectations - and the potential for embarrassment/disappointment if you back out - now become a factor in the decision-making process.  I can't overstate the importance of not letting external expectations influence your decision in so important a decision. 

At the outset I spoke about the idea only with my wife.  Then once I was fairly well advanced in the screening process, I brought my kids and siblings into the loop. I told a few close, trusted friends shortly before the surgery date.   I didn't tell my parents until after the surgery was over and I knew there had been no complications. I didn't feel it was fair to ask them to take part in the decision.  And if I wasn't consulting them, it seemed cruel to tell them in advance and cause them undue worry.  

It wasn't until I was almost finished with the medical testing (a process that took me almost eight months to complete), that I spoke to my boss and the head of my company's HR department.  Obviously, if you are going to be taking anywhere from three-to-six weeks off from work for the transplant surgery / recovery, you are going to need the willing and active support of your employer. 

By the way, in Israel, you don't have to use sick days or vacation time for the workdays you miss due to being a kidney donor.  It is handled by the national insurance in much the same way that they handle military reserve duty.  And all the expenses associated with the medical screening are picked up by the recipient's health insurance.

I think that's enough for one installment.

I'll pick up this thread with at least two or three more installments in the coming weeks. 

I'll respond to reasonable questions in the comments section. But if they deal with things I have't written about (or fully come to terms with), I may ask for your indulgence and patience. 

I'm still working through a lot of the things you're probably curious about.  So bear with me.  I'm using this writing process to enlighten myself, as much as to inform you. 

[If you want to be notified of future posts here, please follow me on twitter: @treppenwitz ]

[Read Part 2 and Part 3 ]

Posted by David Bogner on June 22, 2020 | Permalink | Comments (9)

Sunday, June 21, 2020

Blowing Off The Dust - 7 Things

I kept up this site for more than 15 years.  It contains some of my fondest memories, best writing, and most helpful self-therapy.  Now that I have displeased the FB gods (very small 'g'), it seems like as good a time as any to remember why I used to post here:

1.  My house, my rules.  As in the public square, my ideas are subject only to the criticism of my peers.

2.  FB is not the public square.  They are a private company with every right to censor content and speakers.  Only the government is prohibited from interfering with free speech.  

3.  On the internet, content is king.  On my site, my content is my own.  On FB, it isn't.  After all, if you aren't paying for something, your'e not the customer... your'e the product.

4.  I'll mostly share my own content here.  Except Fridays.  On Friday I'll try to arrange a meme dump similar to what I used to do on FB.

5.  After my term in exile expires, I will probably go back to interacting on FB, but will try to keep Treppenwitz.com as my primary online 'home'.

6.  If you like anything you see here, feel free to share it by posting a link. 

7.  Please do not copy and paste content (other than memes), without asking and giving attribution.

Posted by David Bogner on June 21, 2020 | Permalink | Comments (6)

Thursday, June 18, 2020

Privilege

To all the people out there who are saying you don’t have white privilege because you had to work your ass off to get where you are, and have earned everything you have:

Privilege isn’t about how long your journey was to get to where you are now, or about being handed shortcuts or freebies along the way.

Privilege is about not being repeatedly pulled over and questioned (or worse), along the way, simply because of your appearance.

Posted by David Bogner on June 18, 2020 | Permalink | Comments (0)

Wednesday, June 17, 2020

Nurture Service Sector Businesses

A friend who is in the food service business asked that this be shared far and wide. Everyone should read this if they are enjoying outdoor dining:

  1. Don't run your server. Try your best to ask for everything you need at once. Remember it's going to be a long walk from the street into the building for more water or anything else. Help us out by asking for whatever you need all at once.
  2. No mask jokes or your views on them. The server has to wear it. They have no choice!
  3. The server is wearing the mask to protect you and you have nothing on to protect them. Wash your hands.
  4. You Eat....You Go....
  5. Eat your meal. Have some drinks. Relax, but please do not sit at a table all night. These restaurants are working with very limited space and other customers are probably waiting to enjoy getting out also. They can't afford for you to order 2 side salads and water and sit there for 4 hours. Yes some people do this ALL THE TIME but please not now.
  1. Don't come out if you’re sick!
  2. Social distancing. Keep your kids at the table. Yes they are cute, but if they are running around they are getting too close to other people.
  3. Cut everyone some slack. Everything may be a bit slow because this is basically a new job for everyone. Restaurants have very strict guidelines to follow. Be kind, be patient.
  4. Tip. They are going to be sweating wearing masks all day. Please treat them right and leave a decent tip. If you can't afford to tip, you can't afford to go out.
  5. Be pleasant. You should be happy. You're finally out! Everyone is doing the best they can. Relax and enjoy!
  6. Please share!

Posted by David Bogner on June 17, 2020 | Permalink | Comments (0)

Tuesday, June 16, 2020

Whataboutism

I’m just about out of patience with the rampant ‘whataboutism’. 

Yes, there were black Africans who were slave owners and traders. 

And there was white slavery as well (the Barbary pirates often raided coastal towns in Europe, England and Ireland).

Horrifying. 

But it has nothing whatsoever to do with the conversation regarding the history of blacks in the US. 

Black history in America has gone from horrifying, to barbaric, to cruel, to unjust, to unfair, to barely tolerable second-class citizenship (interspersed with occasional swings through random prosperity and regressions to cruelty and injustice). 

If your contribution to the current public discussion of the range of realities experienced by blacks in the United States today is to point out injustices unrelated to the American black experience, you are essentially saying “We’ve talked about this enough.  I want to talk about something else.”.

Trying to change or redirect the conversation with ‘whataboutism’ is the same as saying the original conversation isn’t important /relevant to you. 

That’s a fair and legitimate position... but be honest and just say you don’t care.

Posted by David Bogner on June 16, 2020 | Permalink | Comments (0)

Monday, June 15, 2020

Unpopular Thought of the Day:

Calling to defund police departments over unprofessional or criminal acts by individual police officers is like calling to defund hospitals over malpractice and criminal negligence by individual doctors. 

There are incompetent, negligent and even criminal, people in every profession.  But that doesn’t mean a profession is superfluous or non-essential.

For every tragic story of negligence and criminality, there are countless, quiet acts of competence, heroism, daring and extraordinary compassion that we never hear about. 

Strengthen the system that weeds out and punishes bad/negligent actors.  Don’t destroy a system or the will of its members to continue doing good.

Posted by David Bogner on June 15, 2020 | Permalink | Comments (0)

Saturday, June 13, 2020

Honeysuckle

We have a huge confusion of honeysuckle on the fence that divides our backyard from our neighbor’s. 

All summer long it wafts its intoxicating aroma across our balcony and yard.

Every so often, when nobody is around, I pick one of the tiny flowers, pinch the tiny bulb at the base between my fingernails, pull the tiny strand all the way out until a a drop of sweet nectar peeks out asking to be tasted... and let the sweetness wash half a century away.

Posted by David Bogner on June 13, 2020 | Permalink | Comments (0)

Tuesday, June 09, 2020

Civics 101

The government is constitutionally prohibited from interfering with protests / protesters when they are assembling peaceably. 

Civil unrest and/or violence at a demonstration strips the protesters of their immunity from government interference. 

That interference can come from a range of government agencies including the police and National  Guard.

Those quoting the Constitution should read and understand it before using it as a fig leaf.

Posted by David Bogner on June 9, 2020 | Permalink | Comments (0)

Sunday, June 07, 2020

It Costs You Nothing...

I’ve said each of these (or some very close variation), on more occasions than I can count:

Wrong
It baffles me that people feel it costs them something to say any of these things.

 

Posted by David Bogner on June 7, 2020 | Permalink | Comments (0)

Friday, June 05, 2020

Clarification Regarding Defunding Police

What you are saying (or at least what I am hearing/reading), is defund and dismantle all police forces. They are superfluous, unnecessary and dangerous. 

What I think (hope), you mean is:

Let’s see if SOME roles and responsibilities currently performed by armed police can be performed by unarmed social workers and/or crisis counselors in order to reduce unnecessary confrontations and violent encounters. 

Let’s see if we can adopt SOME aspects of multi-tiered foreign police force structure where only part of the uniformed force is armed, but all uniformed personnel are given protected status (meaning any attack on an officer carries mandatory draconian sentencing requirements). 

Let’s ensure that the selection of ALL police personnel is geared to weed out authority junkies, racists and abusers.  Perhaps a minimum age requirement, military experience for armed officers, and an associates degree in criminal justice or similar related discipline. 

Let’s ensure that continuous training is provided to ensure the same high level of proficiency with firearms as with deescalation and negotiation techniques.  

Let’s try to scale back the militarization of all but the most elite police SWAT and hostage rescue teams.  There is no need for typical community policing to require assault weapons and other tools of war.  A man with a hammer tends to see every problem as a nail. 

Thinking out loud here, but I truly hope this is what you mean... because it isn’t really what most of you are saying.

Posted by David Bogner on June 5, 2020 | Permalink | Comments (0)

Tuesday, June 02, 2020

For the sake of argument...

Debating should be revived and made a required course throughout Junior and Senior high school... with the subject being given as much weight as mathematics, history, civics, and the hard sciences. 

The rules of polite disagreement, logic and persuasion have become scorned anachronisms in today’s climate of ‘I feel, therefore my views are as valid as your facts’. 

As a result, kids grow up unable to think critically, evaluate news and new information for logical consistency,  or test out new ideas with confidence among their peers. 

Kids must learn how to argue facts with detachment and respect for those with whom they disagree. 

They must internalize from an early age that disagreeing with someone does not make that person evil or an enemy to be neutralized or defeated. 

Oh, and ‘Robert’s Rules of Order’ should be introduced in Elementary School, and used throughout every year of education, up to and including university studies. 

Honest, respectful debate can’t take place outside a safe framework that provides unimpeded access to expression for even the soft-spoken and unassertive. 

A ‘bully pulpit’ can’t exist in a setting where rules of logic and decorum are integral threads in the fabric that clothes the intellect and instincts of a well-educated citizen.

Posted by David Bogner on June 2, 2020 | Permalink | Comments (0)

Saturday, May 30, 2020

Anachronistic Product Branding

I see a lot of online eye-rolling over the decision to change the branding images and name of Aunt Jemima Syrup.

What about if a popular brand of delicatessen products was called ‘Jew Boy Deli Meats’ or ‘Shylock’s Sheeny Pickles’?  What about ‘Money Lenders Bagels’?  

And none of these hypothetical brands were owned by Jews trying to be edgy or ironic...still okay?

Asking for ‘some of my closest friends...’.

Posted by David Bogner on May 30, 2020 | Permalink | Comments (0)

Friday, May 22, 2020

Yom Yerushalayim

I'm once again following the time-honored ritual below:

Find a quiet place... turn off the lights... put a box of tissues within easy reach... and press play:

Part 1

 

Part 2

 

Click here to see an interview that General Uzi Narkis gave less than two weeks before he passed away.

Partial Transcript / translation:

Colonel Motta Gur [on loudspeaker]: All company commanders, we’re sitting right now on the ridge and we’re seeing the Old City. Shortly we’re going to go in to the Old City of Jerusalem, that all generations have dreamed about. We will be the first to enter the Old City. Eitan’s tanks will advance on the left and will enter the Lion’s Gate. The final rendezvous will be on the open square above. [The open square of the Temple Mount.]

[Sound of applause by the soldiers.]

Yossi Ronen: We are now walking on one of the main streets of Jerusalem towards the Old City. The head of the force is about to enter the Old City.

[Gunfire.]

Yossi Ronen: There is still shooting from all directions; we’re advancing towards the entrance of the Old City.

[Sound of gunfire and soldiers’ footsteps.]

[Yelling of commands to soldiers.] [More soldiers’ footsteps.]

The soldiers are keeping a distance of approximately 5 meters between them. It’s still dangerous to walk around here; there is still sniper shooting here and there. [Gunfire.] We’re all told to stop; we’re advancing towards the mountainside; on our left is the Mount of Olives; we’re now in the Old City opposite the Russian church. I’m right now lowering my head; we’re running next to the mountainside. We can see the stone walls. They’re still shooting at us. The Israeli tanks are at the entrance to the Old City, and ahead we go, through the Lion’s Gate. I’m with the first unit to break through into the Old City. There is a Jordanian bus next to me, totally burnt; it is very hot here.

We’re about to enter the Old City itself. We’re standing below the Lion’s Gate, the Gate is about to come crashing down, probably because of the previous shelling. Soldiers are taking cover next to the palm trees; I’m also staying close to one of the trees. We’re getting further and further into the City. [Gunfire.]

Colonel Motta Gur announces on the army wireless: The Temple Mount is in our hands! I repeat, the Temple Mount is in our hands! All forces, stop firing!

This is the David Operations Room. All forces, stop firing! I repeat, all forces, stop firing! Over. Commander eight-nine here, is this Motta (Gur) talking? Over.

[Inaudible response on the army wireless by Motta Gur.]

Uzi Narkiss: Motta, there isn’t anybody like you. You’re next to the Mosque of Omar.

Yossi Ronen: I’m driving fast through the Lion’s Gate all the way inside the Old City.

Command on the army wireless: Search the area, destroy all pockets of resistance but don't touch anything in the houses, especially the holy places.

[Lt.- Col. Uzi Eilam blows the Shofar. Soldiers are singing ‘Jerusalem of Gold’.]

Uzi Narkiss: Tell me, where is the Western Wall? How do we get there?

Yossi Ronen: I’m walking right now down the steps towards the Western Wall. I’m not a religious man, I never have been, but this is the Western Wall and I’m touching the stones of the Western Wall.

Soldiers: [reciting the ‘Shehechianu’ blessing]: Baruch ata Hashem, elokeinu melech haolam, she-hechianu ve-kiemanu ve-hegianu la-zman ha-zeh. [Translation: Blessed art Thou L-rd G-d King of the Universe who has sustained us and kept us and has brought us to this day]

Rabbi Shlomo Goren: Baruch ata Hashem, menachem tsion u-voneh Yerushalayim. [Translation: Blessed are thou, who comforts Zion and builds Jerusalem]

Soldiers: Amen!

[Soldiers sing ‘Hatikva’ next to the Western Wall.]

Rabbi Goren: We’re now going to recite the prayer for the fallen soldiers of this war against all of the enemies of Israel: [Soldiers weeping] El male rahamim, shohen ba-meromim. Hamtse menuha nahona al kanfei hashina, be-maalot kedoshim, giborim ve-tehorim, kezohar harakiya meirim u-mazhirim. Ve-nishmot halalei tsava hagana le-yisrael, she-naflu be-maaraha zot, neged oievei yisrael, ve-shnaflu al kedushat Hashem ha-am ve-ha’arets, ve-shichrur Beit Hamikdash, Har Habayit, Hakotel ha-ma’aravi veyerushalayim ir ha-elokim. Be-gan eden tehe menuhatam. Lahen ba’al ha-rahamim, yastirem beseter knafav le-olamim. Ve-yitsror be-tsror ha-hayim et nishmatam adoshem hu nahlatam, ve-yanuhu be-shalom al mishkavam [soldiers weeping loud]ve-ya’amdu le-goralam le-kets ha-yamim ve-nomar amen! [Translation: Merciful G-d in heaven, may the heroes and the pure, be under thy Divine wings, among the holy and the pure who shine bright as the sky, and the souls of soldiers of the Israeli army who fell in this war against the enemies of Israel, who fell for their loyalty to G-d and the land of Israel, who fell for the liberation of the Temple, the Temple Mount, the Western Wall and Jerusalem the city of the Lord. May their place of rest be in paradise. Merciful One, O keep their souls forever alive under Thy protective wings. The Lord being their heritage, may they rest in peace, for they shalt rest and stand up for their allotted portion at the end of the days, and let us say, Amen.] [Soldiers are weeping.

Rabbi Goren sounds the shofar. Sound of gunfire in the background.] Rabbi Goren: Le-shana HA-ZOT be-Yerushalayim ha-b’nuya, be-yerushalayim ha-atika! [Translation: This year in a rebuilt Jerusalem! In the Jerusalem of old!]

Posted by David Bogner on May 22, 2020 | Permalink | Comments (3)