Friday, December 29, 2017

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.















Sunday, December 10, 2017

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?