"Doctor's orders"

I have not known many people who flew a B-24 bomber, but the only such person I knew in Destin died recently.
The B-24 is no ordinary plane but is one of the most important bombers that was used in World War II. It holds the record for being the most mass-produced aircraft in World War II although it was not as reliable and tough as the B-17 flying fortress.
Mr. VanSustern (name changed for privacy reasons) flew a B-24 in his youth. He never saw combat but flew it after World War II.  Even though VanSustern had flown such a big bomber, in his later years he developed Parkinson’s Disease. This seemed tragic to me but he was always optimistic and never complained much.
Parkinson’s Disease is a degenerative brain disorder that impairs the patient’s motor skills and speech. When VanSustern stuttered in public, I always told everyone that he used to be a bomber pilot and only lately has suffered from Parkinson’s Disease.
Patients with Parkinson’s Disease often develop a shuffling gait which means that they take very tiny steps and have trouble turning around. When VanSustern’s gait became unstable, I had to request a walker for him. I felt sorry that this pilot now had to use a walker but it never seemed to bother him.
One day, I was surprised to find him using the walker with only one hand. I saw him almost fall down a couple of times in front of me!
Surprised by this awkward behavior, I tried to find out why he was not using his second arm for his walker. Of course, I was worried about a stroke having further debilitated this unfortunate man.
However, on further investigation, I found that his shoulder was hurting him and so he was avoiding use of one arm. Yet, he never complained much about this pain but simply put up with it.
It always amazed me how he even came up with ingenious ways to cope with his different medical problems. I had noticed that VanSustern had started to drool as he did not have good control over his oral functioning. But he seemed to have figured out an ingenious way to keep himself from drooling. He always kept his lips sucked inside his mouth so there was much less chance of his drooling. By keeping his lips sucked into his mouth, he was able to keep his lips from quivering and was able to keep any saliva from leaking out by mistake. I had seen several patients with Parkinson’s but I have not seen anyone use this clever coping mechanism.
Being a military man, he had probably been taught to deal with great adversity without complaining. He had learned to keep a positive mental attitude in spite of all the hardships he faced.
Every time I saw him, I kept trying to find out what made him have such a positive attitude. Even though he seemed so perfect to me, his wife stated that it was getting difficult living with him. VanSustern was complaining a lot to his wife instead of telling me and his wife was having trouble caring for him even though they lived in an assisted living facility.
Clearly no one is perfect, but Mr. VanSustern will be dearly missed. Hats off to these magnificent flying men who do such difficult tasks even though they might succumb to diseases just like the rest of us.
Dr. Nitin Bawa is a board certified internal medicine physician. He can be reached at (850) 534-4170.