Bandit Achieves Our Retirement- Part IV

A Dog's Pathway to Retirement, A sense of place, animal behavior, Border collies, Creative Nonfiction, Dog Stories, Dogs and Humans- A Special Relationship October 26, 2023 1 Comment

This is the fourth blog piece in a series that features our first Border collie, Bandit, and is taken from an unpublished book titled The Bandit’s Gift. I wrote this manuscript which I suppose could be considered my practice book, shortly after retiring from my Neurology practice in Lubbock and moving to our ranch outside of Fredericksburg, Texas. The title of the book hints at our Bandit dog’s substantial role in bringing about our early retirement. Trudy and I feel indebted to Bandit for his efforts in hastening our move from a frenetic life in the city to the beauty and peacefulness of the Texas Hill Country.

This installment describes our migration from Lubbock to our ranch near Fredericksburg. It also introduces Mollie, a female Border collie, whom we acquired shortly before our move to the ranch. Mollie as a puppy came from a New Mexico ranch whereas Bandit had been raised a city dog in Lubbock.

                             Mollie our second Border collie who was from herding stock

In August of 2001, Trudy and I departed Lubbock for permanent retirement at our Fredericksburg ranch. Bandit and Mollie rode in the backseat nestled among hanging clothes and piles of shoes.  Mollie sat on the passenger’s side, Bandit on the driver’s side.  As Lubbock receded into the tabletop-flat landscape, Bandit cast what I considered a satisfied if not smug glance out the window for having brought about this major change in our lives.  I wondered how our canine conniver felt, as he had been a motivating force for my early retirement, mounting a determined campaign having nearly destroyed our home in Lubbock.

“Bandit, say good-bye to Lubbock.”

His long white tipped tail began slapping the back of the seat.

“Thump, thump, thump.”

“Trudy, that dog sounds like he’s beating a drum, am I imagining it or is Bandit celebrating?”

“Thump, thump, thump.”

                                                              Bandit looking so innocent

Mollie sat quietly in her corner of the backseat.  When I turned to scratch her chin, I noticed her peculiar smile.  When Mollie smiled, she retracted her lips and exposed her teeth.  Her eyes squinted and her face showed a broad dog smile- a smile sometimes misinterpreted as a snarl. I sensed that Mollie was happy, knowing we were leaving a city and headed permanently for a ranch.

Optimism and a sense of unburdening welled up within me.  My exhausted spirit for years had yearned for a saner, more private existence.  The long work hours, the stress of holding together a clinic and hospital practice, and the daily grind of dealing with desperately ill patients had extracted a physical and emotional toll from me.

While Trudy and I had worked well together, our communication styles differed.  For me, small talk has always proved difficult.  Give me a family with a brain-dead member, or the need to relate a terminal diagnosis, and I am at my rhetorical and sympathetic best.  But when at a social function calling for light banter, I feel like a stammering dolt.  Moreover, I suffer near stupefaction when faced with the usual social banalities.

Trudy on the other hand handles social situations with aplomb.  She can discuss grandchildren, the weather, the latest gossip, or pop-culture with the best of them.  She finds difficulty, though, when talking of emotionally laden topics, especially those affecting her or her family.  It was just such heavy topics that had for years nagged at the corners of my mind.

Trudy’s unhappiness and worry may have prompted verbal zingers aimed at a workaholic, slow to mobilize, and frequently absent husband.

“Remember that Surgeon in Medical Records, draped over his pile of charts like a bad suit of clothes, dead as Hamlet’s buddy, Yorik?  You’re not indestructible either Buster. I’m too young and gorgeous to be a widow.  Lots of young bucks have the hots for well off, sexy widows.”

“Yeah, rave on,” I had said, suspecting I had not deflected this conversation for long.

Later as I drove off the cap rock of the Llano Estacado and away from the loneliness of the high plains, I became lost in a tumble of conflicting questions and emotions. Long drives have always put me in pensive moods, providing uninterrupted time for contemplation. Memories began to tug at my sleeve.

Being a physician had been at the core of my identity.  I wondered how life would change without Medicine being my magnetic north.

Why am I ambivalent about leaving? Sure, I’ve loved Medicine- the intimacy that goes with caring for others.  Where’s the satisfaction gone? Had it been the hospital’s economic realities that at times impinged on the quality of clinical care I wished to give? Had this led to incessant medical upheavals?  Why had it been a struggle to maintain a successful group practice, run an efficient medical practice, and carry out good clinical care and research? Had I asked too much of myself as both a private practitioner and an academic?

After an initial scuffle in the backseat when Mollie tried to take Bandit’s usual place, the canines had calmed. Bandit circled and plopped down with an audible exhalation.  Long before we reached the cap rock, Bandit had fallen fast asleep.  Mollie rested her chin at the window and observed passing fence posts, her light blue eyes tracking and flicking from one to the next.

                                           Bandit on the left and Mollie on the right in profile

As the miles sped by, my mind shifted from labors left behind to this land’s history through which we passed which I began to recall. We headed southeast, counter to the migration of earlier settlers, toward what in 1800 had been the northernmost frontier of the Mexican State of Coahuila and Tejas.  Long before becoming a Mexican State, the land had been occupied by Tonkawa Indians who in turn gave way to the more warlike Apache, Kiowa, and Comanche.

Texas won its independence from Mexico in 1836 and became an independent republic.  In 1845 a proud but destitute Texas joined the United States of America as its 28th State.  The following year German immigrants arrived in the Hill Country to partake of free land and increased economic opportunities.

In Germany, the unwitting emigrants had been reassured the new land was peaceful, only on arrival to find themselves in their newly established village, surrounded by hostile Native Americans.  This grievous case of real estate exaggeration ranks just behind Eric the Red who named a frozen expanse of icecap, Greenland.

We traveled through Sweetwater, a small west Texas agricultural town with yet another unpretentious name.  I thought- did no one have imagination when giving names?! 

Bandit briefly awoke when we stopped at a red light in Sweetwater.  I felt his cold nose nudging my shoulder, urging my attention. I reached back and scratched his ears. The white tip of his tail (the so-called Shepherd’s Lantern) striking the back of my seat.

“Thump, thump, thump.”

Mollie glanced at her emotionally needy canine companion but quickly returned to watching the towns stream by.  I wondered if Mollie expected a meandering herd of sheep or scattered herd of cattle to appear in desperate need of a Border collie to organize them.

I thought how different these two dogs were in soliciting affection.  Bandit fawned on people, begging- even demanding attention. Mollie never stooped to such antics, although she appreciated affection when it was offered by a family member.

Mollie was a rare Border who loved to swim

After leaving the town behind, I heard Bandit again flop down in the back seat.  My own thoughts returned to the history of central Texas that still lay several hundred miles ahead.

German men from Fredericksburg led by their able leader John Meusebach, in a desperate gambit, ventured out of the relative safety of their new settlement to secure peace with the natives.  They successfully met up and powwowed for several weeks beside the San Saba River. After much talk, countless pipes, and no doubt many earnest, silent German prayers, a peace treaty was established with seven large tribes of natives.

This treaty, remarkably, over the years has remained intact. It is claimed to have been the only treaty in Texas, and possibly the entire United States, with Native Americans to have not been broken.  An annual Powwow of Native Americans and Fredericksburg citizens celebrated the success of the treaty for many years thereafter in Fredericksburg.

While the peace talks had dragged on alongside the San Saba River, other natives surrounded the village of Fredericksburg, awaiting news that would either prompt an attack on or befriend the hapless settlers. Huddled within their makeshift cabins, stoic German settlers tried to carry on their lives without projecting fear to their children.

On Easter eve night, bon fires ominously appeared on the many hills surrounding Fredericksburg. The German settlers worried these fires might signal an impending attack.  In truth the bon fires communicated to the Native Americans high in the hills around Fredericksburg that a peace treaty had been achieved at the Powwow on the San Saba River.

Initially the significance of the bon fires was unknown to the settlers, but the fires on Easter evening prompted one mother, full of bravado, to proclaim to her worried children that the Easter Bunny was building fires to boil their Easter eggs.  The brave spirit manifested by the unknown German mother inspired for many years the yearly Fredericksburg Easter fires tradition where bon fires were built each Easter eve on top of the hills surrounding Fredericksburg.

We motored across the Texas prairie where 150 years earlier the Apache had been driven by the still fiercer Comanche.  I recalled the struggle for control of the green hills and streams of central Texas.  With increasing distance from Lubbock, the table-flat, featureless, and bleak landscape gradually changed into rolling prairie dotted with tall prairie grasses, scraggly mesquite, cottonwood, and Juniper trees.

We traveled through Coleman to Santa Anna (named after a famous Penateka Comanche chief) where we turned south, passing by the ruts of the old Great Western Cattle Trail. A roadside historical sign informed that more cattle had passed up this cattle trail to Kansas than had occurred on any of the other Texas cattle trails.  The Western Cattle Trail ended in the wild western town of Dodge City where lawmen Bat Masterson and Wyatt Earp became famous and where Earp was finally laid to rest.

Some twenty million Longhorns had moved up the cattle trails following the Civil War, establishing a viable economy for a desperately poor Texas. I proudly recalled my great grandfather, Thaddeus Septimus Hutton, having been a Texas cowboy who had likely pushed cattle up this very trail through the Oklahoma territory to the rail head at Dodge City.  I pondered what it must have been like to herd cattle in the 1870s through wild country. Had he even a glimmer of the historic nature of the western life he lived and the fame that would be later accorded the lawmen of Dodge City.  Of one conclusion I felt certain, that more hard work and less adventure had existed on the cattle trail than was depicted later by Hollywood movies.

Several hours further on, the rolling prairie gave way to green hills, clumps of stately live oak trees, and cultivated green pastures.  Artesian spring fed streams and rivers snaked among the hills.  Wild game had been and remains prevalent, and the tall native grasses supported greater numbers of grazing animals than had the near barren Llano Estacado.

Looking at this dramatic transition in the land helped me to understand why the Native Americans believed the Hill Country possessed such “strong medicine.” The Texas Hill Country with its beauty and bounty favorably compares to the western, more arid portion of the State.  I thought no wonder Native Americans had fought so ferociously to maintain control of the Hill Country.

While I mulled these matters, Mollie, with remarkably sustained attention, continued to observe the changing landscape.  Once when passing an eighteen-wheeler, Mollie stood upright, staring at a black, ride along dog that stared back from the truck’s passenger window.  I could see the other dog barking. Mollie calmly observed the dog and gazed at the truck until it was lost to sight.

Bandit didn’t awake again until we arrived in Brady, the geographical center of Texas.  He awoke, stretched, yawned, and appeared to anticipate our arrival at the ranch.  I felt his chin on the back of my seat and sensed his warm, moist breath.  I could see in the rear view mirror that he had perked up his ears and was staring down the highway ahead of us.  When I reached to give Bandit a scratch, I was rewarded with several languid licks to the back of my hand.

    Mollie and Buddy at the ranch

“Thump, thump, thump.”

An hour and fifteen minutes later, we drove through the front gate of our ranch. I halted the car briefly, so that Trudy and I could exhale years of pent up tension.  Whimpers came from the backseat.  Trudy and I opened the back doors of the car.  Mollie leaped out and sped across the pasture, ears flattened to her head, back arching, and legs striding.  Bandit jumped out and loped behind Mollie, inspecting trees, clumps of grass, and rocks.  Mollie scared up a jackrabbit, and both collies began a deliriously happy, zigzagging pursuit, interrupted only finally by an impassable barbed wire fence.

Trudy and I joined hands and watched in peaceful silence; an interlude as pure as that between young lovers. We had parked on a caliche ranch road near a grove of live oak trees.   We wordlessly observed the rabbit chase and basked in the exuberance of the moment. Bandit and Mollie eventually strutted back to the car; tails held high.  The two dogs sniffed and scuffled and seemed to be thoroughly enjoying themselves.

From over my shoulder, an orange-red sunset beckoned above a white limestone ridge.  We heard the mellifluous sounds of water rushing over stones in a nearby brook.  I experienced a rare moment of awareness and understanding.  What had seemed confused a few hours earlier, in this tranquil setting, now seemed clearer, even achievable. I could feel a smile develop across my face.

“Welcome home Trudy.”

Trudy slowly turned her eyes to meet mine. I saw a loving smile, crinkled nose, and teary eyes.

“Didn’t think I’d get you out of Lubbock alive,” Trudy said with an uncharacteristic tremor in her voice.  Moments later her tendency to chide rallied and she said, “Besides Cowboy, why are you planted here like a stupid yucca, let’s get on with our new lives!”

Just as I leaned across the front seat of the car to kiss Trudy, from the backseat came Bandit’s black and white head. Trudy and I stopped just short of planting bookend kisses on his furry snout.  Trudy and I laughed, and Bandit cocked his head impishly as if understanding the joke.  Trudy and I were now retired, and with Bandit and Mollie, we were four.

to be continued

If you have not had the chance to read my latest book, Hitler’s Maladies and Their Impact on World War II: A Behavioral Neurologist’s View (Texas Tech University Press), I invite you to do so. The book explores an important aspect of the Hitler story and World War II that has not been well studied. Many of Hitler’s catastrophic errors including the premature invasion of the Soviet Union in June 1941, the slowness of German forces to counterattack at the Battle of Normandy in 1944, and the highly risky Battle of the Bulge in late 1944 into 1945, can be better understood, knowing the sizeable impact that Hitler’s physical and mental conditions had on these vital battles.

Also, consider picking up a copy of my earlier book, Carrying The Black Bag: A Neurologist’s Bedside Tales (Texas Tech University Press). Please join me on my personal journey as a physician and meet my patients whose reservoirs of courage, perseverance, and struggles to achieve balance for their disrupted lives provide the foundation for this book. But step closely, as often they speak with low and muffled voices, but voices that nonetheless ring loudly with humanity, love, and most of all, courage.

Bandit-Our First Border Collie-Part 3

animal behavior, Border collies, Creative Writing, dog behavior, Dog Stories, dogs October 8, 2023 Comments: 2

Thank you for continuing to follow the Bandit story. He proved to be my dog of a lifetime and as subsequent stories will show- changed our lives in meaningful ways.

Evening Trips to the Park

Neighborhood children frequently shadowed us during our trips to the local park. Neighbors often appeared at windows, observing Bandit’s effortless saunter along the sidewalk, pursued by his increasingly haggard looking owner.  Several, gave sympathetic words of encouragement to me as  might have  been offered to the final straggling runners in the Boston marathon.

Ignoring the local leash ordinance, assuming no doubt incorrectly, that voice control would suffice, we allowed Bandit to stride ahead, carrying a ball or Frisbee in his mouth.  He truly was under control, knowing to sit and wait at each corner, and never crossing a street without permission.  Nevertheless, I always felt relieved when I returned from the park without a citation from Lubbock Animal Control.

Once at the park with its smells of newly mowed grass and yellow glare of the lights, Bandit would become thoroughly engaged with our games. He would ignore the thwacking sounds of competing nearby tennis matches, giggling children on swing sets, and even other curious dogs that came around him.  The focused intensity of a Border collie is truly splendid to behold.  Bandit would take his crouch and stare at me, waiting for me to sling the ball.

With visions of Sandy Koufax or Mickey Mantle running through my head, I would rear back and throw tennis balls as far as possible.  I remember thinking a bit smugly that during high school I had possessed a good throwing arm.

Bandit would tear out after the ball, scoop it up while still rolling, and rapidly return it to me. Bandit seemed untiring. His alert, dark eyes would glisten, and he panted with excitement. After several weeks of pitching tennis balls, I was no longer feeling quite so smug about my ability to throw the ball, as I developed a painful arm strain.

Over several more days my arm worsened. It became so painful that I found it difficult to elevate it above my head.  After still more park excursions, it got to the point that I could not easily dress myself.  On more than one occasion, I had to ask Trudy to hold my shirt, so that I could slip my tender right arm into the sleeve.

She then suggested in her inimitable way, “Why not give up the Nolen Ryan bit and try tennis?”

Tennis Anyone

 Following Trudy’s practical suggestion, I began hitting balls with a tennis racket and soon marveled at the added distance this provided.  Hitting the tennis ball with a racket also drew upon a different set of muscles than throwing, so that I could swing the racket almost without pain. Bandit appeared not to care how I launched the ball, as he continued to pursue it with equal enthusiasm.

I enjoyed watching the yellow tennis ball explode off the racket and arc far across the park.  I marveled at the grace and speed of Bandit’s longer out runs. I also observed how Bandit then would drop the ball about three quarters of the way back to me and retreat some distance. The time it took for me to trot out and collect the ball provided Bandit time to prepare and adopt his vigilant stance. By this process, Bandit also imposed my own exercise routine.

Chasing the tennis ball caused Bandit to expend additional energy, leading me foolishly to believe we were at last making progress. But after weeks of hitting the ball, rather than Bandit showing any signs of exhaustion, I instead developed tennis elbow, no less painful than my previous shoulder strain. In short order, I was forced to retire from both doggie baseball and doggie tennis. Heck, I still have doggie kickball and doggie golf.

Unexpected Results

“Hey big guy, you’re not the jock I married thirty-five years ago,” Trudy teased. I responded without comment but likely with a pained smile.  Indeed, this collie had taken a heavy toll on my middle-aged, soft-bellied self and had allowed an opening for Trudy to proceed with friendly ribbing.

Despite the physical toll on me, the new regime of activities and exercise brought about improvement in Bandit’s behavior. Trudy and I, to our surprise, also noticed our own bodily changes.

“Hey Trudy, is the scale broken?” I asked one morning after a month or two of the exercise programs.

“Don’t think so, but I was surprised too when I weighed.”

Not only had we lost weight, but we were feeling more fit.  I found the morning jaunts to the park to be less exhausting than earlier and at times found myself even jogging alongside Bandit to and from the park.

Even more astonishing, our spirits had elevated. We began to laugh more. Life became more interesting. Trudy and I began to plan a date night weekly, something we had not enjoyed for many years. In short, we found ourselves with increased energy– energy that allowed us to better address sources of diminishing satisfaction within our lives.

Frisbee

Bandit and I began to spend more time together as well. It was during this period that I introduced Bandit to Frisbee. He absolutely loved it. Bandit took to Frisbee like a pregnant woman to cheesecake.  Soon he was snatching Frisbees out of mid-air like a lizard catching flies. He learned to make over-the-shoulder acrobatic catches amid his dramatic leaps. His performances began to pay dividends and in highly unexpected ways.

After several weeks, Bandit’s fame at retrieving Frisbees had spread throughout the neighborhood. Adults as well as children now began leaving their homes to walk with us to the park.  Cars would often slow down when passing the park, even parking at the curb to watch our graceful, athletic black and white dog snatch Frisbees out of the air.

One spring day I heard a shout from the street and looked up from our game of Frisbee. To my shock, I spotted half a dozen cars parked at the curb with still more pedestrians watching us. Many were total strangers, intently observing Bandit and acknowledging his athletic ability.

I would rear back and whip the Frisbee in a high gliding arc.  Bandit would sprint away toward the arcing Frisbee, leaping high into the air like a ballerina to snag the disc. Shouts would erupt from the throng following particularly agile catches.

“Hooray, just look at that dog.”

“Never seen anything like it.”

“What a dog!”

Friendly waves and smiles came from the spectators. I sensed these strangers, beaming and whooping support for our black and white ham, somehow benefited from the experience. Bandit put on amazing performances of running and jumping, and making acrobatic catches, but I questioned why his Frisbee catching attracted so much attention.

Occasionally people wandered onto the grassy field to inspect Bandit more closely.  When this happened, Bandit would break off his crouch and would wiggle up to them, swishing his tail in a wide and friendly arc. The momentum of his tail wags was such that they wagged his whole rear end.  He would lick any extended hand.

After more evening Frisbee sessions, I began to seriously ponder the reasons for Bandit’s enlarging audiences. It seemed to me that Bandit provided these city-churned commuters brief moments of joy between hectic work schedules and responsibilities awaiting them at home.  During these brief intervals his fans vicariously enjoyed Bandit’s unmitigated joy.

To Be Continued

If you have not had the chance to read my latest book, Hitler’s Maladies and Their Impact on World War II: A Behavioral Neurologist’s View (Texas Tech University Press), I invite you to do so. The book explores an important aspect of the Hitler story and World War II that has not been well studied. Many of Hitler’s catastrophic errors including the premature invasion of the Soviet Union in June 1941, the slowness of German forces to counterattack at the Battle of Normandy in 1944, and the highly risky Battle of the Bulge in late 1944 into 1945, can be better understood, knowing the sizeable impact that Hitler’s physical and mental conditions had on these vital battles.

Also, consider picking up a copy of my earlier book, Carrying The Black Bag: A Neurologist’s Bedside Tales (Texas Tech University Press). Please join me on my personal journey as a physician and meet my patients whose reservoirs of courage, perseverance, and struggles to achieve balance for their disrupted lives provide the foundation for this book. But step closely, as often they speak with low and muffled voices, but voices that nonetheless ring loudly with humanity, love, and most of all, courage.

Bandit-Our First Border Collie-Continued-Part 2

A Dog's Pathway to Retirement, animal behavior, Border collies, Creative Nonfiction, dog behavior, Dog Stories, Dogs and Humans- A Special Relationship, Dogs- A special Relationship October 1, 2023 Leave a comment

With Andy and Katie’s departures for college, it dawned on Trudy and me that we were in deep trouble. We immediately missed our college age children who had spent time walking the dog, taking Bandit on car rides, and teaching him tricks.

After the kids’ departures, changes in our busy schedules became necessary. Weather permitting on work days Trudy and I would leave Bandit in the fenced backyard. Evidence suggested that Bandit would scamper among the bushes leaving behind broken branches, chase about the patio knocking over furniture, swim in the fountain, topple the water plants, and amuse himself by digging impressive craters in the vegetable garden. The garden excavations  grew  deep enough for me to fantasize about Bandit striking oil and making us rich.

Our outdoor strategy, imperfect though it was, maintained the house in good shape, so long as we gave up any hope of flowers in the garden, vegetables in the garden plot, or legs on the patio furniture.

When autumn colors faded into the sparkle and ice of winter, compassion compelled us to move Bandit indoors to avoid the Texas Panhandle’s “Blue Northers”. This shift in tactic not only provided warmth for Bandit, but also offered him novel opportunities to explore. And “explore” he did.

A few chewed magazines and curtain tassels did not panic us– not two professionals who had successfully mastered screaming divorcees in the courtroom and grand mal seizures in the waiting room.

“Oh, just puppy behavior,” Trudy had said unconvincingly, as if whistling her way to a root canal.

“Of course,” I had opined,  “All dogs chew. Probably good for his baby teeth.”

The indoor move required that we travel home during the day to let him outside to pee. It also allowed a brief respite for playing with the dog. This interlude required Trudy or me to break away from the office, an office often bordering on chaos, replete with hormonal nurses, disgruntled patients, and self-important doctors.

The trips home provided a break for which Trudy and I soon competed. When possible, both of us would head home for lunch and Bandit play. This mid-day interlude, away from the escalating emotions in the office, allowed us most welcome quiet time for conversation and gave us an opportunity to amuse ourselves for a few minutes playing with an appreciative Bandit dog.

Worse Still

Despite our considerable efforts, Bandit escalated his destructive antics- big time.  If we thought we had seen a damaging dog before, we had been fooled, having witnessed merely the preliminary warm-up for a doggie demolition derby. Before we knew it, Bandit had started a whole new gig– home annihilation.

In short order the remainder of our chair legs developed signs of piranha-like gnawing. We found the cording that had mysteriously been separated from the furniture. To this day, I don’t have the foggiest notion  what happened to some of it. We found several electrical cords chewed, rugs macerated, and household objects broken, covered up, or rearranged.

“Bandit, you do this?” I asked, while pointing to a chair leg that looked, as if set upon by crazed beavers. I feared the chair would give away if someone were to sit on it.

Bandit cocked his head innocently to the left and flashed an endearing look, a look of such sincerity that I began to question my suspicions. One day on arriving home through the back door, I spotted Bandit in the den. Rather than his usual hell-bent-for leather charge toward me, he slunk away into our daughter Katie’s bedroom and hid under her bed.  As I entered the den, the reason became all too apparent.

Before me lay a blizzard of pillow stuffing. It covered the floor, hung from the lamps, and decorated the hearth.  The remainder of the pillowcase lay on the floor as flat as a flounder.  When I tracked down the canine conniver, I noticed a piece of stuffing still hanging from his impish mouth.

A few days later our anxieties zoomed into the stratosphere when we discovered Bandit had stripped off the wall covering in the day room and had managed to chew on several door jams and doors.

To understand the pain associated with Bandit’s latest act, its important to understand the significance that the wall covering held for Trudy and me.  To diminish the poor acoustics in the day room, we had applied fabric to the walls over a thick cotton batting.  The upholstered walls had been expensive to construct but a welcome redo to our family room that had echoed like the depths of Carlsbad Caverns.  Now before us our acoustical dampening  lay in tatters.  Our home sweet home had begun to look as if under attack by an army of demented squirrels, voracious termites, and a truculent rhinoceros or two.

“And he looks like such an angelic animal,” Trudy said dejectedly.

“Don’t let his elfin looks fool you.  This dog won’t be happy till we’re living in a heap of sawdust!”

We Fight Back

One effort we employed to occupy Bandit consisted of stuffing cheese or dog biscuits into toys that Trudy found at a local discount store. These clever playthings, no doubt invented by a similarly desperate fellow dog owner, had been advertised as requiring lengthy and determined manipulation before discharging their treats.

Trudy and I would spend thirty minutes each morning stuffing pieces of cheese or dog biscuits into these over hyped furniture and house savers.  Trudy and I bubbled with newfound confidence, assuming we had at last found a  method for diverting our one dog wrecking crew.

Unfortunately, our optimism faded quickly. The toys occupied our strong-minded dog for a fraction of the time advertised before discharging their delicacies.  Bandit was left with far too much unoccupied time with which to work. While this toy proved useful, it was not what we desperately needed.

Trudy and I would arise early and hide scores of these treat-baited toys throughout our house. After our departure for work evidence suggested that Bandit would scour the house for the toys, apparently play with them, and consume the treats.  I have always suspected that Bandit found, obtained, and ate the treats in less time than it took for us to load and hide them. While this tactic met with only limited success, it had the benefit of distracting Trudy and me in the mornings from instead pondering insolvable work concerns.

Increased Exercise

We then determined to increase Bandit’s exercise by walking him to an old buffalo wallow about a mile away that had been converted into a lighted City Park.  I can only imagine what early rising neighbors thought when catching a glimpse of two bedraggled people slow-trailing an energetic dog down the darkened and leafy streets of Lubbock.

Once within the shadowy park, I would throw progressively slobbery tennis balls for Bandit. Trudy and I would then dodge about into hiding places, trying to avoid running into trees and light posts, encouraging Bandit to find us before racing back to hide yet again.  We hoped to wear out what seemed to be an indefatigable canine. This tag-team process may have been successful in depleting Bandit’s energy level slightly, but it proved substantially more exhausting for Trudy and me.

In the evening, rain or shine, and after a busy day of rounds and consults, I would stumble-march Bandit to our local neighborhood Kastman park where I would again throw tennis balls until my arm gave out. This became a routine that Bandit would not allow me to forget. While I would have gladly given half my medical practice at times to remain in my comfortable recliner, Bandit’s whimpering and nudging could simply not be ignored.

When Bandit heard the rumbling of the garage door opening at the end of the day, he always began racing around the house in search of a ball. Upon my entering the house, he would run to me and crouch with a tennis ball in his mouth.  He would rest on his forelegs with rump raised, his eyes staring at me as if to say, “I’ve been waiting for you all day and finally it’s time.”

Having experienced Bandit’s piercing gaze on many occasions, I understand why sheep find the stare of a Border collie so motivating. I can with little effort summon very real sympathy for sheep.

Bandit Makes Friends

Bandit’s park evening outings became something of a neighborhood happening.  People in their yards would turn to watch man and dog head off for their daily excursion.  Once on a hot summer evening bedecked by a gorgeous orange and red sunset, I recall seeing a red-faced Mr. Jones, the undisputed neighborhood grump, descending his stepladder. He turned to face us, as we walked on the sidewalk by his yard.  Fearing the worst, I kept my head down.  Bandit, on the other hand, loped over wagging his tail and proceeded to apply an unhurried lick to the old grump’s hand.

Rather than a torrent of verbal abuse as was expected, Mr. Jones instead gestured in a friendly manner at me, as if he was beckoning to an old friend. He then astonished me even more by asking multiple questions about Bandit. I shared information about his breed, what he ate, and why we visited the park so regularly. Who would have guessed Mr. Jones would prove to be a dog lover.

After extracting Bandit from this unexpected but welcomed encounter, man and dog headed down the block toward the park.  When well out of earshot, I exclaimed to Bandit, “Well how’d you manage that?”   He strutted ahead, ears perked up and wagging his tail broadly, cocking his head around to give what seemed to me to be an enigmatic look.

To Be Continued

If you have not had the chance to read my latest book, Hitler’s Maladies and Their Impact on World War II: A Behavioral Neurologist’s View (Texas Tech University Press), I invite you to do so. The book explores an important aspect of the Hitler story and World War II that has not been well studied. Many of Hitler’s catastrophic errors including the premature invasion of the Soviet Union in June 1941, the slowness of German forces to counterattack at the Battle of Normandy in 1944, and the highly risky Battle of the Bulge in late 1944 into 1945, can be better understood, knowing the sizeable impact that Hitler’s physical and mental conditions had on these vital battles.

Also, consider picking up a copy of my earlier book, Carrying The Black Bag: A Neurologist’s Bedside Tales (Texas Tech University Press). Please join me on my personal journey as a physician and meet my patients whose reservoirs of courage, perseverance, and struggles to achieve balance for their disrupted lives provide the foundation for this book. But step closely, as often they speak with low and muffled voices, but voices that nonetheless ring loudly with humanity, love, and most of all, courage.

Our First Border Collie

Border collies, Dog Stories, Retirement September 23, 2023 Comments: 3

I have written several blog pieces lately about our new puppy, Beau. Writing about Beau and his antics reminds me of our experiences with our first  Border collie, Bandit. Bandit played such a meaningful role in our lives and had much to do with relocating Trudy and me from a frantic urban existence to the peacefulness and solitude of Medicine Spirit Ranch.

If lucky, once in a lifetime your perfect dog comes along. Bandit was that dog for me. Bandit below as a puppy.

Beau reminds me of Bandit in so many ways including his looks, enthusiasm, and intelligence. Our initial unexpected encounter with Bandit came about via Trudy. The story goes something like this.

In The Beginning

While shopping at the Lubbock South Plains Mall In 1997, my wife Trudy unwittingly sewed the seeds of my early retirement.  For one whose life had been meticulously planned and extensively fretted over, this single instance of pure happenstance played a huge role in my future.

“Ooohh, look at that darling puppy!”

So began Bandit’s story with us in mid-April, 1997 when Trudy lovingly uttered these simple, affectionate words,  having locked gazes with a floppy eared, seven-week old black and white puppy. It had cocked his head quizzically and viewed Trudy through the front window of the pet store. With its white tipped tail and white paws, the pup unabashedly stared at her, seemingly beseeching her to take him home. I visualize Trudy standing outside the Lubbock Pet Store window, hands resolutely on hips, head cocked to one side to mirror the puppy’s head cocking and with her usual steely resolve melting faster than an ice cream cone in July.

Andy, our eldest child, had expressed a heartfelt wish for doggie companionship to divert him from his life of torts and criminal proceedings. Andy lived by himself in an apartment in Raleigh, North Carolina and was lonely — an emotion he felt that the right dog would promptly alleviate.

“So why a Border collie?” I had asked.

He responded by saying, “I like smart schools and smart people and want my dog to be smart.” Blissfully ignorant of Border collie ways, other than their reputation for being the most intelligent breed of dogs, Andy determined that a Border collie puppy would make the perfect pet.

Trudy and I proved equally ignorant of Border collie ways. However, we were supremely proud of our son, our Duke Law School student- a boast we trumpeted far and wide. Admittedly, we proved once again to be indulgent parents.

After watching the endearing puppy with the warm, golden-brown eyes ever so cleverly displayed by the owner of the pet store in the front window, Trudy as if pulled by a tractor beam was drawn into the shop. Among the fluttering of parakeet wings, the musky smells of the animals, and amid the mews and barks, she requested to personally inspect the puppy in the front window. A young blonde haired clerk fetched the puppy and placed him in Trudy’s arms. There the conniving rascal had immediately snuggled into the crook of her elbow.  Trudy said she sniffed that unmistakable  new puppy scent and immediately fell in love with the puppy. He solidified his future with us by soulfully licking her arm and playfully chewing on the cuff of her blouse. In retrospect this mere nibble had significance far beyond Trudy’s understanding at the time.

With her usual practicality by then in headlong retreat, Trudy with puppy pressed to her chest had headed further into the pet store where she proceeded to fill a basket with what she described were “a few” puppy-related items.

Trudy’s “few” items later became apparent to me when unpacking her Datsun SUV and finding a dog bed, collar, kennel, six month supply of dog food, chew toys, balls, pull toys, leashes, dog raising instructional books, assorted dog magazines, and various toys- all of which when compressed emitted irritating squeaking noises.

“You think we’ve enough supplies?” I asked in mock irritation.

She replied, “Well, if we’re going to have a dog, we need to be prepared.” I nodded dumbly. Had we only known then how truly UNPREPARED we were.

We assumed the puppy and Andy would stay the summer before returning to North Carolina for the Fall term. Within a few days the dog’s paraphernalia lay scattered about the house like landmines, but what the heck, we thought, such disorder wouldn’t exist for long.

Several weeks later, Andy arrived home, having completed his first year of Law School. He proved eager to hold his new puppy that he previously had seen only in pictures. Andy shared with us that knowing he had a puppy waiting for him had powered him through the slog of final exams.  His mother and I beamed proudly, having done our best to stoke his enthusiasm by phoning him cute puppy stories and mailing him photos of the adorable pint-sized pup.  His excitement reinforced our thoroughly rationalized– if unenlightened– decision to buy the dog.

We had sent Andy one picture showing the fluffy imp staring adoringly into the camera.  Beside his kennel we had placed a sign that read “Andy, Hurry Home Soon.”

“Your Mom and I have been calling him MacDuff. Since the Border collie breed originally hails from the border of Scotland and England, the geography fits.”

Andy glanced away and studied the tiny animal that lay before him. I sensed Andy didn’t care for our suggested name but was careful not to offend his doting parents. After all, we were paying for his incredibly expensive higher education, an expense near equal the economy of a small third world country.  Andy squinted his eyes and looked out the window before tactfully torpedoing our name for the puppy.

Andy sat cross-legged on the carpeted floor while inspecting his pup.  He rolled the puppy onto his back, studied each white tipped foot, tweaked his tiny black nose, and scratched his rounded and protruding belly.  He stared thoughtfully for a few moments into the puppy’s sensitive, dark eyes.

Andy lifted the puppy to his neck, sniffed its uniquely appealing scent and snuggled it. He lowered the puppy while pointing and said, “Look at these black patches around his eyes, looks like a Bandit’s mask… I think I’ll call him Bandit!” Below when Bandit was older with his distinctive black eye patches.

So Bandit the puppy became.  And while it wasn’t the name we had in mind, its appropriateness over the next several months became especially evident.

The Adventure Begins

“Trudy, have you seen that pair of socks I laid out?”

“Have you looked on your feet?”

Not only socks but shoes, books, belts, and small throw rugs disappeared, only to reappear in unusual places, and sometimes having acquired gnaw marks. Items were regularly recovered from under beds, in the tiny spaces behind the sofa, and anywhere humans could not easily access.

One morning just before heading for the hospital and while in a rush frenzy, I could not locate my black medical bag. The allure that my leather bag might hold for a puppy with a leather fetish suddenly struck home.  I became increasingly concerned, bordering on frank panic. Trudy and I launched a search in the usual doggie hiding places. Eventually to my embarrassment, I discovered that sleepy me had failed the night before to remove the black bag from my car.

“My mistake Bandit, but don’t you ever even think about taking this bag,” I said, as I held out my medical black bag for his inspection. Bandit cocked his head to the left and gave me a look that I interpreted as, “Who, me?”

“If Border collies are so smart, maybe you can train him to search for your black bag, because I’m sure not going to, Sherlock,” Trudy harrumphed. I blew her a kiss and backed sheepishly out the hall door into the garage.

A Glimmer of Understanding

The white-coated heavy set vet assistant with heavy footsteps ushered us along an narrow hallway barely large enough for her to pass and into a room at the far end. The room smelled faintly of antiseptic and was furnished with a stainless-steel examination table, sink, and three chairs.

Before the vet arrived, I passed Bandit to Trudy and tried to wash the yellow stain from my sleeve.  I scrubbed with paper towels and hand soap drawn from the dispenser, accomplishing little except spreading the stain.  I had just finished with my unsatisfactory effort when Dr. Brown with white coattail flapping blew into the room. He was a man of average size with an open face, curly salt and pepper hair, exuberant eyebrows, and better tanned than any hard working, small animal veterinarian should be.

Dr. Brown soon turned his full attention to our young dog. Our puppy tried with licks, moans, and waggles to endear himself to this new potential playmate.

“So you decided on a Border collie, did you?” Doctor Brown said while lifting our dog up and onto the polished metal examination table. The puppy fidgeted about while trying to gain traction on the slippery metal exam table.

There was something unsettling in the vet’s tone of voice.  Was he being haughty?  I ignored it, assuming due to my fatigue I was imagining an affront. “Yes, we knew Borders to be such intelligent animals,” I responded.

“Oh, he’s not ours, he’s our son’s to take back to school,” Trudy chimed in, sounding, I thought, a little defensive.  But my wife had reinforced my suspicion that she too had detected something left unsaid by the vet.

Dr. Brown raised his thick bushy eyebrows to a remarkable peak, shooting us a brief look of strained disbelief, if not outright incredulity. He then turned his attention fully to examining our pup.  He began to gently probe the dog’s protuberant belly. Our dog returned his interest by applying a slow lick along the veterinarian’s chin, ending just short of his well tanned left ear lobe. 

Doctor Brown ignored the affection and continued his exam by checking the puppy’s teeth, listened to his lungs, auscultated his heart, and finally administered various vaccinations.  He then surprised me by asking if I would restrain little Bandit while he performed a rectal swab.

Soon the veterinarian completed his taking of a stool sample. I lifted the puppy from the table, again sensing his softness, and cradled the puppy in my arms. Before leaving the room, Dr. Brown looked earnestly at Trudy and me and said, “Border collies can be pretty busy, you know. There’s an old adage, ‘You have to give a Border collie a job, or else he will become self-employed… and never productively.’” Again, as if to emphasize his point, he arched his impressive eyebrows in his quite remarkable way.  He then turned quickly and exited the room, carrying his sample with him in a small piece of white gauze.

“Well, what do you make of that?” I asked when the door had closed behind Dr. Brown.  “I thought his eyebrows were going to kiss his hairline!”

“What did he mean with that job bit?  Audacity, if you ask me.  Maybe not a Border collie lover.  Looks more like the Schnauzer type.”

“Besides,” I said, “You’ve emptied the pet store of supplies and toys, and I’ll take the dog to the park every few days.”

“He just doesn’t know how capable we really are!  Look how successful we’ve been raising our two children.  How much trouble does he think one little bitty dog can be? Besides, we successfully raised a not too bright Dalmatian and two Shetland Sheep dogs. One tiny dog, Piece of cake!”

We murmured all this while keeping our voices low, as Dr. Brown banged about next door within his laboratory.  After about fifteen minutes, the door to the examination room burst open, and the veterinarian like a sudden summer storm swept back into the exam room, his broad face bearing an unmistakable look of satisfaction.

Dr. Brown confirmed to us what he had apparently suspected. The rounded belly (that very one that Trudy and I had found so adorable) resulted from distension caused by parasites.  PARASITES! He explained our dog was small, because he was competing, and none too successfully mind you, for nourishment with his belly worms.

“With a round of antibiotics, we’ll put those parasites on the run and get this dog growing again,” Dr. Brown clucked.

“Great, we sure hope so,” I recall saying, an aspiration I would later seriously regret.

Trudy later reminded me of the old adage that says- be careful of what you ask for.  Little did we know? It was months later before Trudy and I appreciated the full significance of the veterinarian’s not so subtle warnings.

           A Growth Spurt

As predicted by Dr. Brown, those magic little pills shrank the dog’s belly but also had a similar effect on my wallet. The pup over the next several weeks, lacking his parasitic competition, began to grow like the time-lapsed pictures from the TV dog food commercial.

The dog ate prodigiously. He ate vast amounts of puppy chow, canned dog food, leftovers from the table, morsels stolen from trashcans, my comfortable old leather loafers, and a few tasty treats from the refrigerator that admittedly I snitched for the puppy. Yes, I aided and abetted the seemingly starved puppy.

Following several futile refrigerator searches, a miffed Trudy reported she had harbored other plans for the missing leftovers. Our poor parasitic wracked dog deserved a few extravagances or so I thought.

Although he began small, our dog soon surpassed the average fifteen to forty pounds for the breed.  Even more impressive than his weight that had zoomed past 60-pounds was his meteoric increase in height. Despite his classic Border collie markings, people often inquired if he carried any non-Border collie blood.

Soon after beginning the antibiotics, a geyser of energy developed in Bandit.  While he had been active before, Bandit then became super-charged. Admiring his spike in liveliness one afternoon caused me to daydream of performing a medical study to distill the remarkable goodness of his overachieving mitochondria into pill form and cash out by advertising on late night cable TV.  When I shared this daydream with its potential for Midas-like riches with my wife, I once again was treated to her “dumb look” and her lack of a verbal response.

A month after our visit to the vet and after entering from the garage one night, I greeted Trudy and  sheepishly inquired how Bandit had done that day.  Almost on cue, I heard a faint scampering of small paws from the den, followed by a series of noises, suggesting minor collisions in the vicinity of the dining room, followed a few moments later by Bandit in full stride charging through the kitchen door. With an ecstatic face between two floppy black ears, he rocketed off the carpeted dining room, churning like a dynamo on a path straight for me.  Several feet away from me, he hit the brakes, thrusting his paws out in front of him.  The pup sensed that he had lost all traction on the linoleum and immediately entered an uncontrollable slide.

Bandit developed a quizzical look on his face, casting uncertain eyes upward to me in what I thought was an apologetic way.  He vigorously began to backpedal before ending up in a furry heap atop my shoes. From there he looked up at me with a look of adoring and abject joy.

I lifted the squirming puppy to my cheek where he began licking furiously.  Such ungoverned displays of joy are not unusual with Bandit. They have occurred following my being out of town several days, or having just returned from the corner mini-mart.  The dog just doesn’t take long to miss his people.

“Honey, maybe we could get him a job as a greeter at Walmart?” I offered lamely.

To this Trudy responded with a weak smile and a “Huh”.

Trudy and I failed to match Bandit’s surge in energy. His need to stay busy while typical for Borders is not for middle-aged, pudgy, and chronically fatigued humans. Our plans for more frequent doggy exercise hadn’t meshed well with our exhausted physical states.

“Honey, do you feel a slight vibration?” I asked one night while I dozed in my favorite chair in the den.

“Nope, but I thought I heard grinding.”

“There it is again, I know I feel a slight vibration in this chair,” I said.

Fearing what I might discover, I slowly leaned over the side of my chair and looked beneath it. I spotted an open mouthed snout bearing tiny razor sharp teeth with a death grip on the chair leg.  “Say Honey, this chair you like so well?  I think it’s become an alteration project for the Bandit dog!”

Bandit’s piranha-like teeth unfortunately were not limited to teething on chair legs but extended to sampling cushions, carpets, table legs, and even plastic patio furniture.  The dog seemed to have become a pint-sized canine version of a wood chipper. This called for action.

We Fight Back

In a desperate attempt to limit further damage to the house and furniture, we tried distraction. Bandit became the designated companion for any family member leaving our home on an errand.  He became the ever present, excited, ear-flapping, ride along dog, drooling out the window of a Hutton car.

I had never seen him happier than when riding shotgun for the family. Perhaps he saw his rides as a job. I imagined that he felt like the guy on the stagecoach carrying the gun, protecting the driver from desperadoes or Indians on the warpath.  Clearly Bandit’s new position was not the job for which a Border collie had been bred, but it was, nevertheless, a job.

“Say, Shotgun, want to ride to the emergency room with me?”  Bandit wagged his tail vigorously.  “Well load ‘em up Shotgun and mind the strong box.  We’ve got some rough country to travel!”

Andy and Katie, our high school aged daughter, recounted that Bandit visited local fast food establishments and cruised the broad boulevards of Lubbock, often until deep into the star studded west Texas night. Bandit would ride along, head extended from the window, as they drove past the statue of Will Rogers astride his horse, Soapsuds, located on the Texas Tech University campus or circled through downtown Lubbock, passing by the oversized statue of a guitar toting,  thick rimmed and bespectacled Buddy Holly.  Bandit happily accompanied anyone with errands to run or packages to mail.

Bandit occasionally even went on dates with Andy. Trudy and I chuckled at what Andy’s girlfriend must have thought, sharing her date with an enthusiastic puppy.  We imagined Bandit at a drive-in movie snuggled between them, curled up around a box of popcorn, enjoying his people. To my surprise, once prior to a date night, I found Trudy down on the floor next to a curled up Bandit, instructing him on his responsibilities as a chaperone.

“You don’t think this is really going to do any good, do you?”

“Hey Buster, these dogs are really smart, and besides, I don’t trust that bleached blonde bubble-headed temptress,” Trudy said, twisting around to look at me.

“Do you think at the end of the evening both Andy and Bandit will give her a goodnight smooch?  Suspect Bandit could really tickle her tonsils!”

Ride-along car trips were not our only gambit for distracting our young dog.  Desperation, after all, breeds creativity.  At our urging Andy and Katie spent hours playing with Bandit, teaching him to sit and shake, walking him up and down the block, and showing him off to their friends. Bandit proved a quick study at learning tricks and entertaining friends, and particularly enjoyed chasing sticks thrown by Andy, Katie, and their friends.

To our relief, the time Bandit spent playing fetch was time not spent digging gorges in our backyard or shortening our furniture. Trudy and I suffered from sapped energy, stemming from our busy, stressful lives at the clinic and from attempting to keep up with the energetic dog.

To her credit Trudy signed the dog up for two series of obedience classes. After a long day at the office, she sacrificed many evenings, trying to improve our doggie’s decorum. To Bandit’s credit, he became the star pupil in his obedience class.

Trudy took pride in relating his ability to learn quickly. Trudy returned from class more than once disdainful at the slowness of other dogs to learn even basic commands.

“You should have seen Sal, a really stupid and clingy Cocker Spaniel.  The instructor worked for 15 minutes just getting the lop-eared hound to follow her.  All he wanted to do was stay with his master or else sniff other dogs’ butts.  I wasted my time just standing there at the end of Bandit’s leash and watching that dim-wit.”

“Now dear, not all dogs are as smart as Border collies,” sounding I feared a bit too patronizing.

Toward late summer, unexpected complications arose with Andy’s Fall housing arrangements. While reviewing his apartment lease from North Carolina, Andy had discovered a previously overlooked clause that pointedly excluded dogs weighing over 30-pounds.  By then Bandit had eaten his way through the canine middleweight division and was on his way to heavyweight status and was still growing like Jack’s, well fertilized, beanstalk.

The Ask

While Andy toyed with fudging this not so tiny detail in the contract, at about the same time another complication arose in taking Bandit with him back to North Carolina.  Andy learned his scheduled clerkship in criminal law would require longer absences from his apartment than he previously thought.  Lacking a fenced yard, Bandit would have to remain inside the apartment for lengths of time beyond the bladder endurance of a young dog.

“Dad, Mom could I speak with you for a few minutes?”

Something in Andy’s voice should have tipped us off that sweltering August evening, and we should have run the other way. How we missed this opportunity to avoid THE TALK, I will never know. Had I been wise, I would have grabbed my pager and my black bag and trumpeted how pressing matters awaited me at the hospital.

With the gravitas befitting an eighteenth century French diplomat, Andy politely requested we join him at the kitchen table. Outside I heard crickets chirping what must have been a warning.

Once Andy had us gathered at the wooden pedestal kitchen table and had confirmed that we were comfortable and not lacking for refreshment, he bit by bit came around to his point. After more thoughtful moments, as if choosing his words for a final summation before the U.S. Supreme Court and after reiterating his unexpected housing and scheduling difficulties for the third time, Andy came to his question.  I saw him swallow hard and with a look of earnestness on his handsome young face blurt out the reason for our meeting.

“Mom, Dad do you think you might keep Bandit, just till after Christmas?” He quickly added, “I’ll take him back in January, soon as I complete my criminal law clerkship.”  His plight and sincerity proved strangely moving. 

Silly us, I should have known it was a well-rehearsed ploy, a mere affectation learned by all fledgling law students.   Trudy and I should have considered letting our eldest child endure the consequences of his poor planning, although, admittedly, we too were complicit.  It could have been character building for the son– right?

Fortunately, unanticipated consequences of faulty judgments do not always become immediately clear, especially when parents’ well-loved children are the committers. It may even be better for parental self-esteem that we don’t perceive our foolhardiness right away.

At the time I was struggling to manage a busy private practice, direct a neurological research center, and maintain stability in a fractious physician group. These were a lot of plates to keep spinning at the same time.

Trudy had left the practice of law as Director of Lubbock Legal Aid to manage the Neurology Research and Education Center that I had established.  I had simultaneously created the Center along with the private practice but was finding too few hours to do justice to both. Actually she, a Family Law attorney, had tired of divorcing people who inevitably were contentious and angry. I rationalized that she longed for a fresh career outside of Law; however, this doctor/husband has enjoyed claiming (even perhaps boasting at times) to have reduced the legal workforce in Lubbock by one.

In Trudy I had complete trust to coordinate the Neurology Research and Education Center. As a wife, she knew the emotional importance to me of maintaining research and educational interests despite my having left the rarefied air of academia.  Her selfless sacrifice for my career was vintage Trudy.  Whenever my professional advancement had required a change of location, Trudy had agreed to support the change, even when it conflicted with her own career- no blatant feminism in Trudy.  I knew my blessings.

Both Trudy and I had stayed overly busy with our jobs, rarely seeing each other during the workday, despite working mere steps away.  Trudy’s day at the Neurology Research and Education Center would end around 5:00 P.M., and she would depart for home to prepare dinner, clean the house, pick up dog toys, and attend to  family chores left undone from her largely absent husband.

Many days I would work 16 hours or more in the hospital and clinic only to come home with a big stack of electroencephalograms to interpret and to be on call for the emergency room and urgent hospital consultations.  Neither Trudy nor I had time for a needy puppy, especially one as active as a Border collie.

As I listened that evening while sitting across the table from Andy, I glanced past him into an adjacent bedroom. There I spotted Bandit’s impish white face with black eye patches, pink tongue, shiny black nose, and floppy ears protruding from beneath the bed’s dust ruffle.  Bandit cocked his head imploringly in our direction, as if expectant of our parental response.  Trudy and I gave each other meaningful looks, and then answered in unison, in a manner as predictable, as it was foolhardy.

“Of course, Andy, we’d love to keep Bandit!”

So dear readers of my blog, please know that by the time the Christmas holidays eventually arrived, Bandit, Trudy, and I had become so bonded together that Andy could not have gotten that dog away from us with a gun. The weld was sound. Our emotions had meshed. Our schedules somehow had expanded to fit our needs. Our affection for Bandit had become enormous.

The reasons for this tight bond and our love for this amazing dog will be revealed in future blog posts.

 

To be continued.

If you have not had the chance to read my latest book, Hitler’s Maladies and Their Impact on World War II: A Behavioral Neurologist’s View (Texas Tech University Press), I invite you to do so. The book explores an important aspect of the Hitler story and World War II that has not been well studied. Many of Hitler’s catastrophic errors including the premature invasion of the Soviet Union in June 1941, the slowness of German forces to counterattack at the Battle of Normandy in 1944, and the highly risky Battle of the Bulge in late 1944 into 1945, can be better understood, knowing the sizeable impact that Hitler’s physical and mental conditions had on these vital battles.

Also, consider picking up a copy of my earlier book, Carrying The Black Bag: A Neurologist’s Bedside Tales (Texas Tech University Press). Please join me on my personal journey as a physician and meet my patients whose reservoirs of courage, perseverance, and struggles to achieve balance for their disrupted lives provide the foundation for this book. But step closely, as often they speak with low and muffled voices, but voices that nonetheless ring loudly with humanity, love, and most of all, courage.

My Two Left Slippers

animal behavior, Beau- New Puppy at Medicine Spirit Ranch, Border collies, dog behavior, New Puppies August 28, 2023 Comments: 2

Not long ago we brought home a bouncing, baby Border Collie. The cute little bounding bundle of fur is now eight months old and weighs over 40 pounds. Although not without prior experience with Border collies, we have relearned lessons about their energy, enthusiasm, intelligence, and mind boggling shenanigans.

Several years ago for Christmas I requested morning slippers. Being told by my family that I am difficult to buy for, not surprisingly I received not one pair but two pair of slippers. No problem thought I. A little redundancy is not a bad thing. Apparently our puppy Border collie thought differently.

And how innocent he looks

Beau sees no need for duplicate morning slippers. Likewise he sees no need for multiple pairs of shoes and boots, extra rolls of toilet paper, and multiple doggie toys. Slippers began to disappear or appear in mangled form. No problem I thought as I have extra slippers. But apparently our cute little bundle of fur has right-left problems, as I’ve been left with two left slippers.

Last week when Trudy and I escaped the Texas heat for Colorado for a vacation, I received word from our dog sitter/house sitter, Megan, that in her briefest loss of attention, Beau had shredded a roll of toilet paper. She said he had been especially thorough in his determined efforts and estimated that he had left 1.575,854,743,005 pieces of toilet paper-confetti around where she sat. Ah, such industriousness, that’s our Beau.

Beau-New Puppy at our Ranch

Beau- New Puppy at Medicine Spirit Ranch, New Puppies, Puppies July 2, 2023 Comments: 2

Trudy and I brought a new Border collie into our lives despite the incredulity expressed by our grown children.

“At your age?” and “Surely you must know what you’re getting into?” were a few of the kinder backhand comments we heard regarding our surprising decision. “But what happens if the dog outlives you?”

The latter question was met with our steely stares and firm resolve, “As the inheritance goes, so goes Beau!”

Baby Beau below in his toy box after having laboriously emptied it of all its contents.

Indeed, after having previously raised four Borders, we recognized how busy and challenging these sweet and intelligent animals can be but stand in utter amazement at their herding abilities, smarts, and sensitivity.

We rationalized that we needed of a younger dog to assume Bella’s role as chief canine cattle herder. Unfortunately, our sweet Bella had grown old, developed poor eyesight, put on weight, and has limited her herding. In truth, our new puppy will largely be a house pet along with ranch companion and working dog.

Bella below in her younger days.

Bella, “I don’t like another dog on the ranch. I want all the attention”

Melanie Wahrmund, a rancher and breeder of Border collies, lives about 10 miles west of our ranch. She has a slew of working dogs on her family’s large cattle ranch and is a well respected breeder of these working dogs.

Beau has changed our lives in all the ways that new puppies can. He sleeps in his crate and even in the early days, whined very little, but our sleep continues to be interrupted by periodic night time visits to the backyard.

He came with razor sharp teeth that took their toll on us, our shoes, and his toys. I’ll save you the images of Trudy’s and my mangled arms and ankles, but they weren’t pretty. He loves squeaky toys and to eviscerate them, leaving the white stuffing scattered about the house.

Fortunately after three to four months the razor sharp teeth of a new puppy are replaced by larger, less sharp permanent teeth. Also the urge to chew lessons, saving our hands, ankles, and shoes. Why is it that puppies love to remove the insoles of shoes and chew through the straps of sandals? And he looks so innocent!

Below picture taken at the Breeder’s ranch while inspecting a pup. What is there about the scent of a new puppy that is so endearing? The new puppy smell is said to resemble sweetened cream combined with an innocent, celestially clean quality. The unique fragrance is easily recognizable, universally loved, and bonds puppy to mother along with puppy to its human companions.

Below is baby Beau viewing his the garden in his new home not long after coming to our ranch.

Beau, “This place has promise.”

Beau developed a voracious appetite. He was like the dog in the time lapsed dog food commercial and seemingly grew before our eyes.

“Is it mealtime yet?” “Give me food and I’ll let you keep your shoes!”

Beau has always enjoyed falling asleep in his toy box after emptying it and scattering his many toys around the house. If only we could teach him to put the toys back into the toy box. Puppies enjoy sleeping in semi-enclosed areas that lends itself to crate training and likely harkens back to their ancestors who lived in caves and crevices.

Beau, “You just try sneaking up on me now.”

Beau in his constant discovery mode came across the thrill of tennis balls. He absolutely loves them. He greets us on the back porch with tennis ball in mouth and urges, pleads, and implores with his fawning eyes and unflagging persistence for us to throw the ball. We relent but he is so fast that before we can make our way back to a chair, Beau has dashed into the backyard, captured the ball and placed it at our feet even before we can recline in our chairs.

Needless to say, drinking coffee on the porch and watching the orange glow of the sun rise over the blue hills of Fredericksburg proves less relaxing now than it once was, but the mornings are now far more active and entertaining.

Beau, “You want to play ball?”

When Beau was about 10-weeks old, Melanie Wahrmund called with an unexpected offer. She had been contacted by a film crew in nearby Austin about making a Purina One commercial and taking stills for additional advertising purposes. The film crew had asked Melanie if she could deliver cute, young Border collies for the shoot. We were intrigued by the opportunity. Of course we spoke to Beau about the opportunity and he expressed interest. Have you noticed that Border collies are the breed of dog most seen in TV commercials?

A bleary eyed me and a wide awake Beau were soon to meet Melanie at the end of our county road at 5:15 a.m., as she was gathering a few of Beau’s litter mates. Off to Austin Melanie, her daughter, and three puppies went for the all day shoot. It was late that evening when the traveling canines and tired human companions returned to Fredericksburg. Beau was full of zest as always.

Beau apparently had shown out and had become the “star of the shoot”. We were told that he showed the greatest personality of any of the dogs and had become a favorite of the film crew. We still await viewing the finished product that hopefully will be forthcoming soon.

Below are Beau and Trudy in front of a sign celebrating Beau’s new “stardom”. The poster was made by our good friends, Colonel Tom and Danese. Her dog, Pippa, has been duly designated as head of Beau’s recently founded fan club. We’ve had a lot of fun resulting from the photo shoot. By the way Beau’s red collar as seen in the picture was courtesy of Purina.

To our surprise, several weeks later we received a check in the mail as payment for Beau’s participation in the photo shoot. Trudy joked that since we were retired, Beau was the only member of the family (or is it a pack now?) who actually brings in income! The truth was painful for the previous chief breadwinner, but I was proud nevertheless of our cute little rascal.

To Be Continued…

Memorial Day and Toast to the RHS Class of 1964

Memorial; Day, Richardson High School Class of 1964, Toast of Appreciation May 28, 2023 1 Comment

With Memorial Day upon us, I wish to recognize and thank the fallen members of the American military who fought to preserve our freedoms.

This also presents an opportunity to share a long lost toast that touches on those whom we appreciate. Nine years ago as Senior Class President I was asked to give a toast to the Richardson High School graduating class of 1964 at our 50th Reunion. Later I was asked to share the toast but unfortunately could not locate my notes. Recently I stumbled upon them tucked away in the 1964 Richardson High School Eagle.. As the Class of 1964 now approaches its 60th anniversary I share these thoughts. So better late than never class of ’64 and per your request, here it is.

WHERE DID WE COME FROM?
We are the beneficiaries of what Tom Brokaw called the Greatest Generation. Our parent’s and teacher’s generation lived through the Great Depression and fought and sacrificed during World War II. From this cataclysm we benefited. We were privileged to grow up up in the wealthiest and most powerful nation on the face of the earth. It is to our parents,our teachers, and our veterans that we owe special thanks for providing us the strong foundation on which we built our lives.

SO WHO ARE WE REALLY?
We grew up in the turbulent 1960s and our generation is best known for seeking racial and gender equality, protesting war, distrusting authority, taking illegal drugs, and seeking free love. And undoubtedly our class, to an extent, did all these activities and more.


Nevertheless, we had members of our class who answered the call of our nation and fought in an unpopular war in Vietnam. On a personal note I lament the death of my friend and our classmate, Lou Breuer, who was shot down and killed while flying a helicopter in Vietnam. Tragically, too many gave what Lincoln referred to as their last true measure of devotion.


Following our great start at RHS, we had classmates become doctors, lawyers, successful business people, successes in the arts and humanities, and great parents. We have had university professors including our Valedictorian Bill Skocpol, who taught physics for years at Boston College. Many of you have expressed the social consciences we developed in the 1960s and helped make our society more open, tolerant, and freedom loving. We of the class of 1964 are so much more than a simplistic caricature of the 1960s, and we can all be proud of it.

And looking around at this gathering tonight and after playing a round of golf with old friends earlier today I suspect the strongest drugs currently being used are Motrin, Aleve, caffeine, alcohol, and lots and lots of Viagra.

You ladies look particularly lovely tonight. Now it has been alleged that a little hair color and perhaps even a nip and tuck here and there have contributed to your lovely appearances. But if it is true, isn’t that who we are? Don’t we want to stay young, vibrant, and engaged? We are, after all, the 60s generation that seeks to stay relevant and not just dodder off into old age.

SO WHAT IS NEXT?

It’s hard to believe we are 50 years out from our High School graduation. And I think we are looking pretty good despite the years. But for some of our classmates the race has been run. I was saddened to see the long list of our “Fallen Eagles.” For many of us we are in the final laps of our races. Hopefully, we feel good about our lives especially since the fires in our bellies have died down a bit. Nevertheless, many of us have children, grandchildren, and even great grandchildren who we affect as role models and mentors. We still have much to give and much to pass onto the next generations.

Admittedly, I’ve been feeling nostalgic lately having just completed a memoir. While the book tells the stories of very brave and inspiring patients who lived quality lives in spite of serious illness, the beginning of the book actually begins at Richardson High School with me as a lowly sophomore. RHS for all of us was my educational and social foundation and from where I began my journey into a life of medicine.

And to think that my vocation grew out of a fortuitous but painful collision with a large, senior football player. I spent the better part of a month in a local doctor’s office having my broken bone attended to and between treatments following Dr. Bill Powell in his medical clinic. I became hooked on the thought of practicing medicine. I suppose I should thank Mike Brown, the burly linebacker for the hit but it sure did hurt.

TOAST

So fellow Eagles of the Class of 1964 will you raise a glass and join in toasting those who helped build our foundations in life- our parents and our teachers, our veterans, and toast to the many and impressive accomplishments of our classmates, and to those to whom we will pass the baton and who will create the future. TO US THE CLASS OF ’64!

The above referenced book was Carrying The Black Bag: A Neurologist’s Bedside Tales. My second book for a popular audience is now available, Hitler’s Maladies and Their Impact On World War II: a Behavioral Neurologist’s View. Both books are available through Amazon, Barnes & Noble, your favorite bookstore, and The Texas Tech University Press.

Hitler’s Maladies Released

Hitler's Health, Hitler's Maladies Released, Impact of Hitler's Poor Health on World War II April 12, 2023 Leave a comment
It is with a great deal of pleasure and relief that I announce my book titled, Hitler’s Maladies and Their Impact on World War II was released on March 28. I’ve been busy with book events, promotional activities, and podcasts. It is a blast but tiring!

The book can be ordered from the publisher, Texas Tech University Press, Amazon, Barnes & Noble, or your favorite local bookstore. Like many others books these days, it is printed on demand to reduce storage costs. Delivery occurs within a week typically.

The book has been well reviewed and well received thus far. I greatly appreciate the encouragement I’ve received from my many friends and supporters. It was a challenge to write and publish during the Covid-19 pandemic, as the publishing industry was hit hard.

Family Sayings

Family Adages, Family sayings, Old Family Anecdotes January 26, 2023 1 Comment

Cute sayings and pithy advice are part of any family’s history. Such verbal gems usually cannot be chased back to their origins but may have existed for generations longer than suspected. All too often such family history is lost to posterity. I leave here a few examples from the Family Hutton and from the Family Plunket; however, I’m sure many examples have already disappeared into the fog of history. I encourage the reader to take notice of the unusual and clever sayings they grew up with and document them for future generations.

Adages can at times be easy to identify from where they came, even if unable to identify when they began. One such example is I recall my Dad using when braking his car a bit too quickly. He would call out while tromping down on the brake petal, “Whoa, whoa I say, whoa.” No doubt my Dad had heard his father shouting this command. I suspect this action command dates to when his father or grandfather drove a buckboard or wagon pulled by a a different type of horsepower than powered Dad’s car. Under those earlier circumstances the operator was using specific and direct language while pulling back on the reins and hollering a command at his horse.

Portrait of Howard Hutton


Other sayings derive from life’s experiences. Dad provided two bits of advice to me when using public restrooms. The first bit of wisdom he proffered was that the man entering the restroom ALWAYS has the right of way over the man exiting. Such advice of course demonstrates good manners, realizing that the man entering no doubt is in the greater hurry than the man exiting.

The second piece of advice Dad offered was to never get in line at the urinal behind an old man. The reasoning behind this gem, no doubt, is age-related prostatism that most old men develop. This condition prolongs their time at the urinal. The short line behind the old man suckers the unwary and is like the short line at motor vehicles. Both lines move glacially.

Dad always referred to our collective family as “The Hungry Huttons”,” This one needs no explanation with four growing children seated around the dinner table.

My aunt Grace Schwarz, Nonnie, would often comment that our family “might have lacked the millions but we had the airs.” (unfortunately we did not have the heirs)

My great grandfather, Thaddeus Septimus Hutton, advised to always shake out your boots in the morning before putting them on. I imagine he acquired this sage advice the hard way while being a cowboy in Texas. To those living in Texas, we understand scorpions love to infest warm places such as recently removed boots. Ouch!

Portrait of Great Grandfather Thaddeus Septimus Hutton

My sister, Joan, recalls Dad referring to her as “Spook.” The name apparently came from a WWII era comic strip where only the eyes and nose protruded over the fence or table top. Joan apparently in her early years showed this pose when peering over the table at Dad, thus prompting her nickname.

Paul W. Plunket III (Trudy’s brother) described his grandfather, Hal C. Horton, on finishing a particularly satisfying meal would exclaim, he was “superflopity.” Paul thinks this saying might have been a southern corruption of the adverb “superfluously” which means extravagant.

Portrait of Hal C. Horton

When Paul W. Plunket Jr. (Trudy and Paul’s father) did not want to do something, he would say: “Well, can’t dance, too wet to plow.”

Below portrait of Paul and Sarah Plunket

When Sarah Plunket (Trudy and Paul’s mother) in her role as a professional photographer would tell the subject things that were not exactly true to achieve a particular expression. She called these sayings, “misty white lies.”

Paul W. Plunket III (Trudy’s brother) borrowed some good advice from a mentor that he readily shares. “You would worry less what others think about you, if you realized how seldom they did.”

Trudy grew up with the encouragement to tackle a particular challenging task with the proviso, ” No hill for a stepper.” When asked to dress up, the encouragement would be to “put on your Sunday go-to-meetin’ clothes.”

When disparaging a wannabe cowboy, the saying goes, “he’s all hat and no cattle.” When questioning someone’s honesty, the saying goes, “as crooked as a dog’s hind leg”. Or if expressing uncertainty on a specific claim, the saying goes, “Don’t bet the farm on it.” When commenting on a person’s unwillingness to spend money, the saying goes “he’s as tight as bark on a tree.” All of these sayings, Trudy and I heard while growing up. While these sayings go much further than our immediate families, these are the adages we remember well.

My new book titled, Hitler’s Maladies and Their Impact on World War II will appear by April of this year. This is a behavioral neurologists take on the impact of Adolf Hitler’s poor health on WWII. I hope you will look for it.

Also if you haven’t read by last book, Carrying The Black Bag: A Neurologist’s Bedside Tales, I hope you will get a copy. In the book I share favorite patient stories that show insights into what is most meaningful when faced with life threatening illnesses. The book has been well received and has a surprising amount of humor. You can contact me for a copy and send $15 and I’ll mail it to you. Also available via Amazon or your local bookstore at full price. My address is 751 Bryant Road, Fredericksburg, Tx 78624

Tom Hutton, January 25, 2023

Blog Contributor’s Essay on Dealing with Dementia in a Loved One

Dr. Robert Rietschel December 6, 2022 Leave a comment

What follows is a personal essay written by Dr. Robert Rietschel on dealing with dementia in his wife. I have not edited the piece, believing it demonstrates well the personal response of a writer/physician to the ravages of dementia in a loved one.

At this time of year, all too often we get together with loved ones only to find that one of our family members or friends has begun “to slip.”  I have had the personal experience of seeing family members slip into the fog of dementia from which they never recovered.

This essay by Dr. Rietschel is shared here with the hope that should any of my blog readers suffer such a loss in their lives, that  understanding how another person and keen observer learned to deal with his personal, tragic loss will provide benefits and perspective.

Wishing everyone wonderful holidays and a loving embrace from your family and friends.

-Tom Hutton, MD

Perspectives on Dementia by Dr. Robert Rietschel

It was suggested that I write something about dementia. I’ve forgotten who threw down that challenge, but I’ve been avoiding it. My first thought was that I don’t have any brilliant insights on the subject and my medical training hasn’t made me an authority on that discipline. Yet here I am at the keyboard trying to let my mind explore places it would rather avoid.
This disease is not a one size fits all condition. First there are many subtypes of dementia. Even with the bulk of cases fitting into the general rubric of Alzheimer’s, the course of the disorder is highly variable. My mother-in-law lived around twenty years in various nursing facilities as her case slow walked from around age 70 to 90. My wife’s case also became manifest around age 70 and now six years later appears to be on a slow downward progression. Progression is the constant that we can agree upon. This is not a disease that suddenly improves, has miraculously twists and turns, or that you can resolve to fight and somehow influence. I’ve always thought that folks who claim they are going to fight a disease, often cancer, are jousting at windmills. What precisely are you squaring off with? It’s inside of you and you don’t have conscious control over any of the processes involved. If you did, you’d never had let it happen in the first place. I get that there are studies that show a benefit to a positive attitude. To the degree that such an attitude removes counterproductive behaviors that might be facilitating a disease process, I can get on board with that effort. But you really aren’t able to engage the enemy on the field of battle and duke it out.
I am writing this from the point of view of a spouse whose mate has been in memory care for three and a half years. I tried to keep us going together for about two years before the switch to full time professional assistance. I am fortunate in that when we were in our mid-fifties, we purchased very good long term care insurance. Were it not for that, I would have needed to return to the workforce to afford this care which runs around $5000 per month. The other option is to turn to Medicaid, which is run by the states and there are varying rules on how to qualify. Usually, you can have no more than around $27,000 of assets and income of no more than around $2500 per month. Then you have to find a facility that has an open Medicaid bed for your loved one. It was a financial planning seminar that we attended that convinced us to seek out and purchase long term care insurance and it is something I whole heartedly endorse. Enough about practical matters. I’ll not make any recommendations on how to finesse the move to assisted living, there are just too many variables.
Time, Place, and Person
If you visit a neurologist and are asked three questions, don’t be surprised. You are being given a mini-mental status test. Common questions are 1) what is today’s date, 2) do you know where we are, or maybe do you know what type of building this is and 3) do you who the current president is. The first question may seem like an easy one to flub up on. When you are old and retired, you don’t really follow the days of the week like you did when you had to work. It just doesn’t matter. But when my wife was asked that question, I was surprised that she missed the day, date, and year. She was off by about 3 or 4 years. This isn’t like forgetting it’s Wednesday and not Monday. If a doctor is asking you where you are, the easy answer would be in a doctor’s office. What happens in a doctor’s office? You wait. There are lots of places a person might find themselves waiting. Post office, bus station, airport. If you answer a clinic or hospital, you are doing better than my wife who said maybe we were in a church of some kind. My kindest take on that would be that she knew it wasn’t a person’s home but a place open to the public. The president my wife selected was correct. The loss in dementia will often start with the time problem. It is easy to dismiss that as just something old people do. I’ve tried to let you know it is more profound that just getting the wrong day of the week. Time just doesn’t get imprinted with the events of the day.
When my wife entered memory care full time, I would visit in the morning and often telephone her later that day. She would ask when I would be coming to see her. I’d say I was there that morning. She would not agree. I would remind her of some of the things we talked about, and she would say that she recalled us speaking of such matters, but she didn’t realize that was just this morning. There was some memory of the event, but no time stamp. We are all helped by those time stamps on our photographs. We associate some things tightly with time and other not so much. Loss of place is not noticed when you remain in familiar surroundings. Of course, things can become lost in that familiar environment. Did you ever forget where you put something? Sure. Where did I put those keys? Again, in my wife’s case, she couldn’t remember where she put her purse. We would be going somewhere and as I headed to the garage, the refrain was always, “I can’t find my purse.” The search was on. Instead of her purse being on the kitchen counter, it might be in a bedside drawer, in the closet, in the chest of drawers, or no telling. I naively tried to solve this problem by suggesting we always put the purse in the same place. If she wanted to keep it in the bedside drawer, let’s just make that the location. Sorry, but that plan won’t work. She is trying to protect her valuables and that is a directive she learned as a child. My instruction to put her valuables in the same spot every time is recent information. Recent information is what is lost early on in dementia. That older directive to find a secure spot is still working and it is making things challenging. The valuables from the purse were removed and put in a secure location of my choosing so they could be found when needed. She didn’t need money, credit cards, or ID to go with me to the grocery store. She really didn’t need the purse at all, but she didn’t feel dressed without it.
I’m lucky enough that my wife still knows who I am. That isn’t true all the time, but a lot of the time. One time when I was visiting her at the memory care facility the attendant told her, “Your husband is here.” Her response was that that was non-sense as she was too young to be married. Age 73 at the time. Sometimes she remembers me as “her Bob.” I don’t ask for what role this guy named Bob plays in her world. There are things you don’t really need to know. It is grand to be a person known and welcomed. There will come a time when that isn’t the case. That will require more adjusting of expectations on my part, but we’ll get to that subject in just a bit.
Agitation
The dementia patient does not go quietly into that dark night. Things don’t sit well with whatever is going on inside their brain and they are going to respond to what their brain is telling them more than what their senses and the environment are telling them. Conflict will occur and there can be physical altercations. This can be with family members or other residents of a facility. Or even with well trained staff members. There are medications that can help with this part of dementia much more effectively than the drugs used to try to forestall the progress of dementia. Those drugs to date are disappointing. The agents used for agitation are the same ones used to treat schizophrenia. But not in what are called anti-psychotic doses. Rather in low doses that take the edge off the agitation. There are psychiatric nurse practitioners who can help a great deal with managing this and that leads to my next topic.
Dementia is a lot like other mental illnesses
The recent covid pandemic caused a lot of people to lose their sense of smell. Not only were normally welcome aromas like fresh baked bread no longer sensed, but instead a noxious odor replaced the former pleasant one. You pick your most detested odor. Perhaps a garbage dump, maybe a public restroom. No matter, just imagine that every time a pleasant smell came along, it grossed you out. Your behavior would be one that those around you could not make sense of. Here was a beautiful bouquet of roses and you were acting like someone just handed you a time bomb. You are reacting to a repugnant smell and no one else is getting that. Your behavior makes sense to you and you alone. Your outward behavior looks crazy to those around you. That is a specific neurologic circuit screwup. It is covid induced and now very well known. Dementia does that to random areas of the brain and it creates that same exact problem. The dementia patient is responding appropriately to an internal signal that is contrary to the normal signal that everyone around is receiving as their circuits have not been disrupted.
I will use some of my medical training to introduce two features of dementia that I didn’t expect. That’s probably because I hadn’t spent much time delving into the subject, but those are confabulation and schizophrenia-like behavior. Imagine you woke up and found yourself in a room you didn’t recognize. The furnishing didn’t seem to be yours but the clothes in the closet were familiar. You try to piece this together to made sense of what you are taking in. My stuff, but some place I’ve not been before. Oh, I get it. I’m on vacation and this is a hotel room. I must be suffering from jetlag. I’ll just pull on my swimsuit and head to the pool to catch some rays. As you exit the room, a nurse in white uniform asks where you are going, and you tell her the pool. She tells you the hospital doesn’t have a pool and it’s snowing outside, so you need to put something warmer on. You argue with her and insist that you are on vacation, and you are going to enjoy the weather here at the resort. The nurse asks you where you got the idea that you were at a resort and you claim you know that is where you are because…well, because that is where I was going on the flight I took yesterday. The nurse tells you that you’ve been here a week and must have been having a dream about a much more pleasant experience. About this time a couple of doctors in scrubs walk by as the nurse encourages you return to your room.
What just happened? It depends on whether you are the patient or the nurse. The nurse just saw someone dressed totally inappropriately, claiming to be someplace they clearly are not, and who is profoundly disoriented. The patient woke up confused and unable to remember recent events. It is recent memory that goes first in dementia. The dementia patient is not stupid. In fact, that brain is working overtime to piece together something that can make sense of unfamiliar surroundings and this invented narrative is being acted upon. If this patient were recovering from alcohol excess, we would label this confabulation and put it into a syndrome. The medical name isn’t my point. My point is that dementia punches holes in the circuits that create recent memories and when those holes are encountered you can have invented “facts” given to you and you act on what your brain tells you. But when your brain is inventing facts and you are acting on that faulty information, your behavior is no different outwardly from that of a schizophrenic patient who hears voices and acts on them. Both can create inappropriate behavior which the unaffected folks nearby are trying to deal with or make sense of. This may cause behavior that seems ignorant, dare I say, feeble minded. That isn’t what it is. If you are able to sit with the person and ask what has led them to do what they are doing, you may find that they have a perfectly reasonable explanation for what they are trying to do.
In my example, if the nurse had a chance to sit down with the patient who thinks they are in a resort they might find that upon finding their own clothing in the closet but not recognizing the room, the patient figured out that this must be a hotel room. Since they were unable to recall how they came to be in this strange room, the logical explanation was that jetlag was to blame and that would mean a long flight and surely that would be to someplace desirable. So, I was headed for the pool. That’s my story and I’m sticking to it. At this point our understanding of dementia needs to allow for two different outcomes. The patient may argue the position they have staked out and become belligerent if the nurse persists that they are in a hospital. Or the dementia patient may have started to reprocess the additional information of a nursing uniform, doctors in scrubs and think that perhaps it was a vivid dream. My teaching point would be to expect both outcomes and be prepared to deal with each. The second teaching point is that you will not be the one who determines how that will sort itself out. No degree of reason or visual evidence will change the dementia patient’s mind if they have locked into their version of reality. This is not a failure on your part. You can’t fight this disease any more than the patient can. Sometimes you just have to make the patient safe and as comfortable as possible and walk away. It won’t be long before the patient is off on some other tangent.
All the books about dementia tell you to remember you are talking to the disease and not the person you used to know. Doctors are encouraged to treat the patient and not the disease. How do you bridge that dichotomy? I would advise that you aren’t going to have every interaction with a dementia patient break your way no matter how skilled you are or how much experience you have with dementia patients. You’ve always been told you can’t win ‘em all. My advice is first to remember that something that looks like totally stupid behavior is not a sign of stupidity. Those holes in the circuitry have been filled in with bad information. Usually, the reasoning has not been messed with and is possibly sound. One common example from my experience with my wife my help make my point. She couldn’t find something that she valued. For example, she may have forgotten where she put her watch. Since she can’t find her watch, she reasons that someone took it. After all, the rooms where she resides in assisted living have no locks on the doors. There are nine other residents in this facility and she’s sure one of them took her watch. She doesn’t know these people well and there may be thieves among them. She hides anything she thinks in valuable now. This creates more things she can’t find. The problem of course is that she just doesn’t remember where she put things. No one was stealing anything. The items were found in her room in odd places. Like in a coat pocket hanging in the closet. That’s an odd place to keep your watch, but it’s a good hiding place for something valuable. Of course, when such an item was found in her room, she was sure the thief had put it back because she was on to them. Does she sound like a paranoid schizophrenic? Kind of. Can you follow the logic from her point of view? Sure. Here you have the problem of knowing the person who would protect things of value and recognizing how that was once a positive trait and now it is causing nothing but trouble. The disease taking over from the person. But doing it by deleting critical information. And that leads to faulty invented pseudo facts. What would you trust? What your own brain is telling you, or what someone you recognize as family is telling you that contradicts your brain? That is the challenge that the dementia patient faces and that is where you get into the dichotomy I alluded to. They may lock down on their own input or surrender to new external information. Suggesting the misinformation was part of a vivid dream sometimes helps move the discussion away from confrontation, but not always. You won’t win ‘em all. See if this helps. It is context that has been lost and that can alter personality as things are dealt with in outwardly unreasonable ways, but personhood is preserved. There is still a person trapped inside that demented mind and their feelings are intact. They can be offended, their feelings can be hurt, they can express joy as well as anger. Granted they may not remember those feelings in an hour or two, but they will emerge if you trample on them.
A rare syndrome
When I was an intern, I took care of a patient with locked-in syndrome on the neurology service. In this rare disorder, the patient cannot communicate with you by doing things like writing notes or squeezing your hand. They can’t move those muscles. They can’t talk. They can hear. They can think. But they can only communicate with you by blinking their eyes. They must know things they want to communicate but can’t. Imagine dementia induced deficits that block your ability to communicate. A more common example would be a stoke patient who has aphasia. They know the word they want to use to communicate, but they can’t pull it up and speak it. It’s just not coming through. Dementia can disrupt circuits that create similar obstacles. But not just words, entire events. Memories. Gone. A good friend of mine, a fellow dermatologist, was a concert pianist. His Alzheimer’s had reduced him to a state where he could barely communicate with his wife, but he could sit at the piano and play beautifully. My wife could play beautifully too, but her dementia has hit those key circuits needed to read and play music. I told you one size does not fit all. The circuits that are disrupted early are of the most recent events and over time that clock winds backward and more of the past is lost.
The key to happiness
I was at an FDA meeting on the approval of Rogaine for women with female pattern hair loss and I was explaining how the woman who had the best results in my study was not as happy with her result as one of my other patients with more modest results. There was a disconnect between the data and the satisfaction. The FDA official said that I had shown that the secret to happiness was low expectations. I can’t argue with that. I think that attitude helps in coping with dementia. You cope. By that I mean that you are constantly resetting your expectations of what the patient with dementia can provide in any interaction. Their performance will vary from day to day on the gradual downward path this disease follows. It has been my experience that mornings are the best time of day for visits, unless the patient has been up all night. Those neural circuits need their rejuvenation for peak performance. Unrested is best untested. It is called sundowning, but the name isn’t what’s important. Don’t expect cooperation from a cranky, tired dementia patient. A lot of normal folks are similar. By coping, I am trying to provide a way to reset the thinking of the family member or provider of care. You need to have flexibility. The trajectory of this disease is a downward slope, but it isn’t a smooth line. It’s a jagged line with fits and starts. Nothing that resembles recovery, but a better day can follow a poorer one. The dementia patient no longer has control over their world view or perspective. They are constantly having to deal with things that don’t make sense to them as they are coming at them absent any context that experience would have normally provided. They can’t change that, but you still can adjust your expectations and doing that will benefit your own mental health.
Perspectives
That brings me to the need for maintain a perspective that allows for your own mental health. My advice is to waste no time on all that has been lost. I know what has been lost is enormous. Let it go. It is perfectly fine to have fond memories and to share cherished memories with your dementia patient. If the memory is from far enough back, there may be accurate recall. Distant memories are lost more slowly than recent memories. Just don’t grieve over what you’ve lost. If you must, have a good cry or several and get over it. That is not helpful to you or your loved one. What lies ahead is the future for both of you. Your challenge is to make the most of what is in your near future. We live in the near future. It is time to find positives going forward. Does that sound impossible? I am not suggesting a Pollyanna type of slapping a happy face on sad events. I am pushing for a perspective that finds positives amid a lot of negatives.
Did you ever hear the story about a boy who was gleefully digging into a huge pile of horse manure? When asked why he was so happy, he said that with all that manure he just knew their had to be a pony in there somewhere. That’s the perspective we are going to need. Maybe an example from real life rather than from humor will help. I know that there will be days when nothing helps. Those days will pop up and you just have to let the negativity stay only a short while. You’ve other things to get on with. When I was between my first and second year of medical school, I joined the Army and was send to San Francisco to Letterman Army Institute of Research for a summer doing a research clerkship. I reported to the commander of that unit, Col. William Akers. He was from Kentucky. Yep, a Kentucky Colonel. He was a kind and gentle man. You may have an image of Army Colonels as hard bitten and intolerant sorts. That was not the case. He could be firm and exert his authority when it was needed, but he was a Southern Baptist and saw himself as a southern gentleman. Polite and self-assure. I mention him because he and his wife had four children, the last being a late in life child with Down’s syndrome. Alan was his name. Children born when the mother is past forty have a much higher risk of Down’s syndrome and that’s what happened. His wife was a nurse. I don’t know how much there combined medical backgrounds played into their attitude, but here’s what happened. When he told me of his son with Down’s, I express sympathy. Col. Akers was quick to correct me right there. He said that wasn’t the way to think about it. He and his wife saw Alan as a blessing. He said you never met a more loving child and sharing that love was an unanticipated blessing that made them grateful for Alan and all the challenges that came with his condition. They were able to see something that might crush others as something to cherish. That was a hard thing for me to digest. I was able to see him interact with Alan on several occasions and what he said was what I saw. A loving child and loving parents. This was a perspective I had not possessed but wished to acquire. It was clearly the moral high ground. It also seemed to be the practical high ground. I would not have understood that it was possible to make that kind of mental adjustment. But seeing is believing. Col. Akers was a dermatologist and I ended up spending that summer working in his lab on a project studying friction blisters. It would prove to be the beginning of my academic career in dermatology.
How to make this mental adjustment and see something positive to dementia overtaking a loved one. It starts with recognizing that this disease comes at the end of lifetime. It is something seen mostly in senior citizens. This is a time in life when introspection is more common. When each day is a blessing. One of them will be your last and if you made it thorough you dodged another bullet. You made that adjustment, didn’t you? Are you not grateful for each and every day? Now you need to find little things like that in those days when you are able to interact in some way with your loved one. There will come a point when you can’t have any meaningful interaction, just as there will come an end to your own timeline. Be grateful for each small positive. There is a period of time in the dementia patient’s condition where they will still know who you are. There will be memories you can share from distant events. There will be days where you may hear that they were glad to see you, even if they are fuzzy on who you are. You don’t need to quiz them to see what they do and do not know. That isn’t helpful information. If they are talking to you, just roll with it. I am certain that sometimes my wife doesn’t recognize me when I first start talking with her, but as we talk it become clear that she is reasonably interacting, and she is glad to see me.
So much of this is dependent on how far into the dementia development things have progressed. That is why you only cope. You reset based on what’s still possible. You cherish the positive visits. The dementia patient still has feelings, and you can elevate those sometimes by just being there and watching tv together. You might say that isn’t meaningful time spent. I would disagree. Did the two of you spend time watching tv together when dementia wasn’t a part of your life. Sure. When you recreate that experience now with dementia being an added factor, you can still conjure up a feeling of something normal happening in the midst of a sea of confusion. That person can experience that normalcy as a positive. Every now and then while watching tv with my wife, a commercial will come on with a familiar jingle and she will start to sing along. I’ll bet you didn’t think that brain was processing what was being watched. I’ll bet you thought that was just a blank stare. I’ll bet you would have missed the mental processing that Alan was doing despite his Down’s, too. That’s OK. That’s where we work on our mental processes. That’s where we reset our perspective. We are doing more that watching tv. We are present and that present makes all the difference. You know the line from Robert Frost’s poem. The one about two road diverged in the woods and I took the one less traveled and that made all the difference. Perspective is hard to maintain. But it makes all the difference. If you are there, you can make an inane comment on a tv commercial that just might summon up a cherished but forgotten memory for both of you. You’ll cherish that moment and then you’ll know what I was getting at. It made all the difference.