Views from Atop My Bedpan: Living seven decades through the healthcare industrial complex

By Alan O'Hashi

"Views from Beyond My Bedpan" is a story about my life spanning seven decades, but imagined if I lived it in reverse. Rather than being born as an elderly infant, this story follows my life as if I died old, am reborn, and then transfigured to age in reverse.

I've been

• Language: English
• Publisher: Boulder Community Media
• Release date: Mar 17, 2023
• ISBN: 9781088125892

Alan O'Hashi

Alan O'Hashi and Boulder Community Media (BCM) work with community-based media producers, organizations, and socially-responsible businesses to develop their content in a culturally competent manner. His work through BCM seeks to capture the nuance and complexity of self-identity and expands the wider community's understanding of our pluralistic world.Alan creates films and writes books that are not only important and meaningful but also entertaining and inspiring.Through his books and movies, Alan wants audiences to experience the world from multiple angles, challenge their assumptions through stories and gain a deeper understanding of individual self-identities and those different than our own.His writing and movie-making explore the complexities of identity through his personal experiences with other people. Alan's works are powerful explorations of the intersections of race, ethnicity, culture, nationality, and gender and how these facets of identity shape our lives. He complicates the notion of what it means to be a non-white person living in the modern world and challenges the assumptions of others by sharing his experiences and perspectives. By telling his stories on silver screens and the written page, Alan invites readers and viewers to reflect on their lives and grapple with the complexities of self-identity, not only in the present but also in the past. "My hope is to create a more equitable and just society in which people from all backgrounds can be seen and heard."After being laid off from two jobs following 9/11, Alan grew tired of working for marginally competent bosses and qualified for unemployment twice. "My friends told me to take a risk and try something I've always wanted to do, but I didn't because I was always stuck in a job."Alan enrolled in some video production and screenwriting classes at the local public access TV station. Backstopped by unemployment and student loans, he jumped off the entrepreneurial cliff and is the BCM Executive Producer."Self-employment isn't without its challenges. Every morning I wake up unemployed and constantly developing the next project."

Book preview

1

Life Lived Backward

My freakish death at age 79 was a big surprise, even though over 125,000 accidental deaths happen in the home each year.

I opened the dishwasher to add my soup bowl. I must have risen from the table too quickly because I felt faint and passed out. It shouldn’t have been so bad because I’ve tipped over like that before without incident. When I felt light-headed, I’d sit.

I learned how to catch myself on the way down. The Occupational Therapist (OT) placed a coffee table in the center of the front room. A Physical Therapist (PT) helped me to crawl over to it and push myself upright without hurting my back.

I collapsed onto the silverware basket this time and skewered myself with a big, sharp, carbon steel sushi knife. From previous First Aid training, I knew not to extract the blade from the stab wound. That got what little adrenalin I had left to flow. I steadied the knife the best I could and log-rolled onto the floor. Moon, the Siberian Forest Cat, jumped down from the back bedroom closet and ran out to check out the commotion.

Thankfully, I was granted a few hours of in-home care services through my Medicare and Obamacare benefits. Cheryl, my second-shift caregiver, missed the action in the other room. She probably fed Moon before calling 911, which was okay since I wasn’t going anywhere. The cat was more interested in food after determining I was still barely alive.

Ah, shit! The one time I don’t wash the knife by hand. I must survive this ordeal and get one last benefit from Medicare.

I bled out and hovered above the action in the kitchen and simultaneously began my life again.

*******

The future of the past is the present. Views from Beyond My Bedpan is a memoir about my life spanning seven decades, going on eight. Rather than being born as an elderly infant, this story follows my life as if I died old, simultaneously reborn, and then transfigured to age in reverse.

F. Scott Fitzgerald wrote a short story entitled The Curious Case of Benjamin Button (1922). His story, first published in Collier’s magazine, was later made into a movie starring Brad Pitt, who grew younger, and Cate Blanchett. Their aging chronology became irrelevant when their lives collided when they were roughly the same age.

I’ve been thinking about aging and have recounted some of my experiences in the context of the American healthcare industrial complex paradox. The book is about whether I could learn anything from my past decisions and change the future.

Public and private health care providers are dedicated to keeping people alive and free of disease, but, at the same time, they must financially profit to maintain themselves.

My nonprofit healthcare provider, Kaiser Permanente (KP), can make money but is disallowed from distributing dividends to owners and stockholders. I was a member of a credit union for the same reason.

Meanwhile, the industry keeps its heart thumping and pumping based on continually expanding the number of patients who consume pharmaceuticals, visit medical specialists, and are tested by new machines.

It’s better that people stay a little bit sick than be cured, at least from a profit-and-loss standpoint.

If all sick Americans were miraculously healed, the national economy would collapse. The government couldn’t print money fast enough to bail out the healthcare industrial complex while waiting for more people to get sick. The domino effect would be worse than when Wall Street bankers overextended themselves in 2008.

Fixing people up is a compassionate loss leader, meaning medical care is offered at a price below its market value, or services are given away, resulting in a loss of revenue for the doctor or hospital. The lost money is made up by selling high-margin items like drugs or absorbing the cost overrun.

The general business purpose of a loss leader is to attract customers, hoping they will become steady consumers. In the 1950s and 1960s, healthcare was viewed as a public good until the for-profit motive changed healthcare service delivery.

Before private health insurance companies became mega-greedy, medical doctors were shopkeepers providing service in their offices, and hospitals were similar to retail storefronts peddling well-being to customers. Caring and kind TV doctors like Ben Casey, Marcus Welby, and Dr. Kildare dealt with patients who walked through the door and served people with compassion, empathy, and a smile.

In the good old days, doctors saw a certain number of patients daily, provided follow-up advice if needed, and made hospital rounds checking on patients who needed more than routine care.

*******

Since 2018, I’ve been on Medicare and used it some, not a lot, but enough to be sucked into hospitals and doctor’s offices more than ever before. When I became a cog in the medical machine, stopping the contraption was easier said than done. I grew increasingly distrustful of the intertwined system created by the public and private sectors. Doctors and other frontline providers do the best they can within the constraints by which they are bound.

So far, my life has been lucky when facing life-and-death situations. Over seven decades, going on eight, I’ve had three close calls with mortality that happened every 20 years or so. The most recent was after being admitted into the hospital in December 2013, where I arose from my deathbed a few days before the 2014 Super Bowl after recovering from an exotic lung disease I contracted because my immune system failed from working too hard.

We all have unique experiences as we move through life. Being at the top of my game has been hard work. I preferred having positive influences on others I meet rather than negative ones.

If we lived life again, could we alter our past healthcare decisions to create a better future?

I was dead and born in the same breath. This time around, living my life in reverse, my final story is also the first episode in my new life about my encounters with the American healthcare system. A more accurate description would be the health scare system.

My plan was to get the pain of death out of the way at birth and then joyfully end life as a twinkle in my parent’s eyes. I’ve had many experiences to look back upon and maybe make different choices this time around.

*******

I just finished the prologue to my memoir and walked back to the condo from my office in the Silver Sage Village (SSV) cohousing community Common House to take a meal break. My hands were sore from typing—nothing a little Advil wouldn’t fix. The pain wasn’t enough to prevent me from boiling a can of chicken noodle soup, which hit the spot on a chilly fall afternoon.

I was a year late but got around to celebrating the 100th anniversary of the 1932 World Series. The Yankees defeated the Chicago Cubs in four games. I still have the cards and autographs of all the Yankee players from that year. I kept thinking, Maybe I CAN take it with me.

It would just be my luck when I entered the Pearly Gates. St. Peter would welcome me and ask, Glad you could make it, Alan, but where’s all your stuff?

I was still getting in a few steps by walking from my SSV retirement condo to my office next door. It would be great to push the physical and startling pain out of the way at the get-go. My 60th high school class reunion was two years ago. I was one of the few classmates still ticking.

Every ten years, I always suggested that the survivors toss twenty bucks into the pot. The last one standing takes all. After six meet-ups, nobody agreed with my idea.

My SSV place was part of the City of Boulder Affordable Housing Program (AHP). Since there were limits on home value appreciation, I couldn’t afford to move because the deal was so good. SSV was one of five cohousing communities in town and two miles from Nomad Cohousing, where I met a woman named Cherie (pronounced SherRee) Rineker. We shared a life-changing experience.

The last 10 years were physically miserable and not very productive. At the time of my death, I still was on a low dose of steroids for my arthritic hands. The stiffness and pain slowed my typing. That was good because my foggy brain had an easier time keeping up with my slowed-down fingers. 

I could still walk, and my long-term memory was good. The short-term was starting to go, Has anyone seen my keys?

*******

Before my accidental death, I noticed that my mind wandered more than before. I waited for my turn in the Baseline Medical Clinic lobby for the nurse to summon me for the appointment I had made with a brain doctor.

I picked up the Aging Gratefully magazine from the end table and started an article about my favorite President, Harry S. Truman, who took over when Franklin Roosevelt died in his fourth term.

I was aware of Truman not only because he ended World War II by ordering the atomic bombing of Nagasaki and Hiroshima but on a positive note. He proposed a federally funded health insurance program three times between 1945 and 1949.

*******

Cheryl called 911,  the eco-funeral parlor guy, and an obstetrician.

Am I dead or alive? I wondered while omnisciently looking down at all the commotion happening in the kitchen. It wasn’t long before the fire engine, ambulance, and police cruiser lights flashed through the front windows.

I don’t know what happened, but during the commotion of firefighters and  Emergency Medical Technicians (EMTs) coming and going, someone declared me dead, and the baby doctor announced my time of birth.

Being a reborn corpse, my arthritic fingers still ached, and my vision was pretty good from the cataract surgery. I presumed I’d start returning to my old self after a few years of growing younger, which happened 10 years later.

The chicken soup wasn’t what I would have eaten had I known about my impending death. Luckily, I had a habit of eating my last meals as often as possible. You know, your death row food requests? My last dinner would be a medium rare tenderloin steak with lobster and all the trimmings. I had a juicy ribeye the night before, which was close enough. I ate half of it, and that should have been my snack instead of soup.

What was I thinking?

I hoped Cheryl would use all the leftovers in the fridge, including the cold bowl of chicken noodle soup, for my combination funeral reception/baby shower in the SSV Common House.

I had a will and all that. I wasn’t as vigilant as I could have been in keeping the list of bank account passwords up to date, but I had to leave my heirs and assigns some headaches. A few neighbors disrobed me and hosed me off before clothing me in my usual outfit, cargo shorts and a T-Shirt. The funeral home crew loaded me onto a gurney.

*******

My friends and neighbors planned my SSV funeral service. They set up a long folding table in the Meditation Room and assembled the cardboard coffin that was a large version of a fold-it-yourself file box from Office Depot.

Two of my neighbors ran to the grocery store for a load of dry ice they placed on the bottom of the coffin and covered with a piece of fabric scrounged from the Art Room.

The funeral home crew plopped me into the box and placed more ice on top. My neighbors insulated the chill by covering me with the maroon Pendleton blanket I picked up at a pawn shop in Lander.

I was in the Meditation Room for two days. A few familiar people came to mourn my death and rejoice in my birth. Some I didn’t recognize. I think they read the birth announcements and obituaries in the paper and stopped by to see if there was any free food.

It didn’t surprise me that I died and was reborn at 79. At last check, according to the Social Security Administration actuary chart, when I was 70 the last time, I was predicted to have 10.4 years to go.

My grandparents were octogenarians. Grandpa Sakata made it to 103 and attributed his long life to a daily Coors beer and a shot of Old Grand Dad. He was living proof that clean living is highly overrated. My dad died at 80. Mom was the outlier at 76.

My partner, Diana, was six years older than me. Her eyesight was failing, and she had trouble getting around independently. We tended to each other until it became clear we were the blind leading the blind. Neither of us could afford assisted living because most places did not accept Medicaid.

Five years ago, we took out a reverse mortgage, and she and the cat moved in with one of her granddaughters. Diana passed away last December at age 85. I followed six months later and didn’t consider it unusual since my mom died in August 2003, and my dad went in December.

Outliving the rest of my people was always a possible eventuality. My sister and I were childless. Twenty-one cousins were dead but left behind their kids, and their kids had kids—my second and third cousins—but I didn’t take the time to know many of them. Besides, they were considerably younger and scattered around the world with their own lives. I didn’t expect that any of them would show up.

A short service in the Common House celebrated my life and rebirth. Cheryl prepared an excellent lunch afterward before it was time to dispose of my bodily remains.

*******

Compost burial was the option I chose. After everyone cleared out, the funeral parlor guy returned and transported me to a mausoleum, dropped me into one of the cylindrical stainless steel vaults, covered me up with wood chips and straw, and then heated the container.

Natural organic reduction reduces cremation carbon dioxide by the equivalent of driving an internal combustion engine car 500 miles. Composting my remains into a cubic yard of mulch took a few weeks.

We drove to the Boulder Valley Tree Cemetery. Upon our arrival, a hole was dug and ready for a truck to spill me into the trench, where I would nourish the Ponderosa Pine sapling planted on top of my plot.

 Japanese Matsutake mushrooms can grow beneath Ponderosas, and a batch may take root. The tree is a natural monument that family and friends can visit, keep alive, and perhaps harvest a few fungal delicacies.

Putting the pain of death behind me at 79 meant I could get on with life after resetting my biological and chronological clocks to age zero. I didn’t die but was born and then reincarnated as myself with my past frozen in time.

My reborn self was old, sick, and exhausted when I took a load off and sat in my chair.

2

The Living End

We’ll all, eventually, jettison our lifelong miseries and nuisances. Not all is bad, like me recounting a repeat of my life. I was a journalist. Newsworthy events are unique and out of the ordinary. Many of those are negative, like a mass shooting in a church.

There are good things that are the converse of my example, like the hundreds of church services that happen without incident. Why not cover a community service project the youth group is organizing? 

My experiences with healthcare had arcing stories. Last week, for instance, I went to the KP clinic for my annual combined flu/pneumonia/COVID-32 vaccination to stave off diseases. Instead, I keeled over.

Death is more certain the longer we keep kicking. I’ve been with the same healthcare provider for years. KP was still