Happy Easter

Greetings from sunny and warm Florida, and Happy Easter! The celebration of Jesus' resurrection is the sentinel event in our Christian lives. The Easter promise gives us all comfort, strength and peace knowing we will be united with our loved ones when it's our turn to go home. Praise God for that amazing gift!

In the meantime, we are still receiving messages from friends and family that they've had dreams about Karl or have had strange things happen that immediately make them think of Karl. There are two ways to explain these things: coincidence or the real deal. Because of our faith in God and in Jesus' words and deeds (and because of the comfort it brings) we believe Karl is around, letting us all know he's enjoying the Easter promise and that we can be absolutely sure of it.

If Karl has visited you in a dream, or if you were thinking of him and something out of the ordinary happened that seems too coincidental, will you please share your experience? Everyone seems to love these stories; it's such a testament to the Easter promise. I want to compile some of them (I won't name you [unless you want me to]), and post them on this blog so that everyone can see that there's too many events occurring for them to be happenstance. I find it amazing that even now Karl continues to strengthen my faith! I hope he's having the same effect on you.

In January when he heard we had made plans to come to Florida, Karl said in his typical, guilt-trip, chiding fashion, "Oh sure...leave the cripple up north in the cold while you have a great time on vacation in the warm sun.  Don't worry about me. I'll be just fine."

As nice as it is here, I'm sure Karl is in a heckuva lot better place than us!

Enjoy your day and remember to rejoice in the promise of Easter!

Blessings

P.S. Email hamiltonsmith.family@gmail.com with your "Karl event" and let me know whether or not I can use your name. Thanks!

Only Karl

Most of you know that Karl Hamilton loved people and he loved to laugh. It didn't matter who you were, your background, age, sex – he just flat-out loved people. I think it was because whatever love he gave, it came back to him and then some. Take, for instance, the homeless guy who was in the bed next to Karl when he arrived at the trauma-burn unit at University Hospital Jan. 6. The curtain was always drawn between their beds, but a thin curtain didn't stop Karl from endless hours of chat when no visitors or medical personnel were present. Karl made such an impression that this guy came back twice to visit Karl. We found out later that Karl hid the guy's booze bottle under his bed while he went for a doctor’s visit and that later he and his buddy were kicked out of Karl’s room because they were having a party and were a little too noisy. Only Karl.

And then there were all the friends he made with the nurses and techs in the trauma-burn unit. One guy was going to take him to a Tigers' game when he got out. Another knew Karl from when he worked at the bike shop. Another nurse emailed photos of dogs she rescued and he forwarded the photos on to me and told me the amazing story of how she rescued them from a ditch and that they now belong to a famous Nashville song writer. One of the techs used to work for a company that harvested transplant organs. He told Karl all about it. One early morning as he came in to check Karl's vitals and Karl was sleeping, he awoke and told him not to get any ideas because he was still using his organs. Imagine the laughter that got! And then there was the nurse who spent hours with Karl; he counseled her during the weeks her sister was dying and then after her death. He was the listening ear she needed to get through. Only Karl.

On Feb. 13, Gloria Brooks and Marcia Bohannon planned
to visit. Rather than text them his room number, we decided 
to send them this photo instead.

After we found out the cancer had come back and his right arm/hand had lost nearly all function due to the tumor on his C-spine and that the surgery to remove the tumor was unsuccessful, his new nurse on the neuro floor was his newest victim. She had him for only four 12-hour shifts during what would be the last week of his life, yet he still played pranks and in that short time he had her wrapped in his love and laughter. She was there for some of his most excruciatingly painful times – both emotionally and physically – and yet she felt better for having met him. For example, she talked to him one day about going to a sub-acute rehab facility. His answer? He started singing the Amy Winehouse song: “They wanted me to go to rehab, but I said, a no, no, noooo.” Later she was flushing his IV while he was napping. His eyes opened, he feigned gasping breaths and then he turned to the side with his tongue hanging out, pretending he had expired. She let him have it…told him she’d kill him if he ever did that again, and then apologized to us because she was never that unprofessional. Of course we were laughing. No apologies needed. Only Karl.

God works in mysterious and miraculous ways. At the time of Karl’s seizure – one month ago today, in fact – and the day he found out he had run out of time, our dear friend Marcy was there. She had just gotten off her shift and came to visit. God’s timing was amazing and I’m so thankful He chose Marcy to be there when that happened. I'm so glad he wasn't alone. Before we arrived at the hospital, Karl had received the news. When we got there, Marcy was in the bed with him; they were holding each other, whispering “I love you” to one another, crying, laughing and just loving one another. Only Karl.

Karl’s surgeon, Dr. Orringer, who had the horrible task of telling us what was happening, met us in the hallway. Cousin Trese, who also works at the U, told us later that cases are usually delegated to other doctors who then report back to the head surgeon. But because of Trese's connection and because Karl was who he was, Dr. Orringer was there. Little could be done. So between Trese, Marcy, the chaplain, Mom and me, we had to figure out whether to keep Karl comfortable or to put a ventric in that would give him some time for goodbyes. Then it dawned on me; my husband Randy was in the room with Karl, comforting him and talking/laughing/crying. Randy is always so objective. He’d know what to do. And so as I entered, Randy said he knew what we were going to ask and that Karl was lucid and could make his own decisions. Karl chose to be able to say goodbye. How courageous. How selfless. Only Karl.

Brother Kirk had already scheduled a flight to come home and say goodbye, thanks to Wally and Wendy Burr, but when I asked who else Karl would like me to call, he told me a few names. I emailed others. Between Friday afternoon and Saturday night, more than 100 people – childhood, high school, college, work and hometown friends, a legion of nurses and techs from the trauma-burn unit, his neuro nurse of four days, and family – all came to say goodbye. There were so many people coming to see Karl, that the front desk at University Hospital where there’s a capacity of almost 1,000 patients, made maps to his room. Only Karl!

One of his visitors on his final full day, Jen, got this final

photo with Karl. Thanks for the great last photo, Jen.

Generally intensive care units at hospitals like peace and quiet so that patients can rest, but the people in the neuro ICU at U-M were very understanding and encouraged us to keep folks coming. Karl’s vitals were always better when people were with him. Lot’s of laughter filled Karl’s room…like when Karl’s high school buddy Butch told Karl he looked “like shit.” And then another high school chum Charley chimed in, “I've seen him look worse.” A nurse who admitted she was an Ohio State graduate (what was she thinking? She was at U-M!), was emptying his foley catheter. Another friend said, “that’s a high-skilled job at OSU, isn't it?” Karl doubled over with laughter. He thanked everyone for coming. His kissed hands and cheeks and lips. He cried. He grimaced with pain. He told some he’d be okay. He told others he didn't want to die. He told others he wasn't afraid. He told people to drive safely. He told others he’d prepare a place for them. He made people promise they’d do better. He told people to focus. He told kids he’d watch over them. He told EVERYONE he loved them. Only Karl.

And then around midnight, Karl announced to Kirk that he was going to die. About 2 a.m. his vitals started lowering dramatically. He was in a great deal of pain so they started an IV drip of morphine. Around 3 a.m., Randy, Michelle and I headed to the hospital. Nikki stayed with Mom and was later joined by Marcy and Carol Partridge. We were met at the hospital by our family: Trese, Steve, Steven, Joe and Emily Kampmueller, Katie and Jeremy Castorena, and later by friends Rodney and Terri Partridge. As the shifts changed around 7 a.m., the nurse who was leaving grabbed me by the shoulders and told me she had never seen such an amazing display of love. Only Karl.

Later that morning Dr. Orringer came specifically to tell us how sorry he was. He gave everyone hugs, told us he wished he could have done something – anything – to have helped Karl. Apparently this is not the norm for him, but some how, some way, Karl broke through that emotional barrier I’m sure all medical professionals have to build in order to survive.

Around 10:30, Karl’s breaths were shallower, fewer and farer between. We all gathered around his bed. We urged him to go. We all gave him permission. We all told him we loved him. We told him to grab Dad’s hand, to grab Jesus’ hand. When many seconds had passed between breaths I said, “I think our boy is gone.” Then he took another short breath, and I said, “Well, I guess he’s got one more lap.” We all laughed. And guess what? Karl took his last breath in the moment we were all joined together in laughter and love. Only Karl.

Blessings and love.

Mom and I were among seven women in an ecumenical Christian clown group called the Clown Connection. We’d pantomime skits that had fun, but meaningful Christian messages or they’d tell a Bible story. We’d always end our gigs with the prayer below. I think it’s a pretty appropriate prayer for Karl, too.

The Clown Prayer

As I stumble through this life,

Help me to create more laughter than tears,

Dispense more happiness than gloom

Spread more cheer than despair.

NEVER let me become so indifferent

That I will fail to see the wonder

In the eyes of a child

Or the twinkle in the eyes of the aged.

NEVER let me forget that my total effort

Is to cheer people, make them happy

And forget, at least momentarily,

All the unpleasantness in their lives.

AND, in my final moment,

May I hear you whisper…

“When you made my people smile,

You made me smile!”

The final climb

Many of you already know that Karl reached the summit on Sunday, Feb. 24, 2013 at 10:45 a.m. at University Hospital in Ann Arbor. But I know many of you want to know about Karl's final, turbulent climb. What really happened? This post will be a matter-of-fact one. I'll get into the unbelievable, amazing, beautiful stuff about Karl's last days (and post-death) in a subsequent post. Karl continued to amaze people until the very end. He was so courageous. His obituary can be found at http://www.handlerfuneralhomes.com/fh/obituaries/obituary.cfm?o_id=1988686&fh_id=14562

I'll try, to the best of my ability, to give you these events in chronological order. This is tough, but therapeutic

September 2012 -- After a great summer, that included swimming and taking a few steps, Karl starts to notice his legs aren't moving as well and are becoming more numb. He relies on the little bit of feeling and strength he has in them to transfer from chair to chair and in one case, to stand up and take three steps to and from a pontoon boat.

October 2012 -- Karl thinks perhaps the reason he is beginning to lose strength is because some of the hardware in his back is broken. A CT scan or MRI, not sure which, reveals that the hardware was still good, but no cancer appeared on the scans so Karl decides to buy a toy hauler, convert it into a wheelchair-accessible camper so he can go on the annual hunting trip -- which he had missed the four previous years -- with his buddies.

November/December 2012 -- Karl has lost all feeling and strength in his legs. His oncologist at U-M is concerned and contacts his surgeon at Mayo, Dr. Yaszemski. Dr. Y calls Karl on Christmas Eve and tells him to have a good holiday, but he'd like to get to the bottom of the issues and tells him he wants him to have an MRI, among other images. They will schedule it for after the new year.

Jan. 3, 2013 -- Karl starts off for Ann Arbor to get images. It is in the single digits temperature-wise. The door on his van won't close (it usually closes after going about 500 yards, but this time it doesn't). He comes back home and tries to start the other van. It won't work. By this time, he is freezing cold and comes inside. Mom starts to see the same symptoms Karl had when he had the pneumonia in 2010. She wants to get him as warm as possible as quickly as possible so she gets him in bed and puts a heating pad under his stocking feet because they are icy cold. She checks on his feet periodically and is satisfied that Karl is warming up and he begins to act normal again.

Jan. 5, 2013 -- Because Karl can't feel his feet and Mom's only thought was to get him warm, the heating pad was left on for hours. When Karl takes his socks off, well, let's just say it wasn't good. So Karl and Mom head up to Herrick Hospital. They think maybe it's frostbite because of how cold Karl's feet had gotten. The folks at Herrick decide it's a burn and tell him to go to U-M. We arrive at 10:30 p.m. After checking him out they decide they want to admit him because of the burns.

Jan. 6, 2013 -- At 4:30 a.m. Karl finally arrives at his room in the trauma burn unit.

January 2013 -- Throughout the month they take excellent care of Karl, debriding his burns, etc. In the meantime, he finally gets the MRI he was supposed to have on Jan. 3. It reveals a "mass" lower down near his spine along with one in the area he already had radiated. Dr. Scheutze tells Karl that if the mass in the area already radiated is cancer, there is little that can be done. However, the other mass further down can be zapped. That was a bitter pill to swallow. However, later on Dr. Scheutze talks with Dr. Yaszemski who thinks the mass of greatest concern is probably scar tissue and is likely the cause of the loss of function. Collective sigh of relief. In the meantime, a decubitous ulcer on his bum begins burrowing all the way to the metal in his back, AGAIN. We've dealt with that before. No big deal. We are told Karl will be released so Mom gets a Hoyer lift so he can get in and out of his bed/shower without irritating the decube.

Early February 2013 -- They continue to debride the burns on Karl's heals, which sometimes require them to take Karl to the operating room. At one point, doctors tell us that the wounds are so deep, the bone in his heal is nearly exposed and that if it doesn't get better, they would have to amputate. The way to grow healthy tissue is by eating massive amounts of protein. You can only imagine the copious amounts of meat, protein shakes, etc. Karl consumed. He didn't want to lose his feet. He can't go home because of the wound vacuum they put in each heel.

Feb. 10th (ish), 2013 -- After one of these debriding surgeries, in which they lay Karl face down to do the actual procedure, he begins complaining of severe neck pain. We thought it was a charlie horse. Then the pain spread to his right arm and his finger-tips and thumb start getting numb. Then he loses strength in his right arm. His blood pressure and heart-rate become erratic and he develops a low-grade fever. They transfer him to the trauma-burn ICU. They decide to do an MRI with dye on his neck. It reveals lots of small masses and a larger one, about 2 cm, on his C-spine, C-4 to be exact. They also tell us there are cancer cells everywhere; his brain "lit up." They figure it is metastatic cancer, but until they do a biopsy, they won't know for sure. We are all devastated. They think they can "peel" off the mass, which will not restore function, but it will stop it from getting worse. They tell us if it is metastatic cancer, he can have chemotherapy and radiation. New hope.

Feb. 13, 2013 -- Karl is scheduled for surgery, but they can't fit him in. They reschedule it for Friday, Feb. 15. First case.

Feb. 15, 2013 -- 8 a.m.: Karl is taken from pre-op to surgery. They tell us it will probably be two hours before they begin the operation, which should last about 6 hours, but will let us know how surgery progresses. At 10 a.m. we are told the surgery has begun. At 11:30 we are told they are doing a biopsy. At noon we receive another call saying they were closing. We are, again, devastated. We know what that means. About an hour later, Dr. Orringer, Karl's surgeon, tells us that the preliminary biopsy revealed it was malignant nerve sheath sarcoma and that the tumor they were trying to remove was intertwined with his vertebrae and spinal column. He tells us they removed some of it to give Karl some relief but would endanger his life if he removed any more. He tells us there is no cure. Karl is moved to neuro ICU and is his usual happy self. I tell him the outcome of his surgery and his reply? "Well, that sucks." A nurse approaches me and talks about palliative care. I know what this means, but choose not to mention it to Mom or Karl. None of the doctors approach me about it.

Feb. 18-20, 2013 -- Karl is transferred to the regular neuro floor. I approach his nurse about palliative care. She said there has been talk, but that nothing is definitive. Karl has numerous doctors come in and out of his room. One radiologist tell Karl nothing can be done. Devastation. An hour later, the head of the department tells Karl they can shrink the tumors and perhaps even make them disappear. Hope again. One morning a resident comes in to talk to Karl. He is alone. She tells him to get his affairs in order. He is devastated. I am ANGRY! Later as it turns out, I am complaining to a resident about the situation. I tell her a tactless, moronic resident with no bedside manner, and the compassion of a serial killer came it and told Karl, without a shred of empathy and without any family present for support, to get his affairs in order. After she left, Karl told me it was her! I wonder if she got the message. Then a discharge planner comes in and tells Mom that Karl is ready for discharge to a sub-acute unit. They want him to gain strength so he can handle the radiation. However, she says there are no beds available and asks Mom if she can handle him at home. We are baffled by this.

Feb. 21, 2013 -- I tell the discharge planner I don't think Karl is ready to come home nor is Mom able to take care of him in his present state. At 5 p.m. Dr. Scheutze comes into the room. He tells us they still don't have the final pathology report, but that it is, indeed, metastatic cancer. He said they are unable to do chemo. He thought a seed cell got into the spinal fluid and it "took off." He said he'd never seen anything like it. I ask how many tumors and he replies, "Many." I ask how long. He tells us it depends on whether it's slow-growing or fast-growing. He tells us if it's fast-growing, it may be a month or two. If it's slow-growing, which he thinks it is, it would depend upon how Karl responded to the radiation. Again, devastation. But it typical Karl fashion, he decides he wants to get strong enough to go back out to Mayo to see what Dr. Yaszemski has to say. We agreed.

Feb. 22, 2013 -- I get a call about 6:30 a.m. from my friend Marcy who works at the U. She had just gotten off her shift and was visiting him. As she was about to leave, Karl had severe head pain and then a "staring seizure." Doctors decide to take him to get a CT scan. It revealed there was fluid in his brain. En route to the hospital, doctors called to tell me there was a serious change of condition for Karl. Upon arrival, Dr. Orringer is there to greet us. He tells us (by that time, "us" was Mom, Randy, Marcy, cousin Trese [who also works there], the chaplain and me) that there was little that could be done for Karl. He has hydrocephalus caused by cancer cells clogging the ability for his brain to drain. Normally, they are able to put a shunt that drains into the body, but because Karl has an open wound, they can't do that; he'd get Meningitus which would cause excruciating, uncontrollable pain. The other two options are to make him comfortable and he'd pass within 24 to 48 hours or put a smaller drain in, which would give him 48 to 72 hours. Karl was very lucid and chose to be able to say goodbye.

After countless visitors on Feb. 22 and 23rd, he announced at about midnight on the 24th to my brother Kirk that he was going to die. At 10:45 a.m., surrounded by family and two of his best friends, Karl took his last breath. And we were all laughing when he did. Can you think of a better way for Karl to go to heaven?

My next post, when I get the strength and time, will be about all the amazing things that happened while Karl was in the hospital and after his death. What an amazing dude.

Blessings and love,

Kerry