One evening when I was 5 years old, I was thumbing through my parent's records. After passing by Peter, Paul and Mary and the soundtrack to West Side Story (which I loved, I used to do reenactments of the entire musical for my probably bored-to-death mother in our living room), I came across this album with a a candelabra and a piano and Beethoven. It was Vladimir Horowitz, who, truth be told, is not the world's best Beethoven player by a long shot, but it stopped me from further seeking and I took that LP out of the cardboard cover and placed it on my parent's record player.
Now let me explain for a minute. A record is this thing that we used to use to listen to music. It is round, and has grooves in it and the needle of the record player contacts the grooves and magically produces music. Records look like this.
So anyway, it was a winter evening when I found this Horowitz album. It was dark outside. We had a very small house but the rest of my family was doing their own thing. My Dad was probably at a meeting. My Mom was watching TV after a very long day at work. My sister was probably at work or in our shared room listening to ELO or the Beach Boys. My brother was probably in his room plotting his next terrorist attack on me. I put this album on and laid on the couch which my parents had for approximately one thousand years, and I closed my eyes, and I listened to Vladimir Horowitz play the Moonlight Sonata by Ludwig Van Beethoven and I decided, then and there, that I was going to do that too.
This is a true story.
My husband wrote this song once with the lines: "when I was born I was gifted, now I'm just about average. So somewhere I drifted…"
Fast forward seven hundred years to the present time. Parents: dead. Sister and brother still tolerate me. Brother no longer with terrorist tendencies toward me. I am a music major gone astray, now a medical doctor and a mother of teenagers who don't know Horowitz from their very cute behinds.
I spend my days now largely caring for people either at the end of their lives or at the frail end of the aging spectrum. I ran this marathon last weekend, and at the awards, there were not one, but TWO guys in the 85-89 age group. They ran the half marathon. They are not frail, though they are aged.
What is frailty? Scientists really cannot come to an exact consensus on this. You can measure grip strength. You can do the "get up and go" test (how easy is it for you to get out of a chair and start walking). Usually it is more vague. Frequent falls. A lot of trips to the ER or hospital. Choking on food. Episodes of forgetfulness. Your kids or loved ones start to wonder if you can manage anymore, and if you need to be "placed" somewhere to keep you safe.
Vladimir Horowitz did his last concert at age 86. This was in Moscow, and was the first time he went back to Russia since his exile 61 years prior. He reported continued stage fright even at 86, puking prior to performances. I find this oddly reassuring. He also owned over 600 bow ties.
My friend and colleague Dr. Michael Fratkin is doing some interesting work. People, it turns out, are more than their disease, more than their age, more than their cancer stage, more than their frailty index, more than their fall risk, more than their ability to run half marathons or do internationally televised performances at age 86. I think Michael's work is worth supporting. He is touching on something vital and true, and though I am a boot-straps-pulling midwesterner at heart, I can see that palliative medicine is what we all need: even if at the prime of our health. It is about health in the context of being a real, live human being, whether you are about to fall and break your hip, or on your way to radiation therapy for recurrent cancer. Cure may be sexy, but palliation is the very core of healing. What does it mean to be mortal? And what is it you plan to do with your one precious life?
I ran my 6th marathon in 6 years this past Sunday. I am a Master (aka "older American"). I am not as fast as I used to be. I am not as sore as I was for the prior 6 marathons. In fact, after one day post 26.2 miles of dreading stairs, I am not sore at all. This makes no sense whatsoever. I can only think the following:
This run was palliation for what ails me.
I am meant to run, until I can no longer run, at which point I will call Dr Fratkin.
My next goal is to tap into my 5 year old self. The one that snuggled into the well worn couch of my Mom and Dad, and listened to a miraculous bow-tied gentleman play Beethoven, and knew this was my calling.
I do love Beethoven.
Wednesday, October 22, 2014
Sunday, October 12, 2014
Weightlessness
"…so lift me up, increase my buoyancy. I'm still not floating, please, attach more nothing to me."
-Atthys Gage, "Surface"
I was reading through the medical records of a patient and came across this diagnosis in their chart:
Weightlessness. It turns out there is an ICD-9 code for this, specifically E928.0. This is not to be confused with E485, which is "an accident involving a spacecraft". Neither of these is billable, incidentally. And in the case of this patient, I suspect it was the transcriptionist's mishearing of weight loss. Because if someone is weightless in a forest, do they really need a doctor?
For the last 19+ years, I have been either in training or in practice as a doctor. It starts, for most of us, as a naive wish to help, with no serious strings attached, nothing weighing us down. Most in this profession will give up something, or many things: time with family for sure, other passions and pursuits, often one's own health. Still, a good job: you get to be useful, and you will eventually usually get paid reasonably well.
As with most things in life, what was once carefree becomes slowly laden with the stuff that sticks to you, irritatingly increasing your friction and slowing down your cheerful ride. Like Katamari.
If a doctor was a Katamari ball, they would be covered in: MCATs, mean Attendings, grumpy senior residents, expensive licensing exams, soul-sucking debt, grief over all the sad stuff they see, PTSD from that noise that pagers make, one step away from madness from one-too-many middle of the night awakenings, and bewilderment at why, when they are generally just trying to help people, they are so often the target of people's anger and desire for more. Doctors are now on Craig's list alongside the guy who unplugs your toilet.
I have great respect for plumbers, let's get that straight.
Doctors can do some cool stuff that everyone admires, like my surgeon friend who fixed up the surfer who got munched on by a shark, or the times we pick up a diagnosis that was elusive, or when someone gets saved from the almost certain death of ebola. But a lot of times, what doctors do is create a space where someone can get hurt as little as possible while their own body does the work of healing. And truly, a lot of the real work is done by nurses. One of whom is now dealing with her own case of ebola after caring for the man in Texas.
Lately there have been some serious discussions though about what we cannot do. For instance, we cannot keep people from getting frail as they age. We cannot change the fact that the death rate for all humans remains at 100%.
As the parent of teenagers, one thinks a lot about what the point of life is. This is for two reasons:
1) You want to be some kind of advisor for these people who are about to step out of your nest.
2) You find yourself with less life ahead of you than behind you.
As the parent of teenagers, a hospice doctor and the medical director of a clinic for the frail elder, I think way too much about what the point of life is. I sometimes feel like I am trapped inside that Rodin sculpture, with my eyes darting back and forth while people admire me: wow, she's a thinker!
Advice to the offspring, to myself and for those that feel like they are a Katamari ball or trapped within a ripped, iron thinker guy:
Be kind and useful.
Ride your bike to work, take a run, do Zumba, do yoga, take a senior aerobics class, do chair exercises, wiggle your little toe: MOVE YOUR BODY. There is no better drug. Not even lipitor. I know: radical.
Let the angry people vent at you, smile and be kind, and useful.
Never let your work hurt you. Never let your passions wither.
Do not look only to doctors, pills or operations for salvation. They can help, sometimes. But ask yourself: what is it you seek? And did you eat well, exercise, and tend to your own spirit on this fine day?
Move your body, be kind, be useful. Let go, and float to the surface.
-Atthys Gage, "Surface"
I was reading through the medical records of a patient and came across this diagnosis in their chart:
Weightlessness. It turns out there is an ICD-9 code for this, specifically E928.0. This is not to be confused with E485, which is "an accident involving a spacecraft". Neither of these is billable, incidentally. And in the case of this patient, I suspect it was the transcriptionist's mishearing of weight loss. Because if someone is weightless in a forest, do they really need a doctor?
For the last 19+ years, I have been either in training or in practice as a doctor. It starts, for most of us, as a naive wish to help, with no serious strings attached, nothing weighing us down. Most in this profession will give up something, or many things: time with family for sure, other passions and pursuits, often one's own health. Still, a good job: you get to be useful, and you will eventually usually get paid reasonably well.
As with most things in life, what was once carefree becomes slowly laden with the stuff that sticks to you, irritatingly increasing your friction and slowing down your cheerful ride. Like Katamari.
If a doctor was a Katamari ball, they would be covered in: MCATs, mean Attendings, grumpy senior residents, expensive licensing exams, soul-sucking debt, grief over all the sad stuff they see, PTSD from that noise that pagers make, one step away from madness from one-too-many middle of the night awakenings, and bewilderment at why, when they are generally just trying to help people, they are so often the target of people's anger and desire for more. Doctors are now on Craig's list alongside the guy who unplugs your toilet.
I have great respect for plumbers, let's get that straight.
Doctors can do some cool stuff that everyone admires, like my surgeon friend who fixed up the surfer who got munched on by a shark, or the times we pick up a diagnosis that was elusive, or when someone gets saved from the almost certain death of ebola. But a lot of times, what doctors do is create a space where someone can get hurt as little as possible while their own body does the work of healing. And truly, a lot of the real work is done by nurses. One of whom is now dealing with her own case of ebola after caring for the man in Texas.
Lately there have been some serious discussions though about what we cannot do. For instance, we cannot keep people from getting frail as they age. We cannot change the fact that the death rate for all humans remains at 100%.
As the parent of teenagers, one thinks a lot about what the point of life is. This is for two reasons:
1) You want to be some kind of advisor for these people who are about to step out of your nest.
2) You find yourself with less life ahead of you than behind you.
As the parent of teenagers, a hospice doctor and the medical director of a clinic for the frail elder, I think way too much about what the point of life is. I sometimes feel like I am trapped inside that Rodin sculpture, with my eyes darting back and forth while people admire me: wow, she's a thinker!
Advice to the offspring, to myself and for those that feel like they are a Katamari ball or trapped within a ripped, iron thinker guy:
Be kind and useful.
Ride your bike to work, take a run, do Zumba, do yoga, take a senior aerobics class, do chair exercises, wiggle your little toe: MOVE YOUR BODY. There is no better drug. Not even lipitor. I know: radical.
Let the angry people vent at you, smile and be kind, and useful.
Never let your work hurt you. Never let your passions wither.
Do not look only to doctors, pills or operations for salvation. They can help, sometimes. But ask yourself: what is it you seek? And did you eat well, exercise, and tend to your own spirit on this fine day?
Move your body, be kind, be useful. Let go, and float to the surface.
Tuesday, September 16, 2014
It Hurts
Around age 6 or 7, I was solemnly walked into the CCU to say goodbye to my father, after his massive heart attack at age 40-something. He went on to live into his 60's (albeit gaining a literal new heart along the way), against the odds. When I was 10, I came home one day from school and could not get into the locked and dark house. I was furious, and when my folks came home, finally, I let them know in no uncertain terms. Turns out Mom had been diagnosed with breast cancer that day, and I still feel guilty for being such a brat.
Both my folks made it into their 60's, against the odds. I feel sorry that they died so young, but happy I had them as long as I did. Sorry they had to be sick, but happy our family grew closer in the process. Sorry I have such anticipatory grief, like Jiminy Cricket on my shoulder every second of the day, telling me to beware of the inevitable loss of all I love. But happy that I know just how important it is to notice life. In fact, my largest irritation with people over the years is how they take the beauty and impermanence for granted, and find so much negative to focus upon. Teenagers are fairly expert at this, which is highly annoying, but I too was a teenager once. It hurts.
Anyone who knows me knows I do two things when I hurt. I write, and I run. Ironically, when I run, I sometimes hurt more than I did before I was running, but it is a different kind of hurt. When I had my angst-ridden moments as a child and preteen, I often burst out the front door and went running down the street. It was dramatically therapeutic, histrionically healing.
Today, when the call came that Matt had died, I felt trapped. I had 14 minutes to get my shit together to lead a family conference at work. I was trying to field questions about medications and I was just about to renew my ACP membership. I mean, I was pulling out my credit card to renew my ACP membership when I got this call that my friend and colleague and partner and sometimes irritator of 12 years was dead! I shoved my glasses on my head and cried like a stupid baby, then could not find my glasses. I called my husband. I called my friend who knows about death. My medical assistant asked what she could do. I wiped my snotty nose and went to run a family conference.
Several weeks ago, I spoke to Matt and explicitly told him I was concerned about his health, given the stress of his job. He was too, but this guy had elected to take on a monstrous task: the well being of a medical staff in a very broken world, the well being of patients with unfathomable needs, the well being of a budget that is geared toward some alternate universe.
I was thinking today: is it written on our DNA somewhere when we die? I mean, does it matter what we do or is it all just fate? As a physician, I must believe it matters, at least somewhat. But I watched my grandmother eat red meat and butter and live a life on the plump side, and she fell into her final sleep on the couch at nearly 100 years of age. I watched my mother live a life of healthy food and exercise, and she gets her ass kicked at age 42 with the big C.
What matters?
Kindness. Compassion. Love.
Jiminy Cricket would say: do not take it for granted.
Both my folks made it into their 60's, against the odds. I feel sorry that they died so young, but happy I had them as long as I did. Sorry they had to be sick, but happy our family grew closer in the process. Sorry I have such anticipatory grief, like Jiminy Cricket on my shoulder every second of the day, telling me to beware of the inevitable loss of all I love. But happy that I know just how important it is to notice life. In fact, my largest irritation with people over the years is how they take the beauty and impermanence for granted, and find so much negative to focus upon. Teenagers are fairly expert at this, which is highly annoying, but I too was a teenager once. It hurts.
Anyone who knows me knows I do two things when I hurt. I write, and I run. Ironically, when I run, I sometimes hurt more than I did before I was running, but it is a different kind of hurt. When I had my angst-ridden moments as a child and preteen, I often burst out the front door and went running down the street. It was dramatically therapeutic, histrionically healing.
Today, when the call came that Matt had died, I felt trapped. I had 14 minutes to get my shit together to lead a family conference at work. I was trying to field questions about medications and I was just about to renew my ACP membership. I mean, I was pulling out my credit card to renew my ACP membership when I got this call that my friend and colleague and partner and sometimes irritator of 12 years was dead! I shoved my glasses on my head and cried like a stupid baby, then could not find my glasses. I called my husband. I called my friend who knows about death. My medical assistant asked what she could do. I wiped my snotty nose and went to run a family conference.
Several weeks ago, I spoke to Matt and explicitly told him I was concerned about his health, given the stress of his job. He was too, but this guy had elected to take on a monstrous task: the well being of a medical staff in a very broken world, the well being of patients with unfathomable needs, the well being of a budget that is geared toward some alternate universe.
I was thinking today: is it written on our DNA somewhere when we die? I mean, does it matter what we do or is it all just fate? As a physician, I must believe it matters, at least somewhat. But I watched my grandmother eat red meat and butter and live a life on the plump side, and she fell into her final sleep on the couch at nearly 100 years of age. I watched my mother live a life of healthy food and exercise, and she gets her ass kicked at age 42 with the big C.
What matters?
Kindness. Compassion. Love.
Jiminy Cricket would say: do not take it for granted.
Sunday, September 7, 2014
Garmins, Coaches, Young People, Poodles, and Half Marathons.
My Garmin died. You may think this is not a true tragedy. I would have to agree. Yet consider this:
1) Garmins are made of plastic and probably will NEVER leave the landfills.
2) I have only had it for about 3 years.
3) If I continue running with Garmins till I die, which could be tomorrow but let's just say it is 40 years, that is approximately 13 more Garmins I will go through.
4) The Earth is doomed.
I ran yesterday with Map My Run. OK, this is actually a pretty cool app. It lets you choose your music from your list (I chose shuffle from all of my music, which led to a pretty crazy mix of Bach, Beyonce and John Coltrane). Then you hit start workout, and you just run and every mile this flight-attendant voice comes on, politely pausing the bebop or English Suite or whatever and tells you your mileage, overall pace and split for the last mile. Bitchin'.
It does not (yet) talk to Strava though. I really like Strava! All my friends use Strava! It is not real if I do not post it to Strava!
Yesterday, I went out to run, to see where my body was at. I am signed up for the local fall marathon. I have not, however, put in enough miles to give it its due respect. Yesterday was a test run, and my body said "Yeah, so, not going to happen." I mean I can run 26 miles. But not with gusto, and I want to run with gusto. So, as the song goes, If you haven't got a marathon, a half marathon will do. If you haven't got a half marathon, God bless you.
There is an amazing athlete who gives me some coaching. She is like a God(dess). She was kind enough, when I informed her of my decision to go half instead of full, to say I was wise to listen to my body or something like that. Also, I think she said something about kicking some ass at the half. Gulp.
Coaches are key, if they are the right ones. Mean words, discouragement and abuse do not a good coach make. But someone who can see a flicker of fire within you, and blow on it and add just the right amount of kindling to turn it into a full on roar? That is priceless.
Several weeks ago, on a run with my eldest child, I spoke out loud my uncertainty. I said I am not actually sure I am a runner anymore. My body just does not seem to respond like it used to. In a couple of short weeks I turn 45, and maybe I am just done as a competitive runner. My child, who really is no longer a child, turned to me with these words. "Don't stop." And something along the lines of wanting to be as fit as I am when she is my age. I think the word inspiration might have come up in this particular conversation. I held back my tears.
And then there is my dog. He is not super fast (except when the pit bull was chasing him a couple of weeks ago: man, was he fast then). But he LOVES running. When we go for a walk, he looks at me quizzically, as if to say "What is this? Why do you move so slowly? Are you somehow damaged or lame?" The best is the beach. Off leash, he stretches his limbs and we run. For the first 2 miles, he is ahead or by my side. After that, he falls behind, but his tracks are neatly aligned with mine, evidenced in the sand which tells you where you were and what your gait is and what size shoe you wear. Do not commit a crime, then walk through sand.
He falls behind, but he is so content, running at his own pace for 6 or 8 miles, on the beach, with the spy-hopping seals and the flocks of chase-worthy birds and the smell of sea salt and fish and rotting seaweed.
As much as I love the Earth, I will get another Garmin.
As much as I doubt the fire within, I will listen to my Coach.
As much as I mourn my lost youth, I do appreciate the word of a kind young woman.
As much as I hate the way my dog smells after a beach run, I will continue to take him along and revel in his joy.
Thirteen point one: kiss my (almost) 45 year patooty.
Sunday, August 24, 2014
Pixie Dust
On a lighter note, I would like to note that everything is always changing and yet the same. For instance, I recently dropped my eldest at college. She is a freshman. What got me was not only the devastation (I put up a good front but cried for the first 2 hours of the drive home, then pulled myself together, worried that crying while driving was about like texting while driving in terms of danger to self and others), but also the generally overweight and old appearing parents. I kept looking at myself and thinking, dang am I like that? And I think maybe I am, but it is a hard pill to swallow. And for as long as they have made colleges, the parents of students have looked out of place. It is written in some book somewhere, I know.
Tomorrow, school starts for one of my still-at-homes. Back to school he goes, after a hiatus of independent study. Here is what has changed in my view of education since I started parenting. If you are a new parent or not yet a parent but plan to be in the future, feel free to take notes.
1) Rich people who can send their kids to private schools with a lot of resources, small classes, and a high standard for academics will get a better education. I used to think public schools were where it is at, and I continue to use them, but the harsh truth is they, by necessity, cater to those who are already going to be successful, not those who need that extra something. And I am as about as liberal as they come.
2) Boys are not welcome in public schools, unless they act like girls. I used to think boys and girls were more a societal pressure difference than an actual difference. But boys make guns with hands and sticks before they ever watch a TV show and they make things drive like cars before anyone teaches them to, and they are, in general, bewildered by the rules of school, which largely include keeping your hands politely on your lap and yes-ma'aming a lot. God help you if you are a boy with an engine that needs to stay revved during all waking hours.
3) I love public school teachers. Just to be clear.
4) I had better change the subject as this is no longer qualifying as "on a lighter note".
5) I dropped out of high school at age 16 and went to college. Little known fact.
6) No, I will not be making up those lost PE credits. I burned that uniform long ago.
My other still-at-home has 2 more weeks of summer, as there is a late start for some of our schools in town. She is off at camp and is generally the busiest human being I know. Anyway, I have 2 more weeks to try to talk her into cross country as the sport of choice. Wish me luck.
And what does any of this, aside from pushing my child into the best sport ever, have to do with running? I have noticed that about 3 months ago I made a goal for myself, regarding marathon times and pixie dust. Actually really it was just about marathon times, but I am now in search of pixie dust because without it I am not sure if I can believe. I am almost never injured. In high school, a stress fracture put my tibia out of commission. A few years ago, my achilles tendon screamed at me for awhile. And for awhile my iliotibial band rubbed me the wrong way. But since I declared a goal for the 26.2, my body has been in full rebellion. Head to toe, actually: depression. Back pain (thank God for Molly, masseuse extraordinaire). Hamstring tightness. Plantar fasciitis. And most recently what was surely, in my mind, a stress fracture, though now I think most likely just garden variety shin splints. It is like the Field of Screams. If you declare the goal, they will make you succumb.
As long as they have made runners, they have made injuries. But they have also made dreams. And spandex. What did we run in prior to spandex?
I want to briefly discuss the iliotibial band, known also as the ITB. I have seen it up close and personal in my anatomy class. It is like a really big, long piece of beef jerky. How can it possibly be stretched? Have you ever tried to stretch a piece of beef jerky? What, exactly, is beef jerky anyway?
Tinker Bell was supposedly created from the laugh of the first baby (Adam? Caveman? Was it a girl? Who came first, the baby or the Mom?), which broke into a thousand pieces and went skipping about, starting the whole fairy thing. The first Tinker Bell model was Margaret Kerry. She had to wear a swim suit for 6 months so the animator of Tinkerbell could draw her and her "slender cute figure". OMG.
All I am saying is that Peter Pan could not fly without the Pixie Dust. And I want some of that.
Modern Day Pixie Dust for Marathoners and other Miscreants:
1) A Coach,
2) Adequate Sleep.
3) Zen and the Art of Musculoskeletal Maintenance.
4) A Sense of Humor.
5) A Dog Who Will Not Tolerate a Day Without a Run.
6) Daily Stretches of the Beef Jerky and Such Tendons.
7) Realization that Being a Master Means You Might Be Old, But Damn Are You Ever Wise!
8) Knowledge that the Kids will be What They Will Be. Now Go For a Run, For Heaven's Sake.
9) Shoes. Stop Going Barefoot. Unless You Weigh 12 Pounds.
10) Belief.
Tomorrow, school starts for one of my still-at-homes. Back to school he goes, after a hiatus of independent study. Here is what has changed in my view of education since I started parenting. If you are a new parent or not yet a parent but plan to be in the future, feel free to take notes.
1) Rich people who can send their kids to private schools with a lot of resources, small classes, and a high standard for academics will get a better education. I used to think public schools were where it is at, and I continue to use them, but the harsh truth is they, by necessity, cater to those who are already going to be successful, not those who need that extra something. And I am as about as liberal as they come.
2) Boys are not welcome in public schools, unless they act like girls. I used to think boys and girls were more a societal pressure difference than an actual difference. But boys make guns with hands and sticks before they ever watch a TV show and they make things drive like cars before anyone teaches them to, and they are, in general, bewildered by the rules of school, which largely include keeping your hands politely on your lap and yes-ma'aming a lot. God help you if you are a boy with an engine that needs to stay revved during all waking hours.
3) I love public school teachers. Just to be clear.
4) I had better change the subject as this is no longer qualifying as "on a lighter note".
5) I dropped out of high school at age 16 and went to college. Little known fact.
6) No, I will not be making up those lost PE credits. I burned that uniform long ago.
My other still-at-home has 2 more weeks of summer, as there is a late start for some of our schools in town. She is off at camp and is generally the busiest human being I know. Anyway, I have 2 more weeks to try to talk her into cross country as the sport of choice. Wish me luck.
And what does any of this, aside from pushing my child into the best sport ever, have to do with running? I have noticed that about 3 months ago I made a goal for myself, regarding marathon times and pixie dust. Actually really it was just about marathon times, but I am now in search of pixie dust because without it I am not sure if I can believe. I am almost never injured. In high school, a stress fracture put my tibia out of commission. A few years ago, my achilles tendon screamed at me for awhile. And for awhile my iliotibial band rubbed me the wrong way. But since I declared a goal for the 26.2, my body has been in full rebellion. Head to toe, actually: depression. Back pain (thank God for Molly, masseuse extraordinaire). Hamstring tightness. Plantar fasciitis. And most recently what was surely, in my mind, a stress fracture, though now I think most likely just garden variety shin splints. It is like the Field of Screams. If you declare the goal, they will make you succumb.
As long as they have made runners, they have made injuries. But they have also made dreams. And spandex. What did we run in prior to spandex?
I want to briefly discuss the iliotibial band, known also as the ITB. I have seen it up close and personal in my anatomy class. It is like a really big, long piece of beef jerky. How can it possibly be stretched? Have you ever tried to stretch a piece of beef jerky? What, exactly, is beef jerky anyway?
Tinker Bell was supposedly created from the laugh of the first baby (Adam? Caveman? Was it a girl? Who came first, the baby or the Mom?), which broke into a thousand pieces and went skipping about, starting the whole fairy thing. The first Tinker Bell model was Margaret Kerry. She had to wear a swim suit for 6 months so the animator of Tinkerbell could draw her and her "slender cute figure". OMG.
All I am saying is that Peter Pan could not fly without the Pixie Dust. And I want some of that.
Modern Day Pixie Dust for Marathoners and other Miscreants:
1) A Coach,
2) Adequate Sleep.
3) Zen and the Art of Musculoskeletal Maintenance.
4) A Sense of Humor.
5) A Dog Who Will Not Tolerate a Day Without a Run.
6) Daily Stretches of the Beef Jerky and Such Tendons.
7) Realization that Being a Master Means You Might Be Old, But Damn Are You Ever Wise!
8) Knowledge that the Kids will be What They Will Be. Now Go For a Run, For Heaven's Sake.
9) Shoes. Stop Going Barefoot. Unless You Weigh 12 Pounds.
10) Belief.
Wednesday, August 13, 2014
Hope
I wrote about depression recently. Of course it is on everybody's radar now, at least for a few minutes.
Robin Williams was so funny. Nay, the funniest. He used to scare me a little back in the 70's and 80's when he would just get going on some stage and the host of whatever show he was on was clearly no longer in the driver's seat, but sat back in awe, probably thinking something like "I used to be funny too." Over the decades, RW mellowed a bit. Probably more sober, maybe less manic.
He rode bike to feel well. He talked about this a little last year on The Daily Show. Also, in "Night at the Museum 2" (yes I watched this and I enjoyed it, so there) he, as Teddy Roosevelt, said the key to happiness is "daily physical exercise". The key to so much in our health is daily physical exercise: I do not care if you are 5 or 95, wobbly or an elite athlete. When I tell people this as a doctor, their eyes generally glaze over. It is not B.S. though, it is science.
So maybe if Robin Williams had just gone for more bike rides? Ah, if only. And yes, maybe. But it can be hard to get in the saddle when you are pinned under despair, and particularly if that despair is accompanied by a whiskey chaser. Or whatever the drug of choice (video games? meth? our local personal favorite, weed?).
There is a general malaise that has always accompanied being human, and we have become fairly adept at using technology and busy-ness to avoid it. I am reading This House of Sky by Ivan Doig right now. In that time and place (ranching in the unrelenting wilds of Montana, mid last century and earlier), hard work really does not leave any space for malaise. It is a lovely memoir, a tenderly painted picture and a love story of sorts, love of land and family. It also is about the pain of loss. Their life sort of sucks: I keep imagining my own children being put to the chores, the constant moving, the boarding with townsfolk they hardly know during school months. I cannot imagine it.
The ranchers, with their outhouses and their biting off of the testicles of baby lambs, are not movie stars, nay icons of a generation or three, living in one of the most beautiful parts of Marin County. Not like Robin Williams.
Everyone has their struggle, it is said. I am here to tell you that is a fact, though some people glide through much easier than others, and I am just not sure why that is. We are just made up of all these cells and chemicals and infinitely smaller particles that flavor us just so, and somehow hold us together in the days we are allotted here on Earth.
My father sang every morning, while knotting his tie in front of the mirror of his room in his very modest home. He was a dramatic guy, and funny and unpredictable in his humor, unapologetic to the world for being himself, all full of opinions about justice and peace. You just never knew when he would break into an imitation of Richard Nixon, or break into song in a public place. He had a heart attack in his early 40's, and several after. He lost his wife, he had a heart transplant, he watched his children struggle, he watched the world continue to war with itself. And yet he sang. He walked religiously, and I think he knew religious, being a pastor and all. And he just made this one request to me: leave the world better than how you found it. He rarely swore (at least not in English), and almost never involving God in that transaction. But I did hear him once say "That goddamn depression." He knew that it was real, and not everyone can greet the day with song, no matter how hard they will themselves to do so.
There is an opportunity, in losing such a widely loved man as Robin Williams, for a better understanding and a bit more compassion for the struggles of others. Because that is really why we are here on Earth: to be kind to others.
And to exercise. Seriously, exercise is the strongest drug, the purest medicine, the absolute best high, the ticket to a front row seat in the happy life extravaganza.
Music is good too. As is nature.
My oldest child leaves for college in 2 days. That alone could be cause for complete devastation. And yes, I am sad. But inside of me there is this little burst joy for her. The world, it is out there. Its pleasures and hurts must be deeply mined and there is no time to waste. Read! Write! Learn Latin, go to parties, run cross country, stay up late and study. Fall in love. Learn about your inner strength. Visit often. Call even more often. And never forget, in times of despair, that you are deeply loved. Leave the world better than how you found it. Be kind to others. Notice everything. Exercise daily.
We must not let Robin Williams dash our hopes. He was gifted. He gave us his gift. And he also was human and deeply mired in goddamn depression. The world might have been kinder to him.
Rest in peace.
Robin Williams was so funny. Nay, the funniest. He used to scare me a little back in the 70's and 80's when he would just get going on some stage and the host of whatever show he was on was clearly no longer in the driver's seat, but sat back in awe, probably thinking something like "I used to be funny too." Over the decades, RW mellowed a bit. Probably more sober, maybe less manic.
He rode bike to feel well. He talked about this a little last year on The Daily Show. Also, in "Night at the Museum 2" (yes I watched this and I enjoyed it, so there) he, as Teddy Roosevelt, said the key to happiness is "daily physical exercise". The key to so much in our health is daily physical exercise: I do not care if you are 5 or 95, wobbly or an elite athlete. When I tell people this as a doctor, their eyes generally glaze over. It is not B.S. though, it is science.
So maybe if Robin Williams had just gone for more bike rides? Ah, if only. And yes, maybe. But it can be hard to get in the saddle when you are pinned under despair, and particularly if that despair is accompanied by a whiskey chaser. Or whatever the drug of choice (video games? meth? our local personal favorite, weed?).
There is a general malaise that has always accompanied being human, and we have become fairly adept at using technology and busy-ness to avoid it. I am reading This House of Sky by Ivan Doig right now. In that time and place (ranching in the unrelenting wilds of Montana, mid last century and earlier), hard work really does not leave any space for malaise. It is a lovely memoir, a tenderly painted picture and a love story of sorts, love of land and family. It also is about the pain of loss. Their life sort of sucks: I keep imagining my own children being put to the chores, the constant moving, the boarding with townsfolk they hardly know during school months. I cannot imagine it.
The ranchers, with their outhouses and their biting off of the testicles of baby lambs, are not movie stars, nay icons of a generation or three, living in one of the most beautiful parts of Marin County. Not like Robin Williams.
Everyone has their struggle, it is said. I am here to tell you that is a fact, though some people glide through much easier than others, and I am just not sure why that is. We are just made up of all these cells and chemicals and infinitely smaller particles that flavor us just so, and somehow hold us together in the days we are allotted here on Earth.
My father sang every morning, while knotting his tie in front of the mirror of his room in his very modest home. He was a dramatic guy, and funny and unpredictable in his humor, unapologetic to the world for being himself, all full of opinions about justice and peace. You just never knew when he would break into an imitation of Richard Nixon, or break into song in a public place. He had a heart attack in his early 40's, and several after. He lost his wife, he had a heart transplant, he watched his children struggle, he watched the world continue to war with itself. And yet he sang. He walked religiously, and I think he knew religious, being a pastor and all. And he just made this one request to me: leave the world better than how you found it. He rarely swore (at least not in English), and almost never involving God in that transaction. But I did hear him once say "That goddamn depression." He knew that it was real, and not everyone can greet the day with song, no matter how hard they will themselves to do so.
There is an opportunity, in losing such a widely loved man as Robin Williams, for a better understanding and a bit more compassion for the struggles of others. Because that is really why we are here on Earth: to be kind to others.
And to exercise. Seriously, exercise is the strongest drug, the purest medicine, the absolute best high, the ticket to a front row seat in the happy life extravaganza.
Music is good too. As is nature.
My oldest child leaves for college in 2 days. That alone could be cause for complete devastation. And yes, I am sad. But inside of me there is this little burst joy for her. The world, it is out there. Its pleasures and hurts must be deeply mined and there is no time to waste. Read! Write! Learn Latin, go to parties, run cross country, stay up late and study. Fall in love. Learn about your inner strength. Visit often. Call even more often. And never forget, in times of despair, that you are deeply loved. Leave the world better than how you found it. Be kind to others. Notice everything. Exercise daily.
We must not let Robin Williams dash our hopes. He was gifted. He gave us his gift. And he also was human and deeply mired in goddamn depression. The world might have been kinder to him.
Rest in peace.
Saturday, August 2, 2014
Saints
Every day at exactly 11:30 am, I am treated to a chorus of "Oh, When the Saints". I am seated above an adult day health center, with a window to overlook the daily activities. And that is just one of the daily activities. DAILY. I have thought about taping a poster with requests for new songs on my office window, but it occurred to me that my need for variety in musical tunes may not meet the needs of an elder with significant memory loss. Routine, dependable, unwavering, predictable routine might be the best thing. And delving into the oldies is no mistake. A person with dementia may not remember what they had for breakfast or that they met you 5 minutes ago, but they have the most solid of memories of their young years. It is like the brain shuts one door and opens another. During our relatively youthful years the door to the past is maybe just a bit ajar, but we cannot really access the full experience. This may be good, because if I could spend my day playing in my backyard with my Mom bringing me cookies and Kool-Aid, I would probably never get anything else done.
I am not all that old yet, but I am finding myself craving routine. My work offers that now (insofar as any doctor job can: there are usually a few surprises each day. Not at 11:30 am though). My saint of a husband keeps us all fed and watered. My dog knows when it is bedtime and my chickens know when it is time to get up in the morning. My runner self is completely discombobulated though. I have spent so many years in complete time chaos (college, jobs with changeable shifts, med school, residency, and the last 12 years of work ruling me with no intention of offering me a routine) that I developed a plan for running: do it whenever. Which no longer works for this body and mind.
As I find myself relatively out of shape, and signed up for a marathon in 11 weeks, I wonder if it is wise to waddle to the starting line. I am very competitive with myself, and dislike failure. I also respect the marathon. You gotta invest in the aerobic account, or you will find yourself broke and shattered at mile 20.
All that said, it is time to get serious. I am tired of my brain chemistry putting me in a stranglehold. So what if I go and run slow or (gasp) DNF. I could DNS, but I think that might be the end of me. I will just become one of those characters in Wall-E.
Therefore, come humiliation, lactic acidosis or pain beyond belief, I will try.
But I need to focus on what inspires me:
1) Young Warriors.
2) Old (as in friends for a long time, just to be clear), Speedy friends.
3) Dog.
4) Roxana.
5) Beauty.
6) The Strong Person I know resides within.
Oh, When the starting gun sounds its call, Lord I want to be in that number.
And if I am last, well, at least I showed up.
Come on everybody, sing along!
I am not all that old yet, but I am finding myself craving routine. My work offers that now (insofar as any doctor job can: there are usually a few surprises each day. Not at 11:30 am though). My saint of a husband keeps us all fed and watered. My dog knows when it is bedtime and my chickens know when it is time to get up in the morning. My runner self is completely discombobulated though. I have spent so many years in complete time chaos (college, jobs with changeable shifts, med school, residency, and the last 12 years of work ruling me with no intention of offering me a routine) that I developed a plan for running: do it whenever. Which no longer works for this body and mind.
As I find myself relatively out of shape, and signed up for a marathon in 11 weeks, I wonder if it is wise to waddle to the starting line. I am very competitive with myself, and dislike failure. I also respect the marathon. You gotta invest in the aerobic account, or you will find yourself broke and shattered at mile 20.
All that said, it is time to get serious. I am tired of my brain chemistry putting me in a stranglehold. So what if I go and run slow or (gasp) DNF. I could DNS, but I think that might be the end of me. I will just become one of those characters in Wall-E.
Therefore, come humiliation, lactic acidosis or pain beyond belief, I will try.
But I need to focus on what inspires me:
1) Young Warriors.
2) Old (as in friends for a long time, just to be clear), Speedy friends.
3) Dog.
4) Roxana.
5) Beauty.
6) The Strong Person I know resides within.
Oh, When the starting gun sounds its call, Lord I want to be in that number.
And if I am last, well, at least I showed up.
Come on everybody, sing along!
Subscribe to:
Posts (Atom)