to wit, an Inarguably Wise but Jaded Forensic Psychiatrist Expatiating on Topics Medico-Legal, Historical, and Scientific, with a Few Non-Sequiturs for Good Measure
En route earlier this month to Druskininkiai, a spa-resort town near the border with Belarus, our cousin, driving us in his minivan, was nabbed by a Lithuanian highway patrol car for speeding.
Lithuanian police cruiser
It actually wasn’t his fault; he was passing and accelerated to get by the other car at the very moment that the trooper with the radar gun appeared out of the forest ahead. There was no where to hide. We pulled over and the trooper approached the driver’s window.
That was the bad news.
Eduard exited the car to speak to the policeman, and it was apparent even to those of us who do not fully understand the language that a ticket was going to be issued. No warnings here.
The odd news is that, in Lithuania, if you are nabbed, you pay your ticket directly to the police. Right then and there. And you don’t use cash – you use VISA or MasterCard.
The policeman had to figure out how to swipe the credit card using the laptop in his cruiser – apparently he was new on the job.
The good news – and I learned this much later – is that, at the current exchange rate, the ticket cost us about $10 USD and comes with no points.
Roadtrip saved!
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I realize that’s an anthropomorphic attribution to an inanimate chunk of calcium no longer alive, but a skull does appear to smile, even when dirty, fractured, and missing most of its mandible.
My stepdaughter and I were peering into a cracked mausoleum, and there on the dirt floor, amidst the detritus of a century of rotting wood coffins and other accumulated debris, he sat and ‘looked’ in our direction. We tried to get a picture, but the light didn’t cooperate. How very macabre.
Rasos entrance
We were in Rasos Cemetery, which is the oldest municipal burial ground in Vilnius, Lithuania. There were burials on the site as early as 1769, but the 11 hectare Roman Catholic property was not formally consecrated until 1801, which is therefore its official date of founding. Two days after consecration, the late Mayor of Vilnius, one Jan Muller, was interred there, and it’s been a busy place ever since. It’s now filled with neo-Gothic tombs, fragments of columbaria, mausoleums, chapels, bell towers, and memorials, all packed together on the hills and in the ravines with little apparent order. Having run out of space long ago despite the crowding, Rasos has been closed to new burials – except those in preexisting family plots – since 1990.
The boneyard is filled with notables from Lithuanian and Polish history. There are politicians, generals, academics, artists, and writers at every turn. Two of the men who signed the Lithuanian Articles of Independence rest there. Arguably the most famous remains are those of Mikalojus Čiurlionis (1875-1911), the renowned abstract composer, painter, and poet.
Rasos is situated on very hilly land. Lithuania gets a lot of rain. Hills + Rain = Erosion. Thus, almost all of the graves in Rasos are tilted, lopsided, or in some cases have toppled over altogether – hence the cracks in many of the mausoleums, and our ability to spy at least one of the inhabitants. We were accordingly not surprised to learn that an old ossuary had gone over a precipice and shattered at the bottom a number of years ago, scattering bones along the ground.
Rasos
Geology aside, though, Rasos has another problem. Prior to the end of WWI, both Lithuania and nearby Poland were under the firm grip of the Tsar. Vilnius at that time had a majority of Polish-speaking residents. After the Bolsheviks came to power in Russia, Lithuania and Poland regained independence, and immediately came to blows over the possession of Vilnius. The Poles seized the city from 1922 to the late 1930s, after which Lithuania again took control under the aegis of the Soviet occupation; Vilnius has remained the Lithuanian capital ever since.
But that period of control by Warsaw resulted in a lot of Polish graves in Rasos. And memories die hard.
The heart of the general who orchestrated Poland’s initial seizure of Vilnius, Marshal Józef Piłsudski, lies enshrined near the cemetery’s entrance along with almost 200 of his soldiers (including three members of the previously permanent honor guard who were summarily shot when the Soviets took over). Polish flags abound in that section of Rasos. And while the Marshal’s tomb appears untouched, a number of the soldiers’ stones have been desecrated.
1930s Polish graves
When asked, our guide said that the damage to the markers resulted from WWII. But this is not accurate. The plaza wherein is buried Pilsudski and his guards was restored by the Polish government in 1993 with the permission of the Lithuanian authorities. Which makes the damage recent.
I don’t recall now if our smiling skull was Polish or Lithuanian. But it is worth noting that the dead seem to get along just fine in the quiet decay of the old cemetery. It’s the living about whom I’m concerned.
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Prior to leaving for our family visit in Lithuania earlier this month, we learned that my 92 year old grandmother-in-law, Antanina, had been hospitalized in Kaunas. She’s a hardy individual – a 1950s Soviet gulag survivor who still lives independently and has all of her mental faculties about her – but any hospitalization at that age is of concern. At first we were told it was simple dehydration, but then we learned that some pneumonia was involved as well. Thus, as soon as we landed in Vilnius, we made arrangements to drive the 1.3 hours to the hospital to visit and find out more for ourselves.
There are several campuses of the medical center in Kaunas, and Antanina was at one of the older ones. The visit to this Soviet-era hospital is a story in itself: no central climate control (or even electric fans that I could see), no private rooms, no electronic medical records, and only one tiny elevator – meaning that most staff and visitors used the un-air-conditioned staircases. Did I mention that the geriatric unit of this particular building is on the 5th floor?
Kaunas Hospital, early 1950s
Anyway, we reached Antanina’s room, and the first thing that surprised me was that she didn’t have an IV running or evidence of one having been d/c’d recently. She looked good and sat up in bed talking and later walking down the hall under her own steam. But she wasn’t able to give us much medical information, so we hunted down the ward’s doctor to learn more.
This doctor – from Ukraine – was very interested in learning the ‘American perspective’ on the current civil war in her home country (we had to tread lightly on this topic, since it wasn’t immediately apparent on which side of the divide she fell). Once we had (successfully) navigated and dispensed with the politics, we inquired of Antanina’s condition. The doctor said that she had been receiving IV fluids and antibiotics last week, but was now doing “very well” and not needing IVs any longer. There were, however, some abnormalities in her blood.
“What abnormalities,” we asked?
It seems that Antanina was mildly anemic and also had a modest dip in her serum calcium level (not unexpected in a woman in her 90s). In the U.S., neither of these findings on their own would necessitate hospitalization. An elderly person in this condition could be easily be given oral Rx and followed on an outpatient basis with an office or home health visit scheduled.
The doctor added that Antanina might need to stay in the hospital for as much as another week before discharge.
Another week?! In the U.S., 3d party payors often kick you out of your hospital room when the bandages are still bloody.
Rumor has it that medical house staff can be, er, persuaded to keep patients in the hospital a bit longer than might otherwise occur; whether the Ukrainian doctor had been thusly encouraged by others in our family before our arrival I do not know.
My GMIL seemed happy enough with her surroundings and the attention she was getting, so we visited a bit longer and then bid her farewell. I am thankful to the staff of the hospital for taking good care of her and keeping her stable and safe. But as we drove back to Vilnius, I couldn’t help but wonder if there might exist – somewhere – a happy medium of resource allocation between full-blown capitalism and the accountants who rush you out the door, and socialized medicine and what seems like overly protracted inpatient stays that aren’t entirely indicated?
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to wit, a middle-aged peripatetic shrink undertakes the Great American Cross-Country Road Trip with help from little leaguers, German bikers, the King of Rock ‘n Roll, porn stars and an abandoned brothel, a flock of domesticated ducks, the Department of Homeland Security and the West Memphis police, a decommissioned atomic warhead, some dodgy motels… and a strange rider in the back of a 2013 Ford Fusion.
The Bonester and I settled in for a long drive across Texas after escaping the Adobe Inn. The terrain, esp in the far western panhandle, is very reminiscent of Spielberg’s 1971 movie ‘Duel’ – brown, dry, dusty, with the occasional building, wind farm, or oil derrick, and mostly flat but with hills in the distance. Highway mileage signs that read in the ‘400’s. A few vultures feasting on ubiquitous roadkill. A couple of really long BNSF freight trains on the horizon with their soulful whistles. And miles and miles of nothingness. I found the solitude relaxing, but there was little to pass the time except to be alone with one’s thoughts. Even the few radio stations that could be located were in Spanish (though spinning the dial I did briefly find Wall of Voodoo’s 1982 ‘Mexican Radio’ in English just before reaching the wide-spot of Junction, TX).
Despite my love of back roads and unscripted stops, we were trying to drive as fast as possible to make it to College Station, where my son attends university. Once we arrived, he and I had a nice visit – I left my back-seat specimen in the car, however – and I even learned a good recipe for college student chili while there. Afterward, bidding my son farewell, the dead hombre and I turned north and headed toward the Big D and our next destination.
Although I was just 15 months old in November 1963, I was raised hearing about the assassination in Dallas and the myriad conspiracy theories which subsequently grew like kudzu. The centerpiece of these tales was Dealey Plaza, and none of my generation or older can fail to immediately recognize that name and its historical significance instantly.
Dealey Plaza – a National Historic Landmark only since 1993 – was a west-end feature even before the events of November 1963. The area bounded by Main St, Elm St, and Commerce St was named in honor of Dallas publisher George Dealey prior to WWII. It contains monuments to prominent Dallas residents that have long since been overshadowed by the tragedy with which it is otherwise eternally associated.
Visitors to Dealey Plaza today will see a panorama that has (intentionally) changed little in the past half century. Trees are larger and a few new signs are in place. But the buildings that ring the plaza, the triple underpass, the railroad bridge, and the grassy knoll look as they do in period photographs. Even the streetlights are circa 1963.
And then there is the Texas School Book Depository, 411 Elm St, at Elm’s intersection with Houston St, facing the plaza.
411 Elm St
Just a stone’s throw from the grassy knoll, what we know as the depository started its existence in 1903 as the HQ of the Texas division of the Southern Rock Island Plow Company. After going through several more owners, the building became the schoolbook warehouse in the early 1960s. Fatefully, in the autumn of the year, the employees of the depository found an oil leak on the upper floors; immediately prior to the Presidential visit, work had begun to fix the leak and protect the boxes of books, meaning that there was much disarray on the sixth floor and many stacks of boxes in places where they weren’t normally kept.
It was this disarray that allowed Lee Harvey Oswald to secrete himself near a window, hidden from view, and fire no fewer than two, and possibly three, bullets into the Presidential motorcade as it slowed to turn just below his perch.
The building was slated for demolition at one point, but cooler heads prevailed, and it too still looks as it did on that fateful day 51 years ago. The top two floors are now open to visitors – the Sixth Floor Museum it is called – and over 6,000,000 have availed themselves of the opportunity since it opened in February 1989.
Leaving my articulated companion in the trunk once again, I parked, paid, and took the elevator to the top. The exhibits document the life, times, death, and legacy of President Kennedy. The museum – run privately by the Dallas County Historical Foundation which rents the space from the city government – contains photos, audiotapes, films, artifacts, and interpretive displays – arguably the most poignant of which is the President’s original place setting for the lunch at the Trade Mart which he never reached.
Even more than the displays, though, it’s the old warehouse itself – with brick walls, a rickety old service elevator, and exposed wooden beams – that sets the tone. One cannot help but wonder how a plebeian structure played such a pivotal role in world history.
There are still stacked boxes. There is the sniper’s nest. And there is the unchanged view.
the view
Chilling to this day, as cars still busily traverse the fatal spot marked on the pavement below.
Back in our own car, Santa Muerte and I headed northeast out of town. We had to make good time, as we were fast approaching Mecca.
[to be continued…]
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Earlier this week, I spoke of the lavish residency-applicant lunches of which hungry and tired psychiatric residents partook, myself included. As alluded in that piece, however, dining options as a intern or junior resident were not always so ‘five star.’
After that post, my former RN girlfriend dropped me an email and reminded me of how she kept me alive while I was carrying the code beeper as an intern, and asked why I had not blogged on that topic?
Maria, you’re right. That was an oversight. Allow me to expand and correct the record.
As an intern at UVa in the late 1980s, I rotated between services every 4-6 weeks. At that time, the only two inpatient services that were not located within the medical center proper were the psychiatric wards – ensconced at a former TB sanatorium several miles away – and what we called the Towers. Though the Towers unit was just up the street from the main medical complex, it wasn’t physically connected, and therefore if a patient had to be transferred from the Towers to the ER or OR, for example, they had to be taken outside by ambulance.
The Towers was a combination geriatric and general internal medicine service. It is probably best described as an overflow unit for those two disciplines. There were a number of patients there who were elderly and DNR status (Do Not Resuscitate), hanging out in God’s Waiting Room. But there were also younger patients with curable conditions who came and went (and were to be fully coded should something happen unexpectedly). And because of the full-code status of that segment of the patient roster, the lowest ranking resident – in this case the intern (i.e., me) – had to carry the code beeper.
Those with code beepers – the designated first responders to a code – were required to remain on the floor until relieved; naturally, if a patient were to stop breathing or beating, the code resident couldn’t be somewhere else… like getting dinner.
Back then, the hospital cafeteria was in the main complex, and getting to it required crossing two busy streets and walking two blocks. There was no fast-food located adjacent, and I don’t recall that any of the sandwich shops or pizza places delivered to the Towers. In short, unless you had possessed the foresight to pack your own meals – not a high likelihood for a young bachelor resident who was massively sleep deprived – or were lucky enough to know a higher-level resident who was leaving the building and going to get food, you were going to starve as long as you were wearing that code beeper.
Enter Maria.
Computers were rare back then, and dietary orders were written on old fashioned paper and sent over to the food service department (which was up the street in the main complex). Meals for the Towers were then delivered three times a day by van. If a Towers patient was made NPO (Nothing By Mouth) pre-surgery, or had expired altogether, their designated meals continued to arrive, name taped to the tray, until and unless the nurses on the ward sent the necessary paperwork to the food service saying to stop.
Maria knew this and regularly ‘forget’ to stop patients’ meals. And guess who got to eat them when on-call and starving?
I must confess that it never bothered me to sup on the trays of those recently departed. Poor Mrs X would have enjoyed this grilled cheese sandwich I’m certain. But where those erstwhile meal recipients had gone, they wouldn’t be needing the beef stew any longer. And I didn’t then want to expire from famine and join them.
Thanks again, Maria! xoxo!
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I just returned from a trip to Lithuania, during which I found more interesting material that I’ll be sharing online in coming days. And while on the road, I was honored to learn that an essay that I had composed on two unusual antique cameos had been selected to post by The Order Of The Good Death.
Don’t let the name alarm; the Order – brainchild of Caitlin Doughty, undertaker extraordinaire and star of YouTube’s ‘Ask A Mortician’ series – is a group of funereal professionals, academics, writers, and artists who use the venue to explore topics of mortality in our death-phobic modern culture. It’s an erudite, entertaining, and insightful website, and well worth exploring.
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