During the forenoon of Sunday October 11 a heart which only knew love and caring ceased to beat. When I say that we had been married for 63 years this is more or less commonplace. But she was not just my wife; she was my most trusted friend, comrade in arms, and soulmate through all the vicissitudes of a long life. We met two weeks after my arrival in the US and apart from professional trips, there was hardly a day we were not together.

I had found my first employment in this country on my 25^th birthday as an intern at Staten Island Hospital and was immediately assigned to the Emergency Room. Although I spoke fluent English and knew medicine, inches, grains, ounces etc. were only words in my vocabulary without their meaning, because most of the world uses the metric system. In addition, although aspirin, digitalis, morphine and some other drug names are universally recognized, most of the rest are idiosyncratic. There I was alone in the ER with a patient when the door opened and a highly attractive 21-year old student nurse, Martha Kinscher, walked in for assistance. She had pity for this somewhat lost soul and guided me to do the right thing for the patient.

I was immediately smitten by her beauty and kindness, and when I started dating her, found out that horses were the great love of her life.

There was no thought of marriage because I had a girlfriend in Vienna, Erika, likewise a  recent medical graduate, with whom I was informally engaged and was trying to obtain an affidavit of support (needed at that time even for visitors) to bring her here to get married. I told Martha about this situation and we agreed to stay friends. When after a few months I had succeeded to obtain the affidavit from another Austrian physician who had emigrated years earlier, I immediately wrote to Vienna with the good news. Two weeks later came the reply that in the meantime she had agreed to marry an American officer stationed in occupied Vienna whom she had also known for some time, but had broken off the relationship when we started dating. Well, that was it; although there was an immediate twinge of regret, I knew that Erika had been important for my emotional growth but this was a new life and I was now free to get semi-serious with Martha.

I’m saying “semi” because she was a strong-willed young lady and what I wanted and what she wanted were not necessarily the same. We kept dating and in September of 1951 when the internship was over we went on a two week vacation to the Thousand Islands and talked of marriage. Earlier in the year I had been accepted for a fellowship in Neurology at the Mayo Clinic in Rochester MN where I was to start in October. We continued to correspond and Martha thought that Easter of ‘52 would be a good time to get married. Why wait till Easter, I wrote back, let’s do it for upcoming Christmas; after some hemming and hawing she agreed. She and her parents may well have had some reservations about this brash Austrian who had, apart from his MD degree, no credentials in this country. When I asked her father’s permission to marry his only child, who was the apple of his eye, prior to the departure for Rochester, he agreed after I promised to take care of her for the rest of my life. So Christmas it was, and we got married on the 23^rd in the Episcopal Church she attended during childhood and adolescence.

There had been some concern in her extended family that she was marrying a Catholic. But although both of us were friends of Jesus we had no use for church rituals regardless of denomination. Since her father was a member of the Freemasons in Brooklyn, decency of character was the criterion rather than formal religion. As soon as the date had been set I asked my mother to send me my skis because there was plenty of snow in Minnesota and I had started a friendship with a Norwegian colleague, Rolv Slungaard, who obviously also had skiing in his blood. They were sent to Martha’s family and her first Christmas as well as wedding present was a pair of skis we bought in Manhattan the day before the marriage rites. The honeymoon was a railroad trip to Minnesota in a “couchette”, ideal for newlyweds.

Neither one of us had any money because my salary was $150/month and she earned about $250 as a registered nurse, but we consoled each other with the words: We’ve got no money, but we aren’t poor and this is temporary. Prior to marriage I lived in a rented room and although the landlady liked me, when I brought Martha to stay with me she got her dander up and made life difficult for her. Both of us were brought up during the depression and the idea of taking a loan, thereby going into debt, was completely foreign to both of us. We’d make do, come what may.

Well, the Lord took pity on us and within a week or so we were asked if we would want to “house-sit” for the retired chairman of obstetrics and gynecology who intended to stay the rest of the winter in Florida. We obviously jumped at the offer. Not only was it rent-free, in walking distance of the Clinic and St. Mary’s hospital, but also very pleasant and of the right size.

Although Martha desperately wanted children, this seemed to be a vain hope. About a year and a half prior to our meeting she had suffered strep throat which led to serious nephritis and she was warned not to have children because of the danger of eclampsia. In addition there was potential danger for the baby because her blood type was Rh negative. This was fine with me, because I had wanted a girlfriend and as a result of my experience with fathers (see War&Mayhem on this site) felt that I was totally unfit for that job. As the German saying goes: Vater werden ist nicht schwer, Vater sein dagegen sehr – to become a father is easy, to be a father is tough. But what were my intentions against her will? Within two months she had conceived and our daughter made her first appearance in November.

 To say the least, Martha was delighted while I was more skeptical. I was abruptly married to a mother and automatically relegated to number two, which took some time getting used to. But one learns. Peter arrived in 1955 and Eric in 1959. The family was now complete.

While in Minnesota, Martha learned to ski. It was on a little hill where other fellows, the title of physicians in training at Mayo, had built a rope tow and a warming hut against the brutal cold. There we spent our Sundays with Martha carrying baby Krissie in a transport bag to the hut. Martha was a quick learner and since one of the other fellows, who also regularly skied there, kept talking about Colorado powder we decided to go there as soon as the occasion arose. It came in 1956 when we had already moved to Ann Arbor where I was working as a neurologist and electroencephalographer in the Psychiatry Department of the University of Michigan. Rolv and two of his other Norwegian friends, with whom we had stayed in contact, told us that they were going to Aspen for a couple of weeks and invited us to come along. Of course we accepted. Martha’s mother, Viva, came to stay with the children. We drove from Michigan to La Crosse, where Rolv had joined the Gundersen Clinic, and all five of us then piled into a car and drove to Colorado to test the snow. It was indeed as advertised and all of us had a marvelous time.

In 1958 life changed again. I had, from the previous year, an offer from the newly established Lafayette Clinic to take the position as Chief of Neurology and Electroencephalography with an appointment as Assistant Professor at Wayne State University in the Department of Neurology. In addition, the offer included part-time private practice with Dr. Joe Whelan who was at that time the only neurologist and electroencephalographer in the city. It certainly was tempting but jumping from the University of Michigan with its prestige, where I had just been promoted from Instructor to Assistant Professor, into the completely unknown did raise some doubts. Both of us were never after money. My salary was sufficient to buy a house on a small pond and we had joined the sailing club of the university. In the summer we went sailing on Base Lake, initially in ten foot dinghies and later Jet 14s, and in the winter drove occasionally north to Boyne Mountain for skiing. We loved our little house and the pond where we could swim in the summer and ice-skate in the winter. We had our two children who likewise loved the pond and under Martha’s instructions became good swimmers at their tender ages. We were content. So when the offer came in 1957 I was only modestly interested, especially since the mental distance, by the cognoscenti, from Detroit to Ann Arbor was 40 miles but from Ann Arbor to Detroit infinity. You just don’t go slumming, especially when one is a reasonably bright young neurologist who wants to make a name for himself.  

There was another complication. The newly appointed chairman of Neurology, whom I had met at the Ski meeting of the Eastern EEG Society, while he was still working in Boston, was as strong-willed as I and we just didn’t hit it off after his appointment to Wayne’s chairmanship. We had pretty much of a row in Dr. Gottlieb’s office (director of the Clinic) over who would be in charge of the 20 Neurology beds of this otherwise psychiatric hospital. He insisted that he and his staff physicians would be rotating through on a monthly basis. I insisted on the European system where a given unit had its permanent physician in charge and that would be me because otherwise “Chief” is just a meaningless title. It was the proverbial Mexican stand-off. I went home, discussed it with Martha and we decided to stay put. My salary was sufficient for a modest life-style and she could stay home to raise our children.

In the summer of 1958 the university sponsored Hungarian refugees from the 1956 uprising to be temporarily placed in the homes of faculty members until permanent homes could be secured. Obviously we volunteered and a young student, who spoke no English, moved in with us. Then later in the summer my mother came from Vienna for a visit. All of a sudden my salary didn’t cover the expenses. I already had a Board Certification in Electroencephalography as well as Neurology and was in no mood to take out a loan. So I went to one of my bosses (I had two. One directed the Mental Health research Institute of the university, where I was his EEGer, and the other was the Chairman of the Department of Psychiatry because the EEG lab was in his rather than the Neurology department) and asked for a raise. The answer was: “For the money I’m paying you I can buy myself two good electroencephalographers.” Well that was it. I said to myself go ahead; went home discussed it with Martha and we agreed: o.k. let’s jump.

The decision was made somewhat easier because one of the staff physicians at the Clinic was a friend of ours from Mayo days, Peter Becket, and Jacques Gottlieb was a wonderful director. He saw his role as hiring good people and then letting them do their thing in addition to his lobbying the legislature for expansion of the facility and providing state of the art equipment for research. The mislabeled Lafayette Clinic was actually the psychiatric research hospital of the State of Michigan under the Department of Mental Health. In addition Joe Whelan was a wonderful person, competent and easy to get along with. He lived with his wife, Gloria, and their children in Grosse Pointe and when he took us along Lakeshore Drive on the shore of Lake St. Claire we knew that this was doable. It turned out to have been the right decision also for Martha. The Whelans were a wonderful couple who ever so often gave European style soirees in their home with guests from the university and other professionals. This became of vital importance for Martha six years later. As mentioned Eric came along in April of 1959 and Martha, who was actually my intellectual superior, had become somewhat unfulfilled. She went riding on Belle Isle and apart from the house, our first purchase was a 16 foot Rebel to sail on the lake. But her intellect did not have an outlet. Nevertheless, the children were her first priority and taking a job outside the home was never a thought until all three of them were in school during the day.

At that point the Whelan dinners assumed their destined role in her life. Martha had always wanted to go to medical school. She surely had the mental wherewithal and would have made an excellent physician. But Martha’s family was lower middle class where money was scarce but love abundant and they simply could not afford the exorbitant cost. This is after all, “Capitalist” America, where the buck rules and where you have to pay through the nose for higher education, especially since in those days there was no student loan program. Under the American system I could never have become a physician because my family was also practically destitute in 1945, having lost all valuables to the Russian occupiers and Viennese looters. But in “socialist” Austria all education, including university, was paid for through income taxes and essentially gratis. With medical school unattainable for Martha she had chosen the next best thing by becoming a nurse. But regret remained because the intellect remained unfulfilled. On one of the evenings at the Whelans the Chairman of the Department of Anatomy was one of the guests. He immediately took to Martha and after a brief conversation offered to enroll her into a PhD program in his department. She grabbed it with both hands, studied furiously and after graduation joined the department.

Her dissertation was on the adrenergic innervation of the heart valves. She had observed that not only the heart muscle receives nerves that can pour out adrenaline directly into the heart but so did the valves, which was unknown at the time. Throughout these years we always discussed our work and one evening she came home bewildered. All of her students loved her, but this was the hippie era. On that day one of them, who was clearly a member of the scene with the looks and eating a chicken during anatomy lecture, had approached her with the desire that “he wants to do brain research.” Martha wondered what in all the world do I do with this guy, and asked me for advice. Obviously I had no use for a hippie and just said: “Well, let’s sleep on it.” As we say in Austria: Der Herrgott gibt’s  den Seinen im  Schlafe – the Lord provides advice to His own during sleep. In the morning I had the answer. He’s a hippie, he smokes pot so let him and his cronies smoke to their hearts’ content government-provided marijuana, while he helps to run the EEG machine. In this way he’d get his wish and I can find out what the drug does under controlled circumstances. Martha immediately agreed, talked to the student who jumped at the idea and about a year later “The Marihuana Social High” was published in the AMA Journal.

Martha was always the co-worker. Some of my scientific work required the implantation of electrodes into the brains of animals and she subsequently verified the electrode positions for the ensuing publications. But she also did more than that. As a result of another series of experiments in the late 1970s she made a fundamental discovery. Her electron microscopic study showed that the first changes in brains that were subjected to repeated small doses of a seizure producing drug were not in the nerve cells, neurons, but in their supporting structures, the glia. This information was unknown and unexpected at the time. We published the data in a first line journal but the publication was ignored. The concept is only now being given serious consideration by others, using different methods, without mention of Martha’s previous work. A picture from a social gathering around that time is shown below.

Life moved on; we skied, sailed, swam, took trips and, of course, she engaged in her first love horseback riding, where she won numerous ribbons. When I reached my sixties we started taking where we would retire. I needed a place where I could continue with my hobbies: skiing, sailing and science, and she needed horse country. For mine I needed mountains with good snow, a sizeable body of water and a university. When one thinks about this, there aren’t too many places in this country which fulfill all of these criteria. But Eric, our pilot, had after his graduation from college earned his spurs in form of flying hours that would enable him to get a job at one of the major carriers, in Salt Lake. During the week he taught flying at the airport and on weekends skiing at Solitude. It was an ideal arrangement. He got his brother to come out for vacation to Solitude and that became their mountain. Mom and Dad had to follow their lead and Utah instead of Colorado became our ski destination.

I obtained a Utah medical license and in August of 1990 we moved to our permanent home in Sandy. I had intended to spend the first year of retirement on travel while Martha intended to remain at work. Since Peter with his wife lived only a few minutes away from our home he could have taken care of “Mom” in case of need, and I could have hopped on a plane to get back in no time. Of course, all of us know what happens to the best laid plans of mice and men. Our daughter had come back from Europe, where she had stayed and worked for about two decades after having obtained her PhD at the University of Salzburg. She moved to Salt Lake, got a job at the university, married and was now on her way to produce another grandchild for us. The latter fact I was not privy to at the time. This was the signal for Martha: We move now! Krissie needs me! While I was engaged elsewhere she came to Salt Lake ostensibly to ski, but in addition picked the house where we were to live. I had no idea because my fantasies were still on travel so who needs another house? She knew my problem in regard to an immediate move rather than waiting an additional year and was concerned about my reaction. So she used reverse psychology: “It’s such a nice house, I love it, that’s my house, but you won’t like it” was the refrain for several hours. Regardless whether I did like it or not, it was already a done deal because as the saying goes: If mother ain’t happy, nobody‘s happy. To make her happy I flew to Salt Lake looked at the house and it did indeed serve our purpose admirably. Thirty minutes to Alta for skiing, 30 minutes to the university and 45 minutes to the Great Salt Lake fulfilled all of the criteria for successful retirement even if it came a little earlier than hoped for. The house itself was large enough to shelter the entire family. Since all three kids were married and two with children of their own, it could accommodate them whenever they came to visit. The next ten years were the happiest of our lives. In the winter we skied together in the mornings and she spent the afternoons with her horse.

At one point she developed kidney stones but these were taken care of with lithotripsy and hospitalization was not needed. Sometime later cervical cancer was diagnosed. She had a vaginal hysterectomy as an outpatient at Alta View hospital and after the three-hour procedure we went home. The gynecologist apologized that he hadn’t been able to reach the ovaries and this might become a problem later. The two of us, both trained in medicine, decided: so what; if and when it were to happen we’d deal with it at that time; right now let’s enjoy ourselves. We did, until one day while skiing at Snowbird her right leg gave way; she fell and fractured the femur. The fracture was taken care of within hours by an orthopedist at Alta View and two days later she was home again, but skiing was no longer an option.

She continued to ride but increasing age took its toll. She always had a slightly leaky heart valve, which gradually got worse and atrial fibrillation also ensued which made life quite difficult for her. The drugs against the fibrillation were useless and in view of her age, she refused to consider surgery for the mitral valve insufficiency. Pain from severe arthritis also became an increasing problem, to which was added last year a bout of shingles. She bore all of these afflictions with stoicism and her only concern was to take care of my needs, those of our children and our home. We had in previous years enlarged the deck, where she could enjoy the sunshine as well as shade from a magnificent maple tree.

During the early part of this year she became increasingly incapacitated to the extent that all of us knew that her life expectancy was limited to months and possibly another year or so. Krista, therefore, applied in early August for a six month medical leave from the University of Northern Arizona, where she holds the tenured position of Professor of Humanities in the Department of Comparative Cultural Studies, to help out with the household chores and other needs as they arise. It was granted and she has been living with us since the middle of August. It is obvious, however, that she also needs a life of her own and Martha, therefore, helped her find a house that is within 15 minutes driving distance from ours so that she can immediately be available when needed. On August 30 we had a party for family and friends to celebrate my 90^th birthday. Peter’s oldest daughter, Lindsay, had earlier in the year given birth to her second child and Martha had the joy to see and hold her latest great-granddaughter.

The doctors had been wrong! Not only did she give birth to three healthy children, who grew up to be the pride and joy of any parent, but she outlived most, if not all, of her cousins and even met our fourth generation.  The third great-grandchild is on the way and more will be coming in due time from other grandchildren.

Martha and I, as rational beings, had over the years frequently discussed what to do at the time of dying and death. Legalities had to be attended to. Our Wills were identical, except for the different first names, with one’s entire property going to the surviving spouse. We also had a Living Will that specified that no artificial means (e.g. cardiac resuscitation, mechanical respiration, infusion of nutrients) are to be used to prolong the dying process. I had also made it clear to Martha and the children that if I were to suffer a debilitating terminal illness I should be allowed to stay at home, instead of being taken to a hospital, and no medications, except for pain relief, were to be given. Food or fluids were not to be forced into me and I shall die a natural death as our forebears always did. Martha was in full agreement and insisted that this also was her wish.

Nevertheless, this was still personal intention and no one knows what will really happen when the time comes. On Tuesday October 6 Krista and the two of us went for brunch to the Silver Fork in Big Cottonwood Canyon and on the way back I asked Krista to drive by the house which she and Martha had selected but I had never before seen. She did and it is indeed appropriate for her needs as long as I am alive. She will then move to our home so that the rather beautiful property remains in the family. On that afternoon the legalities in regard to Krista’s house were finalized and she became the legal owner. Eric had also called that he might be able to take a few days off and could come for a visit which I immediately urged him to do.

Wednesday morning I asked Martha for a phone number I should have remembered but had forgotten. She tried to recall it but gave up with an “oh shucks.”  I told her not to worry and went on with business at hand. But an hour or so later noticed that she was aphasic. As a neurologist it was immediately apparent to me that she had suffered a stroke that was limited to the speech area. At that point Eric walked in and all of us felt that we had to take her to Alta View. Instead of calling 9/11 we decided that we’d use her Subaru Crosstrack, which had plenty of room, and a wheelchair was in the basement since my leg fractures. Krista brought it up but when we tried to lift her into the wheelchair she fought us to an extent that we knew that she intended to have her previously announced wish respected. Her life was now complete, the children were grown with thriving families of their own, Krista was here to take care of my needs and now it was time to go.

Eric had come for vacation and was now confronted with a disaster about which we could do nothing. Since he has considerable problems of his own, with his wife currently undergoing chemotherapy for breast cancer, I asked him to go up into the mountains in the afternoon. He went to our favorite Big Cottonwood canyon and observed an uncommon celestial phenomenon, which he photographed.

True; these are just two con-trails of fighter jets from the nearby airbase but for us they had meaning. In the evening we consulted with my friend and co-worker, Dr. Tawnya Constantino, about what to do next. There were two options: home care or hospice. These are separate entities with different responsibilities for the care providers. But this division is arbitrary and there should be one system because death of the elderly is becoming an increasing problem for the State and insurance providers. We decided on hospice and a nurse arrived on Thursday to start the formalities.       

Another unusual event had occurred earlier that morning. In spite of her general weakness Martha insisted on going to the bathroom under her own power and one of the three of us had to follow her to prevent a tumble. She refused a cane or even one of our arms. For the past several years she had slept on the couch in the family room in order not to disturb me with her frequent nocturnal trips to the bathroom and to be able to watch TV into the wee hours of the morning because due to relative inactivity her sleep cycle was disrupted. She had picked out the couch herself at the furniture store some years ago. It exactly fit her needs and under ordinary circumstances she always got up at 6:30 in the morning to go to the bathroom but on that Thursday there was a difference.

I slept soundly in our formerly joint bed when I had an unusual dream. A fully clad woman sat next to me on the edge of the bed with her back towards me. Surprised I cried out Oh (and her private term of endearment), tried to touch her, but woke up. I looked at the clock it was 6:18. While wondering in the dark what this could have meant I developed the feeling that Martha might be in trouble. Through the bottom of the closed door I then could see that the bathroom light was on. I got up and found her on the floor next to the toilet where she had fallen and couldn’t get up. She was fully conscious and I helped her onto the seat. Under her own power she returned thereafter to the couch with me in attendance.

The three of us then decided that we’d have to arrange some type of watch system as is common in long distance sailboat races where one of us is always at the helm and can alert the others in case of need. Since from Thursday on Martha shoved us away when we tried to give her some food, even a teaspoon of honey, or fruit juice it was apparent that death would occur within a couple of weeks. Her attitude was: I want to die, so please, please let me. We were in daily contact with Peter who said that he could come at any moment and had already made plans to come on Monday evening. Yet on Saturday I had the feeling that the situation might be more urgent and asked him to come instead on Sunday before she loses consciousness and enters terminal coma. He agreed.

On Sunday morning she was resting quietly with eyes closed, as usual, and slightly labored respirations. It was not clear if she was merely sleeping or comatose but it made no sense to do a neurological exam because if she were to be asleep it would be cruel to wake her up. So I sat in the armchair by the couch where I could watch her respirations and be available in case of need. It was my shift because the kids had gone to bed after theirs. After an hour or so, respirations had become more regular and I thought that even if she were to be in coma some sensations might get through to her consciousness. I, therefore, put on a CD of Mozart’s clarinet and horn concertos and when that had ended replaced it with one of his piano concertos. About a third of the way through, the CD started to stick keeping to the same notes over and over again as was common with the old gramophone records when they got stuck in a groove. I took the CD out of the player and saw that it had a slight smudge which seemed to explain the problem. In so doing I also noted, however, that Martha’s respirations had ceased. I got a mirror from the bathroom held it against her open mouth and indeed there were no respiration effects. Eric had in the meantime come up, brought me my stethoscope and there was only silence instead of a heartbeat. 

She had accomplished her goals in life and now was released from pain and suffering. It had always been her wish that the body be cremated and we honored it. After the Memorial Service later this month, which will be held at Millcreek Inn where our second granddaughter, Amber, was married, we will spread some of her ashes over places she had loved in the mountains. The main urn, which is very beautiful, we partially buried next to our favorite maple tree and a Buddha sculpture she had given me for the 85^th birthday. It thereby remains visible to friends and family, while being protected against the deer. They roam our backyard and might accidentally break it if they were to flee in some panic. It will be joined by my ashes when the time comes. For us she is not dead but keeps living in our minds for the rest of our lives. The tears that intermittently well up in our eyes are not mainly an expression of grief, but of gratitude to have been allowed to share our lives with such a wonderful human being.

For her 80^th birthday I wrote a little poem; it’s no great poetry but expressed the feelings of our family and is printed below.    

TO OUR MATRIARCH

Long ago and far away

A baby girl once saw the light of day.

The world around was rather bare

But she was nurtured by parents’ loving care.

They taught her, though the times were bad,

Important is the life you led.

Material things they matter not

What learning brings decides your lot.

With diligence, good will and faith

You overcome life’s wantonness.

Into a lovely maiden did she grow,

Admired for good looks by high and low.

To help whoever came her way

Became her life’s mainstay.

All creatures: creeping, flying, walking

She loved and cherished, without much talking.

Suitors came from far and wide

To take her as their bride.

In vain they labored one and all

Because she’s spotted a lost soul.

Across the ocean he had come

For fame and fortune to be won.

One glance sufficed to know, here was his fate:

A trusting, loving, caring mate.

Moved by pity for the stranger

She consented, unaware of danger

To become his wife

And share with him the rest of life.

He promised her what was their need

Steadfast love; security from hate and greed.

A girl friend he thought he’d won

But don’t you know: mother she would soon become.

Up and down life’s roller-coaster

She never wavered and only love did foster.

Children in due time did come

Who loved and honored her as Mom.

Grandchildren they produced for her

With whom unstinting love she’d share.

Now the eightieth birthday has arrived

No mean feat, considering what you’ve survived.

So on this day and future years

Remember always: There are no fears!

The love you’ve spread among us all

Will keep you safe regardless what may fall.

Inherent goodness never fails

And over sorrow joy prevails.

You have achieved what’s rare today:

The knowledge: that for you, we’re here to stay.

A family you have around

Where each of us is duty bound,

With gratitude to ease your body’s pain

And let peaceful charis reign.

WITH LOVE FROM YOUR

FAMILY