At the end of my 50th lap the other day, I pulled myself out of the pool and realized the life guard was going around telling others to leave the pool. I caught a few words as I walked by with my pool-watered ears. "Someone hmmphed in the pool". I guess it was vomit or shit. I was oddly unconcerned.
I just recently took up swimming again. I am concentrating mostly on my breathing for now. My friend who swims in the ocean every day gave me some tips. Exhale in the water, and if it seems like it is taking too long to get a breath, exhale in puffs "like a preemie baby with too much CO2". Switch sides-better for the neck. Keep the crown of the head toward the opposite pool wall-do not lift the chin. Just tilt to the side and breath under your armpit.
I try not to suck in too much pool water, because of the whole infectious disease issue. When I was in medical school, we took a class called "I & I" (Infection and Immunity). Let me tell you the salient points: the toilet seat covers they provide in public restrooms are ridiculous. Fanny flora (this is a actually what my professor called it, disdainfully) is not what you need to worry about! Its the things you touch with your hands. Thus I never touch the flush handle directly, nor the bathroom door, nor any door handle for that matter. Also, don't flush and put your face into that space! Flush and run away fast as you can. Will you look crazy, elbowing door handles and running away from the toilet? Probably yes, but so much better than a bad case of E. Coli from that person who never washes their hands, not even once.
I almost never get sick with contagious diseases. Though I hardly need to, since my own immune system is too busy attacking me, myself and I to bother about getting excited about outside threats.
I started swimming recently in my quest to re-achieve some semblance of fitness. I still run of course, though I like to think of it as more of a Frun (flubbery run) or a Pshruffle (pathetic shuffling run). Where the holy heck has my speed gone? I know the cops did not confiscate it. So, I suppose it is hidden like Waldo in the crowd and it is not dressed in stripes but rather well camouflaged. I will find it, if it is the last thing I ever do.
I also do core work. Which is to say, I try to make my middle section feel really beat up. The other day, after the vomitous, feculent swim, I was doing core at the gym and in a small room with 3 other quietly suffering and hard-core women. Three 20-something year old guys came in, and were immediately intimidated by us and turned tail and ran away. Strangely satisfying, was that. I was actually standing on my head at the time. I like to do headstands. It makes me feel age-defying.
When I was a kid I used to do headstands while watching Star Trek and Disney and Little House on the Prairie re-runs. Michael Landon, by the way, looks good upside up or upside down.
I have been thinking lately about choices. We choose whether or not to exercise. Or to stand on our heads. Or to wash our hands. Or to lie or speak truth. We choose whether to run or swim or sit on our couch and eat a donut. Pretty soon in California, you can choose whether to expedite your own death. But only if you are declared to have 6 months or less to live by 2 separate physicians and perhaps a mental health specialist and have 2 verbal requests in person and one written request and another attestation signed 48 hours before you take the pills, by yourself, because no one else can administer them to you, and the attestation shows you still want to do this and are mentally and physically capable and by the way, the drug companies have increased the cost of the death-hastening medication by several hundred percent and your insurance company cannot tell you if they cover any of this unless you ask for that information and the act of trying to accomplish all of this might just make you decide that you would rather spend the last 6 months of your life standing in line at the DMV.
I care for people who suffer. It is my calling. I am a little concerned about this new legislation. But I am willing to support my fellow humans in finding their way. I won't prescribe death, though.
The thing is, I wonder why we are so averse to upholding dignity, to using the great tools we have (hospice, palliative care) and to not being defined by this culture of youth and ease? Yes, I like to be physically active, and yes I want to run as fast as I can. But I am still a valid person just as I am now: vaguely overweight, extremely bald and just not as fast as I used to be. The people I care for are also disenfranchised, because we have no definition for the value of the aged.
I have looked into the eyes of the most demented person, and have come away changed. How can I explain this? Maybe this way: visit a child, especially a newborn or someone aged 1-2. Are they of value? They are all new and they see the world with different eyes. Same with dementia. It is not a tragedy. It is just human-ness in a different way. Different than the hyper-productive, show-offy, Facebook and Strava-worthy way. Different, real, sad, happy and occasionally incredibly annoying. Like the rest of us, actually.
Which brings me back to the pool. Someone either very young or very old managed to shut down the pool with their bodily functions. I had my workout done, so no skin off my back. Also, I am on a mission to regain my (sort of) athletic prowess. Poop in the pool is good preparation for the actual scariness of sharks in the waters of Hawaii, say if I was doing an Ironman or something.
Maybe I ought get my MMSE checked?
Nah. I want to be like the Iron Nun when I grow up:
Friday, June 3, 2016
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.
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.
Tuesday, April 19, 2016
Guardian Angel
Today a patient gave me a gift. Now don't get all excited or up in arms about doctors accepting gifts-it was not a Ferrari or anything. This was an elderly person who is kind of on the gruff side, so it took me by surprise. It was a necklace, an angel, a guardian angel they said. They see me all rash-covered and bald, and they care. I am not easily moved. Well, I am pretty easily moved actually, because the beauty of the mundane and the wondrous punches me in the gut just about every other second. But this was just such a kind and simple gesture. It made my day.
I also got a crown today, of the dental category. I am currently reading this book called The Piano Tuner, which takes place in the late 1800's in London and Burma. As I sat in the chair listening to that terrible whine of the drill, smelling the tooth and prior filling being ground into dust, I was thanking my lucky stars for anesthesia. In my book, the part I read today included a scene where a boy had to have a few fingers amputated. They just tugged his ear real hard to distract him, then cut away when he was not looking. I am a wimp at the dentist, but have to admit it was tolerable, and there was no surprise ear tugging involved. Plus I got to watch my crown being made. Basically they do digital mapping, shape it to match the shape of your real tooth, and they put it in a "mill" which, like a 3D printer, takes the information from the computer and shapes you a brand new tooth cover. A tooth tiara. Then they shove that thing in there and voila! You can go home and chomp on some steak or whatever. Tofu in my case.
The guy who wrote The Piano Tuner was top of his class at Harvard, then graduated with an MD from UC San Francisco. His book was published at age 26. So annoying. My dentist is very beautiful, like an Elf in Lord of the Rings. She is also obviously smart and she can wield a drill like a total bad ass. Annoying. I was contemplating this fact today, how certain people are annoying in their seeming perfection. Why does this bother us? Or is it just me? Maybe I am the annoying one.
My dentist.
Speaking of annoying, the other day, my dog was laying on the window seat, minding his own business, and in recovery from a run in the woods, when the neighborhood black cat showed up. She likes to torture my dogs. This particular time, she came right up under the window and just sat there. My dog was apoplectic. I am unsure if he thought she was a real threat, like a black panther or something, or if he was just pissed off that she was in our yard and a cat. Nothing I said convinced him that he was tilting at windmills. So I just kept playing Chopin which sounded better than ever as I could not hear it over the din of his barking.
My dog(s)-Guardian Angels.
One of the chaplains at hospice (where I work at times), gave me the book My Grandfather's Blessings. There is a story in it about the biblical Jacob wrestling with an angel. The Angel attacked him, but when the angel let him go, Jacob held on and refused to release until he received a blessing. Jacob was hurt from their fight, and the angel touched him where he was hurt. And the angel gave him a blessing and departed. Rachel Naomi Remen, MD, who wrote this book, ponders on this story, told to her multiple times by her aging grandfather. She struggles with inflammatory bowel disease, and has had severe bouts which required prolonged hospitalization. She says "How tempting to let the enemy go and flee. To put the struggle behind you as quickly as possible and get on with your life. Life might be easier then but far less genuine. Perhaps the wisdom lies in engaging the life you have been given as fully and courageously as possible and not letting go until you find the unknown blessing that is in everything."
Doctors who struggle with their own illness are like fish on bicycles. We are supposed to be disengaged from suffering, so that we can face it off every day like a tough teenage boy in a brawl. We do not feel good about weakness, at least not in ourselves. Medical school and residency teaches us that.
We strive to avoid suffering, which is understandable. I, myself, cannot wait to get back to my prior level of exercise, my prior athletic body habitus, and my prior lack of outward signs of illness. I see myself as less than whole right now. Though I suppose that could be because I spent 2 hours staring at my gorgeous dentist today. Sigh.
Yesterday I encountered one of the toughest women I know at the grocery store. She made me laugh, right there in the produce aisle. And reminded me that toughness is not about bullshit, but rather it is about meeting yourself where you are and acknowledging that angel who is beating the shit out of you. The you ask the angel for a blessing, and get back to business.
Which makes me think of Beyonce. Which seems like a good way to end this. However, I would not be hired to be in her video, given my rashy, bald self. Beautiful people are so annoying. They need a Guardian Angel to kick their ass.
I also got a crown today, of the dental category. I am currently reading this book called The Piano Tuner, which takes place in the late 1800's in London and Burma. As I sat in the chair listening to that terrible whine of the drill, smelling the tooth and prior filling being ground into dust, I was thanking my lucky stars for anesthesia. In my book, the part I read today included a scene where a boy had to have a few fingers amputated. They just tugged his ear real hard to distract him, then cut away when he was not looking. I am a wimp at the dentist, but have to admit it was tolerable, and there was no surprise ear tugging involved. Plus I got to watch my crown being made. Basically they do digital mapping, shape it to match the shape of your real tooth, and they put it in a "mill" which, like a 3D printer, takes the information from the computer and shapes you a brand new tooth cover. A tooth tiara. Then they shove that thing in there and voila! You can go home and chomp on some steak or whatever. Tofu in my case.
The guy who wrote The Piano Tuner was top of his class at Harvard, then graduated with an MD from UC San Francisco. His book was published at age 26. So annoying. My dentist is very beautiful, like an Elf in Lord of the Rings. She is also obviously smart and she can wield a drill like a total bad ass. Annoying. I was contemplating this fact today, how certain people are annoying in their seeming perfection. Why does this bother us? Or is it just me? Maybe I am the annoying one.
My dentist.
Speaking of annoying, the other day, my dog was laying on the window seat, minding his own business, and in recovery from a run in the woods, when the neighborhood black cat showed up. She likes to torture my dogs. This particular time, she came right up under the window and just sat there. My dog was apoplectic. I am unsure if he thought she was a real threat, like a black panther or something, or if he was just pissed off that she was in our yard and a cat. Nothing I said convinced him that he was tilting at windmills. So I just kept playing Chopin which sounded better than ever as I could not hear it over the din of his barking.
My dog(s)-Guardian Angels.
One of the chaplains at hospice (where I work at times), gave me the book My Grandfather's Blessings. There is a story in it about the biblical Jacob wrestling with an angel. The Angel attacked him, but when the angel let him go, Jacob held on and refused to release until he received a blessing. Jacob was hurt from their fight, and the angel touched him where he was hurt. And the angel gave him a blessing and departed. Rachel Naomi Remen, MD, who wrote this book, ponders on this story, told to her multiple times by her aging grandfather. She struggles with inflammatory bowel disease, and has had severe bouts which required prolonged hospitalization. She says "How tempting to let the enemy go and flee. To put the struggle behind you as quickly as possible and get on with your life. Life might be easier then but far less genuine. Perhaps the wisdom lies in engaging the life you have been given as fully and courageously as possible and not letting go until you find the unknown blessing that is in everything."
Doctors who struggle with their own illness are like fish on bicycles. We are supposed to be disengaged from suffering, so that we can face it off every day like a tough teenage boy in a brawl. We do not feel good about weakness, at least not in ourselves. Medical school and residency teaches us that.
Yesterday I encountered one of the toughest women I know at the grocery store. She made me laugh, right there in the produce aisle. And reminded me that toughness is not about bullshit, but rather it is about meeting yourself where you are and acknowledging that angel who is beating the shit out of you. The you ask the angel for a blessing, and get back to business.
Which makes me think of Beyonce. Which seems like a good way to end this. However, I would not be hired to be in her video, given my rashy, bald self. Beautiful people are so annoying. They need a Guardian Angel to kick their ass.
Sunday, March 27, 2016
#Soulmates
"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.
#Soulmates
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?
Again.
In Provence, in a new dress.
#25years
#soulmates
Hashtag: The Reason We Are Here::
-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.
#Soulmates
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?
Again.
In Provence, in a new dress.
#25years
#soulmates
Hashtag: The Reason We Are Here::
Saturday, March 19, 2016
Air
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:
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.
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:
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.
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.
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