Sunday, March 27, 2016


"Now the reason we're here, as man and woman is to love each other. Take care of each other."
-The Pretenders

When I was 12, my Dad took me on a road trip. We drove (actually he drove. as a I was 12), from LaCrosse, Wisconsin to Kalamazoo, Michigan to Toronto, Ontario, to Montreal, Quebec, to Quebec City, Quebec, to Bar Harbor, Maine, though Boston, Massachusetts, to New York, New York, to Gettysburg, Pennsylvania, to Philadelphia, Pennsylvania and back home to Wisconsin. In retrospect,  I respect my father for all that driving. On that trip, I perfected my knowledge of the capitals of all the states, about which I was mercilessly quizzed. This came in handy on one of my first days in practice as a doctor out of residency, when I said to a patient "do you have any questions?" and he, a crotchety old man (bless his heart) said "Yeah, what's the capital of Vermont?" Without an instant of hesitation I said "Montpelier." He looked at me with a newfound respect and I secretly thanked my Dad for the previous road trip state capitol torture.

On that same road trip, we were camping in Quebec. The people in the tent next to us had wild and verbal sex. My Dad was a minister and I was 12. Shudder. The next morning, as Dad and I were eating the pancakes he expertly cooked for us on our camp stove, the people next door stumbled out of their tent. My Dad raised an eyebrow at me. Like that commercial says: priceless.

Fast forward 34 years (holy hell, how did that happen??). With my daughter at a respectable hotel in downtown Portland. It is late, we are tired, we finally stop watching Say Yes to the Dress. Not before I have had a complete laughter meltdown regarding the topper to the wedding cake of this one couple, a 3D thing that reads #SOULMATES. I am not really sure why this totally cracks me up, but certain things do and when they do, I am a slave to my laughter. Just ask my nephew Mark, who has the best joke delivery of any person I have personally known. Sometimes I cannot stop laughing.

So anyway, we turned off the show and settled in to sleep, as it was almost midnight. Only then did our hotel neighbors start having the loudest sex known to human history. My kid and I laid in silence for awhile, because, what DOES one say in these circumstances. Finally, I said "hashtag soulmates". Sigh. Credit to the river side Marriott in Portland: the next day I requested a (cough) "quieter room", and they came through and also gave us a complimentary breakfast. Hashtag hash browns.

The day after the said event, we were walking about Portland and stumbled upon a bridal boutique. When we stepped inside, a young woman strides toward us. "So, who is the bride?" she asked with confidence bordering on the obnoxious. Well, it is sure as hell not me, thought I, with my bald head and bad skin. I asked if a kid and her Mom could just peruse with dreams about the future, and she said sure (obviously disappointed, but fuck her anyway). My kid was mad that I did not let her spin some story about her wedding dreams, right there on the spot. And she was right, because she could have spun such a story as never was heard in that boutique. We could have been legend. Even so, we had fun fondling the dresses and discussing our preferences. I have decided I am getting married again if only to get the chance to wear one of these dresses as a self-possessed woman of the 21st century. Husband, get busy re-proposing to me.

Speaking of which, I ran a lot during my Portland trip. My kid, who is a fair bit faster than I, was too sick to run. So I went out solo, each day, on the river front in this town with many bridges. I grew up on the Mississippi River, so rivers sort of tug at my heart. I mean, look at this:

I ran and I swooned for the beauty of Oregon. I ran medium fast. Last time I ran this route, there was snow on the ground. But now it is spring and the weeping willows called to me. We don't really have weeping willows in California. But they beckon me to recall my youth. My best friend and neighbor Amie had weeping willows in her yard.We played Ghost in the Graveyard and Kick the Can amongst those willows. I was afraid and courageous all at once while hiding during these games. I remain afraid and courageous. Ollie ollie in come free.

I am lucky though, because I am married to my soulmate.

My soulmate plays Sudoku while he runs. He understands Beethoven, even the late quartets. He writes prolifically and reads. When he reads, his mind is like a steel trap. He also remembers the lyrics of every important song every written. He and I spent our honeymoon penniless, but happy. We camped in the snow of Vermont and the tangible stars that hung low on a freezing cold night in Bar Harbor, Maine. Now we have 3 children, and still, he is my soulmate.

We adopt our soulmates. We have adopted two children as well. Some say adopting children is not the same, but let me tell you, once you decide to parent a child, they are yours. Only yours. Decidedly yours. Like soulmates. Those that don't understand think soulmates must have genetic relations. Genetics is great. Parenting is greater.

Hashtag: I showed up for you day after day.
Hashtag: I love you.


P.S. Although your wedding dress is awesome, can you please tell me how once dances with such a long train?

No wait, don't tell me. I want to decide for myself.

Atthys, will you marry me?


In Provence, in a new dress.



Hashtag: The Reason We Are Here::

Saturday, March 19, 2016


On Wednesday, I just drove 11 hours for a 90 minute doctor's appointment. It was a good doctor. On that ride, I listened to a book, The Martian. This book, now also a movie which I have not yet seen, proves that it is well worth paying attention in science and math class, and also learning how to plant a garden in an inhospitable place. If you don't know math, science and botany, you are pretty much fucked if you get stranded for 18 months on Mars. Also, air is important and complicated.

While waiting for the doc to come in, I had time to read much of the book When Breath Becomes Air. Paul Kalanithi was a neurosurgical resident and neuroscientist at Stanford, who died just after completing his training. Of cancer. In his 30's. Just months after he and his wife had a baby. What I got from his book is that he loved life. And that his love of life, literature and knowledge saved him. Not literally, of course. But like our fictional friend stuck on Mars, it was the air provided that gave him sustenance. Air in the form of literature, poetry, love of family, knowledge of a greater purpose. He liked to operate. And he wrote this book for us and for his family, even when he was so exhausted. He quotes Samuel Beckett: "I can't go on. I'll go on."

When we run and are out of shape, or when we run at elevation when used to sea level, we suck air. That is to say, we feel like we are breathing through a narrow straw and sucking greedily to get what we need to survive. It is a luxury, of course, to suck air in the pursuit of a workout or race. Illness that causes this same sensation is not a choice. Thankfully we do have medications to help with such sensations, in those with illness. For the out of shape runner, sucking air is just part of the hazing process for induction into the fraternity/sorority of Delta Delta Pheidippides.

When I was young, Nike Air Jordan's were the shoe to get. The name made sense to me, in that the amount of air between MJ and the floor was epic. I wonder really if flubber was in play there. Now Nike has all sorts of shoes in the "air" line, including these:

Image result for nike air shoes pictures
In the literal sense, air is composed of 78% nitrogen, 21% oxygen and a touch of CO2, water vapor, argon and whatever the local factories and cars and farting cows add to the mix.

We air our thoughts and air out our stinky camping gear. We put on airs. We look at the skies as "air space". Airiness can mean a lightness, or unconcerned quality, an open space, something insubstantial.

I am in the midst of a rather intense flare of an autoimmune problem. My best treatments are toxic, in that they slap down my immune system, which is, after all, an important thing to have except when it is trying to destroy you. My self-treatment for the stress of this, and the stresses of my work and life is a complicated regimen of petting my dogs, laughing with my family, watching the Warriors obsessively, playing piano and being out in nature, especially running. Illness can make all of the above tough to do while also holding down a rather intense job. But being outside, being in the open air, this is crucial. Turns out my immune problem gets revved up further by sunshine, DAMN. IT. But the fine doctor I saw on Wednesday did not suggest I stop running or avoid nature at all costs. Nah, he Rxed "sun beads" to monitor things, sunscreen that won't make my skin fall off, and special magic stuff "to wash your running clothes in", some kind of sun guard thing. I love this doctor for not telling me to stop running outdoors. Rx: get out and get some air.

And here is the thing. Paul Kalanithi knew that language, literature, science, religion all matter, in the sense of this is how we relate to each other and to the devastating reality of illness and death. I think "when breath becomes air" might be referring that old style Shakespearean concept of words as breath that flies into the air. Attention to our words matters. Please note this, Donald Trump and all ye who support that fiend.

To be a good healer, listen well, rush not, prescribe exercise and nature,  and read as many books from all genres as you possibly can. Understanding everything as well as possible is a quest worth tilting at, I think. Chased by a healthy shot of "I actually understand nothing." And when the headache from all of this heady thought and self awareness sets in, take 2 pills of "holy shit, does any of it matter anyway? I can't go on! I will go on." Witnessing suffering on a daily basis can get to you. Kalanithi puts it so well, referring to the "endless barrage of head injuries", saying "I began to suspect that being so close to the fiery light of such moments only blinded me to their nature, like trying to learn astronomy by staring directly at the sun." Later in that chapter he returns to the ER after just losing a patient despite resuscitation attempts, to rescue his melted ice cream bar, which he actually then successfully resuscitates in the freezer and enjoys very much.

In second grade, all of my daughter's little essays ended with the phrase "all in all…" , like "all in all, redwood trees are very interesting." So I would like to pay tribute to her here.

All in all, air is very interesting, very insubstantial, and highly under-appreciated.

I can't go on. I'll go on.

Thursday, March 3, 2016

That Feeling

The frogs are chirping outside right now. They come alive after dark, with so much to say. This sound is third in my favorite playlist of things to hear while laying abed, after crickets and the roar of the ocean. I suppose I am less the city mouse than I thought I was as a youth. There is a certain feeling I get hearing these sounds, and it may be nostalgia or serenity or clarity. It may be my serotonin levels are directly linked to singing frogs.

I was eating at a local place on the marina the other night with a dear friend who mentioned that feeling one gets from a run, that no other sport quite offers. Now I am sure people would argue this point, but there is probably a reason it is called "The Runner's High". Only it is way better the getting high (or so I assume, I never inhaled). Biologically, I assume it is built in to us as we once had to run for days to tire out our prey, then hone in for the kill and finally eat. If the running part was highly unpleasant, we might not have survived as a species. Granted, we don't need meat to survive at this point, as we can just trot on down to our local market and get all the plant-based protein our heart desires. But the runner's high persists. It must be there for a reason.

I get that feeling from running even when I am in my worst physical condition. Which is about where I am now. I have an immune system that attacks me and it is rather unpleasant. The medications to treat it are almost worse. Still, when I put on my shoes and head out there and hit the trails, I feel strong and I smile. I can feel my tense muscles relax, and my worries fade. It is not unlike the serotonin burst the singing frogs provide. The real bonus is when I can get up early in the dark dawn and hear the frog choir while running. Mind blowing.

If you think this is a public service announcement for exercise in the outdoors, then you are correct. I spend my days trying to diagnose and treat disease, but here's the thing: If you exercise and spend time outdoors, you wildly increase the chance of good health. At any age.

Art and music also helps us be healthy. I wrote about it here, in my glamorous side career as a columnist.

The smell of eucalyptus in the rain is a balm. The touch of a loved one, leaning or pressing against us, is a strong cure, that has held up against the FDA and time immemorial. The memory of a first kiss, the strains of a song of import, the aroma of your mother's best comfort food: it matters.

That feeling. It will haunt you, the rest of your life.