Friday, May 27, 2011

Steve's "Medical Eulogy" for Memorial Day

Because it's Memorial Day weekend, I've decided to reproduce the eulogy I shared for Steve's Memorial Party on May 15, 2011.

*   *   *   *  

"My mother and father had a wonderful marriage for fifty years. When my father died, my mother said, 'I just thought we'd have more time."

Steve and I were together for a little over six years. But by any standard, it was a rich and intense time. I'd venture that we had in six years what many couples never achieve in decades. We tackled dragons together. And we both knew that we were fully loved by the other.

We gave each other amazing gifts.

From Steve:
  • I received an appreciation of my own competence as a physician. I used to joke with other doctors that just living with Steve should earn me Continuing Medical Education Credits!)
  • And I learned that I am a writer. (Steve used to beg me to ready my chapters to him. Of course, they were all about him. He used to use that narcissistic line, "Enough about me; tell me how YOU feel about me...")
And as for my gifts to Steve:
  • It's true I saved his bacon a time or two on the medical front.
  • I calmed him with hypnotherapy - it was the only thing that helped him sleep.
  • I had fun with him.
  • But most importantly, I loved him deeply.
*  *  *  *

Although this used to embarrass Steve enormously, we met on I had put in an ad stating, "I'd like to meet a nice Democrat."

And Steve responded, "Kerry delegate here."

We were a great match: similar politics, irreverent humor, a love of movies and food, a shared commitment to fitness. We both believed in "doing the right thing," and we tried to live it.

When I met Steve, he and Brita were living on Bainbridge Island - "just a 30 minute ferry ride to the city." We had some initial challenges with my arrival in their lives.

But the real challenges we faced involved Steve's failing health.

Having had high blood pressure and diabetes for many years - and a lifestyle devoted to culinary pleasure, Steve's health crashed in September of 2007 when he fell into Acute Renal Failure. He had to go on dialysis - the kidney machine - immediately. I am convinced that renal failure is one of the worst health conditions a person can experience.

The Northwest Kidney Centers offer the "Choices Class" for new kidney patients. In truth, it should be called the "No Good Choices Class." The options are: dialysis, kidney transplant, or - what Steve and I called "Door Number Three" - death within two weeks with no treatment.

We set out to learn how to do Home Dialysis, and we did it for over three years. Steve and I became serious advocates for Home Dialysis. I write a kidney blog, and with my friend Jane McClure, wrote "Arranging Your Life When Dialysis Comes Home" - which is the only resource of its kind.

I also wrote a very personal book, "Complications: A Doctor's Love Story. (Steve lobbied hard for the title "Steve Williams is Sexually Gifted.")

In February 2009, Steve received a living donor kidney transplant - the donor being his wonderful niece Teresa. And it was during this time that our friend Bob Bost wrote the song "Fight the Good Fight," CDs of which are here for you to take home today as you remember Steve.

The transplant didn't work due to a variety of medical calamities. The night that Teresa's kidney was removed from Steve was one of the saddest of our lives. Steve spent the next year healing and dialyzing. But in the fall of 2009, he began having problems with his heart; he'd already had a bypass when he was fifty. On Thanksgiving night, Steve had a heart attack during dialysis - on Bainbridge Island. I earned my stripes and a few grey hairs that night as we got through it, and took the 4:40 a.m. ferry into town for a brand new coronary artery stent.

What we were to learn in March of 2010 was sobering: Steve's aortic valve - the valve that connects the large left ventricle to the aorta (our biggest artery) had narrowed from the normal size of about a quarter - to the diameter of a #2 pencil eraser.

When he got to surgery, Steve's cardiac ejection fraction was only fifteen percent; normal is four times that. Dr. Joseph Teply - the most courageous surgeon I know - plucked Steve from nearly certain death during that thirteen hour surgery.

It was a feat of medical magnificance! Yet when Steve and Dr. Teply would see each other later, they'd talk about fishing - they were just two guys talkin' about fishing!

Steve's recovery was complicated by a little understood condition known as "Critical Illness Myopathy/Polyneuropathy. Because of this, Steve never walked again. He required twenty-four-hour-a-day care, and, of course, continued dialysis.

But Steve and I made lemonade out of our buckets of lemons. We dated - via Access Bus - the little Metro buses that carry the physically disabled. Access Buses are a mixed bag - never ego enhancing! But they were our ticket out!

Steve and Linda set out for a date in November 2010. Looking scruffy and always
irreverent, Steve would say, "Let's go sell some pencils!"

 On one of our last dates, Steve had an elevator door close on his foot, and that night, I noticed a large blood blister on his big toe. He had gangrene of the forefoot within three weeks, and a below-the-knee amputation the following week.

Because he had survived everything else, it really hadn't occurred to us that Steve wouldn't get through this. We even announced to our friends after the surgery, "Steve Williams lands on his foot!"

We were able to get him home Monday, April 11 - challenged by providing adequate nutrition and pain control. We honestly thought we could do better at home than in the hospital. And he was so glad to be home.

On that Tuesday, the evening before he died, Steve asked Tim and me, "Wasn't I supposed to die yesterday?"

Offering to take him back to the hospital, Steve's eyes opened wide - "No, I can't go back to the hospital; they don't let you die in the hospital."

I thought it was the narcotics talking. I fed Steve chicken broth, dialyzed him, and tucked him in for the night.

But the next morning, Steve was unresponsive - eyes open, a strong pulse, but unresponsive. His heart arrested in the Medic One van on the way to Swedish Medical Center.

On my call, Steve had appropriately gone from a "full code" to "no intervention" in the blink of an eye. Dr. Smiley Thakur, our heroic nephrologist, had shared, "When you are doing something TO someone rather than FOR someone, it's time to make that call."

Steve had always told me that he wanted to die, "when the banter stopped."

And it was time.

Take care,
Linda Gromko, MD

Wednesday, May 18, 2011

Steve's Friends and Family Celebrate His Life at Lake Washington Rowing Club

Steve and Linda

On Sunday May 15, Steve's friends and family celebrated his wonderful life with a party at Seattle's Lake Washington Rowing Club.

The venue had been selected for two reasons: 1) I'm a rower and member of the club, and 2) the club is located approximately where Speakerlab used to be.

We had easily 130-150 people in attendance, with live music provided by Bob Bost, Alecia Healey, and Larry Murante. Everyone brought food, and we gave out picture cards of Steve, and CDs of Bob Bost's song "Fight the Good Fight" - a song Bob dedicated to Steve before his kidney transplant. Many people spoke - most special, of course, was daughter Brita. The energy was amazing: Steve's impact had been so broad in scope! All the lives he had influenced, the careers he'd shaped!

The event brought out a few old photos. Here are some favorites:

Steve and Brita pose for a Seattle Times feature about the Bainbridge Island home Steve helped design. Brita was 7 at the time; She'll be 16 in June.

Steve at a baby shower for niece Michelle, just prior to his kidney transplant in 2/09.
Steve at our wedding in 1/08

There's no way to convey the loss we feel, but it's enormous. The cost of Steve living the way he was - with significant suffering - was far too high. As much as I loved Steve with all my heart and soul, I couldn't bear to think he was living for me in such agony.

At the party, I realized that I was one of the new kids on Steve's block. Many of his friends had known him for 40-50 years. I had known him for only six. But we had in six years what many couples don't achieve in decades. We were each loved...truly the other.

I wish to convey my deep appreciation to Michael and Andrea Ramage for hosting this event, and to the many others who contributed as well.

Take care,
Linda Gromko, MD