与鲍勃一起旅行,我最喜欢的八旬老人。

IF 4.3 2区 医学 Q1 GERIATRICS & GERONTOLOGY Journal of the American Geriatrics Society Pub Date : 2024-07-16 DOI:10.1111/jgs.19090
Dalane W. Kitzman MD
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I affectionately called him “Dad.” Over the years, we became so close and spent so much time together that members of his own family may even have become a little jealous.</p><p>Two dramatic events made it unlikely that Bob would live to age 88. First, during WWII as a 22-year-old infantryman, his stubborn refusals to wear his helmet pushed his commanding officer to teach him a lesson about the importance of head protection in an active combat zone. At dusk, he and his equally stubborn compatriot were given a heavy radio set and ordered to cross behind enemy lines and serve as the forward observers for the night. Several times they encountered enemy soldiers, dodged volleys of bullets and their own side's mortars, and narrowly escaped into nearby brush cover. After finally receiving permission to return near dawn, they stumbled into camp, muddy and exhausted. In the dim light, Bob laughed nervously as he pointed to a bullet hole in the radio set his partner carried. But they both paled when his partner then pointed to the fresh bullet dent in Bob's helmet. Later, when they were unable to find their foxhole where they would have slept that night had they not been afield, they were informed that an incoming mortar blast had obliterated it.</p><p>Second, at age 52 while on vacation, Bob had a massive heart attack. He spent 6 weeks recovering in a small rural hospital. At Johns Hopkins, he was found to have severe, inoperable ischemic dilated cardiomyopathy. My father-in-law undertook several behavioral changes that I believe contributed to becoming a rare 36-year cardiomyopathy survivor: smoking cessation, regular physical activity, an optimistic, cheerful outlook, generously helping others, crossword puzzles, and regular afternoon naps. He also participated in the first clinical trial of beta-blockers, which became the most potent survival-improving drug.</p><p>Bob loved to travel. However, his wife, recalling his multiple out-of-hospital cardiac arrests, wanted him to stay close to home. However, after I joined the family, she allowed him to accompany her cardiologist son-in-law on business trips, opening up a world of adventure and deepening our friendship.</p><p>Our trips together took us to three different countries and eight different US states. In Germany, we visited the Berlin wall and Checkpoint Charlie where the American guard saluted Bob smartly and asked if he would like to help him lower the US flag for the evening. In Puerto Rico, my friend and I swam in the Caribbean, toured the Bacardi rum factory, and watched salsa dancing. In San Diego, he snorkeled for the first time, marveled at the marine life, and fed the dolphins at Sea World. In Washington DC, we visited the recently completed WWII memorial, where Dad shared details of the battles he was in, including the Battle of the Bulge, and his two encounters with the legendary US General George S. Patton.</p><p>Bob's favorite trip was Las Vegas. We visited the huge, opulent Las Vegas casinos, gorged on lavish buffets, and saw Hoover Dam, Red Rock Canyon, and the old “Strip.” At the small, intimate historic auditorium of the old Hilton hotel where Elvis made his Las Vegas debut, we sat together in the front row of a concert by one of his favorite artists, the famous American country singer Trisha Yearwood. Dad's eyes sparkled and he clapped and cheered enthusiastically. Trisha must have noticed his glee, because in mid-show, she stood right in front of Dad, sang a tender, heartfelt love song directly to him, and then gave him a huge bouquet of roses. Dad was enraptured and talked of that moment for years.</p><p>Every Wednesday night, Bob had played neighborhood poker with the same $100 he toted around in a paper lunch bag. He had always wanted to play poker with the “locals” in Las Vegas. After inquiring at many casinos with no luck, an accommodating host at the Mirage invited Dad to join a midnight backroom poker game with a group of locals who met there regularly. The local players, some of whom were retired professional players, slyly eyed an easy mark in the amiable, naïve-appearing old man, and relished an easy win. The host pulled me aside and assured me he would monitor the game closely to help limit my father's losses and humiliation. Three hours later, I was dead-tired and announced to Dad it was time to go. As my father-in-law swept up his large pile of winnings, the other players howled in protest so fiercely that the host had to intervene and support Bob's departure. Dad could hardly wait to get home and recount his adventure to his neighborhood poker friends.</p><p>Like most WWII veterans, Bob had never talked about his wartime experiences, even with his wife. A few years before our trip, Tom Brokaw had ignited national interest with his book, “The Greatest Generation.” Our society began to recognize that these veterans, who at the time were in their 80s and 90s, were rapidly dying off, and the opportunities to recognize their sacrifice and contributions were dwindling. So, on the long, sleepless, overnight flight home from Las Vegas, I gently asked Dad to please share a story or two. There was a long pause and a halting start as his memory began to jog. Then the dam opened. For hours, he recounted one fascinating story after another. Some were harrowing, like the story above. Others were heart-warming, such as how he helped some of the many impoverished European widows and orphans he encountered near the end of the war (Figure 1). My respect and admiration for this older man grew even more.</p><p>My last trip with Bob was the most poignant. I often traveled to Washington for NIH meetings. Dad would drive from Baltimore and stay with me at the hotel. He would bring a deck of cards and a few beers. After my meetings ended each day, we would have dinner and then return to the hotel room where we would spend the evening visiting, playing cards, and watching late shows. We both enjoyed these visits and this routine immensely.</p><p>During our very last evening together, I noticed Dad was wearing a cross necklace I had given him several years ago that matched mine. He said he had worn the necklace every day since I gave it to him. This led to a deep, intimate discussion of our shared faith that I will never forget and that brought great comfort to his family when I recounted it just a week later at his memorial service.</p><p>I worried about Dad during that visit. He had been robust well into his mid-80s, frequently taking neighbors in their 90s shopping and carrying their groceries up flights of stairs. However now, for the first time, he appeared frail. His limbs had thinned, he had some difficulty rising from a chair, and his gait was slower and appeared uncertain. He had never fully recovered from his last hospitalization which began as a laser ablation for bladder cancer but evolved into deep venous thrombosis and a prolonged hospital stay with inadequate attention to a rapid deterioration in physical function. It was alarming to see the sudden decline. Thankfully, Dad still had his intellect, sunny disposition, and wonderful sense of humor (Figure 2).</p><p>I had frequently tried to convince Bob to make a will. He always said it was too expensive and that he had told my wife what he wanted done after he passed and trusted her. This time, I patiently explained that he was putting his daughter in a difficult position that could lead to family discord, and I felt it was so important that I would pay the cost. To my surprise, he agreed. I found him a lawyer who had reasonable fees and with whom Dad felt comfortable. Four days later, he met the lawyer to make his will. A few days after that, my beloved father-in-law, my best friend for 32 years, died suddenly in the middle of the night.</p><p>Whenever I am in the Baltimore–Washington area, I still visit my best friend at the Veteran's Cemetery. These solemn visits usually begin with an outpouring of tears, but transition to a remembrance of the joys of our times together and deep gratitude for the many blessings I received through Bob. I tell him about the trips I have taken since my last visit. Continuing a tradition whereby I always bought him a souvenir cap on each of our trips together, I gently place a new cap on his grave. We “share” a beer together. The visits end in peace, with a kiss to his gravestone and a tearful prayer: “Thank you Dad, for everything. I'll see you in Heaven.”</p><p>This study was supported in part by NIH grant U24AG059624.</p>","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"72 10","pages":"3239-3241"},"PeriodicalIF":4.3000,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.19090","citationCount":"0","resultStr":"{\"title\":\"Travels with Bob, my favorite octogenarian\",\"authors\":\"Dalane W. Kitzman MD\",\"doi\":\"10.1111/jgs.19090\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p>My great fortune was that my father-in-law became my best friend. For over three decades, I enjoyed his company, learned from his wisdom and example, and observed and assisted this member of the Greatest Generation as he aged gracefully despite humble circumstances and multiple severe morbidities. 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Several times they encountered enemy soldiers, dodged volleys of bullets and their own side's mortars, and narrowly escaped into nearby brush cover. After finally receiving permission to return near dawn, they stumbled into camp, muddy and exhausted. In the dim light, Bob laughed nervously as he pointed to a bullet hole in the radio set his partner carried. But they both paled when his partner then pointed to the fresh bullet dent in Bob's helmet. Later, when they were unable to find their foxhole where they would have slept that night had they not been afield, they were informed that an incoming mortar blast had obliterated it.</p><p>Second, at age 52 while on vacation, Bob had a massive heart attack. He spent 6 weeks recovering in a small rural hospital. At Johns Hopkins, he was found to have severe, inoperable ischemic dilated cardiomyopathy. My father-in-law undertook several behavioral changes that I believe contributed to becoming a rare 36-year cardiomyopathy survivor: smoking cessation, regular physical activity, an optimistic, cheerful outlook, generously helping others, crossword puzzles, and regular afternoon naps. He also participated in the first clinical trial of beta-blockers, which became the most potent survival-improving drug.</p><p>Bob loved to travel. However, his wife, recalling his multiple out-of-hospital cardiac arrests, wanted him to stay close to home. However, after I joined the family, she allowed him to accompany her cardiologist son-in-law on business trips, opening up a world of adventure and deepening our friendship.</p><p>Our trips together took us to three different countries and eight different US states. In Germany, we visited the Berlin wall and Checkpoint Charlie where the American guard saluted Bob smartly and asked if he would like to help him lower the US flag for the evening. 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Trisha must have noticed his glee, because in mid-show, she stood right in front of Dad, sang a tender, heartfelt love song directly to him, and then gave him a huge bouquet of roses. Dad was enraptured and talked of that moment for years.</p><p>Every Wednesday night, Bob had played neighborhood poker with the same $100 he toted around in a paper lunch bag. He had always wanted to play poker with the “locals” in Las Vegas. After inquiring at many casinos with no luck, an accommodating host at the Mirage invited Dad to join a midnight backroom poker game with a group of locals who met there regularly. The local players, some of whom were retired professional players, slyly eyed an easy mark in the amiable, naïve-appearing old man, and relished an easy win. The host pulled me aside and assured me he would monitor the game closely to help limit my father's losses and humiliation. Three hours later, I was dead-tired and announced to Dad it was time to go. As my father-in-law swept up his large pile of winnings, the other players howled in protest so fiercely that the host had to intervene and support Bob's departure. Dad could hardly wait to get home and recount his adventure to his neighborhood poker friends.</p><p>Like most WWII veterans, Bob had never talked about his wartime experiences, even with his wife. A few years before our trip, Tom Brokaw had ignited national interest with his book, “The Greatest Generation.” Our society began to recognize that these veterans, who at the time were in their 80s and 90s, were rapidly dying off, and the opportunities to recognize their sacrifice and contributions were dwindling. So, on the long, sleepless, overnight flight home from Las Vegas, I gently asked Dad to please share a story or two. There was a long pause and a halting start as his memory began to jog. Then the dam opened. For hours, he recounted one fascinating story after another. Some were harrowing, like the story above. Others were heart-warming, such as how he helped some of the many impoverished European widows and orphans he encountered near the end of the war (Figure 1). My respect and admiration for this older man grew even more.</p><p>My last trip with Bob was the most poignant. I often traveled to Washington for NIH meetings. Dad would drive from Baltimore and stay with me at the hotel. He would bring a deck of cards and a few beers. After my meetings ended each day, we would have dinner and then return to the hotel room where we would spend the evening visiting, playing cards, and watching late shows. We both enjoyed these visits and this routine immensely.</p><p>During our very last evening together, I noticed Dad was wearing a cross necklace I had given him several years ago that matched mine. He said he had worn the necklace every day since I gave it to him. 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摘要

我的幸运之处在于,我的岳父成了我最好的朋友。三十多年来,我享受着他的陪伴,从他的智慧和榜样中学习,观察和帮助这位最伟大的一代的成员,尽管他身处卑微的环境,而且患有多种严重疾病,但他依然优雅地步入老年。在我未来的妻子带我回家见她父母之后,我们很快就建立了感情。然而,一开始我们的关系很尴尬。鲍勃是个高大魁梧、热情好客的码头工人。我是个矮小、微胖、内向的医科学生。不过,没过几分钟,他爽朗的笑容和热情的欢迎就让我感到很自在。在许多方面,他成了我从未有过的父亲。我亲切地叫他 "爸爸"。多年来,我们的关系变得如此亲密,在一起的时间如此之长,以至于他自己的家人可能都有点嫉妒。有两件戏剧性的事情让鲍勃不太可能活到 88 岁。首先,在二战期间,鲍勃还是一名 22 岁的步兵,他顽固地拒绝戴头盔,迫使他的指挥官给他上了一课,让他明白在现役战区保护头部的重要性。黄昏时分,他和他同样顽固的同伴被配发了一套重型无线电设备,奉命穿越敌后,担任夜间前方观察员。他们数次遭遇敌军士兵,躲过一排排子弹和己方的迫击炮,险些逃进附近的灌木丛中。天快亮时,他们终于得到返回的许可,带着一身泥泞和疲惫,跌跌撞撞地走进营地。在昏暗的灯光下,鲍勃指着搭档随身携带的无线电设备上的一个弹孔紧张地笑了起来。但当他的搭档指着鲍勃头盔上的新弹孔时,两人都不禁哑然失笑。后来,当他们找不到他们的散兵坑时,他们被告知,迫击炮弹已经将他们的散兵坑炸毁了。第二,52 岁时,鲍勃在度假时突发心脏病。他在一家乡村小医院休养了 6 周。在约翰霍普金斯医院,他被发现患有严重的缺血性扩张型心肌病,无法手术。我的岳父在行为上做出了一些改变,我相信这些改变有助于他成为罕见的 36 年心肌病幸存者:戒烟、经常参加体育锻炼、乐观开朗、乐于助人、玩填字游戏以及经常在午后小睡。他还参加了首次β-受体阻滞剂的临床试验,该药成为最有效的改善生存的药物。然而,他的妻子回忆起他多次在院外心脏骤停的经历,希望他能待在家附近。然而,在我加入这个家庭后,她允许他陪同她的心脏病学女婿出差,这为我们打开了一个冒险的世界,也加深了我们的友谊。在德国,我们参观了柏林墙和查理检查站,那里的美国卫兵机智地向鲍勃敬礼,并问他是否愿意帮他在晚上降下美国国旗。在波多黎各,我和朋友在加勒比海游泳,参观了百加得朗姆酒厂,还欣赏了萨尔萨舞。在圣地亚哥,他第一次浮潜,对海洋生物惊叹不已,还在海洋世界喂了海豚。在华盛顿特区,我们参观了刚刚落成的二战纪念馆,爸爸在那里分享了他参加的战役的细节,包括突出部战役,以及他与传奇的美国将军乔治-巴顿的两次邂逅。我们参观了拉斯维加斯巨大、奢华的赌场,大吃豪华自助餐,游览了胡佛大坝、红石峡谷和古老的 "Strip "大道。在猫王首次亮相拉斯维加斯的希尔顿老酒店的历史悠久的小礼堂里,我们一起坐在他最喜欢的艺术家之一、美国著名乡村歌手特里莎-耶尔伍德演唱会的前排。爸爸的眼睛闪闪发光,热烈地鼓掌欢呼。特里莎一定注意到了他的喜悦,因为在演出进行到一半时,她就站在爸爸面前,直接向他唱了一首柔情似水、情真意切的情歌,然后送给他一大束玫瑰花。每个星期三晚上,鲍勃都会用他装在纸质午餐袋里的 100 美元玩邻里扑克。他一直想和拉斯维加斯的 "当地人 "一起玩扑克。在向许多赌场打听却一无所获之后,幻影酒店一位热情的主人邀请爸爸参加午夜密室扑克游戏,与一群经常在那里聚会的当地人一起玩。这些当地玩家中有些是退休的职业玩家,他们狡猾地盯上了这位看起来和蔼可亲、天真无邪的老人,并乐于轻松获胜。主持人把我拉到一边,向我保证他会密切关注比赛,帮助我减少父亲的损失和羞辱。三个小时后,我累坏了,向爸爸宣布该走了。
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Travels with Bob, my favorite octogenarian

My great fortune was that my father-in-law became my best friend. For over three decades, I enjoyed his company, learned from his wisdom and example, and observed and assisted this member of the Greatest Generation as he aged gracefully despite humble circumstances and multiple severe morbidities. We bonded quickly after my future wife brought me home to meet her parents. However, it started out awkwardly. Bob was a tall, burly, gregarious dockworker. I was a short, slight, introverted medical student. Nevertheless, within minutes, his cheerful smile and hearty welcome put me at ease. In many ways, he became the father I never had. I affectionately called him “Dad.” Over the years, we became so close and spent so much time together that members of his own family may even have become a little jealous.

Two dramatic events made it unlikely that Bob would live to age 88. First, during WWII as a 22-year-old infantryman, his stubborn refusals to wear his helmet pushed his commanding officer to teach him a lesson about the importance of head protection in an active combat zone. At dusk, he and his equally stubborn compatriot were given a heavy radio set and ordered to cross behind enemy lines and serve as the forward observers for the night. Several times they encountered enemy soldiers, dodged volleys of bullets and their own side's mortars, and narrowly escaped into nearby brush cover. After finally receiving permission to return near dawn, they stumbled into camp, muddy and exhausted. In the dim light, Bob laughed nervously as he pointed to a bullet hole in the radio set his partner carried. But they both paled when his partner then pointed to the fresh bullet dent in Bob's helmet. Later, when they were unable to find their foxhole where they would have slept that night had they not been afield, they were informed that an incoming mortar blast had obliterated it.

Second, at age 52 while on vacation, Bob had a massive heart attack. He spent 6 weeks recovering in a small rural hospital. At Johns Hopkins, he was found to have severe, inoperable ischemic dilated cardiomyopathy. My father-in-law undertook several behavioral changes that I believe contributed to becoming a rare 36-year cardiomyopathy survivor: smoking cessation, regular physical activity, an optimistic, cheerful outlook, generously helping others, crossword puzzles, and regular afternoon naps. He also participated in the first clinical trial of beta-blockers, which became the most potent survival-improving drug.

Bob loved to travel. However, his wife, recalling his multiple out-of-hospital cardiac arrests, wanted him to stay close to home. However, after I joined the family, she allowed him to accompany her cardiologist son-in-law on business trips, opening up a world of adventure and deepening our friendship.

Our trips together took us to three different countries and eight different US states. In Germany, we visited the Berlin wall and Checkpoint Charlie where the American guard saluted Bob smartly and asked if he would like to help him lower the US flag for the evening. In Puerto Rico, my friend and I swam in the Caribbean, toured the Bacardi rum factory, and watched salsa dancing. In San Diego, he snorkeled for the first time, marveled at the marine life, and fed the dolphins at Sea World. In Washington DC, we visited the recently completed WWII memorial, where Dad shared details of the battles he was in, including the Battle of the Bulge, and his two encounters with the legendary US General George S. Patton.

Bob's favorite trip was Las Vegas. We visited the huge, opulent Las Vegas casinos, gorged on lavish buffets, and saw Hoover Dam, Red Rock Canyon, and the old “Strip.” At the small, intimate historic auditorium of the old Hilton hotel where Elvis made his Las Vegas debut, we sat together in the front row of a concert by one of his favorite artists, the famous American country singer Trisha Yearwood. Dad's eyes sparkled and he clapped and cheered enthusiastically. Trisha must have noticed his glee, because in mid-show, she stood right in front of Dad, sang a tender, heartfelt love song directly to him, and then gave him a huge bouquet of roses. Dad was enraptured and talked of that moment for years.

Every Wednesday night, Bob had played neighborhood poker with the same $100 he toted around in a paper lunch bag. He had always wanted to play poker with the “locals” in Las Vegas. After inquiring at many casinos with no luck, an accommodating host at the Mirage invited Dad to join a midnight backroom poker game with a group of locals who met there regularly. The local players, some of whom were retired professional players, slyly eyed an easy mark in the amiable, naïve-appearing old man, and relished an easy win. The host pulled me aside and assured me he would monitor the game closely to help limit my father's losses and humiliation. Three hours later, I was dead-tired and announced to Dad it was time to go. As my father-in-law swept up his large pile of winnings, the other players howled in protest so fiercely that the host had to intervene and support Bob's departure. Dad could hardly wait to get home and recount his adventure to his neighborhood poker friends.

Like most WWII veterans, Bob had never talked about his wartime experiences, even with his wife. A few years before our trip, Tom Brokaw had ignited national interest with his book, “The Greatest Generation.” Our society began to recognize that these veterans, who at the time were in their 80s and 90s, were rapidly dying off, and the opportunities to recognize their sacrifice and contributions were dwindling. So, on the long, sleepless, overnight flight home from Las Vegas, I gently asked Dad to please share a story or two. There was a long pause and a halting start as his memory began to jog. Then the dam opened. For hours, he recounted one fascinating story after another. Some were harrowing, like the story above. Others were heart-warming, such as how he helped some of the many impoverished European widows and orphans he encountered near the end of the war (Figure 1). My respect and admiration for this older man grew even more.

My last trip with Bob was the most poignant. I often traveled to Washington for NIH meetings. Dad would drive from Baltimore and stay with me at the hotel. He would bring a deck of cards and a few beers. After my meetings ended each day, we would have dinner and then return to the hotel room where we would spend the evening visiting, playing cards, and watching late shows. We both enjoyed these visits and this routine immensely.

During our very last evening together, I noticed Dad was wearing a cross necklace I had given him several years ago that matched mine. He said he had worn the necklace every day since I gave it to him. This led to a deep, intimate discussion of our shared faith that I will never forget and that brought great comfort to his family when I recounted it just a week later at his memorial service.

I worried about Dad during that visit. He had been robust well into his mid-80s, frequently taking neighbors in their 90s shopping and carrying their groceries up flights of stairs. However now, for the first time, he appeared frail. His limbs had thinned, he had some difficulty rising from a chair, and his gait was slower and appeared uncertain. He had never fully recovered from his last hospitalization which began as a laser ablation for bladder cancer but evolved into deep venous thrombosis and a prolonged hospital stay with inadequate attention to a rapid deterioration in physical function. It was alarming to see the sudden decline. Thankfully, Dad still had his intellect, sunny disposition, and wonderful sense of humor (Figure 2).

I had frequently tried to convince Bob to make a will. He always said it was too expensive and that he had told my wife what he wanted done after he passed and trusted her. This time, I patiently explained that he was putting his daughter in a difficult position that could lead to family discord, and I felt it was so important that I would pay the cost. To my surprise, he agreed. I found him a lawyer who had reasonable fees and with whom Dad felt comfortable. Four days later, he met the lawyer to make his will. A few days after that, my beloved father-in-law, my best friend for 32 years, died suddenly in the middle of the night.

Whenever I am in the Baltimore–Washington area, I still visit my best friend at the Veteran's Cemetery. These solemn visits usually begin with an outpouring of tears, but transition to a remembrance of the joys of our times together and deep gratitude for the many blessings I received through Bob. I tell him about the trips I have taken since my last visit. Continuing a tradition whereby I always bought him a souvenir cap on each of our trips together, I gently place a new cap on his grave. We “share” a beer together. The visits end in peace, with a kiss to his gravestone and a tearful prayer: “Thank you Dad, for everything. I'll see you in Heaven.”

This study was supported in part by NIH grant U24AG059624.

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来源期刊
CiteScore
10.00
自引率
6.30%
发文量
504
审稿时长
3-6 weeks
期刊介绍: Journal of the American Geriatrics Society (JAGS) is the go-to journal for clinical aging research. We provide a diverse, interprofessional community of healthcare professionals with the latest insights on geriatrics education, clinical practice, and public policy—all supporting the high-quality, person-centered care essential to our well-being as we age. Since the publication of our first edition in 1953, JAGS has remained one of the oldest and most impactful journals dedicated exclusively to gerontology and geriatrics.
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