Posts by Bryan Howard61

I was scrolling through some sports stats the other day, looking at the sheer scale of modern athletic venues, and it got me thinking about how much the "vibe" of a live event has changed over the last twenty years. It’s not just about the number of seats in a stadium anymore; it feels like we’ve entered this era of hyper-optimization where everything is designed for a broadcast camera rather than the person actually sitting in row 42.

Don't get me wrong, I love the spectacle. There is something undeniably primal and exhilarating about being part of a massive, roaring crowd where the sheer volume of people creates a physical pressure in your chest. When you're in a venue that can hold eighty or ninety thousand people, you aren't just a spectator; you're a cell in a larger organism. That's a feeling you can't replicate sitting on your couch with a high-def remote. But lately, I feel like the soul of these massive gatherings is getting diluted by the pursuit of "premium" experiences.

It seems like every time a major venue gets updated or a new one is built, the focus shifts toward luxury suites, club seating, and VIP lounges. I get it—the economics of modern sports demand it. But it creates this weird, stratified reality. You have the massive, sea of humanity in the upper decks, and then you have these glass-walled bubbles where people are sipping cocktails and watching the game through a filtered lens. It feels like we’re losing that sense of shared struggle and communal passion that used to define these huge gatherings. It’s becoming less about the collective energy and more about tiered tiers of consumption.

I remember going to a huge matchup a few years back—one of those games where the sheer size of the stadium made you feel tiny. The air felt different. There was this tension, this shared anxiety that you could feel vibrating through the concrete. Nowadays, even in those massive places, it often feels a bit too sanitized. There’s so much emphasis on the "event" surrounding the game—the halftime shows, the digital activations, the concessions—that the actual contest sometimes feels like just one more thing on a schedule of things to buy.

I also wonder if we’re hitting a point of diminishing returns with stadium capacity. We keep building bigger and bigger, pushing the limits of how many people can fit into a single footprint. But is there a point where a stadium becomes *too* big to be intimate? Can you actually maintain a sense of "home field advantage" when the crowd is so spread out that the energy can't even travel from one end of the bowl to the other? There’s a certain magic in the mid-sized venues, too, where the crowd feels dense and the noise is concentrated. When you get into these gargantuan cathedrals of sport, the atmosphere can sometimes feel thin, like the energy is being swallowed up by the sheer volume of empty space between the fans and the field.

I’m curious to hear what you all think about the evolution of large-scale live events. Do you think the massive, high-capacity venues still offer that same "lightning in a bottle" feeling, or has the scale and the commercialization turned them into something else entirely? Does a bigger crowd actually make the experience better for you, or do you prefer the more compact, intense atmosphere of smaller venues?

Scott Allen10 said:If that’s the opinion of a cardiothoracic surgeon—which, frankly, is quite reasonable and logical—then at least you can find some peace of mind knowing you’ve explored that avenue, especially since the illness wasn't caught early enough to be treated properly from the jump. Regarding methods that might actually help a heart this fragile stabilize, or what happens if things take a turn for the worse... well, there's the Intra-Aortic Balloon Pump (IABP), or eventually something like a Ventricular Assist Device (VAD). That first option is invasive, sure, but it's a real possibility; the second one? That would mean heading to New York City for open-chest surgery, which is a much heavier lift. Just stay focused on those cardiology channels in the coming days. Don't be afraid to keep pressing the cardiologists, surgeons, and anesthesiologists about diagnostic options, potential interventions, or surgery. Be... how should I put this... "persistent." Ask them until they get annoyed; who cares if they lose their cool? They are there for you and the patient, not the other way around. I know, I know, that sounds a bit dramatic, but it truly irritates me when medical staff act impatient with people who are clearly in shock because of a loved one's condition. Sometimes the intake and information protocols feel more like a concentration camp than a hospital. If you feel any friction or tension in your communication with them... just push through! Things often change for the better once you make your presence felt.
I’ve mentioned before that, in my experience, a tracheotomy is often the best way to help a patient gradually transition off the ventilator. Since the man has been in the ICU for days now, you can see certain things happening around him, and even without being a specialist, you'll likely realize that patience is the only way forward. Don't obsess over "what if" scenarios... just take it one day at a time. Don't get too carried away by tiny improvements, but please, don't lose hope even if things get complicated. There is comfort in the simple fact that he is still alive after more than two weeks in this state.
Two weeks in an intensive care unit under mechanical ventilation and in a state of shock carries a massive risk of complications... it’s just the reality of it. Pneumonia, hospital-acquired infections, urinary tract infections—if you haven't seen them yet, you should expect them. No one in the world has eradicated infections entirely, so we certainly haven't, and most of them aren't even caused by the staff (though, of course, that happens sometimes); they usually happen because bacteria migrate from the digestive tract into the blood, or due to prolonged ventilation through tubes and cannulas, or simply because the body's immune system is so depleted...
Good urine output, getting enteral nutrition via a feeding tube or orally if possible, solid physical therapy (turning him, repositioning in bed, massage, percussion), maintaining strict hygiene, excellent oral care (this is absolutely critical), keeping fluids balanced, managing hemodynamics (blood pressure, CVP, pulse, cardiac output), using antibiotics as needed, and keeping the airway clear (using closed suction systems for lung secretions, gentle ventilation modes like pressure support... etc... I’m just throwing out everything that's standard practice for critical patients in the ICU. I trust that's what's happening in your case too).

The Boeing 747 is a reliable but older model of ventilator that doesn't feature the most advanced ventilation modes. Honestly, my advice is not to stress over the specific numbers scrolling across that screen. If it shows he’s participating in breathing with 2L, it doesn't mean much, because everything can shift in five minutes. You won't be able to put those numbers into any real context, and they'll only serve to confuse you. CMV and SIMV are volume-controlled ventilation modes, and we used them for years. They aren't bad; they do the job, but they aren't necessarily the kindest thing for lungs that have been "wounded" by illness and long-term ventilation. At least, that's how it seems to me. But then again, that's a conversation for a specialized medical forum.
But, since you brought up the Boeing 747 and that whole situation regarding your father... well, if we are talking about signs of breathing, a good omen would be seeing the "flow by" and "pressure support" options enabled in the top row. And where it lists CMV and SIMV, you'd want to see that green light glowing next to the third option, CPAP... That would mean the patient is breathing under their own power, that every single breath they take is being supported by a more or less constant pressure assist, and that the air mix is somewhere around 30-50% O2.... And on the monitor display, you should see a minute volume of 5 - 6 - 7 L, even if the tidal volume is just 0.5L and the respiratory rate is 15 - 20.... On top of that, the patient monitor ought to show decent blood pressure, maybe 90 - 100, a steady pulse (under 100/110) without any major arrhythmias, and an SpO2 of at least 90%... all while the patient themselves doesn't look like they are struggling to breathe—no heavy labored breathing, no sweating, none of those frightening symptoms....
Anyway, my advice, just like I gave to your mom... just take it day by day and try to stay patient.... Good luck!🙂

God! I am the second daughter, and I just wanted to jump in and let you know that Dad actually pulled through. 🙂 You all have been such a huge help to us, and it truly meant the world to hear from someone who actually understands this stuff; it helped explain things during a time when everything was just such a massive unknown to us. Up until the moment he ended up in the hospital, we honestly thought he was "healthy," that nothing was wrong... in the end, they discovered first of all that he has a heart defect—mitral insufficiency (I actually have it too, though mine was caught a long time ago. And every single time the doctors asked if anyone in my family had it—not knowing—I’d always just say no). When they did his head CT, they also found some ischemic damage in the brain, about 1.5cm in the frontal lobe, but they can't pin down exactly when it happened. Whether it occurred during this hospital stay or before. Since the heart ultrasounds showed that the heart issue is an "old thing" and there are already several scars on the heart, it is entirely possible it happened much earlier. He’s just the type of person who won't talk about these things; he isn't exactly a fan of doctors or hospitals, so unfortunately, his condition had to get this complicated and lead to all of this.
Since you seem genuinely interested in this, I would gladly send you a photo of the discharge papers, but I really don't want to overwhelm you with too many details... Long story short, he is home now, recovering, taking it slow. 😉 I just wanted to let you know, in case you remember us, that we have a happy ending. 🙂 Thank God, the doctors, and everyone else that contributed to this! 🙂

In my humble opinion, psychology can really only serve as a compass, pointing them toward ways to strengthen their bond. After that? The heavy lifting falls entirely on them—on those two, or however many people are actually in the room.