How to be Human - The Tale of Dr. Howard Jacobson

September 21, 2016. I looked at my watch because I had to be somewhere else. Yeah, don't we all? It was a few minutes before 11 am. As I turned the final corner and looked across the room I saw a frail man sitting in a wheelchair. Although I had never met him or seen his photograph, I instantly recognized who he was. Our eyes met just before I introduced myself. "Dr. Howard Jacobson, I'm Yatin Chachad. Nisha's father and Mrs. Jacobson's friend."

Flashback. A week earlier. Mrs. Jacobson, Nisha's flute teacher mentioned "My husband is in rehab just a few minutes away. I'm going to stop by and see him on the way home." "Really?" I exclaimed in surprise. "Had you told me he was here I'd have gone to visit him earlier. Of course, if it's okay with him." Mrs. Jacobson, with a sparkle in her eye and a smile on her lit up face, replies "I don't mind at all and Howard would love to see you. In all these years, out of all my students and their parents, you'll be the first one to meet him. I really, really appreciate that. It's very kind of you. He's all alone in the rehab center so I stop and see him whenever I'm in town to see my students. Let me tell you about Howard. He's got a little dementia. As long as there was food on the table and a roof over our heads and someone he could teach medicine, that's all he cared about. Howard is a brilliant doctor but not a street smart and that's the reason we're in the situation we're in. Now, he may not know your name, but if you tell him you're Nisha's father he'll know exactly who you are."

Back at he rehab. The frail Dr. Jacobson smiles as he perks himself up extremely slowly in his wheelchair. He's expecting me. This man is 93 years old. "Please come in and have a seat." he says pointing to the only chair I see in the room. As I take a seat, I quickly glance around and absorb as much visual information as possible. There are two sparse beds, one beige landline telephone, two rolling tables at the foot of the bed (one of which has his cellphone on it), a couple of basic medical stands by the bed headboard where IV fluid bags and what not could be hung, some funky medical machine, and there's an air conditioner with a sign on it not to set the temperature below 76°F. A television hangs from the wall spewing its daily programming. Nothing Else. All very spartan.

I hand him my business card. "So do you do photography for a living?" he asks. "I'd like to but nobody likes my photographs enough to pay for them, and so I just do photography for free." I respond jokingly. He laughs loudly. I think we'll get along just fine.

He tries to read the card closely but needs his spectacles. I look for them and hand them to him. They're twisted and completely covered in something opaque. It's not possible to see through them. I ask if I can have them back and I proceed to fix the bend in them. "Yes, please." he says appreciatively. As I look for a cloth or paper napkin to clean the lenses, I find none. I walk outside the room and summon the nurse and ask her for some wipes. "I'll wash them and be right back." she says and she does indeed. As she hands them over she tells Dr. Jacobson "There was some sticky stuff on it. If they get like that let us know and we'll take care of it for you. Somebody will." Mr. Jacobson puts his spectacles on and says in delight "I think I can finally see." as we both laugh.

Meet Dr. Howard Jacobson

I start my conversation "I didn't know you lived so close by otherwise I'd have visited you sooner. I'd like to write a story about our meeting and your life's experiences. I believe there are many elderly people just like yourself who would love to correlate." He acknowledges and adds "There are people like me who fall and end up here like me. I'm allowed to be here for a hundred days, more or less, for free as a senior citizen. You see the reason I'm stumbling is because of my roommate, I can't figure what the hell he's in here for. He's disoriented and that makes me nervous. I'm scared." "Do you ever go outside?" I ask him. "When I was in the other place I'd go outside a third of the time. But here, I haven't been out in ninety days." I can't even begin to imagine what that's like.

I brought something for you." I say to him as I hand him two Mango and Salted Caramel Ghirardelli chocolate bars and a greeting card. "I know you lived in San Francisco a long time ago and thought these may bring back some fond memories." "Yes. Yes. Of course" he says with a boyish gleam in his eyes as he accepts them. He starts reading the card " Wishing you a Superfantastic Day." Dr. Jacobson thanks me for the chocolates and reads the card. It is addressed to him from all of us in the Chachad Family, including my beloved Baby Elsa. "I'll be sure to show this to my wife." he says as he tucks the items in his shirt pocket. "And don't forget to share a couple of pieces with your roommate." I remind him. "My roommate is younger than me. He's only seventy-eight. But he has no idea where he's at. That really worries me. He lowers his voice. I'm really afraid."  He keeps repeating himself about his roommate. I think it really bothers him. Even college roommates don't get along sometimes, so for elderly it may be nothing new. I tell him it's nothing to worry about now that I was here. He seems to feel better about that not realizing soon I'll be gone. But for now, all is well.

As time passed, I found myself in the presence of a more relaxed person

One by one I introduce all my children in descending chronological order. "Baby Elsa is my puppy. I don't have her any more but she lives in my heart. Nisha is my eldest daughter who plays the flute with Mrs. Jacobson. Rajeev, my son, plays the trumpet. Radar is a new puppy we now have but at 12 years old, he's already a senior citizen." He nods "Yes, yes, yes." the entire time, glistening with happiness. "I'll show you some photos of my children." I tell him as I start scanning through my cellphone.

"I'll share something with you." he says "I'm ninety-three years old and there's so much technology it's all new to me." In spite of all the changes in his world and even at his age his cognitive skills and vocabulary are remarkably sharp. "How did you get the pictures in the phone? Do you keep up with technology? And how far behind you do you think I am?" I stare at him and we both laugh it out.

I can tell Dr. Jacobson is enjoying my visit. "Let me tell you a funny story. This morning I did a shave by myself. My therapists told me I had unfinished business and she took care of some spots. I shaved with just the razor. no shaving cream. I used nothing. You feel around and do a little bit at a time. No mirror. She finished it just before you came and so that was good timing. I look good now don't I?"

"I like Glen Miller orchestra. He was popular in the 50s and 60s. I'm from that era. I was the director at the University of North Carolina, I'm too old and I have no friends who call and that's a shame. I have an Irish friend in Tampa who visits me once in a while. He's doing a story on my professional life and life after the age of twelve. I'm Norwegian. Completely Norwegian as one can be. But I was born in Minnesota, third-generation Norwegian. My wife is German, and some Norwegian. I was told a lot of things about my family when I was five years old, but I can't remember." I interrupt him "My daughter can remember things from when she's five years old." He interjects "Wait till she's seventy and ask her what she remembers." We both laugh. "I'll wait till she's ninety-three" I add. We both laugh again, even harder.

"My father was a missionary in China. Chairman Mao chased away my father when I was six or 7 years old. So this is going back 85 years to 1930. I was then a gunnery officer in the Navy during World War II in the Pacific in Japan. I was part of the task force who took the surrender from Japan in 1945. I was a 22 year old officer. I was a US veteran." I stare at him in amazement. An American World War II veteran, a member of the greatest generation of people ever to walk upon this earth right in my presence. After 1945 when the war ended I became a physician. I went to Northwestern University in Chicago to study medicine." "That's a good school." I add. "That's a great school. It was a young school back then only about 80 years old. I was then at the Presbyterian Hospital in Chicago after that. Next to Cook County Hospital, which is a dreadful place. I resigned from my residency there because I was not learning and went to Harvard University and that where my life began. I became an OB/GYN and Physiology specialist. I went to San Juan, Puerto Rico. I got married in 1961 and the first time I left Boston we went to San Francisco. I worked under Ronald Reagan, but I never met him. He was an awful man because he didn't believe in helping people. It was all about the money. So I left University of California at San Francisco and University of California at Berkeley and went back to Harvard and then Rutgers University in New Jersey. They were all great colleges. I then went to University of North Carolina at Chapel Hill and finally University of South Florida in Tampa, where I was head of the Department of Public heath. Here I am nobody."

All this while, Dr. Jacobson is getting uncomfortable. I apologize to him "If you have to rest or if I'm taking up your time, I can leave." "What else do I have to do? I have all the time in the world." he laughs. I lift him a bit in his wheelchair and he gets more comfortable. "If I had my druthers, my choice, I'd prefer the northeast to go to medical school if your daughter wants to study medicine. Chicago is no longer up to speed and neither is Florida. Ronald Reagan believed in private enterprise and money ruled everything. I wanted to help others. He was against that. I was a little disappointed in Nancy Reagan, because as broad-minded as she was, she still supported him. Her father was the chief of surgery." I ask him "Did you meet Nancy Reagan or her father?" He responds "Did I meet him? He was chief of surgery and I am this little squirt. What do you think?" We both laugh heartily. "After Ronald Reagan got shot he lived a sheltered life. Nancy's brother was a classmate of mine at Northwestern. I can't remember what happened to him."

I push on. "So how did you meet Mrs. Jacobson?" I was dying to ask this question. "On a blind date. She was younger than me. When we got married, the age difference didn't mean much." He gets a bit confused about times and ages. "We got married in Boston. She was at the New England Conservatory of music and she studied with the first woman flutist in the country. The name slips my mind. I can't remember it was the first chair at the Boston Symphony. Julius Baker. You heard of Julius Baker? Julius Baker is a story in itself and my wife studied with him. She was a great student and so she got the best teachers. The phenomenal student that she was. Mrs. Jacobson, she ran a flute workshop in Florida Southern College in Lakeland, Florida and she took on a hundred students."

"She visits me often. Whenever she comes to teach her students she visits me. She times it that way. Four times a week. I don't know if I'll go home because I don't know how much outside help I'll have. I may be in assisted living. I have to be careful, my back end hurts." I call the nurse and tell her Dr. Jacobson needs to lie down. She arrives and shakes her head negatively "Nu -uh. It's time for lunch in a while." She turns around and leaves. Is this woman really taking care? I don't think this woman has any idea of the greatness of the man in her presence. "Is she nice to you? Are you happy here" I whisper to him. He can't hear. I move closer to him and repeat. "Sometimes they are nice, other times not so much." he clarifies. "I'm nervous about being here because my roommate doesn't know where he is and that scares me. The women here, they like my roommate, he's their favorite." "That's because he's just a seventy-eight-year-old young stud" I remind him, as we both burst into laughter once more.

This is where things are wrong. If a person is not comfortable and wants to lie down, that person has the right to do so. Nobody should deny him that comfort. Least of all this so-called professional caretaker. And that's just it. it's just a job that pays bills to some people. They can lack compassion and sympathy and oh please, simply forget about empathy. And I can understand that this can be a frustrating job and I'm not even suggesting that all caretakers and facilities are to blame. On the contrary, we need to appreciate them. And the question lies, if the caretakers themselves are paid so poorly, who'll pay for and care for them when they're old? The facilities, managers and owners are raking in the cash. Will karma deal these people a fair deal in later life? Who knows.

"Has you enjoyed a happy life?" I ask. "Not entirely. Last thirty years it's been grab hold of what you can." He goes blank or he's trying to recollect more than he can. He's lost his train of thought. "Are you afraid of being old? What can you do about it, huh?" I ask. "Nothing. What can you do? Nothing." he responds and smiles. "I think we're in a world that is unknown, more so than I've ever known. I don't want anything, yet I need a few things. I'm worried a bit. Who knows who's going to be the President?"

It's time to start asking a few tough questions. "What are your thoughts on the healthcare system in this country from your experience as a healthcare professional as well as living in a place where you require assistance?" Dr. Jacobson looks at me in the eye and says "The healthcare system is not functional. it all about the haves and the have nots. Money rules. You should start planning for the future and how you want to be cared for in your old age now. I didn't have any children, and so our planning was different. My wife and I lived in so many different places, adoption was not a possibility. We were all over the world. In China, Japan and the Philippines, people care for their family and their elderly. I also like the Scandinavian system of government-managed healthcare. Everyone must have enough, and nobody should have too much. People in this country (United States) are in imbalance. It's not fair. Our culture does not care for the elderly."

"I have to ask you a delicate question. Because I want to know for myself and I think many people who may read your story who are elderly may have similar thoughts. A lot of people your age are scared of their mortality. What do you think? If you feel offended, you can choose to not answer." He replies "I'm too old for that. I thought about it a long time ago. It's a frightening world. But the inevitable is the inevitable. From my own personal experience, you live day by day, take it in stride and don't worry about it. What can you do?"

My personal thoughts - Life is fragile. It's not an ending, but a march towards eternity. You don't want life to be quick or slow, but satisfying it must be. Dr. Jacobson has led a long, fruitful and productive life anybody can be envious of. I felt a certain numbness and emptiness in the room. The empty feeling gripped my heart and my soul. I had to empathize with the man sitting with me. I looked into his eyes and saw his whole life. I didn't shed any tears, but I felt a cloud of gloom cast over me. For whom I was sorry I do not know. But, in an instant the sadness faded and I felt profoundly happy to be in the company of my new most-esteemed friend.

I smile and tell him he's the oldest person I've ever met. He looks at the ceiling and adds "I have a sister in Minnesota who's eighty-eight years old and I'll never see her again. That's a shame. She has four children. Her name is Lois Nelson. She married a Scandinavian as well. Her in-laws came from the same tribe we did." "All you Vikings!!!" I add and we both laugh.

"When do you get to go out?" I ask. "I don't know. I don't go out. I haven't been outside for three years. I'm sorry." he weeps. "I am sorry for you. It would be like jail for me." "Yes. That's exactly how I feel." he responds sadly. I can see the emotions in his eyes. I was asked to leave my "big camera" outside and I cannot take his picture.

A woman arrives rolling a cart. On it is a tray of food containing a red-colored hot dog, stale looking baked beans, soggy coleslaw and an artificially colored cake. Designed by professional nutritionists (I would assume), this meal hardly meets the nutritional requirements of these elderly people. I wouldn't feed this to anyone under my care. Dr. Jacobson looks at me and says "That's lunch. It's been such a pleasure meeting you. I haven't been available for four years but I've never met any of my wife's students. It's been such a pleasure. I'll be out of here in two weeks and then I'll be out of here, but I've no idea where I'll be. I thank you for coming." I stand up and shake his hand. He loves it.

I take pictures of us together. I tell him they're called selfies. He's most impressed. "Don't tell anyone" I remind him. "I won't tell anybody." he smiles and promises. "I'll be back to see you. I'll get you something nice to eat next week." I promise him. "I'll wait for you" he says and smiles. He then begins struggling in his seat. I ask him if he's okay and if he's trying to stand up. "Yes, yes. I'm trying to stand up." "Why?" I ask him. "I have to say goodbye to you properly." I smile and ask him to keep sitting and give him a hug. "Thank you and have a Superfantastic Day" he tells me. I've taught him my favourite new word. I respond with "I'll get you something to eat next week and I'll try to take you out if I'm allowed."

A Selfie with Dr. Jacobson. He finally breaks a smile for the camera.

Dr. Jacobson's cellphone rings. He tries to reach for it, but its too far. I jump out of my seat, pick it up and hand it to him. It's a flip phone, and in spite of his lack of dexterity, he manages to flip it with ease. He chats with his wife and hands me the phone. Mrs' Jacobson wanted to see how things were going between us. She tells me to make sure the temperature in his room is set at 76°F. I tell her it's at 70°F. She's not happy about it and asks me to change it back to 76 degrees. As anxious as she always seems to be, I tell her to relax and hand Dr. Jacobson his phone.

I stare at my watch once more. It's now almost 1 pm. We had spent a long time together in the previous two hours, all of which was fruitful, at least from my perspective. I tell him to enjoy his lunch and promise him I'll be back next week with a treat. After all I must take care of the people who take care of me, because nobody else will. As I walk out I take one final look I'm content I made this man laugh for a couple of hours. Or it the other way around? He says "I love spicy food. Thank you for visiting. Goodbye."

And that's the tale of one Dr. Howard Jacobson. New Friend. Great Doctor. Tireless Teacher. Military Veteran. Wonderful Human Being.

Capture Your Life. Dictate Your Legacy.

Addendum, September 28, 2016 -  I returned to visit Dr. Jacobson with a special treat of chana masala (curried chickpeas), matter paneer (curried cottage cheese with peas), basmati rice pilaf, tandoori barbecued brisket, tomato and cucumber salad, coconut water, key lime cheesecake bar for dessert and cashew and date energy bars for a later day stash-away snack. Needless to say, Dr. Jacobson enjoyed the spicy food - enough to have his nose run and clear out his sinuses ;)

All comments welcome.

Sadly, Dr. Howard Jacobson passed away. The following is his obituary.

Dr. Howard Newman Jacobson

August 13, 1923 - February 5, 2018

Age 94

Howard Newman Jacobson died February 5, 2018 of respiratory failure at age 94. An internationally known physician with expertise in pregnancy nutrition, his work influenced generations of obstetricians and midwives around the world and laid the foundation for current practices in maternal nutrition. He was born in St. Paul, Minnesota on August 13, 1923 and was educated at St. Olaf College and further in the Navy V-12 program at Villanova in Pennsylvania. He served in the Navy in the South Pacific in WW II as a radar officer on the USS Boston. After the Navy he entered Northwestern University Medical School in Chicago under the GI Bill, receiving the MD degree. He did an OB/GYN residency at Presbyterian Hospital in Chicago then did a post-doctoral Fellowship at Harvard. He has held academic positions at Harvard, UCSF, Berkeley and Rutgers. He was director of the Nutrition Institute in the University of North Carolina system for 10 years, leaving in 1988 to become a faculty member in public health nutrition and maternal and child health at the University of South Florida in Tampa, retiring in 2003. In addition to his academic work he served as a consultant to the HEW [now HHS] Children's Board; the General Accounting Office; and the American Medical Assn. He was a member of the National Academy of Sciences Food and Nutrition Council and vice chairman of the 1969 White House Conference on Food, Nutrition and Health. He served as a consultant to governments in 15 different foreign countries while holding his academic positions. In Florida, he was a member of Governor Chiles' Healthy Start Initiative Work Group, during which time he worked with the Disney Institute on customer service in health care and wrote extensively about his ideas for US health care reform. He received many awards including the NIH Career Development Award and The March of Dimes Agnes Higgins Award. A full biography of Dr. Jacobson can be found at the USF Libraries Special Collections web site under "oral histories in public health".

Howard was the son of the late Reverend Irvin O. And Nora Olson Jacobson. A resident of Plant City, Florida, he is survived by his wife Barbara (Jane) Dinger Jacobson, sister Mrs. Lois Nelson of Minneapolis Minn., and sister-in-law, Mrs. Jodine Jacobson of San Diego CA. He was preceded in death by his brother, Edward O. Jacobson of San Diego. He is also survived by nieces and nephews, both in Minnesota and California. Services will be private, followed by interment in the National Cemetery at Bushnell, FL.

Notes: April 21, 2020. As per my notes with the late Mrs. Barbara Jacobson, At some time or another Dr. Jacobson was a professional involved in OBGYN, Physiology and Reproduction of Cerebral Palsy. He was affiliated with Harvard University Medical school, UCSF, UC Berkeley, Rutgers University, UNC Chapel Hill and USF Department of Public Health. Dr. Jacobson was at the Highlands Lake Center - Rehab Section (OPIS) Room 316 when I conducted the interview.