Every patient has a story...

Sal Raises a Glass

The house sits next to a frozen pond, home to a few geese, and a weathered clay pony stands guard at the foot of the driveway. Sal stands a little unsteady in the living room, hand outstretched but the reserve showing on his face. “What’s this all about?” he asks as he sits down in an easy chair next to a bowling trophy—a painted pin from 1980 commemorating a perfect 300 game. Crispin and I are there volunteering with Regional Hospice to help gather people’s stories and see if there are new ways to help people in end-of-life situations. We’ve been interviewing people intermittently for nearly a year, and Sal is the first person we’re talking to today after driving up from the city.

Sal shows off his bowling trophy

He’s tentative at first, not sure if we’re going to break into a sales pitch or try to “get him involved in something.” But he warms up from the sitting and talking, and he tells us a bit about being in the army at the Battle of the Bulge. He’s anxious about his medication and keeps breaking off to consult with his social worker, but as the hour progresses he settles more deeply into the conversation and begins cracking jokes and eyeing the wine bottle on the floor by my feet. He offers me a glass but it’s 11:30am and we decline, telling him we’ll raise a glass in his honor later that night. Then something interesting happens as he starts talking about the years when he was a competitive bowler in the local leagues—the stories prompt a memory from my time in graduate school about the importance of people building connections with one another.

In the mid-1990s, Harvard Political Scientist Robert Putnam published a groundbreaking study of civic participation in America entitled “Bowling Alone,” in which he examined decades worth of data regarding patterns of involvement in voluntary associations such as the Elks, PTA, or the Boy Scouts. He found that levels of participation have been declining since the 1960s, and he seized on the progressive disappearance of bowling leagues as a bellweather example. Apparently, in the 1970s bowling leagues were widely popular, but in just a single generation they began to disappear.

Putnam thinks this is a problem, and not because he’s a fan of bowling. It turns out that civic participation is a critical element in socializing ourselves for modern life. The experience of attending meetings of civic organizations or volunteering for the public good appears to be linked to the development of trust in others. People who attend more events tend to trust their neighbors, believe that we can work together to solve problems, and participate in the kind of give-and-take activities that form the basis of modern democratic politics. Putnam calls this “social capital,” and he believes it is linked to the health or sickness of our democratic polity. The decline of associations such as bowling leagues turns out to correlate neatly with the decline of trust and the polarization of our political and social landscape. Putnam’s article gave a name to the idea of social capital, and it is considered a classic in the field of political science.

Sal and his family

When Sal began talking, he brought Putnam’s work alive for me in a powerful way. He talked about meeting his wife at a bowling alley, and how their initial bond formed into a great and lasting love. When she got sick and entered a nursing home he brought her lunch every day for three years until she passed away. Sal joined a bowling team and competed all over the New York area for many years. There were so many leagues that even a small town like New Rochelle was able to support five bowling alleys operating simultaneously. This was in an era when newspapers published results from the bowling leagues each week. Sal showed us the clippings showing he had the best scores among dozens of competitors, averaging around 200 points per game. After a night at the alley, his team would go out to dinner at the sponsor’s restaurant in Mamaroneck, with everyone enjoying free food and companionship. One time Sal bowled a 299, missing only the last pin in the last frame to upset his perfect game. He still wears a thick gold signet ring as a remembrance of that night. “I used to go down to the city and compete at Bowlmor, and the pros would show up and we would watch them bowl,” he said. Bowlmor, which just a few years ago was a destination for hipsters and New School students on first dates, is now a rectangular crater awaiting development into another condominium block.

Somehow, with his end of life so near, Sal’s stories take on new urgency and freshness, and I could easily imagine the clatter of bowling pins echoing as he recounted the nights of an era long passed. We sat rapt as he shared his recollections, and it struck me that I was lucky to be meeting one of the last of a generation of civic Americans, people who made our way of life what it is today, through simple acts like sporting a sponsor’s shirt at the alley, caring for their loved ones, and of course defending our nation in times of crisis. I suspect that Sal and his friends added a lot more to the social capital of our society than they took out. He has a strong appreciation for people who are generous; in one story, he recounted how a black family that moved in next to them in Mamaroneck brought over food one night when his dad was sick in the hospital. “I’ll never forget what those people did that night, and how touched my mother was when they came over with the dishes,” he said.

We asked Sal how we might be able to help him or people in his situation, and the strongest theme that emerged from the conversation was the challenge of feeling like a burden to his daughters who are caring for him. He served heroically as a caregiver but is uncomfortable when he has to rely on his family for support. It occurred to us that some kind of program where patients could get recognition for the people caring for them—maybe a certificate or a pin—would help improve their quality of life through enabling people to say “thank you” in another way.

Tom Kamber toasts Sal later that night

We loved talking to Sal, hearing his off-color comments and jokes, and getting a window into a world that existed just a few miles away, but is forever altered and opaque. We found ourselves inspired by Sal to renew our own enthusiasm for volunteer work. Calling someone a “great guy” seems so casual, but with Sal somehow it fits and carries a certain importance.

On the way out of the driveway, we noticed the weather-beaten pony statue looked a bit like part of an honor guard, there standing at attention during Sal’s last days, and somehow that seemed fitting.

Written by Tom Kamber for Regional Hospice and Palliative Care