Friday, May 13, 2016

R is for Reality

You haven't known fear until you've lost your 9 year old in China. It was not the first time he was lost. That was in Toys R Us. The second time was in Golden Gate Park, which I would rate as just slightly less terrifying than China. You look away and he absconds. In China, it was along the Yangtze River, flying kites. The city has about 7 million people.

Don't worry, we found him. He was surrounded by women helping him untangle his kite string and pull it out of the river.

Sometimes you are concentrating on flying your kite and are oblivious to everything else. Or maybe chasing a butterfly down a path by the boat playground near Ocean beach in San Francisco. People think you should be concentrating on the slides and sand box. But there is so much more to see and do.

What is important in this given moment and why is the world the way it is? A friend recently sent an article from the Atlantic regarding the illusion of reality. Although I have no doubt the author is right, I also have no doubt he is wrong. Who am I to say that what I see is what you see or that it even exists beyond what my brain has constructed as reality for my daily consumption and survival? Is my sky your sky? When we simultaneously ooh and aah at things of beauty, are the beautiful things even there or just a product of mathematical and hormonal  and axonal constructs? My answer: yes. Like one hand clapping, grasshopper.

The other day, a patient mentioned they wouldn't be making it to their specialist visit (for which they had waited for months), as there was a luau that day. The doctor part of my brain was like, are you fucking kidding me? The human part of my brain was like, yep, good choice. Both truths existed and my brain exploded, and they are still picking pieces of it off the walls in my office.

When my 9 year old was lost, I freaked out but also became very focused. There is this thing about mothers, where the little annoyances can make you completely lose your shit, but when big things occur you become like a hawk who has focused upon a mouse far below you in a field. Nothing else exists, and everything becomes still and silent and you dive with dead accuracy and a stony demeanor. You get the job done. My son, he was found, and my daughters who were also flying kites never suspected anything amiss. Job done.

It helps to have a good mate, with a cool head. Dads can be cool as cucumbers. But I don't think they have that same instinct, the mother bear, the hunting hawk, the do not mess with my children or I will rip your head off sensibility.

Once, long ago, my youngest was playing basketball. Just rec basketball. She was 6, and very, very small for her age. She actually weighed less at 6 than many of my friends' 2 year olds. Anyway, there was this Amazon-sized 6 year old guarding my daughter and she kept knocking her down. Hawklike, I rose from the stands and walked onto the court and went chest to chest with the ref. My child was mortified. But seriously, don't mess with my children.

 I am reading H is for Hawk right now, and perhaps this is why hawks are on my mind. In this memoir, the author deals with the grief of loss of her father, and tells a tender and harrowing tale of training ("manning") a goshawk. Her perception of the world is changed by her interactions with this bird of prey. It preys on her heart and not in a bad way. It turns out hawks can play and they see so much more than we do. They are tamable but not domesticated. And they really, really like raw meat.

So, when someone chooses the luau over medical intervention, is it real? Is it wise? The longer I parent and the longer I doctor, the less I know about what is right or wrong. But the more I know about how each creature, each human, approaches their life with hawklike intensity and a faulty grasp of reality. We see what we think we should see and our brains play along. We think we know what will make us healthy, happy, rich and perfect, but this all changes as fast as our browsers refresh and our attention spans waver.

I propose the following: nothing is real, everything matters and the luau is always the right choice. Also, don't mess with my kids or I will tear you from limb to limb, like a hawk and its prey.

But if my kids are reading this, remember: Compassion is the greatest power.

What does this have to do with redwoods and running? Well, hawks (and falcons) are super fast. And watch how they maneuver through the woods. Compared to them, we are slugs. Slugs with uncertain reality and prone to losing our children in large, foreign cities. Slugs who love a good luau.

Could be worse.

Monday, May 2, 2016

I Pulled on Trouble's Braids

I pull on trouble's braids. I diagnose the enormous vertebral artery aneurysm, the unalterable dementia, the untouchable pain and the metastatic cancer. What kind of cancer, you ask? What does it matter, I know them all. Disease brews in all shapes and forms and pulls on trouble's braids. Eosinophils gather and gather in my own blood and wreak havoc, along with antibodies that fuel the fire that puts me in my place, unable to run, unable to play Beethoven, only concentrating hard on the well being of those I serve.

I pull on trouble's braids, asking the healthcare system for more than it wants to give, both for myself and for those I treat. The ridiculous expenses, the misguided goals, the unrealistic expectations all threaten to extinguish my dedication but they won't, at least not to to others and at least not today. My medical school loans will be paid off by age 65 or so and I think every penny was worth it. I know how to stay one step ahead of trouble.

But I pull on her braids. Just like that kid who sat behind me in 3rd grade. We met on the playground at recess and in those days no teacher lurked at every corner to micromanage every interaction. 3rd grade boy no longer pulled my braids. But grown up trouble has not been able to catch me at recess just yet, probably in part because on my proverbial recesses I curl in a ball and lick my wounds and try to talk my eosinophils off the ledge or back into their box.

Trouble's braids bite back. But I know the sweet tune to lull them so I am unafraid. As I have taught my children,  compassion is the greatest power. That tune lulls the worst kind of trouble. Compassion, compassion. Compassion for others, and for oneself.

I pull on trouble's braids, fighting for the most vulnerable. It is what my parent's taught me, and so I do it.

I pulled on trouble's braids, and took up a sport some say ruins the knees. Some say running too far can damage the heart, the feet, the vertebral column. Ask Ms Ida Keeling about running and I think her opinion might differ. Trouble probably just lets her pull on its braids, no questions, no complaints.

I pulled on trouble's braids, and I lived to see another day. I found solace in the arms of those I love. I laughed at the jokes my elder patients told me. I fought side by side with the disenfranchised to get them the care they deserve, or don't deserve, because care should be unconditional. I curled up into a ball and prayed for someday soon being able to run, to play Beethoven. To play Bach. To play Chopin, To play.

I pulled on trouble's braids. I pulled on trouble's braids. I pulled on trouble's braids.