Friday, December 18, 2015

Wellness and Wabi-Sabi

"well, Ness…"

I am expert in disease. This word hails from the French for "trouble, discomfort, inconvenience, lack of ease". That's a hell of a thing to be well schooled in, and even though I am well-schooled (to the tune of 1/4 million bucks in student loans which I will possibly pay off before trouble and discomfort claim me), I still struggle with just how well a living being is supposed to be.

Should we never have pain? Should we always be at our athletic peak, able to leap down stairs without a thought and climb hills without gasping? What does it mean if you are born with disease? Why is good health "normal", when in my experience, every day threatens us with trouble and inconvenience? Some people, whom the modern slang might describe as "haters", even consider disease and trouble as a sign that God is angry with a person, or more often a group of people who do not share the hater's views. Most of us, when we get sick, can find some blame somewhere, and I suppose most often in ourselves. Because we are supposed to be healthy.

I have a kid who likes to get 100% on tests and assignments. And though we are not biologically related, I can tell you that apple did not drop far from the adoptive tree. I find myself telling her to let there be imperfection, to rest more, to cut herself some slack. Deja vu and bullshit, because I have heard those words myself and do I listen? Yes, I do! And I meditate five times a day! And I lived happily ever after.

Being bald, with an autoimmune system that eats my skin alive and stroke-worthy hypertension is the trifecta of beauty and perfection. Just the other day, Sports Illustrated called up to see if I would be the centerfold for the next swim suit edition. I, of course, had to tell them no because I am too busy doing my  MKSAP 17. Also, napping and taking warm baths. "My doctor made me take some time off, and posing for your magazine is way too strenuous for my delicate self. Good luck finding someone as cute as I am!"

I am not so delicate as to stop running though. Yes, I recently found myself on a casino floor and yes, I sprained an ankle on my Thanksgiving day run. But me and Klay? Nothing can keep us down. Not even hypertensive encephalopathy, the Milwaukee Bucks and other such inconveniences.

Why should people be unwell? And if being unwell is part of being human, why do we fight it so very hard? Many of my colleagues bristle at the battle analogy for dealing with disease. I tend to see more grey area here, because I understand, as an athlete, how approaching something hard as a challenge that you must face is valuable. We find out who we are and tap into our own strength when we compete. The thing is, disease is not a foe with any scruples. As a matter of fact, disease is a concept that we have created to describe the physical and mental imperfections of being human. Therefore, fighting disease is a little like fighting ISIS. It hurts, it stinks and it makes no sense. Finding the perfect battle plan is folly.

Which is not to say we should give up on being well. Here are ten pointers on how to guarantee wellness in the New Year:

1) Psych! Never believe this shit!

Seriously though, I do have a few thoughts on wellness.

1) Listen to your doctor/NP/PA. No, I am not saying this to promote my already inflated sense of ego, but rather to say, these folks care about you. I actually listened to my doctor and I am starting to feel better already. It was not easy, because it is widely known that doctors are second only in being the worst patients to nurses. Nurses: love ya!

2) Exercise.

3) Beethoven. Or whatever music floats your boat.

4) Allow yourself to grieve. For whatever life throws at you that gives you grief.

5) Hugs.

6) It is normal to have some disease. Don't ignore it. Seek help. And don't judge others OR YOURSELF for their/your suffering or infirmity. That's just mean.

7-10) For me, personally, I have to run. Even when I've been benched from the rest of life for impending cerebrovascular disaster.

Lucky for me, I get to run here (watch this video). And while watching this, remember, even the young and fit have imperfections. They just hide it better. Imperfection is beautiful. Reduce dis-ease by accepting the transient nature of suffering. Go full on wabi-sabi!

Tuesday, November 24, 2015

It Was a Dark and Stormy Night

I was lying on the floor of my hotel's casino after my recent half marathon, wondering what the point of   anything was and whether anyone would ever notice that I was there. Perhaps it is a frequent occurrence, the person laying flat on their back on the (rather digusting) carpet while the lights continue to flash and the booze continues to flow. Thankfully, a friend texted:
where r u?
To which I answered:
on the floor of the casino

She heroically came down to fetch me, and the hotel pseudo-medics did their best to talk me into an ER visit. No offense to my friends in the ER business, but no thanks. So instead I got a first class limousine wheelchair ride to the 22nd floor of Mandalay Bay, baby, with a gallant assist-transfer into the fetal position in bed.

The end.

All of this is to say, if you are going to run a half marathon, consider adequately training first. Then consider that 40-50 mph gusts of cold wind with sand flying into your eyeballs while rain is falling in the dark on the strip of Las Vegas at night may not actually be ideal running conditions.

Still, I am glad I did it. No really, I am. Mainly for the time with the good people that I spent time with in Sin City. Also, because it reminded me that even when running reminds me of some kind of Dante circle of hell I still like it and the medals in Vegas had these slot machine things on them that were pretty snazzy. Also, I met Meb at the expo. He is very kind.

Big race expos are bizarre. Or maybe like a bazaar. How much running related merchandise can one fit into a convention center? Is that much spandex in an enclosed building hazardous to your health? And how much stranger can the Gu energy gel flavors be? These are the questions I have.

Today I was walking down the street, basically minding my own business, when a bird nailed me. That is to say, it shat upon me, on the front of my pants. I was 15 minutes away from my next house call and this was one impressive stain. The last time I was targeted by a bird was in 6th grade, on one of my first dates with my boyfriend Fritz. That time we were holding hands under a tree when a bird nailed me on the shoulder. He laughed at me. That relationship was short-lived.

Last night, I was awakened by a windy, rainy storm. I groggily raised my head, and my trusty dog was sitting up on his haunches, staring intently at the skylight. I finally coaxed him back to a restful position, but he was disturbed.

Storms, bird assaults, casino floors. What is the meaning of all of this?

As Snoopy noted, it was a dark and stormy night. And this, though terrible writing, is an accurate depiction of so much of life. Why do people hurt each other? Why do children die? Why must people respond to fear with hateful actions and thoughts?

A wise person I know mentioned that the woods at night represents the dark parts of our being. However running in the woods is like the light that diminishes what is scary and dark. And having someone with you running in the woods at night is even better.

Running the Las Vegas strip at night? Perhaps not so profound. Still, as I ran toward the finish line at The Mirage in Las Vegas (the irony here was not lost on me), I could see the light. Mainly from the fake volcano and the neon signs. Still, light is nice, especially on a dark and stormy night.

My dog peering at the fathomless night sky may not know the mystery but he knows that what matters is we are safe. Or maybe we are not. If you cannot be safe, be near those you love. Thus he snuggled next to me, spine to spine. And the wind howled on.

Friday, October 23, 2015

The Woods at Dusk

There are eleven things worth living for today, I reckon.

1) Dogs. Dogs who like to run. Dogs who cuddle up to me during house calls. Border collies are always my favorite (sorry Miles). Dogs with names like Miles, which apparently is from the Germanic "Milo", meaning gracious. There is a local kid named Milo who is an amazing dancer, by the way. It could also be from the Latin "miles" for soldier. Or the Greek Miles for "destroyer". Or Irish meaning servant or Hebrew meaning gift from God. All of this is from the internet, so I don't believe a word of it. Tonight, running at dusk in the woods, he acted the soldier-destroyer once when a fellow (who seemed perfectly nice, btw) surprised us on the trail. Miles does not mess around. Phyllis is a good dog name too. Apparently derived from foliage (Greek), and might be linked to a woman who killed herself out of love for some guy named Demophon and then turned into an almond tree. The Phyllis I know takes no shit from boy dogs, so I am suspecting she is safe from becoming almond milk at Trader Joe's some day.

Miles and Phyllis, October 2015

2) Husbands. Specifically mine. I do not know how your's behaved today or on average in recent days, months and years. Mine is a saint. There is no internet derivation of his name, which is unusual and often misspelled. 

3) Friends. They are the people who show up every day, any hour of the day, without whining or complaint. They say funny things. They often are a lot wiser than I am, and they do not mind when my hair falls out, including half the hair of one eyebrow. Friends like their half bald, half-eyebrowed companions. You know who you are. 

Any bets on how bald I will be tomorrow?

4) Running. OK, I have not been talking enough about running on this blog purportedly about running! I am not as fast as I used to be, and in this town I was never that fast to begin with compared to the elites who seem to breath speed through redwood mist or something. But, I can run. I mean literally, I can put on shoes, go outside and run. There are many people that cannot do this physically. Or are so busy trying to just survive that the idea of spending time running in the woods is ridiculous. Tonight's run, in the woods at dusk, was nice. And every time I run somewhere beautiful, I feel better. Every single time. 

This is my back yard. Yes, I am boasting. 

5) Patients. Erma Bombeck once said "Never go to a doctor whose office plants have died". Which is why I never keep plants in my office. Seriously though, if your doctor has the time to tend their plants, they are not working hard enough! Your doctor should be oliguric, and preferably divorced because they have spent so much time with you that their spouse left 16 years ago and your doctor hasn't even noticed yet. Their children are all nuclear physicists and your doctor's last day off was at age 10 when they skipped piano lessons to ride their bike to Kwik trip to get an orange push-up. Seriously though, my patients are why I do medicine. And when I am with them, time melts away. Like an orange push-up on a summer day.

6) Children. Full disclosure here: parenting is harder than anything I have ever done in my entire life. This includes: 
a) childbirth, which is hard but temporary
b) standardized tests
c) learning Ravel Jeux d'eau
e) all of the marathons I have run, including the one NYC marathon where I cried all the way through Central Park

Children, whom I would lay my very life down for in an instant. They make me soar, they stomp on my heart, they can destroy me in an instant. Love them. 

7) Music. I am currently rereading, for about the 18th time, Song of the Lark by Willa Cather. It captures something about music and musicians in a very organic way. And I do not mean organic like Whole Foods, California, healthy, snobby, righteous organic. (I only buy organic). I mean salt of the earth organic. Music is at the very core of who I am. For some reason I shied away from it and decided to be a doctor. This could be why I get so sad sometimes. KIDS IF YOU ARE READING THIS: FOLLOW YOUR TALENTS AND PASSIONS. Unless they are illegal, in which case I suggest you get your shit together immediately. 

8) Books. I am surrounded by writers. My husband, my eldest child. Sometimes I think my poodle is writing a book in his head because, just like my husband, he will suddenly sit down and stare into space intently like there is something there he is trying to figure out. I can converse with husband or dog at these times, until I finally realize I am essentially talking to myself. Writers live on some different plane of existence. I am grateful for them because when I read, I too get to escape to a different plane of existence. As long as it is not a real plane, because I dislike those intensely.

9) Rocks. Literal and figurative. I can spend hours collecting rocks. I can also appreciate the solidity of them. Today I bought a couch for my office. It represented to me the solidity of the decision I have made around work. A couch is kind of a sign of commitment. Nothing is really set in stone, and stones actually change with weather and water and time. But they are so nice to hold in ones hand. And a good, solid couch? Let me explain, my couch is not made of stone. It is actually comfortable and soft. I just think couches represent solidity. 

Stones. October. Woods at Dusk.

10) Hats and the people who make them. 

Do you like my hat?

11) The Woods at Dusk. This is when the mountain lions are said to prefer eating people. I never worry though, as I have lightning speed and a fierce poodle and West Highland Terrier to protect me. The woods are good anytime, but early mornings and late evenings are the best. The light is ever changing. The redwoods split the light, which is one of their superpowers. It is quiet and usually few others are around. It is like a cathedral, but with big hills which suck the living air out of your lungs and make your heart almost explode. It is a labyrinth with cut backs and fern canyons and redwood droppings as soft as pillows underfoot. It is not for the meek of spirit. It renews your soul and kicks your ass all at the same time. It can save lives.

I have a cathedral in my back yard. Nyah, nyah.

Sunday, October 11, 2015

Lippity-Lippity-Not Very Fast

Peter Rabbit crying, Attribution:

"I am sorry to say that Peter was not very well during the evening. His mother put him to bed, and made some camomile tea-and she gave a dose of it to Peter!
One tablespoonful to be taken at bedtime.
But Flopsy, Mopsy and Cottontail had bread and milk and blackberries for supper."
-Peter Rabbit by Beatrix Potter

Fictional mothers are rock stars. Peter Rabbit's Mom, for instance, can solve everything with camomile tea. Granted, Peter lost yet another jacket and with Mr Rabbit already baked into a pie by Mrs. McGregor it is all she can do to keep the family clothed, fed and housed. 

Then there is Little Bear's Mother. She cooks, sews, tells stories, never gets angry and generally kicks ass. Little Bear is well-adjusted, kind and high achieving. And they are all drawn by Maurice Sendak. Sometimes I wish I was drawn by Maurice Sendak.

Image result for little bear mother bear

Perfection in parenting is all around us. In the doctor's lounge, it is manifested by tales of science fair victories by future nobel prize winners. At sporting events, it is a gaggle of future olympians, bringing honor and glory to us all, with parental button-popping serving as a serious threat for eyes being put out all over the place. Which is why I ALWAYS wear protective glasses to children's sporting events. On Facebook, which I personally am quite fond of, it is happy, shiny people with happy, shiny children and happy, shiny dogs. Guilty as charged. 

I spend my days with people. Which seems like a stupidly obvious statement because unless you live on an island that is yet undiscovered or unless you are one of those Humboldt hermits, you too probably spend your day with people. But I am an introvert and I am telling you I spend my day WITH PEOPLE. Like up close and personal, getting right to the intense stuff because generally there is no time to waste in end of life care and/or geriatrics. And here is what I can tell you about the state of people: they suffer.

I think Maurice Sendak might've been trying to get at that concept with Where the Wild Things Are.

Image result for where the wild things are

I am, in general, not in favor of suffering. 

But without suffering, there is no sense of relief. Like the pleasure of gulping water when thirsty, of an ache that subsides, of a heart break that slowly becomes nostalgia, then a portal to something bright and precious that has been crystallized by time and the searing heat of tears and intolerable grief.

I was running today (this is a blog about running, after all). It was in the woods, and it was with dogs. They and I meandered. They gained on me on the uphills (dogs seem completely oblivious to the hell of incline), and fell behind when I went down. I have been in a deep state of grief in recent days, but today I laughed twice. Not just a giggle but an unexpected eruption of hilarity. First time was at the car wash. I was out doing housecalls and my car was so dirty I could barely see out my window, so I went into the automated carwash. I was listening to Beethoven's Choral Fantasy during this and it was so in sync with the massive red brushes and dramatic shower of water on my car that it was actually kind of idiotically spectacular. I could totally see it as a scene in an avant garde film. I hereby claim this so don't try to use it in your next avant garde film. Second time was while running. I was running down hill after what seemed like endless climbing and I kind of lost control. I mean, I just started bicycling my legs faster and faster and essentially let go and I was flying. I was suddenly 7 years old again. The dogs were in my dust, It was a blast, and I just burst into laughter.

Grief. It is a funny thing. It engulfs you and you feel trapped inside of it, unable to breathe. Then it releases you and you fly up into the light and gulp the post-rain pine scented air only to fall back down, wracked with the ruinous violence of sadness. Like breathing, there is not a choice.

Parenting is to know that suffering is worthwhile. You cannot have the smell of your child's sweet head without the hurt of loss. You cannot control how the world, the genetics, the impulsive decisions of young people and the immaturity that believes suffering is only something other people should do informs the path your beloved child takes. 

When grief lets you go for a bit, you fly up into the light. You revel in Beethoven and run with abandon down a path in a redwood forest. You release some of your lightness and send it with a kiss to where the wild things are.

Thursday, October 1, 2015


This morning I was going through my usual routine of a cup of coffee with quick email, Twitter and Facebook check before work. This is after showering, dressing and smooching my family and dogs. There might be cereal or, better yet, waffles with peanut butter involved (a breakfast I learned from a surgery intern when I was a medical student: damn good fuel for a day that might not allow you to pee, much less to stop and eat something).

Anyway, I was looking at social media and came across a headline: "Shooting on Oregon Campus". Irrationally, or maybe actually rationally, I stabbed at my iPhone screen to open the article because I immediately needed to know WHICH Oregon college campus and please God let it not be the one where my child is right now.

It was not. But does that make it OK? Several people had children, family, friends who were murdered on a college campus today. Why is that OK?

The evening before I was at the hospital admitting someone who would have rather not been admitted but such is the way of healthcare in our advanced society. The first thing this person said to me when I walked through the door and introduced myself was "They sent me here unarmed!" In my head I was saying "Yeah, that was intentional"because I know the history of expertise in concealed weapons in this particular individual. To my credit I did not check every square inch of the bed and bedclothes.

Maybe I would be safer if I armed myself? Then every threat I receive in my line of work would be countered with my calm bedside manner accompanied by a steady finger on the trigger. Does that sound crazy? Hell yes, it does, because IT IS.

Thoughts and prayers are nice, but inadequate.  There is a thing going around on social media now about letting people who love guns have them, because America is about freedom. But I have to ask myself how free I feel when I can seriously contemplate, over my morning coffee, that a mass shooting on a campus might involve a child of mine. Other countries do not have this problem, because they control gun access. Period.

I run in beautiful places whenever I get the chance. It allows me to clear my mind, to feel blessed by beauty, to let go of anger, stress and fear, to feel the strength of my own body and to tap into endorphins which are almost as powerful as waffles with peanut butter. I have, occasionally, been threatened by unsavory men. Once I was almost intentionally run over by a guy in a pickup truck. But ultimately, I feel safe because I do not feel hate toward others. I actually like people and I will and have and will again not attend some family function because some stranger needs me due to their health crisis.

I believe in compassion. I am in favor of freedom. I fight for health in individuals and my community for a living.

Today, we were robbed. Someone walked into our home and stole from us. I actually suspect it was some kid who has been here before, and although I feel invaded and frankly pissed off, I also recognize that humans are flawed and there is no way to avoid unpleasantness in life. Suffering is part of the human condition, and those who perpetrate hate and burglary and murder are certainly suffering the most. Otherwise, why would they do this?

I have also been recently robbed of a ring my father gave my mother not long before she and he died, and my one pair of real pearl earrings, received as a gift from a dear friend over 25 years ago. That hurt. But mainly because I want to believe in the goodness of people, of children, of my neighborhood, of my community.

But no amount of hurt, anger or vulnerability could prompt me to arm myself against another human being.

Can guns be OK? Yes. Should they be very, very, very difficult to buy, carry around your community and point at another human being? Fuck yes.

Enough is enough.

Sunday, August 30, 2015


My daughter dances for a studio called "No Limits". It is an apt name, given the way they can just leap and land in the splits (makes me cringe every time). Life is full of limits though. The ones we set for ourselves are probably the most restraining, but we learn it from years of parents, teachers, other kids, classmates and work mates telling us we should or could not do something.

Limits make a great excuse for staying in our comfort zone.

The other day I signed a form at the recruiting office for the US Army saying I was OK with them potentially sending my 17 year old son into combat. Now it helped that my son wants this more than anything. Also that the recruiter is the son of a nurse I know and respect. Also, being a young man in Humboldt County without direction is actually quite a bit scarier than being part of the military. I just hope to God that Donald Trump will not be his Commander in Chief.

20 years ago, I would not have pictured myself signing a child up for the military. But the grey area of life is expanding, while the black and white is just a little tiny sliver in my peripheral vision. There might be  a few things of which I am totally sure, such as Beethoven is to die for, racism is never OK, women are just as capable as men and soda causes cavities and obesity. Truly though, I can say I would be proud to support my son in the Army. Not because I like the idea of combat (I do not). Not because I agree with the wars we have fought (I do not). But because I respect the service, the dedication and the potential self-respect someone like my son might gain from making such a commitment. I am the daughter of parents who would've risked their life for peace. But they too were deep thinkers, and taught me to question even my own beliefs. Life is complicated.

Limits are bad. Except when they are helpful, such as how many pounds an elevator can hold, what blood alcohol level is acceptable for driving and how many times "Let it Go" can be played in ones presence in a 24 hour period.

I am registered for a wilderness medicine course in Big Sky, Montana in February. I hope to get my Advanced Wilderness and Expedition Provider Certification. Why, you ask? Well, one never knows when disaster will strike (the "big one" is going to happen at any second here in Northern California, and that's no joke). But more importantly, I want to push my limits in terms of what I can do to take care of myself and others around me in a situation with limited resources. I have a goal of doing a long run for weeks to months on trails, and having a few tricks up my proverbial sleeve will be reassuring. Also, I need to learn to use a compass. I am almost 46, and it is about time, I would say.

Medicine is an interesting profession, in terms of limits. We like to think we have none, and that whatever comes we can resuscitate our patients, unless they choose not to have us do so. "Would you like to be resuscitated?" "Why yes, doc, I would!" The only glitch is the whole 100% death rate thing. I personally have resuscitated a 103 year old. They lived and were able to get the tribal tattoos given to those who make 104. Once I did CPR on a VA patient on the floor of a VA nursing home. The next day, he grouchily declared "Next time, don't push so hard!". Seriously though, why is death so scary? Are we limited by our imagination? Every living thing must die and if we all lived forever, I would shudder at the thought of the lines for the women's bathrooms.

On September 18th at 6-8:30 PM at the Arcata Community Center, there will be a showing of the documentary "Being Mortal", based on the book of the same name by Atul Gawande. Is this a shameless plug right in the middle of my blog post? Yes, it is. I am Emceeing this event, which, by the way, is pushing my comfort limits right to the very edge.

My eldest daughter is a runner, a writer, a comedian and a Zen Master. She has not gotten run over by a Segway recently. She has not celebrated a top finish too soon. But she shows up every day and runs her best. She writes with skill. She makes people laugh. She raises an eyebrow when I get all type A. Her limits? Well, sometimes she does not recognize the power she holds. It can be hard when people judge us on first place finishes and consumerist prowess. She is not a shopper or a spotlight grabber by nature. On a recent trip she slugged a lamp in the middle of the night thinking (in her dream) she was reaching for a basketball. This made me laugh till I cried, but not because I thought it was ridiculous. Rather, because I thought it was sublime. Even in her dreams, she shows up and gets the job done. Lamps be damned.

Will I run hundreds of miles on trails? Probably. Will I ever find balance in my work life? Probably not. Will my kids flourish and push their limits? I hope so. Will I die? Most definitely. Will my dogs ever stop barking at the garbage truck? Unlikely.

There is exactly one limit we all need to heed: life is finite. I keep Matt Miller's picture on my desk as a reminder of that and a reminder of what matters most. In no particular order:
1. showing up
2. having compassion
3. laughing
4. spiritual renewal

Speaking of spiritual renewal….

Thursday, July 30, 2015

Wild and Precious

In Travels with Charley, John Steinbeck turns phrases through multiple states of America, with his stately blue standard poodle at his side. He covers miles and answers the deeply American urge to be on the road of discovery. His questions seem to be unanswered though, only finding further ambiguity around every turn. A fair amount of whiskey and coffee fit to eat with a fork is involved. He encounters kindness, and the most abhorrent "vomiting of demoniac humans". He puts his feet in cold streams, decides not to shoot a pair of coyotes and argues politics in his home town with his staunchly Republican sisters. He comments on the "real man." Charley is completely self-possessed throughout.

The weird thing is how it could've been written yesterday, aside from some use of words that should be forever banned from our vocabulary. He taps into the bizarre way Americans are all linked, despite disparate ethnic origins and a general distaste for his NewYork license plates from anyone west of the state line. He has a point about our collective alikeness. And our individual uniqueness. Paradox in red, white and blue.

Prior to my rereading of Travels…, I reread Wild. This book now turned movie about a woman trekking the Pacific Crest Trail (PCT) has received critique from those that are in the know about hiking the PCT. You cannot just get a pair of ill-fitting boots and a ten million pound back pack and hit the PCT! She did though, and though I can see the point of the experienced hikers, I think they miss the point of her story. A heroin abusing, grieving woman in her 20's, now orphaned and completely clueless about the trajectory her life should take. That is the story: a search, a quest. Not unlike 58 year old Steinbeck, looking for America, and maybe a little for himself.

Recently I trekked through the Bay Area (San Francisco and environs) with my two teenaged daughters. We stayed in the lap of luxury, in some soulless high rise Financial District Hotel with a staff who were truly lovely. We walked to restaurants, great and mediocre. We drove to find playgrounds: water slides, the Sausalito Bay to stand up on boards and paddle against the fierce wind, rock climbing on a man-made wall in the middle of the Mission district with no parking anywhere within one hundred miles. We watched Giants swing bats by the Bay from the truly highest seats in the stadium, and I kept picturing Harry Potter et al at the Quidditch World Cup, just wishing I had one of those pairs of magical binoculars.

My eldest and I ran the half marathon in San Francisco. It was most memorable for the cab ride there, and the cabby himself, but I cannot describe him as my author-daughter has already claimed him as a future character in one of her books. I have learned not to cross the authors in my life.

I have a weird perspective on life. I had these parents who were both fully present and got the hell out of my way. These days that would be called "neglect." "Why are you not helicoptering about your children?", the authorities would say. "You mean you did not drive 150 miles at 5:30 on Saturday morning to watch their cross country meet? What is wrong with you?" My parents had their own life, and they loved me. That's all I needed. And they gave me the tools to live independently and well. I bring this up because I have been thinking about loss, and what is important in life. I lost my parents as a 20-something year old, not so much older than my own children. I start to picture them without me around, and my main hope is they wash their sheets weekly and occasionally cut their fingernails. Also,  that they have compassion for their fellow human beings and animals too. And they always, ALWAYS, appreciate Beethoven and John Coltrane.

My weird perspective, I think brought on by an early realization about mortality (said goodbye to Dad the first time at age 5, in the CCU) is I am often overwhelmed by beauty, but it does not have to be what I see at the Metropolitan Museum of Art or even the grandiose redwoods I run by regularly in my own back yard. I mean the small beautiful things that just present themselves, almost constantly but only if you are awake and not sitting there obsessing about your glory, fame, pocketbook, getting through the next light before it changes or fitting into those jeans from when you were 23. Things that can even be there after you have witnessed the greatest sufferings, as I do frequently in my line of work. Like today, when I walked out of the hospital in Fortuna, the sky was painted with clouds that would make the most sappy of paint-by-numbers paintings blush. I stopped, looking at the sky and picking the gravel out of my flats from the parking lot, filled with awe and gratitude. And also very hungry, as the overcooked broccoli at grand rounds did not offer much sustenance for my long afternoon in the field. As Mary Oliver said so nicely: "what is it you plan to do with this one wild and precious life?" Today's answer: no more overcooked broccoli, unless I am really, really hungry, then overcooked broccoli might be the cat's pajamas.

Curt Harper is a 49 year old autistic surfer who, if this 19 minute movie can be believed, has the answers Steinbeck and the author of Wild were looking for. He shows up for the waves, for his job, for trains (he admires trains), for dinner with his (might I add here amazing) parents, and for the groms who delight in his presence.

Spend 19 minutes watching this. Or not. But either way, I think the pleasures and answers to life might not be so much complicated as they are mystical. Or perhaps just hysterically funny, like a cab ride to a half marathon on a Sunday morning. If you want more on that, read my kid's book.

Tuesday, June 30, 2015

Ode to Joy

I am overdue for a post. Bloggers who hardly ever post are almost as annoying as bloggers.

Sometimes you have to talk about running more than actually doing the act of running. For instance, when you work 12 hours a day and are on 24/7 call and are thus highly irritated and exhausted because you are almost closer to 50 than 40 and getting up at 5am seems a lot harder than it did. Well actually it never felt easy, as I am not a morning person. I am not a night owl either. I have a few good hours between 10 and 3, and all the other hours seem really good times to take a nap.

I am a little injured. I was on a run recently and suddenly someone shot an arrow through my right hip. I fell to the ground, and my dog promptly mauled the arrow shooter. I then gave birth to dragons and now am a nomad in the desert with a limp and a sidekick with an English accent.

Or maybe I just pulled a muscle. It could also be a stress fracture but that is just not acceptable. So never mind.

Thinking about the future, I become paralyzed. I am a professional with a lovely life and I need for nothing (except time to take a pee). I just sometimes wonder what it all means and then I come to my senses: that is an unanswerable question, like the sound of one hand clapping. My grasshopper once told me if I ask it one more time, he will hop away into oblivion and all of my luck will be gone forever.

I cannot remember the last time I saw a grasshopper, come to think of it. I have seen a housefly that, though reported to have a 24 hour life span, survives on for now over a week in my bedroom and allows me no peace. What is the meaning of that fly life? And why cannot my ninja poodle capture it so I can finally get some rest?

Recently, there came to my attention a 70 year old ultra marathoner. So humbling. She even ran an extra 3 miles, getting off course for a bit. If I ever finish Western States, even once, I will feel like wonder woman. It does occur to me that there are a lot of hurdles (so to speak) in life and running. Injury is one: it means time away from running and defining your physical self otherwise. Then there is the age thing. But age is a good thing, for without it we are 6 feet under.

What scares me most about Western States is mountain lions. Second most is the prospect of getting lost. Third most is my terrible night vision. But none of this is insurmountable. Mountain lions probably hate spandex. Getting lost is the surest way of finding oneself. And if a blind person can run, play piano (at my alma mater!) and live fully, then a night-vision-disabled person like myself can probably get by.

I spend my days caring for the most vulnerable. The seriously ill. Those at risk of dying, and soon. The frail elderly. The disenfranchised. I like this work. It is tiring though, and sometimes a doctor needs to refuel. Pretty soon this cannot involve tuning into The Daily Show. Sigh. But I have a lot to be thankful for. And as the mother of Dragons, I am not to be trifled with. Plus there is the wonder of human beings. The fact that gay people can freely marry. Obamacare lives to see another day. And: Beethoven.

It's all good.

Except for the lack of time to pee.

Monday, May 11, 2015


I have 3 children, but really do not feel I qualify as a true Mom. Moms are ever-present. They always put dinner on the table. They dress like Moms. They show up for every school event and parent-teacher conference. They never let their kids eat junk food or watch TV. They give birth naturally at home in a house with scrubbed floors and low-flow toilets. Their kids follow the rules, do well in school and live happily ever after.

My experience as a Mom is I try. I try hard. I have a mixture of biological and adopted children. I am generally considered adequate but not stellar, by those that rank me. I also bring in the bacon, but no longer eat pigs so just feed it to those who insist upon doing so. I am half bald, but a highly competent physician. I cannot figure out how to dress to please everyone. My cutlery and plates do not match.

My Mom also worked, but somehow did it all. She got up around 5am, at which point she woke me to braid my hair, then sent me back to bed till my proper wakeup time. Off she went to work, and then home by the time I came home from school. She cooked dinner every single night and we ate almost exactly at 5pm. She cleaned the house meticulously and did all the shopping for the week on Saturday mornings, long before I was awake, then would make me pancakes or cinnamon rolls to eat in front of Saturday cartoons. Even while undergoing chemotherapy for her breast cancer, she did all of this. In between getting up in the middle of the night to puke her guts out.

Moms are undervalued in our country.

I know some amazing Moms. There is the nurse I work with who single parents, works and manages to raise chickens and landscape her yard. There is the Mom who is an amazing athlete in more than one sport and works and raises her kids and inspires me half to death. There is the Mom who lives in Little Rock and has these wonderful boys and teaches me new things about music and writing and humor and  love on a regular basis. There is my cousin who parented 3 kids to successful adulthood and has continued on with her grandchild. There is my friend who has withstood a dissecting aorta who continues to model stability and strength to her child. There is my sister-in-law who is my model for motherhood. There is the mother who adopted my kids unofficially as grandchildren and makes me feel like a daughter. There is the the nurse I work with who is strong and hilarious and thoughtful and together who shows up for her kids and her friends without fanfare. There is the Mom who made a huge sacrifice in the name of love. There is my Godmother who makes me feel loved when my own mother is long gone. There is my doctor friend who has a baby and works and makes it all seem easy despite over a year of sleep deprivation. There is my single Mom friend who works full time and creates a safe and creative environment for her child to thrive and do handstands all the day long. There is Michelle Obama who puts up with more than her fair share of absolute bullshit and judgement. Can you even imagine trying to raise kids in the White House??? And there is my husband who is not a Mom, but has taken on the stay at home parent role with grace and a strong sense of self rarely seen in a man.

What does any of this have to do with running? Well, when I run I am a better Mom. I used to tell my kids "I need to run to chase away the grumpy monster." They were totally on board with this, because who likes the grumpy monster?

I am not able to find a way to feel like a real Mom. Nevertheless, I will continue to show up for the gig. I can take the attitude, the piercings, the eye rolls and the contempt. I love them anyway, and someday maybe they will appreciate me, sort of like the way artists and poets are appreciated: posthumously.

Besides my own, my all time favorite Mom is Little Bear's mother. She is da bomb. And someone for us all to aspire to be.

Don't even get me started on Peter Rabbit's Mom.

Thursday, April 23, 2015

Humble Pie

Today while on a post-run run in the woods with my dog, there was a man crouched at the side of the trail holding one of those outrageous cameras with a lens so big and long that it could be used to beat someone to death, or it could cause forearm tendinitis for the photographer. Either way: dangerous. My dog sensed this danger and stopped cold as I ran past the man and his camera-weapon-orthopedic disaster. He just stared at the guy, from 20 yards away, mind you, and let out a low, menacing growl. I had to finally go back and coax him to pass, which he finally did with as wide a berth as possible.

Standard poodles are a lot cooler than I thought they were before I really got to know one. But they are not fond of surprises. My poodle (a phrase I never thought I would say) is a stellar runner. He runs 6-8 miles with ease. He chases flocks of birds tirelessly. When no birds are around he tucks in right next to or right behind me and does not stray from our path. He likes to run with me.

My post-run run tonight was testimony to that fact. When I came home in running clothes, having forced myself to do a run from the hospital after work, he was having none of me being in running attire, clearly sweaty and not having invited him to the party.

Lately I have been running with the San Francisco Marathon in mind, as I am all signed up for it. It is a nice race, taking you on a loop around one of the loveliest cities I know, and including a trip over and back over the Golden Gate Bridge. I have done a marathon a year for the past 6 years, and this will be number 7.

If I do it.

This is where the whole humility thing comes in. I have been dining on humble pie a lot recently. I cannot tap into my speed, such as it was, anymore. Where did it go? HELLO OUT THERE?

I recently started taking piano lessons. These are the first lessons I have had in over 25 years. Now I used to be a pretty decent pianist, and I even have a degree in piano performance and stuff. When I left music school for medicine, I actually pretty much stopped playing for almost 8 years. Why play when you cannot play at the highest possible level? Still, I dragged around my piano everywhere we moved and finally decided about 10 years ago to play the damn thing. Recently, it occurred to me I could play it decently if I had some structure and guidance. Humble pie tastes like scales and slow practice. My teacher is fucking cool too.

Sometimes I fight against the reality of my schedule. Work can be like this thing that robs you of your life if you let it be that way. But when I take a nice big bite of humble pie and chew it slowly, with intention, I can see that every minute is worth treasuring. And how lucky am I to have a profession that pays well and allows me to care for people? Also, I just sort of love medicine. It is never boring and there are so many cool diseases out there. You just have to pay attention and do a good physical exam. Surgeons are the coolest, of course, but internal medicine…. let's just say Benedict Cumberbatch would play an internist if he was going to be a doctor.

And then there is parenting. And housecleaning. And weeding the garden. And my baldish head. I am getting fat on humble pie.

My favorite part of the Boston marathon this year was Meb's finish. Classy.The guy was with the leading pack for most of the race. Everyone said he was over at 40. It would be easy for him to be bitter But instead, he grabs the hand of a woman running next to him and finishes the race with style.

And then there is Paula Radcliffe. She is doing London one more time, knowing she cannot compete anywhere near her peak. It is her last marathon. She just wants to run another one. Because that's what runners do.

All this is to say that who really cares how fast you go? Love the run, as my dog clearly does. Love the music, as my highly terrifying piano teacher clearly does. Love the work, because it is worthwhile and it puts food on the table.

Food, like humble pie. Quite delicious once you get over yourself.

Monday, March 30, 2015

This One

This one is for Greg. Also Pam.

I am inherently an introvert. Somehow, I found myself in a job that requires constant contact with other human beings, with them basically telling me all of their most intimate secrets and me asking them to put on a paper gown after stripping naked so I can physically examine them in order to rule in or rule out some life threatening or mundane illness. After hours, I am on call almost 24/7 (occasional days off do exist), which means I must answer my phone and talk to people on it, on demand. I really do not like talking on the phone at all. I am an introvert.

Being introverted, I do not instantly make friends, winning them over with my gregarious and hilarious personality. I suppose I am actually pretty awkward and broody much of the time. It is likely that on the day I hang out with people in a social situation I have also told 3 other people they are probably going to die in the next 6 months. It weighs on you a bit. Plus, introverts hate small talk.

All that being said, I love being connected to people, and I cherish those connections. Facebook is super nice for introverts who like connections. As is going for runs with friends. As is being with people who accept my awkward broodiness and quirky sense of humor.

Greg is moving, and I think it is brilliant for him and Pam. They are ready for a new adventure, and are moving to a city that has so much to offer. Greg and Pam are, however, the kind of people you want in your community forever because they are the kind of people whom, when you walk into their presence, make you feel like life is a good place to be. Not in a syrupy way, but in a real way. Like when you are walking down a sidewalk to your car and feeling irritated because you are late for your next meeting, then suddenly a waft of rose scent stops you mid-step and you see there next to you is a rose in bloom and it is March and you still expect there to be nothing in bloom in March, having grown up in the northern midwest, and you lean over to smell the rose and all of your irritation melts away. Greg and Pam are like that.

It took me awhile to get to know Greg. I am, as previously noted, an introvert. But I watched him interact with my child and the children of others, as a coach. He has a gift for this. Good coaches can extract excellence without instilling fear and anxiety. They can promote hard work without making people feel small when they don't do well. They make kids want to show up and do well just because they feel the love and respect of their coach. Also, Greg teaches by example. He brings joy to the task of running. You see it and feel it and want to be a part of it.

In recent months, we have done several longish runs on Sundays and despite my less-than-stellar speed these days, Greg shows up and makes me feel hopeful that I might run faster again, and maybe soon. He always runs about 6 inches ahead of me, and is like a deer while I am sort of like a slim hippo. I try to draft him but it is pointless (a hippo drafting a deer?). I really like running with Greg.

My awkwardness and weird jokes do not seem to throw him. This might be due to our having survived 2 Portland to Coast High School Challenges, wherein 12 teenagers are driven through the night to run 129 miles whilst 4 adults drive the vans which smell of socks, hormones and teenager sweat. This might be due to the time he has spent with my kid, who is an apple not fallen far from the mother tree. Or it might just be due to the fact that he likes my jokes. And he is just a spectacularly nice person.

An introvert may be boring at parties, but when we have friends we cherish, we are loyal and true. I also suspect introverts make good long distance runners, because we can go for long periods of time without social interaction quite happily, thank you very much.

Still, having a true friend at your side for those runs is the best.

Greg and Pam, being an introvert I am not the best at expressing myself. But know this: you are loved, and you will be missed.

Wednesday, March 11, 2015

Hashtag No Excuses

I had the funniest dream last night. I was driving in a car with Gandhi. Well, he was named Gandhi but I think he might have actually been the Dalai Lama. He was driving. It was a stick shift. He had a question and answer session, and I stayed quiet. After he was done, and there was silence for awhile, I said "Actually, I have a question." He (Dalai Lama-Gandhi) sighed, and shifted down. "Yes, what is it?" "I would like to know how a parent can teach loving-kindness to an angry, stressed out teenager," said I.

When I awoke this morning, I was hoping I had the answer to all parenting dilemmas and thus could write a bestselling novel, retire and run ultra marathons between practicing Beethoven piano sonatas. But this is what happened in my dream: He (DL-G) took me to a room with some other people. We laid a multi-colored rug on a table and did incantation over it. We coaxed smoky puffs of incense to the ceiling. That was his answer to my question.

It occurs to me that this means both nothing and everything: loss of control, ridiculous ceremony around impossible quests, and just a touch of smoke and mirrors. What sticks with me from this dream though was the affect of Gandhi-Dalai Lama. This guy was no-nonsense, and he drove a stick shift like he was James Dean. There was no struggle in his demeanor. And our questions were partially annoying to him.  He was old and not old.

Lately I have become enamored with Twitter. I am approximately 7 centuries behind, because when twitter first started I saw it much the same as I saw the internet when it first started to catch on. Mainly, with both, I said to myself, "What the heck is the point of this? And who will ever use it?" Which largely explains why I am not a multimillionaire living in Silicon Valley. Anyway, I like to post random things, ranging from the political to the satirical to the runs I take. I find myself especially inspired by stories of athletes who can be classified as geriatric. Maybe because I am spending a lot of time as a doctor to the elderly lately. And maybe because I see what exercise can do for them.

Take this guy, for example. He set the 200meter record for 95 year olds. #noexcuses

This particular story was sent to me by a friend who is about as inspiring as they come. She is not old, and in fact I am the elder compared to her, but she is strong, solid, smart, and dealing with what life has thrown her with grace and wisdom. Also humor. And what blows me away, is she takes time to support others. #noexcuses

So in full disclosure, I am not running as much as I would like these days. The reason is (here comes some excuses):
10-12 hour work days
dark mornings
I am bald and unamused
with whatever causes this baldness comes fatigue
I am unhappy with my (lack of) speed, and therefore am considering quitting running altogether

Now, if one of my children (bless their hearts) started on such a monologue of excuses, I would be saying "Hold on, I need to get something out of my pocket", at which point they would roll their eyes and sigh loudly and histrionically. Click here to see why.

I do not know why I am a slower runner than I used to be.

But does it matter? I forgot to ask Gandhi-Dalai Lama this question, but I am figuring his answer would've been just as *useful* as the rug-incantation-incense thing about my parenting question. I think what he might have meant, ultimately, was #noexcuses

It is good to show up when G-DL is driving and answering questions. It is good to show up when a strong and wise friend offers their love and support. It is good to show up when you are desperate for a run, even if your pace is not what it used to be.

Growing old is not for sissies.

Not that I am old. But I am feeling old these days. I am wondering, at times, what it all means.

And I am still trying to figure out why hashtags are a thing. They will forever be, to me, the sharp sign. As in musical notation. I have not been playing enough piano lately, but that is another story.

Monday, February 2, 2015

The Funny Thing

I DNF'ed Clam Beach. The funny thing is, I am not all that broken up about it, whereas at some points in my life I would've considered this a portent of doom. Turns out I was like the Little Engine That Couldn't. Seriously, literally: Could. Not. I proceeded to call my husband, go home and sleep for about 30 of the next 36 hours, awaking to acknowledge a stuffy nose and all-over body aches. And no, I did not call my doctor for antibiotics, because it was likely a virus, and besides antibiotics are best avoided unless ABSOLUTELY necessary.

As an aside, 10 reasons not to take antibiotics unless ABSOLUTELY necessary:
1) diarrhea, sometimes fatal Clostridium difficile-related diarrhea
2) breeding of resistant organisms that will take over the planet earth and laugh as we all die
3) yeast infections:they dig it when we kill all our normal flora
4) nausea, vomiting
5) side effects which may include: complete depletion of your bone marrow, a life threatening, skin-sloughing rash, anaphylaxis which will likely kill you unless you have epinephrine in your back pocket,  random achilles tendon rupture (runners, beware of fluoroquinolones!), liver failure, pancreatitis, seizures, renal failure…….
6) did I mention diarrhea?
7) itchy rash, all over
8) money that could be spent on something that might actually help you feel better, like a really good dose of chicken noodle soup (yes, scientifically proven)
9) your doctor is really tired of trying to explain why it won't help, and might harm you
10) antibiotics are AWESOME when necessary, so shouldn't we respect them and save them so we can use them and avoid the next Bubonic Plague scenario?

I felt guilty (back to the race I did not finish) about the friend I let go off on his own. The funny thing about running is although it is a fairly lonely sport in some ways, it is also one of community. This particular race, celebrating its 50th year, is a good example. And when you run at the side of someone you care about and enjoy, there is a bond that forms that is pretty cool. And when that someone also pushes you to be better than you would be otherwise, it is golden.

I still feel pretty cruddy today, but I went to work. The funny thing about being a doctor, is you pretty much have to be dead to take a sick day. Are you aware that your very own doctor has probably been puking their guts out prior to taking care of you because they cannot imagine taking the day off? After all, there is not really anyone to take their place. I am certain they cleaned their hands thoroughly prior to seeing you though, so you can rest easy.

I am here to tell you that although life is serious business, and running is IMPORTANT, there are some funny things about both life and running.
1) Have you ever stopped to consider just how hard it must be for the editor's of Runner's World magazine to come up with a bunch of new articles about running, which, let's be honest here, basically involves walking really fast and is done by millions upon millions of people daily without ever needing to consult a magazine article?
2) Despite #1, I do enjoy my running magazines.
3) Hundreds to thousands of racers at any given event using porta-potties. Funny.
4) Skorts.
5) Running blogs. Ha.
6) We think we know what life is about. Sometimes we get PhD's in knowing stuff. Then we die and worms eat us. Funny.
7) One of my well-educated and dear friends once ran a marathon listening to Eddie Murphy singing "Boogie in your Butt" over and over again, a multitude of times, on her iPod.
8) People think antibiotics might be the answer to EVERYTHING.
9) Diarrhea is not at all funny. Unless you are 8 years old.
10) I still think I could break 3 hours in the marathon. In your dreams, sucker!


Thursday, January 22, 2015


Running in the rain last Sunday for 16.6 miles was just plain fun. The last 3-4 miles kind of hurt, especially my lateral right foot. My shoes were all squishy and wet and the course was inclined so I felt like I was running with ataxia or on one of those courses they use in car racing. I might have tweaked a tendon or worse. But probably nothing ice and tincture of time cannot cure.

Since then, I have been resting. Partly to be sensible (doctor's tendon, heal thyself). Partly because work is kicking my butt. I cannot blame weather: it is unseasonably warm here. I cannot blame lack of motivation. I mean I love running. But I have been undisciplined in my lack of a routine. Rock Creek Runner had a good post today about how to plan and be efficient. Common sense stuff. Being a midwesterner by birth, this should be my strong suit, but I now live in California, which, while known for many things, has never been known for its common sense.

One of my favorite runs comes up soon. And I am once again faced with not being at my best and hesitating to do it because if I don't break an hour, WHAT WOULD BE THE POINT? This run celebrates its 50th year this year. And the t-shirts are reportedly way cool. So, I should probably do it even if I am as slow as molasses on a Triscuit on a sunny day in August in Alabama.

I am getting better with the whole humility thing.
Humble about parenting? check
Humble about my hair falling out again? check
Humble about doctoring? check
Humble about how a 6:30 mile use to come easy and now it just seems unattainable? getting there.

Sometimes too much humility can make you want to crawl under your covers and hide.

I think midlife does present a sort of crisis. For women, you have reached an age where you have to accept that college students call you "Ma'am" and your wrinkles are permanent. People should not be judged by their looks, but women are, every single day, in every situation. Also, midlife points out to you that less years lay ahead than behind. It is called "midlife" but it is probably pretty far past the halfway point. Also, you realize you have already messed up your kids and cannot have any do-overs. Unless they have grandkids, in which case, send them over to eat cookies for breakfast and take long rambling walks in the woods and to dig in the sand at the beach and watch stupid TV shows and listen to Beethoven. All of which I actually did with my own kids, except maybe cookies for breakfast, but somehow grandparents just do stuff with more flair.

I said to my husband the other day, regarding the midlife crisis issue: "I wish I could just buy a corvette and be done with it."

Alas, for me it probably is going to have to involve months to years of soul-searching, a lot of long runs and a completely new wardrobe. A corvette is just too easy.

But if I did do the corvette, it would be a 1957, red and white.

Can you soul-search in a '57 corvette?

Sunday, January 11, 2015


"The only good race pace is suicide pace, and today looks like a good day to die."-Steve Prefontaine

Death: you can't talk about it. You can't prevent it. You can't predict it. You actually cannot play chess against it. It is final. Or maybe not. It is ugly or beautiful or devastating or a relief or something in between and far less glamorous.

I have seen people die. People I love. People I know. People I care for. I have no particular fear of death, just the sadness of leaving my loved ones. I don't think it is all that special, as everyone does it. It is a drag. It is mundane. It is shocking. It is brutal.

But I digress, as what I mean to write about is the place you reach into when you do something really hard and not very comfortable. Death is a good example of this. But life offers plenty of chances to perfect the skill. You might try parenting to audition for the part of ultimate heartbreak. You might try playing music or writing a book or painting a painting to experience the baring of the soul, not unlike a tarring and feathering with scattered applause. Running? I see it as the basic built-in skill of humans that is both second nature and hard as hell. It is one thing to trot along and, over days, tire out the prey. It is another thing to inch up your splits, until you can find the personal record (PR). That takes:
A. Guts
B. A large ego
C. Just the right pair of running shoes
D. All of the above

I used to be faster than I am now. I might be able, still, to run faster than I ever did before. Age is a factor, yes, but I am not that old yet, and I have an excellent masseuse. The biggest barrier is psychological. For instance, my job kept me from feeling I could afford a run for all the weekdays of last week. I kept picturing leeches, sucking me dry. It reminded me of a summer day long ago, when I played all day long in some swampy area of Wisconsin and my mother lovingly pulled multiple leeches off of me. She was a no nonsense nurse, and though I complained bitterly about the disgusting task she took on, she did it, and did not flinch or complain. Which brings me back to the whole parenting thing. You will do anything for your kids. But they just see the world through their glasses tinted with "why is my Mom not a beauty Queen with a ton of money and who thinks my use of alcohol and drugs and tobacco is just so spiffy?"

Hold on, I once again digress.

Death is relevant here. You can spend your life putting off your dreams. Well, good luck with that one. You can spend your life playing chess with death. But death could not give a rip about a good end game. He has one job and that is to ferry you to the next destination. You can spend your life hating, or complaining, or seeking approval and fame and money and the next high.

Van Dyke Parks put it well. When people ask him where he is from or where he grew up or where he has lived, he says, it does to matter. Who you are is:
"The books you have read, the art you have seen, and the culture which has impacted your personality."

Read a book. Listen to music. View some art. Know your community. And do not underestimate the power of the death. Is today a good day to die?