John Jurgensen and John Jurgensen

00:04 I am John Jorgenson. I'm 37 years old today is June 11th, 2011. Where in New York City and I am the son of Craig durrington.

00:17 And I'm first name John Craig Jurgensen 71 very soon next week on Thursday. I'm going to be 71 birthday June 16th for 1940. I tell you of course as John says searching the 11th of 2011 when the small recording booths at the foot of the federal courthouse in lower Manhattan, and I'm happy to be John Sessa.

00:46 So we came down today to talk about a few things, but specifically your profession and wondered what made you first want to become a doctor.

00:58 Rush on that dates back to when I was a small boy probably in middle school that I got the inspiration to be a doctor and there was no one they happening but I remember just growing up in in in the middle school years and loving science and loving biology courses and I have a doctor friend who I knew from church and he was inspirational to me and very very outstanding person. I got to know him well and he was a surgeon but I think that's kind of set the tone for me and I didn't have any other thought in mind as to Career when I was being high school a few years later. I was writing essays on why I want to be a doctor and things like that and that course Next Step was

01:51 What's undergraduate college and took a pre-med curriculum and it was just no other pathway. Did you see sickness around you when you were young was that part of it?

02:04 I know I did not till I had very strong religious orientation as as a boy in the church, and I remember and also in college I belong to a religious Christian organization and had the idea that I'd like to be a missionary to the ecology was thinking I'd like to be a doctor. Yes and missionary work seemed like it was where I should apply that I thought. I was going to be a medical missionary early in hurting College.

02:35 How so I wasn't just sociate with illness my sister though and maybe important I did develop diabetes when I was a teenager Rock to the family medical situation little bit cheap can't be all in that we had to focus on her on the oldest in her diet. And so that was the first undisclosed as I got to the disease that teenager and I think that was important.

03:06 Soon enough for eventually you came to specialize in the brain and neurology became at your Fields. What what really made you want to hone in on that it matter school. I was turned on by neuroanatomy. I loved under Academy of thought I'd like Anatomy subjects in general. But when I came back to school at that first year in joint Anatomy, I was just fascinated by the idea that they were bundles and Pathways send full size and hemispheres and things like that in the central nervous system that made us develop the way we do in behave the way we do and talk the way we do is just faster than and just compel it to learn more about neuron Anatomy as it explains. Our existence was was was my love

04:01 And then most importantly it was my exposure to my pastor in my church who in the early 1960s developed Parkinson's disease.

04:14 And that was right before the two years before the the development of antiparkinson treatment.

04:22 And So within a year, are you going to have time he wilted and went the rapid course shut down as Parkinson's patients do if they don't have treatment and he really Wilt in front of my eyes. So I had a year's time and I was impressionable and a devoted to him then served for him at the altar and things like that and spray close to him physically that way and spiritually and so when he developed treatment when he developed Parkinson that couldn't be treated that died. I know what impacted me immensely and I think cuz I set my course in pursuing.

05:03 A career in neurology, I think based largely on my my closeness to her father Reverend Gene Adams Frederick Adams. His name was when he died. I was two years before the Advent of antiparkinson tree, but which would have changed everything in his life and and in my understanding of these wet but you aren't a doc you want a doctor yet at that point. I was high school. So you didn't have the kind of Detachment that a physician might have ruined seeing that happened to her and you felt right.

05:41 So that was before medical school, then then because medical school and their anatomy and I saw the place in the in the central nervous system where parkinsonism happens. They have substantial Niagara. I found out there was a place where if it's the disease that causes what he had I made the connection between the impact of his life and death and then found a location in the central nervous system. Later. Where do remember the first drain the first physical brain you saw.

06:20 Well when I had a residency much later and in neurology, what are the tasks we had as residents that was to detect the brain that was much later from me. But that's your question. I remember the six months or maybe four months, of course and you're in that began as a resident in the 70s that I had to that take a human brain into sect it it in System since there's a way to do it that way to take Pathways apart in sequential fashion and get down from surface to depth in see the bundles and handle them that was impressive. I remember years ago when I was a kid, do you brought home brains back from time to time and I don't really remember if that was you just haven't had a brain in the trunk of the car or if you were intending to use as a teaching tool was going to tupperware container. I sloshing about right?

07:20 They had them because from time to time I would do a lecture or an in-service speech to either group of nurses or students biology students some of the other school teachers in the high school would call me from time to time. I talk and bring her brain to the class and BYOB.

07:44 And and I would I would bring one in and and demonstrated but my dissection of it was was really Hands-On. It was so the weather to see that there's a difference between gray matter and white matter. I wish I was this mysterious interested in the fact that they call this gray matter and white matter and what is what's all that about and it the second you can see why it matters by Mattern.

08:10 It's an interesting also add that the related to the axis of life. In other words. I'm interested that the the brain and central nervous system is like a tree you have a stem and roots and a top of that you have leaves and a network that spread out over the top of a crown and it's it's a communication from Roots that have leaves leaves the roots and it's it's such a wonderful organism that is beautifully built could have created and has much more mystery about it than way you can know.

08:53 What when you were in the in the body of your practice, which went on for many years what kind of cases that you connect with the most which ones were the ones that you really were drawn to it came to be that was pretty much a Parkinson specialist more and more as my years went on in the town where I lived in Pennsylvania to Carlisle Pennsylvania division are the only me and so I met anybody developed Parkinson syndrome over the years and decades would usually get referred to me. So I had a large compendium of patients so

09:36 I went through the facilitates it the making of the diagnosis and in the management to it because I think there's no more Dynamic and fluctuating disease in in all of medicine than Parkinson many points along the other up someone's

09:55 Existence with the disease their ups and downs and sideways and half ways ups and 1/2 in terms of movement to movement disorder and the fluctuations of its complex in difficult to analyze then so I would help pain Physicians and patients.

10:14 I learn about how to understand how the disease.

10:18 And there was plenty of treatment that point and so I can make a big difference in people's lives in the end out at SM any neurological illnesses. It's the natural history of the natural course of the disease that makes the difference and more more. I came to respect then wonder about the the the net the nature of the natural course of that disease Parkinson and other diseases the natural course of which has has its own time span in situations medical treatment treatments don't cure the illness help manage it but the lifespan maybe not much altered by the prescription.

11:11 In a small town like that and being on urologist you must have many times treated people that that you knew always all people to decline that you knew much of the way they did that for that experience change as you became larvae.

11:27 A veteran of of the practice. Yes, and I became often more more attached as I felt bonded to these patients with Parkinson again to dating back to the heads of my first experience as a boy. And then later on how I saw that impacted the patients lives really him. Some of my friends knew where were reflected. One of my close friends. In fact is a surgeon who is dexterity was altered by having Parkinson's I made his diagnosis and was strongly bonded to in both ears to help manage his case. I continue even though I'm retired now, I continue to follow him personally and I'll make visitations to him and I support him and advocate for him. I'm even putting together some diary kind of observation to his case send expected. I'd like to do something like that like that the book that was written some years ago Tuesday with Morrie about an illness that

12:27 Ends up being fatal, but the bond between the patient and the supporter of the treatment or the treater is like what I'm doing with my friend Jim Johnston, who is One Piece still managing with difficulties disease drawing pretty much part of it and taking notes and we have a good relationship, which I hope is supportive and therapeutic a certain way. I what kind of therapy can I do now that I'm retired and I have a license. I don't pry prescriptions.

13:04 But in the diseases of the nervous system enjoy being able to support without a prescription advisory are at be an advocate. I just said love you since you're not going to take that cured with dependents with the prescription. So and Alzheimer's to I think they need a lot of support and management understanding and I'm involved in that area.

13:33 Currently in

13:35 Can I ask a question? What was it like telling Jim that he had Parkinson's?

13:41 How was it as a doctor? And how is it as a friend? Right? Well, I think he might have known what he had and he was a right-hand man and had to

13:56 It in fact you close to retirement at that point and so I'm but I made his pronouncement to him. I think the number of other people had told him that it was something more benign the other things like it's confused Parkinson is is Sophocles essential tremor, and I told him this is not what they call attention. This is Parkinson's and drop and coming from me. We have strong relationship. He accepted it with the grace and with me a forbearance and went on retired and

14:33 Absorptive dwelling. So I put in my treatment and the treatment was helpful and Ashley as it usually is.

14:40 Are you if you were tired yourself, not terribly long ago, but as you alluded to

14:48 You're pure crack, not your practice, but your profession in some ways followed you into retirement right now.

14:57 Talk about when you first started to see some some symptoms in and I don't buy Mom. Your your wife has inspired me from a youth and has directed me from using my car my professional career and has also got to be now it to the position of support which I think is the hell it is very wonderful and Away in my own situation. My wife has so the last 2-3 years harm. Your mother has that developed Visual and behavioral and replace a cognitive symptoms that may predict that she's on the way towards the Alzheimer's disease.

15:44 And now in that position as her husband as a spouse has a supporter as their Advocate. I feel an in a privileged position to be able to use my experience and knowing and understanding of the disease to be the best treatment that she can have.

16:03 She's at the point actually what she needs treatment in what we call activities of daily living which serve in the bathing dressing and complicated aspect of feeding and preparing meals and things like that. I can do all that in some of the situation is parallel to this that they employ a professional staff to take care of but I think it might background and my knowledge Hub that I can understand all her behaviors and naiah and give Insight. I feel that she's going to break.

16:36 Satisfying a situation that she can have the comfort and security treatment at home by The Physician / neurologist / intimate take take me back though to the really the first things that you saw like, what what specifically did you see in the way? She was moving the way she was acting the way I'm going to do remember actually a day when when you felt something is wrong and having course diagnostic eyes, which I know if light in my profession that can make a diagnosis in the office, but I can also make a diagnosis on the street. So to speak at home with my experience. I know when someone's the begin to show their logic symptoms and I started to say that she had trouble reading and judging space and

17:36 Findings locations Adventure. She started to have difficulty putting the car in the garage and she scraped a star that car on the side of the garage. Winters. They're just showing up right and realize that was about five years back that there was a problem with the visual scanning in locating and then more more with the reading became a problem. We measure the number visit to the opthamologist and opthamologist. I couldn't figure out what her visual for my problem was he would put her in front of the echart then ask her to read the stand that line Sunday the Snellen chart so-called and when she couldn't work away down in a linear sequential fashion. He he started to become confused. I thought I knew sitting in the individual assessment room that to the prom with no logic at that point. I was four years back and she developed eventually diagnosis, which I was able to make it was called Alexia without agraphia.

18:36 That is she can she can write with a hand she could do hand writing, but often she cannot read what she just wrote.

18:44 Let's call Alexia without agraphia. She can ride it.

18:48 And I was insightful enough and diagnostic enough to know that there was she wrote a message to me or to herself of her shopping and then she couldn't read it that told me they brighten portly. What are you talking about? Diagnosis is if you know that the home was the here at your office. I mean, you must have felt panic. I mean what what is you feeling that's part of the creep in right hand and diagnosis for better. I think for better not worse wasn't home at that point that and I think they many of those situations without a knowledgeable spouse without knowledgeable diagnosis in front of the spouse of the family would have been confused and sometimes curious if not corrective and some of her measures and errors that she made saying what's wrong why you do that as is in it, but it took

19:48 I might understanding and my appreciation and my early detection detectability. Yes. I was I was aware that this was in the central nervous system. It was subtle at first and I knew that you know, there was more to come didn't Panic did increasingly feel the day of the brunt end that I'm not going to say Burton, but I felt to you the gravity I might saying

20:22 I think developing inexorably how people have one do the sheet first. Really. I mean you were asking her questions you were trying to understand what she was saying. You're not seeing.

20:37 What kind of conversations did you have? I mean, I remember when we would have conversations, but I was at work never in the room when you and Mom would talk about the stuff. What what kind of things were would she say?

20:49 Oh, she was distressed. Of course, if you couldn't read and said she was Richard kruspe and she got a cat gave up. Driving and then eventually the problem was shopping. And so as these deficits and things had it up. I took them over As a caretaker and I did the shopping and I did the meals and we didn't talk about in corrective ways in terms of that movie thing. We talked about it in realistic terms that since she needs help with this. I'll I will do it. I will do it together and more more our life became afraid definitely a partnership in all kinds of ways that married couple courses is a partnership in in in most ways increasing our partnership was essential and evolved everything eventually two activities of daily living

21:40 And she was she supported and she never has she's never expressed. Even the fact that she feels a birndorf are afflicted are damaged during like that. So I think the smoothness sends it to do we have my support as major except this that she can have her she's graceful just been some depression, but I can get over that and she's she's taking it all in my myself to people sometimes come up to me and say it. You feel burdened and should feel

22:20 Deprived her something like this for selfish and I always ask her know. I think I have the time I've retired from my professional life and I'm using all my skills, but there was this is not the way you pictured your retired life when you right before this arose. What did you see you doing with Mom? Where did you see yourself right now if this disease have her doing well, we would probably traveling more we would like to go to Europe. I would like to go to concerts. We like to be cultured folk and and make a lot of fun music and cultural visits. We have done that I'd say our traveling activities have decreased and the one trip that we made to visit family in in Germany back in March recently was somewhat difficult because

23:20 3 airplanes and airports is is is difficult. So we tend not to do it. Then. I think we have stayed at home we've done is to relocate that we had a 4 bedroom house in Carlisle, which was owned for almost 40 years and I've decided to scale down then sell it and move to a small cottage and we have that one-third the house that we had before so we we've closed in a bit and we've also contracted for meals. So we sleep at made major modifications. Although I think peanut we rationalize that we need to do that. We had 40 years equipment the furniture and elections.

24:09 And a couple said that stays off in sooner and sometimes much much later. I have to go to the process of downsizing and selling at auction again. So this actually gave us the impetus to do it and I think it's better. We did it now than later. So we were filled with such a fortunate but mandatory procedure for us to go through in the location where and is manageable and we're happy where we aren't so I think I think I think a lot of What you talkin about is has been put into place and you didn't the last year especially as he said you were selling the house moving to a smaller place. There were a series of steps that you took very very decisively to address this new situation. But you know, there's a. A few years or couple years really wear.

25:03 Beeweaver in this kind of a gray area of like what is this disease? And what is it going to mean for our lives and finding where the boundaries of of safety and awareness were and I mean remember you telling me the story of when you went to nothing choir practice and Mom stayed home and cried. She went out for a walk and got lost in the neighborhood. We lived in for 35 years.

25:34 That that was that was about three years back two years back and that was the decisive moment the visual aspect and visual cognition the impact what was manifested in this territorial walk. She talked with the with the dog one evening and I have known enough to that time that her problem with the space and locating was was quite that house if you're so I went to choir and came home and it was dark and she was not home. It was that moment that I realized. We had to locate you walk you walk in the house and she wasn't it. I walked in the house and then it was dark and the dog was gone.

26:17 And I packed that and I had not predicted that she might get lost until I S S. I do have a problem with reading and locating things and so far but I didn't think it was going to be a problem locating the house and shows that are problems not with visual Acuity and sing small things right accident sing everything they from the size of a house even to the size of a minute. So I came up rather suddenly on that discovered that the she has subwoofer called topographical agnosia and how to dye out of to find her that night. She went to a neighbor cuz she knew she was lost knock my neighbor's house, but you didn't know what how she was out. She got to let him go back to vote for going to stay dangerous strangers house and said, I'm Jon jergenson. Could you take me home? What's your address? And she is your new address?

27:13 Hand and that person knew where she lived two. So I'm standing out in the driveway in the car drives up and she's in the car and she gets out of the car and we hugged and she I felt as the same emotional as she did and we just pledged to her that I'd never let her go again. They'll protect better that she won't be able to get lost again and it was that that discovery that the next day we expecting a phone call to a retirement community that you're by that was accessible available and we visited the next day.

27:58 Three months later. We were I relocated. So we made the decision to sell the house and that auction. It was the strength and the impact of that disorientation in space.

28:12 That that. Force that that decision in a quick hurry

28:20 You

28:22 We are in this mode here. Ethically if you were still a practicing physician, this would be not your legal or is it really going to go to Robbie's wrecker Medical Association has a code of ethics that in fact some nomination of its quarterback of the wrecks that Physicians should not have practice or treat their own relatives are

28:55 And with that prescription didn't understand what that is, and I think that may be applied to but perhaps prescription medicines or surgery things like that. So I understand even why it why I'm doing treatment.

29:10 I'm calling a treatment. It's for the treatment of course, but it is treatment to we're doing treatments in the nervous system that really that include occupational Therapies.

29:23 Individual therapy which I administer to her at home because of my own understanding. Well occupational therapy is at visual therapy at practices. So I asked on the treating spouse e might say in the situation. I'm not bothered by that the code of ethics that says it is, I think it's still different realm of treatment. What I'm doing is is is still spousal still personal but I do it with the knowledge and the background that makes me still her physician in real in a very real sense of unity unique situation. I think cuz that allows me to be naughty her partner, but her and a buttered her support her advocate Earnhardt Twitter.

30:13 Occupational therapies that I'm administering are they all are helpful to Sia hope so I met this its hardness in the degenerative disease to measure what occupational therapies do because you're difficult.

30:39 And and the other thing is that I'm seeing I'm reminded of what it looks like to look at a neurological disease. It doesn't have your. Doesn't have a pill or an operation to take it away Harkins me back to my Parkinson pasture who before that was treatment Wizard and declined.

31:07 High as it as an ultra boy then treated him in a way. I was supporting have him and remember to the shifting at man in the church it hard to say back almost there parallel here. I am. 71 looking at a disease while so that is showing some decline for which observing these natural coarse natural this disease understanding it and supporting it so it reminds me of where I've been before it also seems

31:42 It gives you a vocabulary and a base of valence to talk about this thing that

31:49 Innocence is also a defense mechanism. I think because of the emotions involved. I mean I am become, you know, I become overwhelmed when I think about it for more than 30 seconds, and I know that you do to write from time to time, but

32:06 Do you have you can have this kind of this apparatus and we're going to cope with this thing. Understanding is is helpful to me and and don't but I think I'm in no matter what our condition is a disease or are a misfortune knowledge I think is what we need to survive. I think we live on understanding and remember Greenport li My neurologist Mentor in my residency told me what it said that they I left wind got the practice. He said Craig what you do mostly and your Urology practice is dispensed information.

32:45 Because many things you can't cure like Parkinson's and Alzheimer's but the information is helpful to the family the person as it turns out the information is helpful to me at 2 that I have an estate when she has a deficit that doesn't that that is unfortunately to potential for accident or injury. I can understand what what to do to prevent it. I got understand and somebody hit my understanding can help me or Dixon to avoid injuries avoid accident void being lost in neighborhood again.

33:18 And I'd avoid the accidents in the bathroom and thinks like this. So yes, I think I'm I have defense I have rationalization because I understand and I think understanding and knowledge makes all the difference in in many of us and starting my case too. Far with a spouse should say why is this happen? Why her why us I would think I'd be pretty distraught now, but

33:52 I don't feel distraught I feel like that I am able to provide and I'm doing it as soon as mentally and as passionately almost is that like it's like I was trained for this. I feel like I was perhaps the train to be the best husband. She gets the best mate. She could have through license. We've been married to have 40 48 years and like I can predict how it's going to be a couple years from now, but I'll be there and what will make it that will make it to 50 and Beyond hopefully we were talking about someone who's not in the room. I was here with us and you know, she's at home playing with my son right now and let him and very much loving that situation. I did. Can you tell me about the way conversations play out between you wear at times you just forget that this is a problem. What kind of things do you to talk about the make it seem

34:52 I got them. There's no problem at all. Right. Well, we will we will we talk about family with the family is doing what are granular sugar doing a visit them she freaks out then she gets she just wants to participate must be involved so that she she thrives I remember that and not just family but it's also memories. I mean, I'm a ride home. I forget it was maybe six months or a year ago. We started talking about letters that have been sent and in between you and her and some some teenage boy. That was okay because you know, what? All this stuff is very much right locked in place and night and my wife and your mother had written diaries for all of her many years going up until her she was probably 40 years old and we are reviewing Diaries and we have recalled.

35:51 Therapy and at her her Diaries are beautiful and described and for my writing standpoint their works of art for 10 min ship is so we get that we have some lunch or twice a week and get the diary out. It helps refresh the old memory and relive a memory and then get your choice so that diet diary Sarah P has been helpful and gets her Joy sheet. She's right. She likes humor. So we got a good TV program on and I like to watch a good comedian and funny movie. It is tremendously helpful together.

36:35 Like Seinfeld and slight that we usually stay up too late to watch Trail at all because Jay Leno makes funny things of the whole day and she enjoys that she laughs and you know that that's very available and she's seen that some two seconds away. If someone tells a good joke, she's got a hearty hearty smile after and it's abroad facial.

37:02 Show of Joy I mean what you actually is a nice I like because you're not call her nickname from you over the years is is Joey Joie which in French means she has lots of July the nickname actually is well deserved and well-earned that because she is has had joy and still has Joy many moments of the week. So I enjoy yourself. It's a great nickname for her because it's she still got plenty of it then it's fortunate.

37:37 I stand with you when when she talks about this disease, and I know that it's tough for her to talk about and

37:47 Although I think because of you she's not very used to talking about it, you know, maybe more than she wants too sometimes but she says well I had so much good health in my life. It's just my time right by turn. Yes. I've heard her say that many times to print their friends and people are sheets irrational as she's very rational if she has very very very strong face as I do about her face allows her to say something like well, I'm fine and you know, it is not a matter of deserving is that are matter, but I've been healthy at well and I have a good situation have good. I think she feel she gets a good mate. And I think she has Joy, so all those factors are letting her tolerate and exhibit this disease and it's in its severity yet with the grace and poise.

38:45 I think that's the best you can do if you have something that's malignant or degenerative and you can

38:55 Shape up under a tendon and live with it and end indoor with it and still have some Joy intolerance then I think that's that's the best you can be. So she's

39:07 She has that demonstrated that well and I hope it lasts. I think it will be can keep her. Joyful. Do you have conversations about where things will be 2 years ago to talk about it where they think we're two years ago two years from now or things might be a dude Utah, No don't know if there's anything that gives her a frown it's what's What's happen next? And so we don't we don't go there. I would have had it when we relocated. She knew that we did a big move and retirement center in a supportive environment in our community there and I think that that's evident enough to her. Now that the needs surroundings institutional potentially institutional surrounding to that may happen in the years to come and they're available but perhaps so we can delay it as much as possible.

40:07 This also takes it back to me didn't even mention this the fact that he went through something not dissimilar with your mother, right? My mother became demented at a much later. Asia vicious. Does she live 294 became different dimension when she was 90 and I helped understand and help support her condition to and my father was my guide in this my father was a supporter and The Advocate than the end of feeder and the dresser for my brother. I'm perhaps the following is example that his demonstration to me about how it has to be totally intimately one with your wife. Is this the best the best you can be Devotion to Althea, whatever the condition

41:05 What he did Bastian, so now that we have an eye doctor in the doctor right now. So I have a lot of the different realm of understanding and my prescience printer and addresses unique to me. So

41:26 But you're talking about his example, and yes, I'm passionate patience patience compassion. Yes.

41:39 So it's wonderful to be able to talk this all through I'm reminded of the idea of bookends that in my life. I had the book ends of above a mystery illness has an impressionable young boy, and now I made your illness has a retired physician looking at me as directing and guiding my life and my behaviors and my my goals so it's I'm up the nervous system has been mice.

42:14 Maya Acura my Fascination from day one until I think it will be forever that hit it deserves that the nervous system is a Wonder.

42:25 As much Anatomy that there's anything to about that. We have a brain but make sure I ask what is the mind? What is the mind and I've got things to think that the mind is much much bigger is almost as if he know what the mind is what the brain does the brain is this is suspicious lump of a gray white matter. Otherwise you have for 5kg mg. The mind is as big as the universe and I'm in awe of what the mind can be and thinks about 10 losses in in the human existence. I think it's it's it's created wonderfully and

43:09 We do the best we can to understand it and to study the mind and it's working send and this gives you the smile gives you comfort but it gives you knowledge and but the rest of us don't necessarily have that and I think that you know, I think you are you're you know, you are tools are used to you but I the rest of us, you know, her children her sister her brother might have to find some other way to write to rationalize their lives and I and I hope that I can help in the family's understanding of this but we understand it but it doesn't necessarily make right did the other clothes that's about this is that John has a twin sister.

44:03 And a twin sister a has had the obviously strong interested in what's happening with her sister and it is it's been closed gender studies looks too also to meet us at 4 for understanding an inside than an II. She's got major worries force and I hope I can help with all the all members of the family in in making this again providing information dispensing information, but I think that we've talked about this for I think she like

44:41 Myself and my sister sometimes feels like well, sometimes you can't diagnose it away and explain it away. I mean, I think she like so many of us sometimes can't get frustrated with how clinical it is for you right when going over seeing something and you said to me before, you know,

45:01 What happened to work for losing her? That's something that's not right textbook, right? I don't think someone's being lost. I think that someone is changing the mat and I take that I don't have to deal with that concerned to about loss and I don't I don't I'm not going to allow the term loss because I think cuz someone changes a lot we all age sooner or later faster or slower and I think the aging process is something we did a lot that we don't know about and what's the tempo with it than the staging of Aging is says hope realm of that. I just took my people studied and that's what that's what we resent. Right? Right, but I think it's changed at this point.

45:52 Is there a mean there must be some part of this that you don't understand and I'm wondering how you deal with that? But the part I don't understand is is what if causes atrophy.

46:06 Atrophy, we know that in the nervous system diseases. There's stroke. There's trauma there is poisoning this malignancy.

46:16 And there's atrophy atrophy between cell death what causes of interest in the nervous system the cell death in the Fe happens in specific locations.

46:32 As in the Parkinson's patient, it happens only in the substantia nigra.

46:38 I'm mystified and I'm overwhelmed by the difficulty of Parkinson above part of the same as Alzheimer's it happens that these people have acrophobia the hippocampus.

46:52 What in the world is atrophy? Why does cells in this love these locations die off slowly?

47:00 And sometimes it seems like it's a snowball effect. The symptoms are subtle in mild 1st and ends by the Year by the six-month seem to add up them rapidly. What is that infection is not inflammation is not this is not that the scientist in the laboratory need to do a lot of quick hurry up the investigation to find out what causes atrophy and I'm I'm mystified the weather for me. I guess what I'm getting at is you're also a man of faith and I'm just wondering where maybe your medical training stops in your face takes over are there instances of that?

47:43 They're they're wrapped together. I think faith has been part of my life from the beginning and I had two example of Faith was was demonstrated in Frederick Adams at the dean. He was a priest of the church has Parkinson was so severe. He could not utter a word he'd stand up in the pulpit and just his physical presence.

48:11 Whispering words that no one could hear was inspiring through them he exhibited in a face and a Nana bread of presence then I might even though he was worth it by this disease and he he he was a pastor at that point and I saw many diseases are over the years that the although they got sicker were sure people can exhibit strength and endurance and forbearance and tolerance and that's where the faith comes in that. I think if you have if you're not jamming your fists together thing, I want this stopped I want this gone that there is a positive rationalization or passive outcome in some way that you have to look for in the faith aspect. I think about you to see maybe a better and more and more common in my wife think she's more comfortable.

49:07 The faith of her of her of her course and her her life that despite the burden of disease is positive. She can still smile and she is good treatment and the church has been the church Members Exchange John's in Carlisle the members there have been very supportive and helped a lot they come visit and she has quiet joy joy when she stands in the place and says her prayers, but she's

49:36 What she's learned over the years that likes to sing actually team going to choir practice now with my boy and I've also noticed that do, you know last time we were at church with you guys that she she sang every song in country ham and no need for the book. I mean you talk about you no memory challenges are there was nothing Apparent at that moment when you see the the words crying out so that the faith is in full view when she is when she's in the in that setting and yet we've had this conversation in one form of there before work. I think Ruth asked you once. What comes next? Is there a is there a heaven is there an afterlife but you didn't write well, how does how does that jibe with the least medicine and we think that the heaven is on Earth Heaven is here in the right setting nurturing with a Shepherd like present with doing good for mankind you for your mouth?

50:36 Unconditionally had loving that's happened. So I think that as to afterlife after that's more than that the nother level discussion, but I think she's in a very Heavenly situation. Now she has strong faith. She has she has joy and she's not mad. I'm not mad with her certain aspects of the like atrophy would understand and accept we've had friends who've died of breast cancer in the end end of car accidents in things like this, my neighbor friends and not many but a number of important friends have died passed away.

51:17 So you don't have to be loved had worst diseases, but you probably would often scares you is what if something happens to you and this is all contingent on you being able to be there. Yes, we we we we have to be in our Vital ate a couple now and so we're both were in a retirement community access to care if I have a car accident, so I have to go somewhere we have peace of mind. The other positive thing that we have we can smile the fact that if we have access to care and level of a care institution life we need be that we can turn to tomorrow if need be

51:56 And if so, I know the source of Joy a peace of mind is Faith in Welby.

52:06 So I didn't answer in a certain personal sense that she's she's well and she's got

52:17 All things provide

52:24 Thanks for the profession. Thanks.