Cleveland HO! Leaving

The day had warmed nicely, into the sixties, without a thundercloud in sight. I left the protection of wooded grounds and hit the streets, chilled by the light breeze. I wished for my running shoes for the four-mile walk back but my shorty-cowgirls were up to the task.

I noticed the plates of a parked car. Ohio’s bicentennial license plate proclaims: Birthplace of Aviation. Really? We’re a long way from Kitty Hawk Dorothy. As it turns out, Wilbur and Orville Wright were Buckeye’s. Not only born and raised, they designed and constructed their flying machine at their Dayton, OH bicycle shop. In 2003 Congress made it official, yes indeedy, by virtue of Wright’s birthplace, Ohio - not N. Carolina - IS the birthplace of aviation. The vote passed 378 to 3 with the Senators from – you guessed it – N. Carolina casting ‘Nay’ ballots.

I came across a rather new-ish out-door mall with European flair: cobbled streets, bright awnings, and ornate, wrought iron balustrades. Reminiscent of our newest mall, The Fountains in Roseville, it must represent the latest in mall-making fashions across the US. I wandered its storefronts and cobbled streets.

Ever notice that people who should not wear spandex in public – do? Enough said. More people: men, women, and children wear hats in Ohio, not baseball caps, rather cabby caps, Greek fisherman caps, porkpies, and fedoras. Perhaps I was observing a seasonal trend, that on the heels of winter, Clevelanders would not bare their heads until spring sprang.

Dress in California seems more flowing, airy, diaphanous, not necessarily loose but less constricting. Their clothing reminded me of… Nantucket. Nantucket? What is that? White collars, cuffs and cufflinks – I could stop right there; couldn’t I? But I’ll continue: striped cloth belts, khakis, geometric versus abstracts patterns, primary colors, high-heels, long and stylish overcoats. Young adults however, seemingly conform to a national dress code standardized by Abercrombie & Fitch.

The Legacy Village was organized around a central, grassy piazza and bandstand. Its marquee promised live music during summer. Part of its stubby, scrubby, brown lawn was cordoned off for reseeding. I was elated to see a CPK – California Pizza Kitchen – at one end of the piazza. I LOVE their salads though a single salad can be the caloric equivalent of two-full days. Grrr. At the opposite end of the piazza - the Brio Tuscan Grille.

I chose Brio and an eggplant-mushroom hors d'œuvre. Taking a corner table in the bar, opposite the entrance, I watched patrons come and go. The décor was ala Cheesecake Factory, walls colored in saffron, faux mortar and brick beneath crumbling lath and plaster, 20-foot ceilings with crown-molding and clerestory windows, all very faux Italiana – I liked it.

Not unlike the Cheesecake Factory, Brio’s portions are ridiculously large. My hors d'œuvre was served in a 12-inch boat of creamy, black-pepper sauce - spicy, delicious, if not a bit too salty – but you’ve heard that complaint repeatedly. I’ll save the diatribe.

There was a time in my life when I would forgo eating over dining in a restaurant alone. I’ve gotten over that but I must say, I do miss sharing food and breaking bread with others. It is perhaps this feeling of loss, so acute when publicly dining en solo, which has me wanting to avoid the situation entirely. Conversely, I am happy to eat what I want, when I want, and without a concern for the dietary preferences of another.

A very Morrie-looking man hobbled in on bilateral canes. His attendant, a young Polynesian woman, steadied him by his elbow. He was bent forward in back and knee, giving him the awkward gait of one inflicted by neuromuscular disease. Wispy, white hair stood straight up - for many inches - compensating for any loss in stature. An over-sized gray blazer, hinting of his former self, billowed loosely round his withering frame. Shape-ups? My mind did a back-flip and eyes a double-take. Is he wearing Shape-ups?

Skechers makes a line of sneakers promising weight-loss and gluteal tone to-die-for, and dog-gone if he wasn’t wearing a pair. You go-boyfriend! I suspected the rocking nature of their soles might aid in ‘push-off’ and thereby – ambulation. You know… like atrial-kick aids ventricular filling and blood pressure… just like that.

It was the early-dinner hour, that time when seniors are typically discounted. Morrie-like was seated immediately, he shuffled off, my study of him over before it began. While the bar filled for happy-hour, the elderly streamed into the dining room. People seemed shorter, dark-haired, olive-toned; I imagined them all Italian: little Italian men from the old country sporting thick-framed, Larry-King glasses under a cabby’s cap, their forearms coated in thick, black hair and belts deviating slightly south, who could say paesano with perfecto. And tiny – almost frail - Italian women with thin, gold-edged tri-focals and tailored pumps of maroquin, impeccably dressed for dining out. Notably absent were the willowy blonds of California and Stetsons.

People are not so obese here, I wrote. On the heels of The Longevity Project publication, one of the emerging observations was: thin people consort with thin people. No mention of casino buffets, the American diet, or super-sized portions; simply put: thin people consort with thin people. Hmmm – interesting.

My simple statement on a page, “People are not so obese here,” led my mind to The Longevity Project. Let me give you the backfill. The Longevity Project was published this year. It is the analysis of a study by the same name that followed 1500, San Franciscan, public school children continually since 1921 - from childhood to death. All remaining participants turn 100 this year.

Is longevity associated with being married, daily jogs, living with pets, or faith in God? “The Longevity Project uses one of the most famous studies in psychology to answer the question of who lives longest— and why. The answers will surprise you,” says Malcolm Gladwell.

The project examined other factors conferring not only longevity but also health and wellness. I examined my own group of friends. Do I consort with thin people? The answer is an unequivocal YES. And I admit, before completing the Wisdom Course, I had virtually no girlfriends who were not women athletes. All reasons point in a single direction: how I choose to spend my limited leisure time, nothing more.

I am intensely interested in wellness, my own and that of others. I am interested in healthcare models that not only manage disease but provide pathways to wellness. The Cleveland Clinic’s Wellness Program is one such model. The Longevity Project may provide guidance.

Outside, shadows lengthened and dissolved into dusk. I phoned my hotel and requested shuttle service. Their van was en route, for a deposit at the Apple Store, two doors up. “Look for a white, unmarked van. Our driver Jamal is wearing a hotel uniform.”

“Jamal?” I asked as I approached.

“Ms. Bacon?” We both smiled and I stepped into the van. Jamal made two additional stops, retrieving hotel guests along the way.

At the hotel, Jamal arranged for my 0430 pick-up for an 0600 flight due southwest connecting to long flight due northwest to Sacramento. I would be home by noon. I repeated the previous nights visits to gym, sauna, and hot tub before curling in bed with Morrie.

I returned to dog-eared page 126 and began reading. I turned into dog-eared page 127 where Morrie says, “Remember what I said about finding a meaningful life? Devote yourself to loving others, devote yourself to your community, devote yourself to something that gives you purpose and meaning. …Status will get you nowhere. Only an open heart will allow you to float equally between everyone.”

Most of you know I participate in on-going training and a body of teaching by Landmark Education. I would describe their teachings as philosophical in nature, an amalgam of great philosophical truths taught by all religions and practices coupled with communications, exercises and projects that internalize the lessons.

The entry course is called the Landmark Forum. Participation in their courses create a fundamental shift in one’s life from inward focus to outward focus, from me, to us, to all-of-us, to the open heart that Morrie describes. There are many bodies of work that espouse such theology and philosophy, however Landmark produces that result with reliability and velocity. Morrie woulda dug the Landmark Forum.

Dog-eared page 135: I believe in being fully present. That means you should be with the person you’re with. When I’m talking to you now, I try to keep focused only on what is going on between us. I am not thinking about something we said last week. I am not thinking of what’s coming up this Friday…”

Do you know there are exercises that teach presence? To really BE with the people you are with? Do you know that upset does not exist in the present? What if you could move with velocity through upset, anger, and suffering? Would that make room for more love? What would life be like with more present and presence in your present?

The hour was late as I flipped the final pages of Tuesdays with Morrie and dog-eared page 149 where he expounds on marriage. Happily, respectfully, and contentedly married for forty-four years gives Morrie license to pontificate, in my viewpoint.

There are a few rules I know to be true about love and marriage: If you don’t respect the other person, you’re gonna have a lot of trouble. If you don’t know how to compromise, you’re gonna have a lot of trouble. If you can’t talk openly about what goes on between you, you’re gonna have a lot of trouble. And if you don’t have a common set of values in life, you’re gonna have a lot of trouble. Your values must be alike. And the biggest one of those values… your belief in the importance of your marriage.

Morrie died on November 4, 1995. His respirations ceased just after his family slipped into the kitchen for a fresh pot of coffee. Ted Koppel recorded a final tribute that you can watch on youtube along with his Nightline exposés.

I wiped my tears, closed the book, and turned off the bedside lamp.

Four hours later I was airport bound. Let me just say that a window seat twelve inches from the turbine housing should not be billed as a window seat. The engine block consumes any view, the vibration loosens dental work, the sound deafens.

I sat with a young woman in jeans and a mohawk armed with a Kindle, a Shuffle, and earbuds. A chef of three-years, Amy was headed for the kitchen in Kings Canyon National Park. She planned to be there for dinner and the next several years. She was excited to see, in full-living-color, that which she had only seen in pictures. Amy described herself as a city-girl excited about the great outdoors.

We (of course) talked trails, and backpacking, and solo female trips, and on, and on, and on. She owned no backpacking gear and I assured her the REI in Fresno would not steer her wrong. At the end of the season, I encouraged her to get into Yosemite before snow made the roads impassable. She assured me she would. I loved her enthusiasm and tinkered with a trip to King’s Canyon to say, “Hey.”

During my second leg I was sandwiched between two large men, one whom overflowed the boundaries of his seat. A more than large woman ahead on the left, consumed 1.5 seats. Flight attendants relocated the person relegated to the 0.5 seat next to her. On a nearly full flight with few open seats, that was a task.

A little boy flying to California for the first time occupied the window seat and view of the engine housing. His grandparents begged to be re-seated, so he could see the earth passing beneath us. Flight attendants pulled another rabbit from their hat when a lady willingly relinquished her window seat.

Do you know that when the girth is sufficiently round, it moves one forward in the seat. And if one is sufficiently tall,  knees push into the seat ahead. After that, the only place for them to spread is out. I sat thigh-to-thigh with a very large man for several hours. Do you know how much I like thigh-to-thigh for several hours with a stranger? Not so much.

 I have more recently begun a regular practice of yoga in a studio. I don’t like strangers touching my mat or me. I am learning to deal with that. Sometimes the studio is crowded. I have learned that my practice is about my mat and me, nothing more.

My yoga practice was helpful in sitting thigh-to-thigh with this unknown man. I did not appreciate it but he did deplane without Monkey bites. (Y’all haven’t heard of Monkey for many, many moons. That is because I am involved in practices to tame Monkey – yoga is one. For those who are completely clueless, that which Freud called the id and Landmark calls the it, China calls the Monkey – that part of us more interested in survival and protection than love and connection.)  

Home again, home again, jiggety-jig. I returned home with fuel added to my fire. Renewed in my efforts to create a pathway to wellness for cardiac and diabetes patients interested in disease reversal. It’s not for everyone though clearly, it IS for some. I had put this project on hold until I could experience the program at Cleveland Clinic. I journeyed there for myself. There is no tax deduction, no continuing education credits, no Kaiser reimbursement. I went out of a commitment to health and wellness. I have been to Mecca, it is time to put structure to this idea and sell it to my director and chief. I’ll keep you posted.

I’ll close this with thoughts: first from Morrie.

Keep an open heart and open it up further and further and further until you encompass as much as you can with your love. Sounds kind of soppy but it’s not; it’s not.

Be compassionate to yourself and others.

Be involved.

Second from the Navajo nation: We are the ones we’ve been waiting for.

Third from Hillel the Elder – Jewish sage and scholar: If not me – who? If not now – when?

Lastly me: Be well and dare I say – thrive!

Cleveland, OH-Ho! Day 2: Living Well & Thriving @ the Cleveland Clinic Wellness Center

 I arose at 0600 EST (0300 PST) and brewed coffee, fully nuked – caffeine is my friend. The excitement of spending time at the Cleveland Clinic Wellness Center all but mitigated my fatigue. Icy showers with temperatures in the forties were forecast. I dressed in layered business-casual in my belief the east is more formally attired and my consistent experience of freezing in climate-controlled buildings.

As an aside, when I first arrived at my new digs in Kaiser-Fair Oaks, my office was frigid while the rest of the building wanted for cooling. I telephoned engineers to inform them of the problem. I phoned again when no engineer seemed forthcoming. Finally I left this message, “The forecast in my office is for snow. There are icicles on my computer. Please help.” They did not find my message as amusing as I thought it was or they might. Given that we summon engineers only to fix the broken, I thought they might enjoy some humor. Not for the first time, I thought wrong. Nonetheless I DID get a response!

When they were unable to stop the arctic blast down my back and through my bones, I took matters into my own hands. Hmm… I recently relocated to Kaiser- Folsom (Sierra view, two miles from home, saves 90-minutes/day and $240/month in gasoline). I should perhaps telephone the new occupant of my old office and have him remove the heavy visqueen taped inside of the vent cover. :-D But I digress – as I am wont to do.

I stepped into the hall and eased my door shut. The doors of the Hilton are weighted such that, left to their own devices… I’d listened to numerous doors slam shut during the night.

The robust aroma of coffee wafted down the hall, tumbling through the Concierge Club’s door each time someone entered or departed. At 0730, breakfast was in full swing. Cleveland talking-heads delivered morning news on their large, flat-screen, HDTV. People sat in onesies or twosies holding quiet conversations, reading or watching the news.

Continental breakfast offerings were extensive: oatmeal, hardboiled eggs, pastries, bagels, toast, yogurt, freshly sliced fruit, cereals, juice, milk, tea, and coffee. I glanced at the USA Today while eating yogurt and fruit. I packed an apple for mid-morning, a bottle of water, and headed to the lobby for my shuttle.

Google Maps located Cleveland Clinic’s Wellness Center a straight shot and four miles north. We drove past brick colonials and wooden split-levels. The lots were large, the homes surrounded by spacious lawns and unfenced yards that flowed one into the other, in utter contrast to the fenced, postage-stamps of California.

No stucco and tile, the architectural theme was one of front gables and columns with decorative capitals, porticos and colonnades, corniced eaves and wide friezes, architectural features popularized during the Greek Revival and Italianate periods of colonial America.

My driver Martin said these were expensive neighborhoods but that a friend had recently purchased a three-bedroom, two-bath home for $115,000. He hoped to do the very same, very soon.

We passed entire city blocks of uncut forest, thickly wooded lands, their understory tangled with bramble and briar and no doubt, innumerous creatures therein.

Mid-block we turned left, west off the main thoroughfare. There was no signal, no fanfare, just a sign, an understated combination of stone and wood: The Cleveland Clinic Wellness Center. A long and winding road rambled over hill then through wooded dell, and the world of roads and malls and hotels and business became obscured and remote.

Wild geese paddled in a pond ringed by wooden benches. I imagined them pleasant perches in the verdant springtime sylvan. Under a gray sky, the sprawling lawns and scattered benches brought immediate peace and calm, reminiscent of the proverbial sanitarium, where peace and calm were thought to be requisite for wellness. Sanity – a clean and uncluttered mind. Maybe they were on to something.

The van labored up a steep hill that when crested, revealed a modern structure of glass, girders, and wood painted to blend with the forest. We circled the gravel drive that popped and crunched beneath the weight of the vehicle. I was let out in the roundabout, 45-minutes early.

The lobby was spectacular, like a Hyatt, with a soaring glass ceiling that fell at an acute angle from the third floor. The flagstone pond at my right funneled to an abrupt edge, sending water freefalling three stories below grade, to land yet again, in another flagstone pool. Flowing, falling water filled the lobby with music. Potted trees, and shrubs, and ferns encircled chairs arranged in conversational clusters.

I stopped at the security desk just inside the front door. They pointed across the sunlit lobby to a woman sitting alone at a four-top.

“Jackie is over there. She’ll check you in.”

I veered left, rounding the central stairwell as the ceiling plunged to touch down in the cafeteria’s dining area. Southern exposed, it was awash in early light. Gigantic, tubular, metallic mobiles hung overhead. I wondered if they would awaken, enliven, and animate as air warmed in the apex above.

A stone rimmed pond nestled against the building. Ducks floated on its glassy surface colored silver by the new day.

Jackie sat at the edge of this scenic, utilitarian space just beyond the sun’s reach. Her table was strewn with stacks of binders and folders and nametags. Jackie is Dr. Esselstyn’s secretary.

I exchanged numerous emails with Jackie prior to my arrival in Cleveland and it was nice to put a face to the gracious woman who responded to my requests.
 I'm glad you could come," she said, handing my materials over. "We are down the hall." She extended her left arm, gesturing toward the hall, its external wall of glass circumnavigating the duckpond. "The bathrooms are on the right. Dr. Esselstyn and Ann are already down there.”

I entered the room.

“Well hello young lady.” Dr. Esselstyn smiled, reaching to hug, pulling me into his crisp, starched, white, lab coat. “This is my wife Ann.”

“Wonderful to finally meet you,” I said, reaching for her hand and covering it with my own.

Dr. Esselstyn is an engaging, commanding figure, standing a full six-foot-two with a thick thatch of white hair. He is long, and lean, and authoritative - though warmly so.

I first met Dr. Esselstyn via videoconference from Kaiser Permanente (KP) -Santa Rosa, approximately eighteen months ago. He spoke of heart disease as a “reversible, food-borne illness and a toothless paper-tiger that never need happen.”

At that time, five of my patients had engaged their diabetes and diets such that, we had weaned them from insulin. I knew he spoke truth, evidenced-based truth. I spoke to patients about driving their disease into remission. Dr. Esselstyn spoke of driving disease into submission. That he had come all the way from Cleveland to stand in Dean Ornish country and espouse a plant-based diet was entertaining to me.

Let me give you the back-fill. Back in the early 90’s men like Esselstyn (Cleveland Clinic) and Ornish (Santa Rosa) began studying their patients with the hypothesis that heart disease was a lifestyle disease and thereby reversible. They were quickly labeled “quacks” until their research bore out their hypothesis. Men like Esselstyn and Ornish forever changed our paradigm of heart disease. It wasn’t long before that hypothesis - that many of our diseases (in fact, the top five killers) are brought on by lifestyle - was applied to other disease states. The ones of Essy’s focus include heart disease, it's cousin type-2 diabetes, and erectile dysfunction.

I conversed with Essy last fall at Kaiser’s annual COAST (Cardiovascular and Surgery) Conference. For a full accounting with backfill visit my blog at: http://lorinzmuze.blogspot.com/2010/09/falls-reflections.html

That conversation culminated in an invitation to Cleveland Clinic, to the induction day of his program.  Here’s how it works. Every patient that enters Cleveland Clinic for a heart problem: intervention (angioplasty, stents), surgery (valve repair/ replacement, coronary artery bypass grafting), acute myocardial infarction (heart attack), etc. is offered a complimentary, one-hour consultation with a representative of the Wellness Program. During that consultation they are introduced to the benefits of a plant-based diet and the program of support. For patients who choose participation, Essy holds a monthly workshop to deliver the “why”, while Ann delivers the “how”. It was for this induction day that I journeyed to Cleveland.

Ann is petite, with bright blue eyes, porcelain skin, straight, light hair, and blond brows, all the features - sans height, of them I’ve label “blond and blue from up there.”

“You mean northern Europeans?” My cardiology buddy teased, smiling through ruby lips and rosy cheeks against porcelain skin, his blue eyes laughing beneath light hair.

“Yea, like you,” I pointed, “Blond and blue from up there.” More specifically, blond and blue from up there refers to Scandinavians. Ann fit my picture of an elder Scandinavian beauty. She was trim and spry and full of vigor.

After greeting me Anne announced to the sparsely filled room, “This is Lorin, she came all the way from Sacramento.” I made the rounds, greeting participants. As each couple arrived, they did the same. Participants had come from as nearby as Chicago and as far away as Florida and Arizona. All in all there were nine patients, nine spouses, three health-care providers, and Essy’s team.

The patient demographics of this group included seven men and two women. The women exceeded 60 years of age; the men were under 55, some under 45. All the patients were lean, their spouses - not necessarily so. Every patient had experienced a catastrophic cardiac event that provoked seeking.

I visited with Joe and Nancy from West Palm Beach, Florida. He was long and lean with a cleanly shaven head and olive skin. Joe cycled 200-miles each week. Nancy and I were similar in size.

“Why are you here?” they asked. I told them of my work at Kaiser, of my patients who had weaned themselves from many of their medicines. I told them of my kidney failure and my improved tests and function after switching to a 99% vegetarian diet.

They told me their story. Joe’s bicuspid aortic valve failed – as they are wont to do. Bicuspid aortic valve disease affects only 2% of the population and is more prevalent in males than females. Present at birth, it is thought to be the symptom of an underlying connective tissue disease.

Normally, the aortic valve has three small flaps or leaflets that open and close securely to regulate blood flow, allowing blood to flow from the heart into the aorta and preventing backwash into the heart. (Remember forward-flow from Day-1 Getting There?)

Joe’s aortic valve had only two leaflets and was replaced last year. During the pre-surgical assessment he was found to have mild triple-vessel disease resulting in triple coronary artery bypass grafts. We call it the incidental bypass, not severe enough to crack a chest but since we’re there, chest already cracked… incidental bypass.

Post-operatively Joe and Nancy were perusing Borders bookstore, scanning the shelves, looking for answers.

“Essy’s book literally fell onto the floor in front of us. We picked it up to put it back, looked at the title and thought, maybe we should read this.” In retrospect, they felt the hand of God directed his book in falling to the floor. They contacted Essy through his website and within 24-hours he was on the phone hearing their tale.

Essy’s book, Prevent and Reverse Heart Disease is filled with recipes and reason. Joe and Nancy adopted the program and lost weight: 37 pounds for he, 32 pounds for she. They are lean and feel great – more energy, more stamina, more gusto, more vitality, more aliveness. It’s a good thing you know, being alive while you live.

We were assigned seats; I sat at the back table with Moira, a registered dietician and her mother Debra, a charge nurse for KP-Orthopedics.

Essy shrugged off his white coat, “Let me get out of this costume so we can begin.” He dove into a four-hour power-point presentation including the who: societies with a prevalence of heart disease and diabetes and those without.

The what:  the pathophysiology of endothelial (inner-most layer of blood vessels) disruption, cholesterol crystals, plaque formation, plaque rupture, cardiac ischemia (asphyxiation), pathogenicity (creating sorrow/tragedy) of the western diet, retrospective data/studies (i.e. decreased incidence of heart disease in Norway during WWII when all meat was consumed by the German army and Norwegian citizens were forced into plant-based diets and the subsequent rise of disease once dietary meat was reintroduced.)

The how: mechanisms that promote endothelial healing and disease reversal.

About halfway through, Moira, our in-situ registered dietician raised her hand. “What if you are vegetarian four-days a week and the other three…” her voice trailed off, her point made and question asked.

“Are you going to be a problem?” Essy asked with a wink and a smile. “Moderation kills,” he said. “Animal proteins ignite a state of inflammation in your body and in your endothelium. You restrict animal proteins and inflammation starts to subside, your body starts to heal. After a few days you re-introduce animal proteins and re-ignite the fire.” A picture of firemen pouring gasoline on a house-fire filled the screen at the front of the room.


He confirmed that which I have observed with my own patients: exercise is preferred but not requisite. Even the sedentary can extinguish their smoldering endothelium.

Then he said something that almost got past me. He mentioned autoimmune diseases and improved symptomatology with the introduction of a plant-based diet. He moved on and my brain hiccupped. Did he just say what I think he said? My hand shot into the air.

“Lorin?”

“Dr. Essy let me ask you to backtrack. You said something about plant-based diets and autoimmune diseases. I’ve heard you speak twice, this is the third time, and I have never heard you say anything like that. Can you say more?”

“Yes. Autoimmune diseases are those in which the body attacks itself. Remember macrophages and lymphocytes, the soldiers of the bloodstream? These soldier-cells misidentify a body protein as,” he raised his hands and pulsed pointer and middle fingers of each in quotation marks, “The enemy and attack. It likely started with eating an animal protein. There is a theory about gut-leak, whereby an unusually large protein molecule leaks from the digestive tract into the bloodstream. Macrophages and lymphocytes identify it as harmful and destroy it. Later, they encounter a similar but normal and useful body protein and attack.”

“In the case of rheumatoid arthritis, that body protein is the synovial fluid of the joints. There was a small but significant study involving patients with MS, multiple sclerosis, who experienced significant reversal of their symptoms once they began a plant-based diet.”

I drew a star in the margin of his syllabus, for future conversations with a few good men. Pictures of stars, keys, and the first letter of names are my recurrent marginalia. I constantly and consistently annotate for future conversations. This held more urgency for me than most.

“In the beginning,” Essy asserted, “They said a plant-based diet wouldn’t work. But there is good, hard science behind it now, this is evidenced-based medicine. Now they say, patients won’t do it. We haven’t found that to be true. There are many patients interested in disease reversal.”

We broke for lunch. I stood in line with a pasty and pockmarked, obese and elderly man in coveralls and flannel.

“My wife had a heart attack,” he said, “They put in some stents. But I don’t have any heart disease in my family,” he justified, “So I think I’m okay.”

Really? I wondered if his heart-healthy predecessors had sported an extra fifty pounds. “Based on the lecture this morning, I’d say if we are eating typical American fare, we are all in trouble.”

“Well, that might be true,” he acquiesced.

Denial is a powerful, albeit temporary, survival tool.

Our plant-based luncheon buffet was a delicious combination of: kale/humus/cilantro wraps, carrot/ginger soup, lentil chili, water chestnut/onion/cilantro/tofu pot-stickers, and decaf ice tea.

During the afternoon Ann taught shopping and food preparation: how to de-spine and use kale, reliable brands at Whole Foods, eating and travel, reading food labels, useful websites. I found her presentation extremely helpful because while many of us can agree with “the why”, “the how” stops us. There is little convenience in a plant-based diet.

Their son Rip is the national spokesman for Whole Foods. Ann held a copy of his book high for all to see, The Engine 2 Diet: The Texas Firefighter's 28-Day Save-Your-Life Plan that Lowers Cholesterol and Burns Away the Pounds. On the cover, Rip squatted in fireman fatigues. He was svelte and sported the familial thick thatch of white hair. Ann beamed, “He’s an awesome man; we’re proud of our son.”

“Let me wrap it up by saying this,” Essy said, “I’m 76 years old. I have no disease. I’m on no medication. I’ve been eating this way for 27 years. I hope to keep on going until one day I get pneumonia and die. But I don’t expect I’ll suffer with chronic disease. My wife and son are similarly healthy. As I said, much of chronic disease is a toothless paper-tiger that need not happen.”

A lengthy question and answer period ensued. We discussed heredity and children – some had very young children.

“Genes load the gun,” Essy said, “Lifestyle pulls the trigger.”
Lifestyle pulls the trigger...

Class ended all too soon. Our induction-day was over. Patients made arrangements for routine follow-up via email and forwarding lab results to Essy. He and Ann would be available via phone and email to offer dietary support and advice.

He signed books. People requested photos.

“Let me put my costume on.” Essy lifted his white coat and shrugged it into place. I waited until the paying public had their fill.

“Well young lady,” he turned his luminous smile on me, enveloping me in warmth and tenderness, “Was it worth the trip?”

“Absolutely! Thank you for the invitation.” I hugged them both.

“I will be speaking at the University of California Davis on June 22nd,” He said. “Let me check with my hosts but I’d like you to bring as many Kaiser people as you want.”

My mind whirred with the possibility.

I returned to the grotto in the lobby to reflect and plan my afternoon. The Rock and Roll Hall of Fame is in Cleveland and the late afternoon and evening were available for exploration. I sat in the sunlit cafeteria jotting notes into my tablet. I stared through the glass; the pond glimmered with afternoon sun, inviting me outdoors. I had to be honest with myself; I have little appetite for exploring a strange city alone.

I am a denizen of the suburbs, uneasy in cities, and more so in unfamiliar cities. In them I feel small and vulnerable and anxious. I would rather be alone in the wilderness with wild mountain goats than alone in a city. I would not venture into Cleveland city proper to seek out the Hall of Fame.

I stepped outside (my Heaven) and balancing stone to stone, circled the pond. I ducked beneath a branch where a single, curled, dried, brown leaf clung like a chrysalis, trembling in the light, warm breeze. At the tip of every twig, a tightly bound bundle of green was ready to explode.

While the rest of Cleveland wrestled with winter’s grip, the Eden-esque lands round the Wellness Center were well-groomed, well-nourished, and well-on-their-way to spring. Tall stands of stately trees, long and gracefully bent were bursting to bud. The grounds had the faintest patina, the promise of resurrection and life anew.

I shouldered my backpack and began walking.

You can visit Essy’s website at: http://www.heartattackproof.com/

See Essy on utube with Wolf Blitzer, President Clinton, and Dr. Dean Ornish in the Situation Room at: http://www.youtube.com/watch?v=s2yaaypVmaI

Cleveland, OH – HO!

Day 1: Getting There

There is no easy way to get from here to there, my note said, from Sac to Cleveland. I searched departures from both SMF and SFO. With a flock of Southwest’s birds grounded, the itinerary with fewest touch and goes, minimal transit hours, one-stop only, included Dallas - Fort Worth (DFW). Dallas - Fort Worth? Really? The most expedient route to Cleveland is a long flight southeast to board a long flight northeast? Cleveland is obviously not a popular destination for Californians and even less so for this one.

At 0522 I queued to remove shoes and unload my laptop. CLACK! Clackitty, clatter, clatter, CLACK! Gray square bins clattered onto stainless counters and rolled under the X-ray machine. TSA personnel barked at sleepy passengers. “Remove your shoes and jackets. Have your boarding pass available.”

This was a smallish plane, only five seats across. Gate attendants asked passengers to squeeze suspiciously plump bags into “the sizer,” that measured bin at the jet-way entrance. Good-eyes, those gate attendants. They confiscated corpulent carry-ons, to the chagrin of their owners. The flight was full, overhead bins filled quickly, forcing final boarders into surrendering their luggage for check-in.

The intercom crackled, “Flight attendants, begin cross-check for take-off,” a nasal male voice urged. Have you ever had a female pilot? Talk about a glass ceiling! I glanced at my watch, much to my amazement, the airplane door closed only one-minute late. American actually has a fairly good on-time record (77%) as compared to Southwest (65%). No Hawaiian-time for Hawaiian Air whose on-time record is a whopping 86%! And how ‘bout those Rainbows? Er… sorry, I digress.

American Airlines is a no frills operation. They serve complimentary juices and sodas, coffee and tea. No blankets, no pillows, no music, no movies, no peanuts, no pretzels, no cookies, and those Gawd-awful meals? They may be purchased. It’s just as well; ALL airplane food is crap anyway! It gives me license to bring my own; I’d brought three pieces of fruit and a California Roll.

I sat with a tall, affable, and talkative chap from Napa Valley. You know how much I like talkative at 0545? Not so much. Eb works in the cellular business and would fly to Dallas for a single day of meetings. He was a likable fellow though, quick to laughter and smiles. He kept chickens for their orange, scrumptious yolks, and dogs, and cats, and a horse. Or rather, his wife did; Eb was on the road a lot.

He laid cable during winter in Haines, Alaska some years ago, to fulfill on a promise for DSL service to that remote village by Christmas.

He drifted to sleep after downing his complimentary cup of CranApple juice. I opened my book, a dog-eared copy of Tuesdays with Morrie, a book I’ve been meaning to read for some time. This was apparently that time.

Morrie was a college professor with ALS - amyotrophic lateral sclerosis - or Lou Gehrig’s disease. Morrie externalized his internal dialogue on disability and dying quite publicly, through a series of interviews with Ted Koppel on Nightline. He was an energetic, optimistic man who came into the national spotlight for aphorisms like: Accept the past as past, without denying it or discarding it, and Accept what you are able to do and what you are not able to do.

I pictured a disheveled, Woody Allen-ish character who loved life and the people in it… and told them so. In a series of taped conversations with his former student Mitch, Tuesdays with Morrie was penned.

I found Tuesdays with Morrie in a used bookstore. It is a different experience reading a dog-eared book. First, I have my own experience with the words on the page: how they feel, what they evoke, where they take me, and how I land; and then - there is pearl-diving - looking for the phrase or paragraph that drove the previous page-turner to dog-ear.

“My heaven will be a used bookstore,” I’ve declared for many years, “With a coffee shop that serves robust, Sumatran beans. A deep, wrap-around porch shades rocking chairs that overlook a long, white beach ringing an azure bay. Dolphins and honu (Hawaiian green sea turtles) populate the bay. I live in a bikini, sarong, and floppy-brimmed lauhala hat.” On earth as it is in Heaven.

“Beer!” My companion said with mucho gusto, “There has to be beer. And Mexican food!”

I’d love this man visiting my heaven. “Muy bien!” I responded with equal enthusiasm after realizing no dietary restrictions exist in my heaven. “Cerveza and fresh Mex; I’m good with that.” Ole’!

The first time I am aware another addressed my heaven outside my own cranium, was Alice Sebold in Lovely Bones. She expands upon the concept and I love the idea of visiting others when our vision and versions of heaven coincide. On earth as it is in Heaven. It is a worthy read and stellar first novel. I added honu to my heaven post-Lovely Bones.

My heaven has not taken the techno-turn. There are no ebooks in my heaven. I love sewn spines, and leather bound, and roughly hewn pages, and textured paper that yellows with age, and the scent that wafts when I flip pages. Kindle can’t touch that – yet.

Used bookstores are comforting, familiar, and frequented by denizens of the written word. Such stores are typically chockablock with teetering towers of paperbacks and out-of-print texts. They smell of musty paper; their owners are bookish omnivores of print. Used bookstores are the depository for those that were loved, read, shared, and dog-eared.

It was during a foray into my favorite used bookstore, the BookWorm, at the corner of Madison and Kenneth in Fair Oaks, that I acquired Tuesdays with Morrie. But I digress.

The first dog-ear marks page 43, where Morrie says, “So many people walk around with a meaningless life. They seem half-asleep… This is because they’re chasing the wrong things. The way you get meaning into your life is to devote yourself to loving others, devote yourself to your community around you, and devote yourself to creating something that gives you purpose and meaning.”

I glanced out the airplane window. Talk about scorched earth! The land below was a reddish-brown wasteland, devoid of trees and water, though certainly not of scorpion or serpent. The wasteland buckled and rose into mountains and harsh, shadowed valleys, and seemingly parched riverbeds and tributaries. And suddenly a deeply carved river twisted and turned, teal colored torrents against red rock canyons. We must be near Lake Powell, I thought.

“For those of you on the left side of the plane,” (that’d be me) the cockpit crew broke into my thoughts as if on cue, “We are passing over Escalante National Monument.” I’ve been meaning to visit Escalante and it creeps higher on my list. A rock formation known as teacups, cascading pools that spill one into the other, came into view. And then the mountain town of Santa Fe, where only if you paint or water it, will it be colorful.

Second dog-ear, page 52: “The most important thing in life is to learn how to give out love and to let it come in. Let it come in. We think we don’t deserve love, we think if we let it in we’ll become too soft. But a wise man named Levine said it right. He said, ‘Love is the only rational act.’”

I love that! Love is the only rational act.

Pressing southeast, beige dirt, seemingly untouched by the hand of man, gave way to a flat patchwork of squares. Each square contained a crop-circle partitioned like pie-pieces, wedges in stages of till, cultivation or fallow. Fully sown and sprouted, they were giant, green polka-dots. Crayola calls it spring-green, that soft, yellow-green of new shoots all the more pale against the maroon or eggplant soil of north Texas.

Small ochre mountain ranges cropped up, texturing both northern and southern edges of said fertile farming flatland, like crust on bread. We flew onward. The mountains acquired the patina of vegetation, rivulets of greenery followed water, flowing downhill in all directions.

Earth is etched by water flow, by great receding glaciers and the undulating sea, by rivers and streams, creeks and rivulets; like arteries and arterioles and veins and veinules, reaching out to every patch of land and inch of dirt.

An occasional truck or two parked at the edge of a crop-circle-containing-square. Sun reflecting off their windshields flashed as we soared by.

“Folks, that’s the Red River below us.” It churned with mud - not red river - very, very brown river.

Just remember the Red River Valley, (played in my head) And the one that has loved you so true. This song is a cowboy standard and my Dad, though nary a cowpoke, used to sing this ditty. Where IS the Red River Valley?

I found no pearl on dog-eared page 65.

On the ground in DFW, I set-up camp at Starbucks, known for its at&t wifi access. I bought a skinny, vanilla latte and settled in for my two-hour layover. A T-Mobile website popped up and offered visitors a roaming log-in. I tried, and tried, and tried, and finally called at&t. I reached out and touched Juan, with his distinctly Spanish accent.

“I’m surry ma’am, ju do not have access through a T-Mobile hot spot.”

“But there’s a roaming feature for at&t customers,” I explained.

“Ju hob to find an at&t hotspot,” Juan repeated himself using different words.

“Okay, does at&t have a hotspot in the Dallas-Fort Worth airport?”

“No ma’am, es all T-Mobile.”

“Didn’t you just buy T-Mobile?”

Juan laughed, “Jes ma’am, but it doesn’t work for us yet. I’m surry ma’am. Es there anything else I con help ju with?”

“Yes, please tell at&t to step on it.”

“Jes ma’am,” he giggled. “Thonk ju for choosing at&t.”

DFW is very techno-friendly with many places to plug-in and juice-up. No worries, without wi-fi I’d start writing my trip journal and walk the terminals. I jumped the monorail to my next terminal and gate, which looked identical to the last.

The eateries in DFW are generic junk: McDonalds, Pizza Hut, TGI Fridays, Dunkin Donuts. Do Pizza Hut and TGI Fridays even exist anymore in the lands beyond airport beltways? I opened my small bento box of California Roll; so happy I’d thought to pack lunch.

On dog-eared page 91 Morrie said, “The fact is, there is no foundation, no secure ground upon which people may stand today, if is isn’t the family. It’s become quite clear to me... If you don’t have the support and love and caring and concern that you get from a family, you don’t have much at all. Love is so supremely important. As our great poet Auden said, ‘Love each other or perish.’”

The waiting areas of the DFW are too small to accommodate the volume of today’s big jets. Passengers aggregate in the hallways, congeal in the concourse, and block forward flow (a cardiac term - think blood flow through the heart) through its thoroughfares. Walking briskly for exercise was difficult under such circumstances.

Samsung provides several, very comfortable lounges at DFW, complete with alcoholic beverages, hot-wired couches, soft-cushy-sink-into-chairs, and a computer bar.

Dog-eared pages 104 & 105: If you hold back on the emotions – if you don’t allow yourself to go all the way through them – you can never get to being detached, you’re too busy being afraid. You’re afraid of the pain, you’re afraid of the grief. You’re afraid of the vulnerability that loving entails.

When you learn how to die, you learn how to live.

I queued for my second flight behind a young Mom with two little ones. You know, diaper bag, stroller, car seat, all that? American Air boards uniformed service men first – nice. However, they no longer offer pre-boarding for people traveling with young children. That’s a mistake methinks. Moms traveling with young’uns need all the help they can get and every convenience we can extend.

My flight into CLE (Cleveland Hopkins Airport) was uneventful except that it was filled with Rush faithful. Rush, a 70's band, was scheduled to perform in Cleveland the following evening and the faithful were flying. The couple across the aisle lived in New Mexico. I sat with two men who shared a laptop and earbuds. Each listened through one earbud and one played "air drums", with Rush, bouncing in his chair all the way to Cleveland.

His companion nudged me smiling, "he plays better air drums than real drums."

Fifty-something faithful fans... it was a little like hanging out with Deadheads.

Apparent even from the air, Cleveland remained gripped in the aftermath of winter. The snow had melted but grasses were burnt brown, frost-bitten seemingly to the root. Trees stuck their bare, naked branches into a bone-dry, winter wind. Songbirds did not serenade; birds did not tweet. Crows cawed from their perches overhead and scavenged the parking lots and roadsides. Spring had not yet sprung in Cleveland, OH.

I called for ground transport and shared a van with an elderly man from Oregon, just arrived for his niece’s wedding. Joe was a slight man in jeans, a plaid shirt, and sensible black shoes. He had retired to Oregon with his wife and now, now that she was gone, eight years from breast cancer, he planned to relocate to San Diego, for proximity to his kids and grandkids. I heard Morrie from a remote crinkle in my cranium: It’s become quite clear to me... If you don’t have the support and love and caring and concern that you get from a family, you don’t have much at all. Deposited at his hotel, Joe and I shook hands and I wished him a grand time with his family.

I checked into the Hilton and upon unlocking the door, found my room occupied. Surprised, I gasped and backed out. At the front desk, Halima was apologetic. She was a beautiful young woman who looked fresh from college. I learned she was a 35-year-old mother of ten and twelve year-olds. After relocating me, she gave me a Concierge Club pass for my troubles. It was a generous gesture, access to their “frequent flier” lounge stocked with beverages, booze, and vittles.

I exercised on the gym’s cross-trainer for 45-minutes, visited the sauna and hot tub, and turned in for the night. I would need to rise at 0600 EST (0300 PST) for a timely arrival at the Cleveland Clinic Wellness Center in the morning.

Dog-eared page 125: You can’t substitute material things for love or for gentleness or for tenderness or for a sense of comradeship.

Money is not a substitute for tenderness, and power is not a substitute for tenderness. I can tell you … when you most need it, neither money nor power will give you the feeling you’re looking for…

I closed the book and switched off the bedside lamp.

Good night Morrie. Smart man he.

Moon Chee Eulogy - unabriged

What follows (excepting the last two paragraphs) is the eulogy written for my Uncle Bill. The point-of-view and tenses were changed for its recitation at the celebration and memoriam to his life and times.

He was born on October 23, 1914, the second son of a first generation Cantonese man and his picture bride. He died during Superbowl on February 6, 2011, his family about, enjoying the game and enough food to feed an army. He lived the intervening 96-years in quiet unpretentiousness that was the hallmark of the man we knew as Uncle Bill.

What’s in a name? Named Moon Chee by his paternal grandfather, I wonder what he saw in that new face. What hopes and promise were suffused into the single element that would travel with his grandson unchanged for life, his name - Moon Chee.

“The boys were named for the elements: earth, wind, fire, and water,” Aunty said. We failed to learn the Chinese characters of his name so its true meaning returns to Earth - with him.

As a young boy Moon Chee attended Royal Elementary School, not long after Royal Ele. was attended exclusively by the royals (Hawaiian Monarchy) themselves. Later he attended Central Intermediate School, then McKinley High School. During those years he adopted an English name: William. The world knew him as Bill Chun.

His father raised pigeons and at 14-years of age, Bill caught pigeon-fever. He raised and raced Racing Homers for his remaining 82-years. Racing Homers have been used to carry messages during times of war and in 1941, during WWII, soldiers from the military came and released his birds. And while they were homing pigeons, trained to return, only a few did so. Some time after that, Uncle Jerold took an interest in pigeon racing and Uncle Bill took him under his wing, so-to-speak.

In 1950 his birds raced from Upolu Point on the Big Island to Oahu. The birds were released one hour after sundown and race 140-miles to Oahu before the race-clock stopped and time expired, one hour before sunrise. Uncle Bill’s pigeon won.

Uncle Bill was a Lifetime member of the Honolulu Racing Pigeon Association who, even in his final week, continued to inspect the hatchlings or squabs of his loft.

We helped slaughter pigeons as kids. Uncle Bill cut them open and let us feel their innards, the sponginess of their lungs, the sliminess of their intestines, teaching us to identify their organs.

But that was not why we slaughtered pigeons. Why we slaughtered pigeons was the secret to keeping a winning pigeon loft.

“These pigeons are a day late getting home,” Uncle Bill said. “They got lost and went to some other coop. I don’t want them breeding with my good birds.” So we learned to dissect pigeons and eat teriyaki squab –which is a little chewy – if you don’t mind me saying.

Uncle Bill followed his father’s footsteps, yet again, into metallurgy and steel, first, at Libby's Cannery and then at Hickam AFB during the war. After the war he worked for Grome’s Steel Furniture and Oahu Plumbing & Sheet Metal. Eventually he returned to the Hickam Sheet Metal Workers and retired as a supervisor in 1973.

Newly retired at age 59, Uncle Bill learned to cook and drive, and care-take his mother. He was a compassionate, patient, and happy man, walking Popo (grandmother) up and down the hallway for exercise, moving her arms as he danced to her laughter, before her.

A novice cook, his fried chicken was super crispy– he used a blend of cornstarch and flour – a secret Colonel Sanders would be well advised to adopt. His combo oxtail, tendon, tripe, and beef stew was made in a gigantic pot that bubbled and boiled on the stove. The reduction was ladled over steaming bowls of rice. Even more ono (Hawaiian for delicious) the next day, leftovers were only to be enjoyed if family and dietary restraint prevailed. Uncle Bill’s hau-yau (oyster sauce with anise) pig’s feet was my personal favorite and a frequent request.

“Pig’s feet!” he’d yell when I arrived to smell to its ooey-gooey mud simmering on the stove.

Can you imagine learning to drive at age 59? That’s courageous! Remember his Valiant station wagon, white with blue interior? The gearshift was a series of push-buttons!

One day the cops pulled over brother Mace not one block from the house. The officer said, “This isn’t your car coz we know who this car belongs to and it’s not you!” A humble man, no one had to wrestle car keys from him. Uncle Bill quit driving when he deemed himself unsafe.

I remember choking down a foul, herbal brew Popo concocted on the stove when we were sick.

“Why do I have to drink this?”

“Because it’s GOOD for you!” Uncle Bill said with a wide grin, holding a cube of brown sugar as a reward when the brew was downed and bugs drowned.

“Because it’s GOOD for you!” was his signature phrase in our younger years.

Uncle Bill lived a clean life: no tobacco, no booze, no wild women that he would fess up to. His passions were pigeons and stocks. He learned investing with his older brother Joe at age twenty-one and quietly amassed a small fortune. He read the stock section in the daily news and watched the closing bell on TV every day. The millionaire next door, that was Uncle Bill.

He divested part of his investment portfolio some years ago, giving the maximum, non-taxable gift allowed to each of his 20-plus nieces and nephews, great-nieces and great-nephews. His generosity was grand and memorable.

He was known for an acute memory. He could recollect with great accuracy the birthdays of his gargantuan family and corrected details during the retelling of family stories.

Hospitalized before his death he told his doctor, “If I’m going to die, I want to die at home in my own bed and with my family.” Hospice was called, hospital bed and oxygen delivered, and Moon Chee returned home to Pacific Heights Road, not a quarter-mile (as the pigeon flies) from the very site where he was birthed and named.

Word flew out electronically, (which is much faster than courier pigeon), “Call Uncle Bill, he wants to say goodbye.” And so we did.

“What is the purpose of my life?” he asked. “I never told anyone that I loved them. I love you,” he said. “I love you. Goodbye,” his voice cracked with emotion. “You were always one of my favorite family,” he said over and over, to each and every caller.

“I love you too Uncle Bill.”

“I had a miracle in the hospital.” He described being in his bed and suddenly, he was outside his body - watching. Family and nurses surrounded him. Someone said, “This service is for you.” They began to countdown, 4 – 3 – 2 – 1. The countdown stopped and he returned to his body and bed as abruptly as he’d left.

“God has planned my funeral,” he said. “He wants me to accept Christ as my Savior so he can bring me home.”

And so he did, welcoming Christ into his heart, singing Jesus Loves Me with his sisters. Pastor Don was summoned and Uncle Bill broke the bread of Eucharist just days before his Spirit took wing.

They filled the house with family and friends each night and lifted him into his chair, so he could partake in every way; dining in communion with loved ones, holding hands round the table for grace. Nearly everyone flew home to see him, either during the holidays or in his final weeks.

Cousin Kenny sent pictures to my iPhone of Uncle Bill, dressed in an Aloha shirt, sitting at the table eating breakfast: ice cream with papaya.

I want to eat ice cream with papaya, I texted.

When you are 96, you can eat anything you want, including pigs feet!

Ice cream with papaya. Almond cookies. Jamba juice. He ate whatever his little heart desired.

I called the following Sunday.

“Why am I still here?” he asked.

“To grace our lives with love.”

“Haaaa!” He laughed in his characteristic way.

“I wish you were here,” he said quietly.

“I wish I were there too.”

“When are you going to come clean my ears?” he asked.

“Hey, good thing I just cleaned em,” I poked at him, “Now you can hear all the phone calls you’re getting!”

“Haaaa!” He laughed again. “I’m just teasing you.”

“I love you Uncle Bill.” Tears coursed down my cheeks.

“I love you too. I'll be thinking of you,” he said with a lilt before his voice trailed off.

“... And I you,” I whispered.

Kenny sent a text: Death leaves a heartache no one can heal,

Love leaves a memory no one can steal.

He died the way most of us would want methinks, with his wits and family about him. His was given the gift of time and opportunity to express and receive love, and Christ, and life eternal. Not one to miss an opportunity, he let her rip.

Aloha Uncle Bill, malama pono, take care. Mahalo for your love and care, your attention and intention, your provisions for family. Well done. Bravo! May your journey elate and your faith expand in the miraculous, the infinite, the unfathomable, and glorious grace of God. God speed.

May time heal our hurt and never, NEVER pale who he was, how he lived, what he meant, …and how we loved.

They recorded the Stock Market’s closing bell and its clanging closed his memorial service. His friends released pigeons at the gravesite and Uncle Bill’s body joined our family in the Chinese graveyard on the slopes of Punchbowl.

Forasmuch as it hath pleased Almighty God of his great mercy to take unto himself the soul of our dear brother here departed, we therefore commit his body to the ground; earth to earth, ashes to ashes, dust to dust; in sure and certain hope of the Resurrection to eternal life, through our Lord Jesus Christ.