A Job to Be Done

Banana Slug by Moonlight. Van 2, PTC relay 8/2012

The kids are back in school. Ambivalence meets excitement meets mourning a summer gone meets the widening of the social circle, that last thing being highly beneficial for the teen of the species. And, of course, it is fall, thus cross country season.  Cross country season! CROSS COUNTRY SEASON!

I ran today, just easy for 45 minutes. I am calling it my official first day of training for the 50 mile ultra next year. Here's my plan: run far, and get faster. While running today I did not devise anything more definitive than that. But I did contemplate the thing I did/witnessed this weekend. This thing was on my top 10 list of the most memorable, inspiring things I have done in my life. And I didn't even run.

This is what I am talking about:

With 12 teenagers, 3 adults and me. Also 2 banana slugs (see above picture), named James and Marlene. Locals will know why.

There are no words, but of course I will need to try to word-paint a picture:
Life changing, exhausting, and hilarious. 2 days in a van with smelly, wonderful kids. Surreal visions, surreal conversations. Chaos. A primal scream at pre-dawn. A sky heavy with stars and the milky way. Fierce competition softened by teenage pop music. Singing children to wakefulness on a field in the cold, wee hours of the morning. Watching children who are really just about adults feel blissful and sure of themselves.
Two quotes:
First, when my iPod was turned on to entertain the van: "Elvis Costello? Did he play with Lawrence Welk?"
Second, and this one came more than once: "This is the most amazing thing I have ever done in my life!"

But my favorite quote is one that could be found in a Zen manual or it could be a quote from Atticus Finch. It moved me near to tears while also making me laugh. I think I will use it in my own life, for night shifts, for tough parenting days. And for 50 mile runs. This quote came after a predawn leg of the relay, from a very tired young woman who left a warm sleeping bag, strapped on a head lamp and ran, fast, into the dark.

"I just told myself: There is a job to be done."

Eat, Pray, Run

Tomorrow I leave with 3 other brave adults and 12 near adults (teenagers, high schoolers, cross country runners) for Portland. For a 129 mile high school relay. More on this later.

Today I did medicine. With a break for lunch in the doctor's lounge. I literally could NOT eat the vegetarian burger puck, nor anything else, except a carton of chocolate milk. Chocolate milk can be the perfect food, but in this case it was like the only actual food in the room.  Meat and meat-substitute pucks play starring roles in doctor's lounges and public school cafeterias. They do not seem to ruffle inspectors and they don't take much preparation. Here's the weird thing: we have an overabundance of food in our society. So why do we eat non-food?

I am reading this book by Scott Jurek called Eat and Run. He is an ultramarathoner. Also a vegan. He runs fast, far. Really, really, really far. Scott Jurek might be over the top. I have not decided yet, though I do not suppose this is for me to decide. I understand his drive and passion.

It seems obvious, how we are what we consume. My patients who eat too much get sick. My patients who drink too much get sick. My patients who eat too little get sick. And it goes beyond food. Good literature and art feeds the heart and brain. Great music is like protein or manna from heaven or that canteen of water after a walk in the desert. Spiritual sustenance is more personal, but for some a turning away from spirit can manifest in scurvy of the soul and rickets of the religious center of balance. And physical motion? Physician is derived from words meaning nature, or the art of healing, or to bring forth or produce or to exist or grow. Fitness is derived from words meaning competence, being suitable, being qualified. Our physical nature and our fitness is essential. Until it isn't, and then thank goodness for good books and good music. And good food. And when we can no longer directly enjoy any of these things, we can feed upon our memories.

Nothing a Music Festival and More Than 5 Seconds Off Can't Cure

"Running prepares you for the hard things in life"-my middle school cross country coach


Like Jack Nicholson, if I don't play run, things can get ugly. I have not, so far, noticed my kids writing messages on the mirror or talking with their index fingers, so I believe their is yet hope. Also, I am pretty sure I have found the cure:
A MUSIC FESTIVAL AND MORE THAN 5 SECOND OFF. warning: side effects include giddiness, sore dancing muscles, San Francisco fog fright, grass stains on your favorite jeans, and fainting when Jack White goes on stage.

The magnitude of suffering I've witnessed in the past 20 days of work is, well, big. Big enough for me to realize how stupid it is to feel sorry for myself that I am exhausted to the bone and that I have not had a chance to run more than once or twice in all of those days. Running is a good way to prepare for suffering but ironically, without it, my own suffering increases.

My fatigue is so deep in the bones that my youngest kid has reversed our roles: each night she has arrived at my bedside to give me a hug goodnight and tuck me in, as I am already half asleep under the covers well before her summer self would consider such a destination. I feel almost sick, and have started worrying maybe I am. This too is a danger in my profession. You can take a bruise and make it leukemia, or a tummy ache and make it carcinomatosis. But I think I have my diagnosis, and did I mention also a cure?

My Mom died 16 years ago this week. I have told several people they have a potentially terminal illness in the past 2 weeks. I touched someone's pulsating brain. I have taken the wrath of stressed out colleagues and the sadness of families bent over in grief. I miss a friend and mentor who recently died suddenly. I resigned one of my jobs, as 3 seemed too many, but I liked it and it was my only source of health insurance. I miss my children and husband. I have eaten way too much doctor's lounge "food".
I could use a run.

And this:

Animal Brain

Oddly, last night before we heard about the horrible shooting in Colorado, my husband and I were discussing violent acts. Admittedly, this discussion came in the context of just having watched an old ER episode, the one where Mark gets beaten up. I wondered aloud how people can stand to inflict such violence upon one another. This question always brings to mind a friend many years ago whose fiancee was beaten to death when walking home from a basketball game one evening. He had an open casket and forever will I remember the artificial attempt to reconstruct a beautiful young face, and the very real and visible breaking heart of his lover at the casket's side. My husband and I pictured our reaction if we were called upon to protect each other or our 3 cubs. At work, I am known as the den mother, the "ubermadre", and have more than once stood against my better judgement to defend my team. God help someone who comes between me and the wholeness of my family. I believe, at that point, I would switch over to the animal brain.

This, in the context of running deep into the peaceful and pastoral woods, has been on my mind. As I contemplate a 50 mile trail run, hopefully at the side of one of the strongest women I know, my fear does not settle on the magnitude of distance, nor the conundrum of feeding oneself properly during such an event. It does not shiver at the inevitable blisters and lost toenails and the risk of hyponatremia or rhabdomyolysis. But my fear settles and sinks its anxious teeth into the frightful imaginings of creatures lurking in the dense overgrowth that is the redwood forest.

Our neighborhood has built itself against nature's door, and we have no reason to complain if She comes knocking on a regular basis. The family of bears, 2 cubs included, are a cute addition in theory. But the banshee scream of a mountain lion through an open window at 2am is scarier than Voldemort and The Gentlemen combined. I saw a lion once, as it skulked away into the brush on trail 11 in our forest. I almost vomited out my heart, and am ashamed to say I ran away while my trusty dog ran toward the catamount as if he thought himself a match. I prayed, swore and ran and was so relieved when my dog appeared at my side again. He seemed a little shaken. It took me 6 months to go back to trail 11.

Truth be told, our lions are well fed. Fat deer (thanks to my garden and others) are the main course. How often has a person been attacked? Not all that often. But it is the idea of the thing.

I run in the woods often. It is safer than driving to work. It is good for my soul. It is where I find solace. It smells nice. Strangely, I find that the more I run into the woods, the less I am afraid. Wendell Berry calls it "resting in the grace of the world".  So maybe the violence, even the violence in protection of loved ones, is not the animal brain, but rather the fear brain. And to find the grace of which Mr Berry speaks is to find a path to be truly free. Without fear.

Also, find the strongest girl you know and bring her along for the ride.

I Asked For That One

Recent conversation:
Me: "I admitted an entomologist today."
Husband: "Did he catch a bug?"
Me: "I asked for that one."

Not long ago, I spent a week playing piano. I do that from time to time, play piano. It was my first love, discovered under headphones at age 5 listening to my parents LPs. Specifically to this:




One can argue regarding the purity and perfection of Horowitz' Beethoven playing, but that guy won my 5 year old heart over faster than you can say Torsades de pointe. I then begged for piano lessons till my parents finally gave in on my 7th birthday. I still have the card, with a picture of Schroeder playing guess who and the pronouncement I was being given piano lessons and an old upright piano. My friends patted me on the back with sad looks on their faces. But, nerd that I am, I was psyched!

Anyway, playing piano for a week at a chamber music workshop was a marathon of sorts. Day one, my fingers rebelled, but then they seemed to find this muscle memory, and started to act like they were made for this and took on an existence all their own as well as a sassy attitude, as if to say "what the hell took you so long to play some serious piano?"

I did not run a whole lot that week, though got a couple of good ones in. All that sitting started to make my behind feel like it was going to permanently widen, and a run in the woods at least gave me the illusion of decreasing possibility of said widening.

And like the meth user who unceremoniously comes down from their high, usually in my ER and usually quite unhappy about it, I woke up the morning after my last marathon piano day and headed back to the hospital. Now I could go on to say that the 70 hours of work in the last 5 days was horrible and exhausting. And I definitely could say I am antsy as I just did not have the energy to run even one of those 5 days. But truth be told, I had a fairly good week. There was some great medicine, and it was good to be among friends at the hospital. Yes, 70 hour work weeks are stupid. But, I guess I asked for that one.

One day at work, while taking a moment to absorb some vitamin D out in front of the hospital, a friend called and told me this joke: "Let's do an ultra marathon." I laughed and laughed and laughed. Turns out she was serious. It took about 5 minutes to talk me into it. She accused me of being easy. I certainly am not! I am simply trying to support a friend in their time of insanity. And one should not let friends approach 50 mile trail races alone. And plus I actually am easy, at least regarding certain things.

Ask and you shall receive.

Liking It

This poem.
-Stephen Dobyns


Running in Tryon Creek Park in Portland last week, I dodged a few banana slugs. The slugs and the ferns and the rainforesty feel made me feel at home, though the trees were different.

Tryon Creek Run. Tree. 6/2012

Whilst dodging slugs, a couple of thoughts crossed my mind:

1) I am tired.

2) I am not liking it enough.

I did truly enjoy the beauty. And when I ran in Tryon Creek Park with my kiddo, I also enjoyed the beautiful company. In any given moment, I can like it so much it is absurd. But the grander Like is getting harder to grasp, probably mainly due to Fatigue with a capital F.

Tina Fey quips about her problems, noting simultaneously that for people with real problems she must appear ridiculous. I can relate to this, as a well-fed, employed, happily married mother of 3 stunning children. Still, it is hard sometimes (see prior post), even for a WFEHMMOTSC. No one escapes grief, I have noticed. Or fear. Or vomiting children during long car trips. Or disappointment, disbelief, disconnectedness or dummkopfs.

I cannot imagine running a marathon in a month, as I am so tired I can barely keep my head balanced on my shoulders. At any second I expect my head to fall off and roll across the floor like that meatball in the song.

If this was being written by a child of mine, I would be pulling the world's smallest violin out of my pocket and playing for them. They love it when I do this. They have grabbed and stomped many of these violins of mine into tiny little pieces, but I have a lifetime supply so I just let them stomp with abandon. Cry! Stomp your feet! Decide to quit everything and take up organic farming on a plot of land in the middle of nowhere while living in a shack and reconnecting with the deeper meaning of things. Then, come to your senses regarding your medical school debt plus that annoyingly and deeply ingrained need to take care of sick people, and go for a (pathetic) run. Go through the motions, and, perhaps, discover How To Like It.

Paths

Life is sad
Life is a bust
All you can do is do what you must
You do what you must do and you do it well
I'll do it for you honey baby
Can't you tell?
-Bob Dylan

 Marsh path run, 6/16/12

I have an ulcer. Again. I can blame this on many things. But I suppose it is largely due to the path I have chosen. And dipping into the Naproxen doesn't help a whole lot either.

Stress is such a buzzword these days, it hardly means anything. Standing in line at Starbucks is stressful, and so is getting a diagnosis of cancer. Also, final exams, raising teenagers, trying to heal heroin addicts and waiting for your Hulu TV show to download. It is like all in the same category: stress. Personally, I am stressed that they hired back Thomas on Downton Abbey. What were they thinking?

I would like to think my choices have been reasonable. I mean, giving up music performance for the relatively easy path of medicine seemed very sensible at age 21. Leaving primary care for the hospital fits my type A personality. Chopping off my unruly curls will surely solve the problems I face. It has also decreased my wind drag so I can run marathons with abandon. Marathons. Another questionable path. Sometimes I wonder.

And my children: what path will they choose? I can tell you there is no shortage of anxiety as I ponder this question. Teenager-world has only one well worn path, and it is called uncertainty. Which is why I read Wendell Berry at least once per day. Wendell Berry works better for me than proton pump inhibitors.

A wise young friend recently told me I should let my children take the path they are meant to take. In other words: let go.
I am thinking this might be good advice for me, myself and I. So I called a meeting and the three of us agreed: Just do what you must do and do it well. I do it for you, honey baby, can't you tell?

Oh, this is dedicated to my husband of nearly 20 years. Happy Father's Day (I know your views on the Hallmark absurdity of this holiday, but that aside, you are an extraordinary Dad).
One path I am absolutely sure of: my path with you.

Marsh path run, 6/16/12