Facts, Fracks and My Telltale Heart

Facts: Today was my one hundredth day in a row of running. Which is about 27% of my goal of a whole year of runs. The average person has 100,000 heartbeats per day. My resting heart rate, so says my watch anyhow, is 45. That makes around 65,000 beats per day not including my runs which get my heart going pitter-patter. Over a million Americans have HIV/AIDS. Almost 200,000 do not know they have it. The entire Presidential advisory council on HIV/AIDS was fired this week. My son turns 20 in a few days. He will be behind bars till about age 30.

Some patients of mine broke their backs recently. I had about 36 hours of bad low back pain this week. I never get low back pain. I decided, like a father with morning sickness, that my body was empathizing. Worldwide there are about 8.9 million fractures due to osteoporosis annually. If you are 50, white and a woman, you have a 16% risk over the rest of your lifetime of developing a broken back. Today I ran before my evening hospital rounds. I passed a silver haired older woman riding her bike. She waved at me and said "I'm impressed!" I waved back and said "So am I". Which is to say we acknowledged each other's badassery.

Yesterday I was running at the beach. It was one of those foggy days where it can be hard to know where you started and easy to lose your dog if he strays too far. With my head in that fog, and earbuds budding from my ears,  I listened to Prince Harry interview President Obama. It was like being on another planet, what with the fog, the waves, the prince, and a highly thoughtful, intelligent, well-spoken president. Miles, my dog, stuck pretty close except when stealthily tearing off after a seagull or raven. Speaking of bad asses, beach ravens are the baddest. I've seen one teasing Miles, swooping down and darting out of his reach while he barks his head off, over and over. This is the same poodle who notices animals on TV then searches for them behind the TV. If I had a choice between a raven and my poodle to take my next Boards exam for me, I would have to go with the raven.


Facts: Once a tagged wild raven lived to be almost 23 years old. My father knew Poe's The Raven by heart and used to recite it to me in a creepy voice at bedtime. My father had two hearts. The one he was born with, and the one that was transplanted into him at age 60. I think Poe would've liked this. He might've even written something like The Telltale Heart Transplant. ZDoggMD, can you do something with this idea??

I like to read and re-read and listen to and read again the books I enjoy. Same with TV shows. Recently, we are revisiting Battlestar Galactica. I like how everyone in charge is called sir, gender non-specifically. I like how the women are strong, the men are good looking and the cylons are above average. And the way everyone gives such a frack about everything is inspiring. I mean, they are less than 40,000 souls and the only surviving humans and go months and years without a run at the beach or feeling one bit of sunshine on their backs. And yet, they keep surviving. And they keep caring about each other and their kids and, most astoundingly, the deeper meaning of existence. Also, Fred and Carrie from Portlandia totally lost their jobs because BG is such an addictive TV show.

I have been working a lot lately. I am not proud of this, it is just a fact. When I work without breaks a few things tend to occur:
1) My heart sinks when my phone rings.
2) I get cranky.
3) I start to feel responsible for all disease in the world. Like personally responsible.

If you ever try calling me and wonder why I don't answer or I answer with crankiness, please see 1 and 2 . Although I try to combat number 1 above by changing up the ring tone. For awhile it was the Downton Abbey theme song. When that started making me want to smash my iPhone to pieces, I switched it to the theme to James Bond. That went off when I was rounding in isolation garb the other day, thus my phone under layers of antibacterial, neon urine-colored, paper gown material. I just sat there and continued discussing life and death issues with a bemused gentleman, in his own hospital garb of a butt-flashing, bleach-smelling cotton dress of the typical drab coloration. He laughed at the Bond serenade. And wanted to know where his goddam pants were. Ah, the healing power of American Medicine.

As for number 3, I gotta work on that one. Fact is I cannot keep everyone healthy all the time. It is perhaps possible that I give too much of a frack to have a sustainable life as a physician.

And yet, a physician am I. Care I do.



Pretending not to care about stuff that matters must be exhausting. If one has to be exhausted either way, why not choose caring. If life hurts either way, why not choose hope. If love lives in our hearts and that heart beats 2.5 billion times before we give up the ghost, it seems we have a lot of love to go around.

Facts: I can run 100 days in a row and live to tell the tale. My dear son is almost 20. My patients live until they die. My heart breaks and heals again, stronger than before. My heart breaks. My heart heals again. Stronger than before. My telltale heart.

Hope

Have you read The Color Purple? If you are in prison in Texas, then you have not, as it is banned there (while Mein Kampf and books by KKK members are not banned-bah humbug). But I am not in prison in Texas, so I am re-reading this book, which I first read around age 19. At that time, some slightly older than me and erudite woman asked me what I was reading, and when I said The Color Purple she rolled her eyes and scoffed "ohhh". "I thought you read real literature". I was baffled then but am even more baffled now as I re-read it. It is well-crafted, hard to put down and did after all, win the Pulitzer prize. The thing is it is quite prescient. That is to say, it is scary how it still sings truth to a broken world that might even be slightly more broken than when I was 19.

But this post is not about despair, this post is about hope. As someone who has been struggling with my spiritual mooring for several years, born and bred a Lutheran (albeit a radical, left-leaning one) of many generations, and now mostly aghast at the words that come out of vocal American Christian mouths, I have been trying to figure out how to define my faith. Because I have it, I do. Alice Walker's character Shug Avery gave me some words for it, which I think I did not get the first time I read this book so many years ago:

“I think it pisses God off if you walk by the color purple in a field somewhere and don't notice it. People think pleasing God is all God cares about. But any fool living in the world can see it always trying to please us back.”
― Alice Walker, The Color Purple

She says a whole lot more on the subject, but I don't want to spoil this shiny part of the book for those who have not yet read it. Notice the word "it". Not "he", not "she".

Anyhow, I injured my hamstring but am still on my running streak, day 81 today. It has become like breathing. Sometimes it helps to remove the "if" and replace it with "what time, exactly" in life. Like, "if things get worse I will speak up" becomes "I will speak up at 2pm today, rain or shine, fire or flood, as my country is losing its soul while thinking it has gained the whole world."

Not my words, of course. Take it from the experts:






































Hope is not a plan, says Atul Gawande. He refers to planning during serious illness and in the last phase of life. But this quote is good for many occasions. The word hope derives from "to have confidence and trust in the future". Maybe related to "hop"--"leaping in expectation". Add to that a plan, and we are in business.

Hope: the world does not end because of climate change.
Plan: stop consuming so much.
Hope: my hamstring will heal despite my stubborn decision to continue my running streak.
Plan: do massage therapy, heat, ice, stretching, and use the evil foam roller.
Hope: that compassion will win in the end.
Plan: model compassion and vote out the assholes.
Hope: my community becomes healthier.
Plan: show up, face the inequities, and stop waiting for someone else to fix things.
Hope: my dog doesn't eat another entire bag of pistachios again today, or any day.
Plan: hide the pistachios in a poodle-proof bunker from now on.

Have you noticed the color purple?

The Maltese Falcon

I recently re-read The Maltese Falcon. Dashiell Hammett is a decent writer. A decent writer with a cool name. Dashiell was on my list of names for our son. Would things have been different if we had named him Dashiell?

The thing is, Trump ruined everything. What I noticed this time through Hammett's fabulously noir, San Francisco hip novel is:
-"a girl is here to see you"
-"shoo her in, sweetheart"
-"you'll have to trot along, precious"

Also, Cairo was gay and that was clearly not cool in Hammett's world. Or at least Sam Spade's world.

If any of the "girls" tried to do something, say something, THINK something, they were patted on the head and sent on their way, or into the kitchen, but usually only after they were squeezed, kissed, touched or fucked by Sam Spade.


I wonder why I was not too bothered by any of this before? I used to read Hammett while on the N-Judah or J-Church. You could be even more in San Francisco in his novels than you were by actually being in San Francisco itself. His novels made me want to smoke hand rolled cigarettes and drink scotch like it was a major, nay essential, food group.

The J Church, San Francisco

It is possible misogyny is an essential part of being a manly man's man, I suppose. The Greek is: miso (hate), gyne (women). Clearly Sam Spade does not hate women. He loves them, as does [insert name here of any of the recently discovered misogynists whom likely just represent the tip of the misogyny iceberg]. As does Trump.

An interesting aside. Though I could wax poetic about how poetically Hammett describes the tender rolling of a smoke by Spade, I am actually a misocapnic. I miso (dislike) capnia (smoke). In medicine, we talk about hypercapnia in reference to the retention of carbon dioxide in the bloodstream of those who no longer have the urge to breathe properly, making them pretty doped out. Smoking is a risk factor for developing the tendency to forget to breathe properly, in part because the brain gets so used to having a low oxygen level.

I can hardly breathe recently. Who will be next in the world of misogynistic creep wads? And why is the president endorsing a child molester to represent people in the governing of our country? Oh yes, it is because it is better to have someone who has hurt children be in power than someone who is a democrat. Or brown. Or gay. Or a woman.

It is exhausting to realize I have a president who would see me as an ugly person. And not because he actually cares what I think, but because I have wrinkles and some grey hair and am old enough to have daughters he would want to date. It is likely many will not understand how exhausting it is. Because I do not just sit there and think about how my daughters have to see such men rule the world, and sexually abused children have to hear their president say it is OK for people to molest children. But I have this deep-seated fear of what the backlash from white men (not all of them, just the ones with power and great fear of the rest of us) will be. I keep picturing an Atwoodesque response, ala The Handmaid's Tale, where subjugation of women became the way they/we were protected from misogyny. It is sneaky and creepy and scary as hell. It felt like a weird science fiction bizarro world the first time I read it. But like Hammett, I re-read it recently. And Trump has ruined everything.

I am not a sacred vessel. I am not a girl, a sweetheart, a precious. I am not the one doctor in the room you call by her first name because all the other doctors are men and need to be addressed as Doctor So and So. I am not interested in your opinion about my waistline, my outfit, my hairdo, my legs, my vagina, or my choice of shoes. I am tired of feeling like I might get raped or verbally assaulted when I run in the dark or in public. I am sick of worrying about my daughters having to experience all the same shit I did, which in the grand scheme of things was really just the usual shit, nothing too extreme. But lots and lots of women suffer in the extreme, because they are women.

On a brighter note, today was day 62 of my running streak. I have noticed I am getting stronger. My heart rate averages 47. My body keeps asking me "are we training for a marathon or W.T.F.?" My dog is fairly elated, my laundry quotient is through the roof, and I think my brain might be directly connected to my Strava feed. I don't even need any electronic devices anymore. I am one in connection with the social athlete media world. I laugh at the pounding rain of the pacific northwest. I revel in the dark encroaching upon my morning and evening free hours. I fly free and fast and furious.

I am furious. Which brings me back to reading Dashiell Hammett.
Sam Spade was more tolerable in the Obama era because hope abounded. Sam Spade was the past. Hope and respect and, dare I say, even love for others was the present and future. There would never be any going back. Until there was, there is. Until the Asshole era.

But I do not want or need to be protected from all the assholes. I just want to be able to speak my mind, teach my daughters, practice my medicine, play my music, love my neighbors and go for a run in the dark in peace.

On the other hand, children DO need protection from assholes. I hope my country wakes up and does the right thing, which is to say do not look the other way any longer. Just a few for instances: No child molesters in office. No rapists in office. Flint needs clean water. Immigrants need respite. Puerto Rico needs the lights on. No one needs to walk our streets/schools/churches with loaded weapons of assault. Our graduate students need to be educated without suffocating debt, so we can be an intelligent country who can solve problems.

Now excuse me while I get down off my soapbox. I have a hot date with my foam roller.

48

When I was 8, I knew my next best age was going to be 48. Then after that 84. It is a thing with me, this attachment to the numbers 8 and 4. I might have thought about this at age 4 too, but I cannot remember much about age 4. Mainly I remember the feeling of my toes in the the sand of an Atlantic Ocean beach on some family vacation, probably to Florida or maybe it was Long Island,  and the time my family stopped on the highway to help another family who had a car crash in front of us. There was a lot of blood involved. My Mom was a nurse, and she seemed pretty much in charge of the situation, as I remember it.

I recently turned 48. I am celebrating with a streak. You can rest assured I will not be running around naked. The last time I was naked in public was that summer night a bunch of us skinny dipped in Lake Mendota. Although I guess I have done a few of the quick changes at the beach after surfing or swimming since then. I do recall a gaggle of well toned naked surfers of the male variety which I spotted on a run a few years back, them just toweling off on the side of the beachfront road while I ran by all sweaty and middle aged. It was one of the moments where you both blush and thank God you are a runner who likes to go off the so called beaten path.

My "streak" is a run a day for 365 days. I have recently started regaining my health after a few years of struggle. The struggle as an athlete was compounded by mega doses of steroids, and not the ones that acned teenaged boys or Soviet era track stars might take to get all buff. Nope, just the kind that make your body turn into an alien. A blobby alien that would never get picked up at one of those bars on Star Trek. Anyway, thanks to science, a new drug came out this year that finally let me kick steroids to the curb. Thank you science.

Science. Remember that? It was this thing we used to pride ourselves on in this country and now our media ridicules it. It is only adored when it does us a good turn, like vaccines or safe contraceptives for our teenagers. Oh but wait, did I say adore or abhor?

Please forgive my digression. I am 48 years old and my mind sometimes wanders.

I am on day 25 of my streak. I have been at this running thing for enough years to know that this kind of thing can be risky. Especially in middle age and beyond. So I am varying pace, terrain, mileage and shoes. I am also lifting weights because I want to be strong. Very few people are aware of my secret identity as a Ninja Doctor. I must work my core and be ready for stealthy diagnosis and most especially be ready to jump out at my staff unexpectedly.

From the Ninja Doctor series, by Heather Irvin

I am not quite ready to go back to racing yet. I might never reach my prior pace, but I think with a little more time in the post-steroid era and some steady daily running, I might have a chance. Maybe at the Avenue of the Giants.

I just read a tweet (does one read tweets? Or is there a special verb for this, like #skimmed140?) about a guy who completed 800 official marathons all under 3:20.  I would love to run one under 3:20. I was 6 minutes shy of that in the pre-steroid era. Who knows what 48 will bring. I also #skimmed140 today that Meb ran his last long run before NYC, a 27.7 miler, in 2:56.
Ah, Meb. Coolest cat around.

Yeah, that's me and Meb

I have been thinking about the frivolous nature of going for a "streak" during these times. Puerto Rico is under water, yet without barely a drop to drink. An amazing colleague and friend lost her home in the fire, still burning, just south of us in California. My baby boy is in prison, and once again they are on "lockdown." On lockdown, all prisoners must stay in their cells 24/7, sometimes for weeks. They get a shower every 72 hours. I spent this weekend admitting people to hospice and putting the finishing touches on a lecture I will give soon on dementia. People, life is grim. A friend mentioned this weekend she feels bad complaining in the context of the abject suffering around us and around the world, but really suffering is not a contest. It is like comparing that apple snow white was given with the orange man in office. Or Harvey Weinstein and the guy who dry humped me against my will at age 16 when I was trapped, one of many sardines, on a bus in Rome. It is like comparing the unthinkable with the unfathomable, or the irritating with the bothersome. It is like comparing cancer with dementia or a hurricane with a fire or a bully on the playground with a bully in the workplace. Which is worse? I would say it doesn't matter.

Plus I am 48 this year and my 8 year old self is telling me that no matter what evil befalls us, 48 is golden.


Don't do it SW!

Speaking of Twitter, and Facebook, today many women have posted "Me too". That is to say, that almost every woman you know has been sexually harassed or assaulted in some way at some point during their life. I wrote last time about running as a woman. Short version is, I think we should be allowed to run free and we should not be expecting to be attacked. Except maybe by a mountain lion, and that is their prerogative given we are on their stomping grounds.

Run at your own risk...

I also just finished re-reading The Handmaid's Tale. Sheesh, talk about grim. What struck me about the book this time through were three things:
1) Atwood has a brilliant way with words
2) Never take the game "Scrabble" for granted
3) They justified enslaving women as a way to protect them from assault and misuse by men. So, it is like doing them a favor.

#3 is kind of scary, because I could see this happening. In a society where predators are considered unable to control themselves, you either shoot them or you hide. And although many think it is OK to shoot a mountain lion who wanders into "our" space, I would bet many would not see punishment of the predatory male, particularly the predatory white male, as optimal. In fact it is possible some might even want such a predator to be in the oval office! But I have been reading too many scary fairy tales lately...


Incidentally, I do not agree with shooting lions for simply wandering into our back yards which were once their own backyards. But they are scary as hell, and I hope I don't meet one tomorrow morning when I go for my run! At least not too close of an encounter, because spotting magnificent wildlife is wonderful. Just let it see my fierce poodle companion and know we are not worth the bother.


Roar!

The heaviness of grief involved with just being here and awake is potentially suffocating.

Rx: hope, run, read, love, laugh, rinse and repeat. 48 times.

Running With XX

Now don't get excited. I have neither the personality nor the stomach for pornography. What I refer to here is the female chromosomal composition.

I have been thinking about the whole issue of being female lately. I mean, I have been thinking about it my whole life, but with the election of a proud misogynist who considers our White House a dump and pussy grabbing fair sport for all men, it has been on my mind more. Also, as the days shorten I face my yearly dilemma. How comfortable am I running in the dark?

My email feed fed me this story today, about a high school XC runner attacked. The response is the team will fight back, learn self defense. Turn off the music, remove the ear buds, be vigilant, etc etc

All good advice that I would readily give my own daughter but where is the strong and furious shout to men to "STOP ATTACKING WOMEN!" Granted, I don't worry about it as much anymore, as I am relatively old (yeah, I turn 48 this week, planning to ask for headstone for my birthday) and not particularly beautiful. But even today, I was on a walk during my break at work. The neighborhood I work in is pretty sketchy. I like to listen to my book on "tape" while I walk. I like to walk to get my ass off my chair. Anyway, this guy was acting sort of weird and blocking my way on the sidewalk. I considered a different route, but instead put my game face on and moved forward. He so completely owned the sidewalk that I had to step into the dirt and circumnavigate him. I was ready to kick his ass if necessary. But alas, he turned out to be not interested in me. But he was also oblivious to his power.

Men who might read this: please be aware that you have power, just being you, just walking on a sidewalk, just stopping in front of us for reasons we cannot fathom. I am sorry if this is a drag for you, but imagine how your friends of XX chromosomes, wives, daughters, coworkers feel. Every time we venture out into public space alone feels potentially dangerous.


Not long ago a runner fought off her attacker in a rest room during her long run.
Moral of the story: never stop to take a piss.
Moral of the story: take a self defense class because some men are really awful.
Moral of the story: Not today mother fu$%er.

Even that phrase, "mother fucker" is so awful. Violence against women made into a catchphrase. Now I love Miles Davis as much as anyone ever has, but his use of that word was excessive. I got to see him in concert once, and he just flung that word around on stage, like it was nothing.

I don't really get what it means, though I guess it might be considered praise. it might be that men are so intensely disempowered by their mothers that they had to think of a way to regain that power. Or maybe I am overreacting. Whatever. I will continue to enjoy Miles Davis' music.

When I was in elementary school, I could outrun all the boys. That is the beauty of pre-pubescent youth. The male-female thing does not mean much until the guys sprout density and the girls sprout softness. Even just a few years ago I could outrun a lot of men. But then age, health, gravity, and discouragement got the best of me. Which is not to ay I can never return to my prior prowess.

But in order to do so I need to run in the dark, because summer is short and I work long hours. I need to be able to go out in the wee hours of the morning and not fear for my life, except maybe a healthy fear of the mountain lions and tripping over redwood roots on the trail. I would like to think my advanced age and elder status is like an armor, so I no longer need to worry about creeps on the streets and trails. And maybe I do not.

Women are objects. Women cannot be president. Women are either beautiful or worth nothing.

Or maybe our president and his followers are actually mistaken. Maybe we are just people too, some of us fierce and powerful, some of us petite and shy, some of us goofy and nerdy, some of us gay, some of us transgender, some of us soccer Moms, some of us Paris Hilton, some of us just about to turn 48 with hopes of one or two more PRs in the marathon.

So what should we do about women runners? Should they just be able to run, whenever and wherever they wish? Without fear? Except the fear of their own limitations? Or should women be always on the alert for the next attack?

So, what?

For Granted

I am not exactly sure where the phrase "taken for granted" came from. I assume it has to do with the thought that if someone grants you something, it comes at no price, it is expected, it is bequeathed, it is a gift.

There are seven things I commonly take for granted:
1) The 800 acre redwood forest that is my back yard
2) The ability to run, albeit slower than I used to
3) My career, though I did work pretty hard for that one
4) Playing piano, which is something I can just do
5) That I will one day retire, and be able to enjoy my days without worry
6) That my son is OK, despite being in prison, because surely someone cares about him there
7) That I will wake up tomorrow

My parents put off a lot of things till retirement. Then they both died before retirement so....HA! That gives me pause.

The other morning, I was getting ready for work. We boil water for our pour over coffee, and I had just turned off the burner and poured the boiling water on the precious grounds. I knew the stove grates needed cleaning, and started lifting them up, one by one, to put in the sink. The last one I grabbed was the one I just turned off. It immediately started to melt the skin off my thumb and index finger. I screamed. My high school kid did not wake up. My husband freaked out. I spent the rest of my pre-work morning with my hand soaking in a bowl of ice water.

The thing I took for granted: playing piano. What if I actually burned my fingers so severely that they died? A thumb and index finger on the right hand is a requisite for every single Beethoven Sonata.
I have not played much recently. I am too busy. Studying for Boards. Working a lot. Not able to get this darn piano recital together, so why bother at all?

But the thing is, if you told me tomorrow I would never be able to play Beethoven again, I would swoon. And not in a good way.

I have a very good job, and a very nice house. Very.

So when I come home from work and walk the dogs in the woods with enormous redwood trees towering over me, I should be awed. Often, though, I am just thinking "Zoe! Take a crap already!" Zoe is our 12 year old Golden Doodle who is an idiot savant. She loves music, but only through the very early 20th century. She chews on stinky socks while contemplating Mozart. She faithfully trotted down the hall every night to sit at my feet and peer up at me while I sang my children to sleep, back when I did this. She needs a gold-engraved invitation to take a shit.

I used to run sub 7 miles. Now I am ecstatic when I run sub 8. True, I am fatter, as my 100 year old patient so aptly pointed out the other day during a house call. But there are things that affect speed beyond blubber. Like:
1) son in prison
2) working 60 hours a week
3) lack-o-motivation

Now about work, I do like it. I get to think hard every day about challenging puzzles. I get to serve people in need. I get to take the Boards again October.

The boards:
1) expensive
2) standardized
3) a racket


My son, well he is in prison. What can I say? I am a terrible Mom.

Oh, also, he is not half the criminal our current president is.

What I do not take for granted, when I stop to ponder:
1) my children, though not flawless, are beloved
2) my husband, who is a rock
3) my legs, which might someday reach sub 7's again, at which point I will gloat mercilessly
4) my piano hands, which through not invited to Carnegie Hall, can play pretty much whatever you place in front of them
5) my work, which feeds my family and feeds my soul
6) my compassion, which you can just try to pry out of me. I dare you.
7) my friends. Who provide comfort, hilarity, steadiness, support and reality checks.

Seven ways to not take things for granted. Just kiss not taking for granted goodbye.

Ode to Cross Country, A Sport for All Seasons

I. Summer
A licorice aroma, is that wild fennel?
Mixes with pine and sand and clean air.
An apothecary of molecules,
Carried on the rapids, insistent,
And musically I know where the river must dip
And rise, the bass drum of depth,
The floating soprano skimming over smoothed stones.
Bird song composed to recall expanse,
Not grounded.
Asynchronous, raucous, lightly
Orchestrated to surprise.
Not so much tan as dirty, the demarcation
Of where my socks meet the narrows above ankles.
trail sand and dirt clinging on me as if I can carry them to safety.
Roots, shadows, rocks try to trip me
But I stay grounded while I fly.

II. Fall
At the gym today a proud Dad talked about his son the football player.
He also excelled at track.
I found myself wishing he ran cross country instead of playing football.
The start of cross country season is like no other magic.
At the gym today, as I lifted weights with my almost 48 year old prowess, I recalled similar sessions,
Back when I was young and had a team.
Weights and sit-ups practiced amidst the other teams with larger arms and legs.
This after piling into the Coach's pick-up truck bed, no permission slips in those days.
Carted off to a better place to run then the streets around school. We stayed grounded
While we flew.
Season started with leaves crunching underfoot. In California we don't have that,
But I have found that abandoned mussel shells crunching underfoot on beach runs
Hits the same spot of satisfaction.
Season ended with near snow or actual snow. Near snow is a certain feel in the air,
The visible breath on exhale. Actual snow means fall is over,
Except there might be one or two more random days inviting runners to wear shorts.
Nothing is more peaceful that a run on freshly fallen snow.
Not one damn thing.

III. Winter
It was early in January this year.
Downtown Portland.
On the river.
The people in the hotel room adjacent to ours had loud sex.
Awkward, when it is you and your eldest child listening, silence broken
By giggles. "#Soulmates" was all I could think to say. Stork stories are long past.
Sun up, looking with sleep-crusted eyes down 14 floors onto
Snow. Snow on the streets of Portland.
The world is a miracle, or else about to end.
Either way, shoes laced up and good running friend is met.
There is nothing more peaceful than a run on freshly fallen snow,
Through campus and along the river.
It was so quiet I seriously wondered if the world was at an end.
Where was all the ambient noise, the orchestrated city bustle, the slap of shoes
Against pavement?

IV. Spring
Spring marathons are a challenge.
You have to train in the short daylight of winter,
Dark when the alarm goes off, dark when the work day ends.
Just when I seriously start to wonder if the world is going to end,
Days elongate and orchestrate to surprise, with frogs peeping and birds tentatively
Offering their song.
Trillium bloom, then Purple Iris.
Fiddle leaf ferns unfurl.
Season starts with dead, soft redwood fronds underfoot, just as new lime green buds are sprouting at The ends of Redwood branches.
Not one damn thing can make a spring marathon easier,
Except the sun offering just a little bit more of itself than it has in recent months.
And the smell of Eucalyptus on a rainy day.
Everyone is so hopeful on the morning of a spring marathon.
At the starting line you can feel like the kid who toed the starting line,
First meet of cross country season, gun about to go off, young muscles still,
The still before the storm.
Like no other magic.

Emily

I do not usually post so frequently. I am a somewhat reluctant blogger, a sometime writer, a midwesterner turned Californian who has discomfort with sharing and yet knows the only hope is to reach out to others.

I have been listening to podcasts a lot lately. My real addiction is  Audible.com, but as I try to spend less cash, I find I can do without so many books all the time by tuning into the podcast genre. Today, while walking one of my dogs, I was listening to an interview with a poet, Marie Howe. She teaches her students this poem, by Emily Dickinson:

I felt a Funeral, in my Brain, (340)

BY EMILY DICKINSON

I felt a Funeral, in my Brain,

And Mourners to and fro

Kept treading - treading - till it seemed

That Sense was breaking through -

And when they all were seated,

A Service, like a Drum -

Kept beating - beating - till I thought

My mind was going numb -

And then I heard them lift a Box

And creak across my Soul

With those same Boots of Lead, again,

Then Space - began to toll,

As all the Heavens were a Bell,

And Being, but an Ear,

And I, and Silence, some strange Race,

Wrecked, solitary, here -

And then a Plank in Reason, broke,

And I dropped down, and down -

And hit a World, at every plunge,

And Finished knowing - then -

Her students were like, "What?" 

She asked them "Have any of you ever experienced a panic attack?"

And if you have, read this again. 

Ahhhhh, poetry.

But Emily is just so-

When I was about 10, I was sitting on the concrete wall next to the driveway of my childhood home. My brother's friend, who happened to be named Emily, asked me what I wanted to be when I grew up. I said "A poet."

How weird was that?

But it turns out that my husband is a writer, my eldest daughter is a writer and I am-

I am-

Today I spoke with two families and patients about "code status". This is where we get to decide, on paper, whether to do cardiopulmonary resuscitation or not. Do we intubate? Do we put in the intensive care unit? 

Do we put a tube down their nose or into their abdomen to feed them when they cannot swallow? 

My advice: no tubes. But then my perspective is that of a doctor. I Know I would not want it for myself. I know that life ends. I know that death can be hard. I know that just because we can do more things to people does not mean it is right.

21 years ago, my Mom died. 21 years ago this weekend, my Mom died.

 I was nursing my eldest child in the waiting room where we slept when my Mom died. I was a medical student, who knew so little about it all but then learned more than I wished to, when my Mom died. My Mom died when we all stepped out at once to have some food. I ate a veggie burger in the hospital cafeteria. I can still taste it. It was not good enough to be absent when my Mom died.

But then again, I can still taste it. It was not like real meat. It had some substance to it though. The bun was whole wheat. I ate it next to my husband and brother. My caloric intake was important, because I was breast feeding.

When I came back to her room, she was no longer gasping for air. She was gone.

I wailed, but my Dad wailed louder. Not 2 years later, he was gone too.

Poets are amazing. They have to condense, speak truth, follow the rules of decent writing, and touch our hearts.

Sitting on the concrete wall of my parent's yard, I did not know it would be so hard. Nor did I now doctoring would encompass so much poetry. Nor did I know life would encompass so much-

So much-

Emily? 

The Emily friend of my brother is now a physician. And so am I.

Thanks, Mom.

Perspective

I just started listening to a podcast called Ear Hustle. It is relatively new, only 4 episodes so far. Which works out well because I am relatively new to having a child in prison, and this is like a connection to him. I keep hoping I will hear his voice in the background (as it takes place in his current prison), or maybe he will get interviewed. Yes, I did not really picture this as an aspiration for my child. I can see the bumper sticker now: "My Kid is the Ear Hustle Inmate of the Month!"









Ear Hustle is quite good. I recommend it to anyone, whether you have had a prisoner in your life or not.

I was listening to it today while working in my yard. For perspective, I am on call this weekend, and thus not exactly "free", but as I listened to the stories of the inmates, while sweat poured down my face from pulling weeds (yes, I am a wimp), I felt so very free. Houses, gardens, work so often feel like traps or cages or something we do while we wait for the good part of life to start. Which is ironic given house-garden-work represents the American dream.



Turns out life is just life. You wake up (if lucky), go to work (if lucky), eat some good food (if lucky), try to exercise (if lucky), walk your dogs (if lucky), do the wash for the millionth time (if lucky). Unless you are in prison, or a war zone, or a drug addict or super sick or mentally ill without good treatment or poor or Donald Trump. Whom I do not suppose has done a load of wash in his entire life.

artist http://www.lizavonrosenstiel.com/gallery/


I posted on Strava the other day.


I have not been posting my runs all that often, because I am really slow now. I mean I was never super fast, but could run 7 min miles for a prolonged period, up until that *cough* extra 30 lbs. Freaking steroids. So anyway, I posted the other day all whiny about my slowness and was reminded by someone "yeah, just be glad you can run."

As my teenager would say, "oh, snap!"

So today I ran and posted it because, let's face it, I do like my social media, and just had done my rounds at the inpatient hospice unit, then walked the hospice labyrinth and somehow it felt OK that I ran like a slug on quaaludes. Which might be slightly redundant.



Who ya calling a slug?

Another thing that gave me perspective recently was listening to The Brothers Karamazov on Audible.com. Which took 37 hours and 8 minutes to be read aloud to me. One part was really funny, about the over-specialization of doctors:

"I tell you, the old-fashioned doctor who treated all diseases has completely disappeared, now there are only specialists, and they advertise all the time in the newspapers. If your nose hurts, they send you to Paris: there's a European specialist there, he treats noses. You go to Paris, he examines your nose: I can treat only your right nostril, he says, I don't treat left nostrils, it's not my specialty, but after me, go to Vienna, there's a separate specialist there who will finish treating your left nostril."

I also liked getting to know Stinking Lizaveta (and her unfortunate son). Because a band I like quite a bit derived its name from her.



The perspective I gained in "Brothers K" was:
1) I am not the worst parent in the universe. It is amazing the Brothers K made it to adulthood.
2) It was probably not worth 37+ hours of my life.
3) Some guy READ FOR 37 HOURS DOING ALL THE ANNOYING CHARACTERS.
4) Stinking Liz is mute though, so that part was easy.
5) Dostoevsky did not like doctors much. His Dad was a doctor, and he grew up playing in the gardens of a hospital for the poor. He did seem to like courtroom drama. A lot. A whole, whole lot.
6) Russian novelists of a certain era seemed to lack editors.

I don't have an editor either, so there. Ha. It's my blog and I can share my perspective for as long as I want to.

My parents both died a long while ago. Coming up on the 21st anniversary (deathiversary?) for my Mom next week. They may have left the earth prematurely, but their perspective on life and love and compassion and humor had a big impact on me. A cousin recently sent me this picture of them.
You might think it odd that they are turning their back. But I know them, and they were just being goofy. Perspective.

  

Running amongst the giant redwood trees gives me goose bumps, even after all these years. They are really big. Even the young ones. The old ones are just so stunningly massive, it feels like being in the presence of a living piece of history, like the kind of history you find on timelines long before anyone was doing much besides scratching off their cave lice and dragging their fists in the dirt. Perspective.

The point? I don't really know. I thought I did but I see now that life has no point, so to speak. We just keep showing up until we don't. What makes it bearable is noticing. Noticing the funny and horrible and beautiful and goofy and painful.

artist: Jianhong H.

One guy who is a master of this art of noticing is actually playing my town tonight. Still out there playing, after all these years.

I am on call pretty much every day of life. For work, which is truly painful, but hey, I have a job I love so....I try to keep perspective. But I am also on call for life. I am waiting for the next little thing, which I suspect involves walking the dogs given their impatience with this endless blog post. Thank goodness beepers are no longer a thing, because if life was paging me on a beeper all the time, I just do not think I could take it.
Life: "beep, beep, beep"
Me: "Fucking pager, what is it now?"
Life: "come out and play, stat!"

Ode to Laura

I have known strong people.
I have known hilarious people.
I have known people who run fast.
I have known people who are kind and compassionate.
I have known people who light up the room when they enter.
But it spins my head to know someone who is all of the above.

I would like to be Laura when I grow up, all buff and intelligent and
Such a good story teller.
It hurts to run with her because
1) she is way faster than I am and
2) she makes me laugh so hard

When you are just trying to hang on to a pace, laughing is not at all helpful.
Elite runners might want to take this to heart, and tell killer jokes on the third turn of the track, just before you kick to the finish while your opponent is doubled over with hilarity.

When I have felt shame for my parenting woes, true kindness has been a hand reaching to me with words of solidarity and "it could have been any of us".

When I have felt shame for my health woes, true kindness has been a reminder that just being able to move is a gift and the speed demon inside is only waiting for the next best time to emerge.

When I have wondered what strength is, I get my magnifying glass out and check my Oxford English Dictionary.

Strength: 1. Laura McNulty.
Used in a sentence: Laura is strong as shit. Unbreakable pretty much.
Cuz females are strong as hell.

I have known strong people.
I am thankful for them.

And I am thankful Laura is no longer in my age category for road races. For the time being.

My goal: to be unbreakable as LM. And to be as kind as LM.

Orange is the New Black

When President Obama said "orange is not the new black" I laughed and laughed.

I am no longer laughing.

For profit prisons have no motivation to rehab their prisoners. And Mr. Trump has no reason to behave, because he was elected while wildly misbehaving. How can you tell your children to strive for a better education, a better understanding, a more compassionate heart so they can be successful, when the Oval Office is occupied by someone who does not read, does not care to read and apparently does not give a shit about his own country?

I like the show "Orange is the New Black", but as a parent of a prisoner, it is no longer just mild entertainment. My son is not a big person, and he has mental illness and he likes to please the people around him which is partly why he ended up in prison in the first place. But all of that makes him a target. I am terrified of what might happen to him. And I cannot do a damn thing.

The local online rag published his arrest, and the comment section was filled with hate for him and my husband and I. Now we are not perfect, but we are parents who love our children, and we both are solid citizens, and we did our very best. Two of our children are pretty darn successful at life--they are kind, smart, caring, funny and capable. And they are not on drugs. It turns out being on drugs really messes up a kid's mind. Naive as I am, I never imagined drug dealers would present themselves to my child's middle school with drugs and make them feel like big heroes with money by asking them to sell drugs for them. Seriously, I am not stupid, and I have cared for many a drug user and pusher in my work over the years, but in my little, rural town, who would've thought drug dealers can just walk onto campus and fuck up your kid?

Once there was a young man (20-30 years old) who was admitted to our hospital for cutting off his own penis in a fit of drug-induced insanity. He was not on my service, but my colleague caring for him commiserated.

I keep thinking of what I could have done better as a parent. Maybe I should have worked less. But they had a full time Dad at home. I grew up with 2 working parents, and I considered it a  luxury to have a stay-at-home Dad.

We loved and sang to and read to and educated and supported and travelled with and did I mention we loved our children? But it was not enough.

All that aside, today I did a house call on a 100 year old person and prevented an emergency room visit and hospitalization. After that, I got a haircut and my teenaged daughter said I looked "on fleek." I think that is good, but I am not absolutely sure.

Today I also ran on the beach and my dog was thrilled. The fog was dense at the beach, though cleared just 1/4 mile inland. I have learned to love the fog. It is mysterious and cool, and thankfully it keeps my runs from being 100 degree torture sessions. The sand was a little like molasses today and I was also not exactly on fire. But I ran, my dog frolicked, the birds ran away from my dog and I kept a 100 year old out of the hospital. So if I die tonight, let it be known, my last day was not so bad.

For profit anything might be super cool for rich people, but it is the pits for everyone else. For profit healthcare? Not compassionate. For profit education? Bullshit. For profit prisons? A good way to ensure young men, especially men of color, stay incarcerated and never get a chance to shine in life.

A house call on a 100 year old is not particularly profitable, in the monetary sense. But I beg the world to listen and understand: when you are laying on your back, with your eyes watching God, the only thing that matters is how much you cared.

Orange is the new black. Now, what exactly are we going to do about it? And how will we live this one precious life?

Screen Doors

There are certain things I miss as a Californian. I have been here more than half my life now, and it has always felt right for me, with the ocean and mountains and relatively progressive politics. But there are some things I miss as a Californian.

One thing is screen doors. I grew up in a home where the front door was open all summer, as was the back. But both had a screen door to keep the mosquitoes and other sundry flying creatures from making residence inside. For sure, if you left that screen door open for too long, Mom would be on your ass to close that thing. It was almost as heinous a crime to linger with an open screen door in the hot Wisconsin summer as it was to lollygag with an open refrigerator door while deciding which snack (American cheese in those little plastic wraps? Braunschweiger on bread? Mom-made leftovers?) to devour. Refrigerator door lollygagging always led to the following statement from whichever parent was nearest: "Are you trying to air condition the neighborhood?".

We did not have an air conditioner, we had screen doors. An air conditioner might've been better when it was 96 degrees and darn near 100% humidity, but to this day I cannot really get used to air conditioners. Like when I go to a meeting in a warm place (Florida or Vegas) and know (after experience) I need to pack a sweater because in the dead heat of summer it is going to be 52 degrees in the windowless meeting room. When I was at a meeting in Fort Lauderdale several years ago, the beach was not even within running distance. My one free afternoon, I took a cab to the beach. The ride there took 25 minutes, and was uneventful. I walked the white sands, marveled at the entirely different universe that was Fort lauderdale compared to my home beach which is generally almost uninhabited except for seals, crabs, my dog and great white sharks. When I caught a cab back to my hotel, the cab driver was unfamiliar with the hotel, which was somewhere near some mall and which had highly efficient air conditioning. It took 90 minutes to get back, and several times along the way his GPS said "rerouting". During that ride, he told me his life story in a thick Brooklyn accent. He was pretty pissed at his teenaged son. At the time I could not relate, though now I sort of can. Anyway, he charged me only half the fare (which was still considerable) and I was just glad he did not rape me and throw me into his trunk. Guys out there-don't be shocked. I cannot think of a single woman who would not consider that possibility in such a situation.

When it was really hot in Wisconsin, the best place in the house was the basement, which is another thing California lacks. I mean there might be a basement somewhere in California, but I have never yet met one. Basements are innately creepy, but always delectably cool in the summer. My brother made his bedroom in the basement. I was not allowed down there much during those years, but sometimes would sit on the steps of death (as a physician catering to the geriatric crowd, I now know that was what these steps should've been called). There was no way those steps were built to any code, and it is amazing we all did not fall down them and die in a bloody heap at the bottom. Anyway, I would sit on the death steps and listen to my brother playing his Kiss albums when friends were over. If he found me there he got very angry, and I ran like a bat out of hell. Or maybe it was Meatloaf he was listening to on those days.

The basement held spider webs, darkness and the laundry room. We had a storage area and it was definitely crawling with vermin but sometimes in the winter you HAD to go in there to get your ice skates. My brother made a darkroom under the stairs, and he rarely let me in there either. I am concerned about those darkroom chemicals he was breathing in our haunted basement all those years ago. But last I saw he was biking around some mountain lake in California. Which is something we did not have in Wisconsin. I assume the chemicals gave him super powers to bike as he does. Maybe I should have spent more time in that dark room, like when he was not looking.

I sat on those fall-risk basement stairs with my hands over my ears when they came to take away my Dad's body. Now before then and since then I had and have seen plenty of dead people. I am not a serial killer, do not worry, rather I am a physician and it comes with the territory. Especially as a hospital physician, you get called a lot to "declare someone dead." It is an awkward moment, as usually loved ones are at the bedside grieving. I remember my Mom once saying to me "make sure I am dead before they bury me." I was probably like 10 when she said this and I will never forget it. The thing is I did NOT make sure she was dead. But I assume the doctor that declared her dead DID. It is a source of continued worry and guilt.

The other thing California does not have is proper seasons. Granted, I am not complaining. I get to run, bike and take my dogs out year round without freezing my proverbial or actual ass off. And I have become familiar with the subtleties of season change where I live: certain wildflowers bloom at certain times. The redwoods fronds pad my path with pillow softness in the fall. The ferns unfurl and tickle my legs when I run past in the summer. The birds sing in the mornings in the summer, and the frogs peep in the mornings in the late winter and spring. But in Wisconsin, there were at least two distinct seasons. It went like this:
Summer: Yesterday it was 50 degrees, today it is 90 degrees. Suck it up buttercup.
Fall: Oh man, those blood red trees are magnificent. Wait, it is 90 degrees again! Oh, never mind, it is snowing.
Winter: Cold. For at least 6 months. Which is so fun except when the snow turns brown with dirt and salt and it is April and you cannot get your back door open to let the dogs out because there is TOO MUCH SNOW.
Spring: "Professor, can we have class outside?". Three days later: summer.

I signed up for the California International Marathon in December. Can you blame me? It is a "net downhill course". The thing is I am conflicted because the North Face Endurance marathon in the Marin Headlands is in November. I won this race a few years back. It is grueling, with intense climbs. When I ran it, there was also the 50 and 100 mile races, so when people cheered me on I kept saying "Oh, I am just doing the marathon."

Who says that?

My runs lately have been lacking speed. I am not sure whether I have another marathon in me. I really want to PR (personal record) but this might be LI (literally impossible) as I am OOS (out of shape) and have an AID (autoimmune disorder). But my DOG (dog) thinks I should just run a lot to get ready for whichever race I end up doing, and take him along for the ride.

I had a dog in Wisconsin. My Dad named him Brandy because he was the color of brandy. I have never personally drank brandy but it is on my bucket list of things to do before I die. I had better not visit my childhood home and walk down the basement stairs before I have had brandy. And also I should not do so after I have had brandy. Conundrum.

My dog Brandy lived a long life, and he enjoyed walks and runs off leash because he was just that cool. One day I was running and realized he was not at my side. I looked over my shoulder and saw him about a quarter mile behind me running next to my friend's Mom. That's when I knew he was old.

Now I am my friend's Mom. My fate will be sealed when the elderly neighborhood dogs find me a compatible running companion.

Until then, I plan to be inspired by the greats. I plan to unplug my ears while sitting on the stairs of doom and face the realities of loss, aging and grief. I plan to keep the refrigerator door open for as long as I please. When I meet my parents on the Other Side, they can lecture me. I am looking forward to giving them a heavenly eye roll.

I plan to open the screen door of my heart and let it all in.

Except the gosh darn mosquitoes.

Joan Benoit Samuelson. How cool is she?

Black Lives Matter

I am thinking it is time for another marathon. I have put it off due to slowness and sickness and tons of work and fear. But time just keeps ticking and I am pushing 50 and I think a marathon is in order.

Now both of my parents died in their 60's, so pushing 50 is no joke. When you are 20, time is endless, when you are 30, you still feel pretty invincible. When you are 40 you start to sweat a little, like shit I am 40 and I had better do all those things I meant to do 20 years ago but never did. Except when you are 40 you are likely busy, either raising children or building your career or having a mid-life crisis. But when you are 47 going on 48?

We got a letter today from our son at San Quentin. He is just barely 19 and in the special needs yard. Which is interesting, because he was considered "special needs" when we adopted him. At first that seemed accurate, as he needed thickened formula due to tracheomalacia. But as we got to know him, and saw him (literally) make other mothers nearly cry from jealousy in the sandbox when they realized that at 12 months old he was speaking in full paragraphs, we were not so sure. Then he went on to somewhat wreak havoc throughout his school life. And eventually find drugs and gangs and finally, prison.

My son is white. But I think he has some struggles that made it hard for him to survive and flourish in the world of academia and white bread success. When I think of his struggles, I cannot help but think of the black mothers who  have seen their children be killed. I do not pretend to understand the pain and fear of this phenomenon. But I continue to wonder at the repetitive aspect of this particular type of murder.

Philando Castile.

So marathoning seems a little ridiculous in the face of social injustice and racism. But what it provides is this:
A chance to test limits
A dance with the body and the mind
A glance at the impossible and improbable
A prance with all the other fools who choose to do this crazy race
A look askance at those who judge

I ran early this morning at the beach. It is day 2 of summer. The mist and fog sort of clung to the river feeding the beach. The sun was rising and painting the ocean pink. My dog was fucking crazed to chase the birds. My heart was pounding regularly at a rate of 143 bpm. My resting pulse is about 51. I ran along the sand thinking "will I ever be fast again?"

I think the answer is yes. I may need to lose my prednisone pounds. I certainly have some work to put  in:
fartleks
tempo
repeats on the track
core work

But mostly it comes down to the mind. My son, in his recent letter from prison, said "I need to focus on the present. That's the only way I'm going to make it through this."

Be here now.

Recognize the struggles of those in your community.

Understand life is precious, limited and all in all, sort of hilarious.

Never stop fighting for what is right.

Black Lives Matter.