July 28, 2025
Sandy’s birthday came around. “Don’t buy me anything, we’re spending enough money,” she said. We went to dinner with family and friends. She made her own cake, without candles. We sang “Happy Birthday.” The restaurant gave her another hunk of cake, which she didn’t eat. It was a nice evening.
Friends sent cards, the kids called. I drove up to Caesar’s Head State Park, near the state line, looking for something not mass-manufactured. I picked up some South Carolina earrings, hoping they didn’t look too much like the ones I bought last year, also at Caesar’s Head.
The real meaning was the six-year mark since the strokes. We were in Bridgeport, Pennsylvania that day, visiting our son and daughter-in-law. It was the hottest day of the year in the Philadelphia area, close to 100F.
The day before, on the drive up from Virginia, Sandy felt dizzy. Then early the next day, July 20, 2019, her left arm went numb. “Time for the ER,” our daughter-in-law said. She drove Sandy to nearby Bryn Mawr Hospital, a stroke treatment center. That night she was in the ICU.
The next day, on her birthday, she had an MRI. A neurosurgeon conducted an exploratory cerebral angiogram, which meant inserting a wire fitted with a sensor through her femoral artery into her brain. The finding: several mini-strokes, called transient ischemic attacks or TIAs, caused by narrowing of arteries in her brain.
She went through a week of tests and scans at Bryn Mawr, her blood pressure monitored continuously. I stayed at our son’s and daughter-in-law’s place in nearby Glen Mills and battled rush hour to the hospital every day. The docs’ consensus: a recent change in her blood pressure medication had caused pressure to drop, restricting blood flow to her brain.
Cardiologists and neurologists who examined her debated the right level for her blood pressure, controlled by medication. Either too high or too low would be risky, as with anyone. Her pressure had to be kept at a higher-than-average level to ensure adequate brain blood flow.
She left the hospital with new prescriptions. In coming months, more appointments, more tests, including a stress test involving a treadmill, a plan for a new lifestyle. A year later we packed up and moved away.
Birthdays are a bigger deal for some than others. They’re important for young kids and their parents, with parties, cake, presents. After the 21st things calm down for most adults. Work and relationships are center stage, life gets complicated. Forty is often a big one, we had people over for my 40th. After that no memories for a couple of decades. Birthdays amount to rushed phone calls.
Years fly by, people start to pay attention again. I put on a surprise party for Sandy’s 50th, the kids came home from school, friends showed up, hugs and photos all around. A priest new to the parish stopped by, he has become a friend. We made a big deal for my 65th, hiring a place for a dinner with music and dancing. Hers was lower-key, in the back yard, her childhood best friend flew up from Atlanta.
The years exact their price. Birthdays become acts of defiance or irony. Am I really this old, is the question. Mortality crashes the parties, no kidding. We know the last birthday party, when it happens, is a lot closer than the first.
Our son drove down for last week’s birthday and stayed a few days. The grandsons had fun with their uncle, who they see maybe once a year. He and I took them out for Chick-fil-lay, putt-putt golf, ice cream. They were thrilled.
He walked around downtown with us, we got lunch, window-shopped. He bought some books, we sat in a quiet tearoom and sipped tea. He cooked dinner, we talked about his work in medical physics for cancer oncology, the patients, the treatments, the tough cases. He made some points about health, fitness, diet, that whole routine, which is his career.
He headed back to his place in Jersey. I thought once again of the symmetry, my life formed there in the urban north of the state, he now settled in South Jersey just across the Delaware from Philly.

All four of them, the boy and three girls, are keeping pace with us in birthdays, like everyone else. The youngest girl is next, in October, then the grandsons. The eleven-year-old is starting middle school, the younger boy is three years behind him.
Sandy’s big day is still in the season. The health things are center stage. She is getting her early morning walks in, getting to the gym, watching the carbs, as we all should be.
Birthdays reaffirm connections across years. “I’m so glad you have become my friend,” one young woman wrote. “I love you Sandy,” a little girl wrote in her card. The kids, the young adults, the busy working folks are present, so are the old ones, the eighty- and even ninety-somethings, women who she sees at the YMCA senior gatherings, some in tough shape, who need Sandy’s touch of kindness, concern, love, sometimes just a phone call.
We are looking at down time through our South Carolina summer, blasting heat, the grass and trees parched, the air conditioning roaring. The days sometimes seem to drag but weeks speed by, the routine we recall in Virginia and in Tennessee, just a bit worse in the deeper Deep South.
The suffocating days pass, like that hot 2019 Bryn Mawr week, when the docs puzzled over her but found answers. She marched forward across the years and birthdays. This one, with good people near, was special. They are all special.






