My Boy

My son Grant turns five this week, and I'd like to wish my Little Buddy a happy birthday.

He and I had a wonderful opportunity to bond over the past two weeks. Due to our move and some free time in my schedule, he and I headed out to Southwestern Colorado to spend some time on "the Ranch," a friend's spacious and idyllic mesa in the middle of nowhere. My parent's joined us for the first weekend, and my wife and other two children joined us for the last, along with my brother and his wife and two children.

But in between, it was just me and Grant and a whole lot of wide open spaces. We stayed in a log cabin on a small lake in a remote corner of the mesa. At night, looking out the rear window, we could see by starlight the Lone Cone and the Delores Peaks towering on the horizon, and it was impossible to see any other signs of humanity. There were absolutely no city lights, no streetlights, no anything in any direction.

We would look to the stars and everything was crystal clear. No light pollution. If fact, it was only when we saw the slow drifting satellites in orbit that we felt reminded that we weren't the last two guys on earth. The Milky Way was so prominent that it looked like, well, spilled milk.

Grant and I had a deal. He had to let me write for four hours a day, but the rest of the day was his. And we had a great time. We cooked all of our meals together, chopped a lot of wood, played football and baseball and frisbee and horseshoes (we modified the horseshoe's rules, and Grant is very proud that I could never beat him, and believe me, I was really trying). We played chess, checkers, chinese checkers, puzzles and several other board games. We read lots of books. We tried to fly our new remote controlled helicopters, only to irreparably break both of them within minutes of take-off. We built campfires and roasted hot dogs and marshmallows. We went canoing on the lake. We fixed crooked signs all over the place. And mostly, we did a LOT of four-wheeling, at least 3 hours a day, I would guess, and probably rode well over two hundred miles in ten days.

We hunted for turkeys, and though ultimately unsuccessful, we saw several dozen of the sneaky rascals. We saw countless deer and birds and squirrels and rabbits. We saw an owl, a golden eagle, some prairie dogs, and too many cows. (This is still a working cattle ranch). We never did see any elk, though we know they were around.

The climactic moment came on our last day. We came zooming around the corner on our four-wheeler, and there, in the middle of the road, was a good-sized black bear, not twenty yards away. He was so startled that he literally jumped in the air, turned and stumbled away quickly thorough the scrub oak. He was gone within seconds, and to be honest, neither Grant or I felt the least bit scared. Of course, we had our snazzy four-wheeler and a trusty firearm to back us up.

In the end, I got some great writing done, and we had dozens of memorable experiences, but by far the best outcome of the whole endeavor was getting to spend an extended time with my son. He and I have battled mightily over the past few years, and particularly over the last few months, as he seems to have been fairly rattled by our move and to have acted out with attention-seeking behaviors and fierce tantrums.

But not on this trip. Almost without exception, he was perfectly behaved. We didn't clash even once, and I think both of us discovered how much fun we had together, how much we enjoyed each other's company. Quite honestly, by the end of the trip, I sometimes found myself forgetting that he was my son, and not just my hunting buddy.

He was extremely cute in a most unintentional way. I noticed for the first time how dearly he loves his stuffed animals, particularly his T-Rex and his Glow Puppy. Sometimes, I'd take a break from my writing and just watch him from the balcony, playing contentedly or even exuberantly by himself around the cabin, throwing rocks or jumping off stumps or collecting pine cones. Here was a four, almost five year old boy, and it seemed to me that the most important thing in the world for him was to be exactly where we were, doing whatever it was we happened to be doing.

Grant is a boy who, for good or ill, wears his emotions very prominently on his sleeve. But for two weeks, the tantrums and attention-seeking disappeared. It was just him and his Daddy on the Ranch, exploring and playing and four-wheeler riding. Other than missing Elizabeth, Joy and Justin, the world seemed absolutely perfect for both of us. And more than anything else, I knew he was happy, which made me overwhelmingly happy.

So here's to my wonderful five year old son!

Happy Birthday, Grant Guy! I love you!

Props to Craig and His List

No posts from me for a while, but no worry. I'm sure all six of my infrequent readers have yet to notice. ;)

Actually, to those who may care, we have successfully moved our family back to Colorado and are enjoying settling into our new home and a new routine.

Now, today I wish express my appreciation for that cyberspatial miracle known as Craigslist.com. Why? Because Craigslist has saved me money. Big time.

Ever wonder who Craig is? Check this link out and educate yourself.

In the past month, I calculate that I have saved more than $3000 by spending just a little over $1000 on some perfectly fine and (even exceptionally nice) furniture. This includes a gorgeous solid oak dining room table and china cabinet, bunkbeds, patio furniture and an office chair.

In each of these instances, I went to Craigslist, found the desired item within a 25 mile radius at a reasonable price, and then graciously (mercilessly?) negotiated an even lower price with the anxious sellers. I have been grateful for my Toyota pick-up, because it has made it possible for me to head out at a moment's notice to pick up the merchandise, which has allowed me to negotiate lower prices with the sellers.

In each instance, instead of feeling like I was being robbed by some money-grubbing retailer, I felt a strong fraternal connection to my co-barterers, like we were co-collaborators on a new utopian social experiment. They got money for something they didn't need anymore. I got a good item at a great price. Everyone went home happy.

How many things in life are consistently win/win for everyone involved? Not many, and so that's why Craigslist gets my props today.

If you haven't bought something on it before, give it a shot.

And if you've got some cheap furniture to sell, give me a shout. (Let's keep this Craig dude out of the loop on this one.)

Farewell to OB

For an unlucky 600+ babies in this world, the first thing they saw coming out of the womb was my ugly mug, which could explain all the crying.

Two of these infants were my own sons, although the first delivery I ever witnessed was that of my only daughter, who was born on the weekend before I started clinical rotations in medical school. When the doctor held up our new baby and asked me to declare her gender, my mind, which must have been stupified in wonder at witnessing the miracle of life, went blank and the answer to this most basic of medical questions eluded me. I stared at the doctor, at the baby, at my wife and finally the kind doctor relieved the palpable confusion and declared matter-of-factly, with vicarious shame, "Uh, it's a girl."

Well, I got better at identifying gender as time went by and the deliveries started to pile up. Before too long, the ins and outs and subtleties and dramas of a labor and delivery unit, which had seemed so intimidating, began to be familiar and even comfortable, though I never lost the wonder and awe of the event. Rapidly, obstetrics became my favorite aspect of residency. As the final groans and shrieks and splashes and cheers of yet another birth would crescendo down the hospital corridors at three a.m., it always seemed to bring a welling of (but not actual!) tears to my eyes.

I chose my residency in order to get extra training in OB, including the ability to do Cesarean deliveries. I felt that if I was going to be delivering babies in a rural environment, I needed to be able to handle not just the routine and uncomplicated births (which, honestly, rarely require the supervision of a physician, as women were delivering babies for a several eons prior to the advent of modern medicine--anyone could catch a baby), but also to handle the small percentage of births where the life of mom and baby hang in the balance. When things went south in a hurry, I wanted to have the training and confidence to be able to deliver via C-section, sometimes referred to in medicine as the "vaginal bypass" surgery.

I got excellent training in residency in Colorado, and was able to put that to good use for two years in my first practice in Wyoming. I also became aware that not only did I enjoy OB, but that I was (in my humble opinion) pretty good at it. I gave good care, developed a sharp clinical skill and intuition, had generally very positive feedback from patients and families, and earned the respect of my medical colleagues.

So considering all of that, how can I now walk away from OB?

I have a number of relevant excuses: the demanding call schedule, the emotional fatigue, the high risk of litigation, the difficult patients. The most accurate and understandable excuse is that, in order to accept the many lifestyle benefits of my new job in Colorado, sacrificing my OB practice would become a necessity. It would be essentially impossible, both politically and geographically, for me to practice full-spectrum obstetrics at a major metropolitan hospital: family doctors just don't deliver babies or do C-sections in that setting anymore, not to mention the fact that my new practice would be located at least twenty minutes from the hospital, which would be prohibitive.

The bigger and more poignant truth is that, having practiced OB for five years (including residency), I no longer feel willing to make the personal sacrifices required to continue it. Been there, done that, had some good times and bad times, now ready to move on. That sounds a bit crass, but it is probably the most concise summary.

I admit to very mixed feelings about this. I have invested a great portion of my time, youth, money and well-being to learn a rarified skill that will now turn fallow, likely never to be utilized again.

But there you have it. Who knows what the future will bring? Who, a mere three years ago, could have guessed that we would move to Wyoming, practice and move again in such a short time frame. Maybe in the future I will provide obstetrical missionary services in foreign countries, or moonlight in rural hospitals. Maybe I'll get to be the hero on the local news when by chance I happen upon a woman delivering in her car alongside the highway. Or maybe I'll miss OB so much that in another three years we'll move back to an environment where I can practice it again. (Unlikely.)

But for all of the endless memories, the triumphs and terrors of the labor deck, the privilege of participating directly in the miracle of life, I bid obstetrics a most fond farewell. I will miss it dearly . . . as I sleep uninterrupted through the night.

Empty House

When I pulled up to our empty Worland house late last Sunday night, I didn't expect any melodrama. I had helped move my family down to Colorado two days prior, and then had driven solo back up to Worland to finish my last week of work. We hadn't yet closed on the house, and so although it was barren, we still had ownership, and I had to check on a few things prior to heading over to a friend's spare bed for the night.

When I pushed open the garage door into the kitchen and flicked on the florescent light, a blast of muggy air greeted me, which brought with it a humid sense of deja vu. I recalled a similar rush of warm air almost two years prior when we had first walked into the house late on a hot summer evening. Everything looked almost identical and just as empty as it had then. I surveyed the vacant rooms, and unexpectedly a deep poignant ache began welling inside, which, once once I recognized it, became quickly a nearly unbearable sadness.

The strength of the emotion caught me off-guard. I had been so engrossed in the physical bustle of moving that apparently I had not dealt with the emotional aspect of it. But that is the way I typically handle big life changes: suppressing the emotions of the moment, only to have them surface at later times in unexpected ways.

But why did I feel so deeply sad? All in all, this move was a happy one, and in spite of my occasional misgivings about it in the preceding months, I had no doubt that it was right for our family; only days prior I had felt what can only be called elation as we crossed the state line back into Colorado. So why the sadness? Somewhere in the back of my mind, I was aware that the home wasn't the source, merely the vehicle, of the sorrow. The source seemed to be something vague and ineffable, something that brushed tangentially along the corners of the relentless pressures of time and the fragility of our lives.

I shook my head and began walking around the house, flicking on lights and checking closets. The squeaky floors, which had been a constant annoyance while living there, were somehow reassuring by being familiar. Every room seemed to resonate with a profound absence of what should have been there. Where were the toys strewn around the room? Where was the baby gate blocking up the hallway? Where was the pile of letters and keys and miscellaneous junk that inexorably coalesced on the corner of the kitchen counter?

I couldn't bear to be in any one room for more than a few seconds before feeling compelled by the aching sadness to leave, only to find the next room even more oppressive. We had done a number of major improvements, yet the physical parameters of the house seemed utterly unchanged by our two years there. It seemed as if by vacating the house so completely, two years of our lives had been erased, just like that.

I crept down to the basement and examined every room, searching for something, anything that we may have left behind, ostensibly in case we might have missed it, but secretly hoping for some shred of evidence that these two years of our lives had not totally dissipated into thin air.

And then I found it. There, beneath the laundry chute, something red and white, crumpled. Closer inspection revealed its true identity: a pair of Grant's dirty "Lightning McQueen" underwear. I picked it up and laughed out loud. How and why he had placed it down the laundry chute in the very brief interval between our "final sweep" of the home and getting into the car, I didn't want to imagine. But the concrete proof of existence it conveyed was most welcome. In that moment, it may have been the most appreciated piece of dirty underwear of all time.

But after chuckling to myself at the absurdity of my own emotions, the silence and emptiness in the house reasserted themselves as the dominant force of the evening. I would soon be gone again, and the house would continue existing with or without me. Underwear in hand, I hurried upstairs, closing doors and shutting off lights, and finally resurfacing through the garage into the cool night air. I stood by our front porch and glanced down at the pink rose bush that had exploded in colorful buds a few weeks before. Now, the browned wilted petals hung precariously to the stems or fluttered lifelessly to the grass. The grass itself was getting longer and ragged in some patches, brown and crisp in others. Weeds crept along the driveway. I looked up to the clear night sky, nearly untarnished by the relative paucity of city lights in Worland. Stars burnt coolly into the high desert air, constant yet flickering, unimaginably brilliant and unfathomably distant.

Two years. A new child. A new career. This home had been the arena where the dreams and heartaches and memories of our precariously short lives had played out. And now it lay undisturbed and empty, devoid of any trace of our time there.

And now not even tainted by a misplaced pair of dirty underwear.

Wimbledon Classic

This weekend I watched what will likely go down as one of the greatest athletic competitions of all time, as young, hungry and indomitable Rafael Nadal outlasted the venerable, invincible five-time defending champion Roger Federer in a five-set, seven hour thriller in the Wimbledon finals.

Anyone who follows tennis even casually (like I do) had been anticipating this rematch of last year's final for the past twelve months. As the number one and two players in the world, Federer and Nadal had been on a collision course for this championship rematch ever since Federer gutted out a five-set victory last year.

But coming into this year's final, Nadal had time and momentum on his side--not to mention a healthy knee which had slowed him last in last year's final. After all, Nadal had crushed Federer in straight sets on the clay courts of the French Open final just a few months before. But Wimbledon is a grass surface, and Federer has owned that surface for the past five years running like nobody else ever has in history. Going in, he had sixty five straight victories on grass to go with his five championships.

Not to mention that Federer, in his five year run of greatness, has maintained such a totally dominant physical and psychological edge over every opponent. He garnered the nickname Darth Federer when he wore black once in the final and appeared like a black-clothed tennis exterminating machine, completely unflappable and untouchable. To watch Federer has been to watch tennis played to perfection: perfect body control, perfect power, perfect temperament and perfect focus.Only one thing has seemed to be able to faze Federer in his unprecedented dominance, and that would be Nadal, who has been the Kryptonite to Federer's Superman, owning an 11-6 lifetime record against him, really the only opponent who has been able to consistently compete with and even outperform Federer over the past five years, though Federer's Wimbledon victory last year seemed to reassert his physical and mental superiority to Nadal, as well as to every other tennis player who has ever lived.
But Nadal was having none of that this year. In contrast to Federer's polished perfection, Nadal has the appearance of a raging wild beast, all sweat, sneers, stringy hair, grunts and fist pumps. For all of Federer's graceful precision, Nadal has equal amounts of pure energy and athleticism. And both have unparalleled competitive wills: the same brilliant fire that illuminates Federer also radiates from Nadal. In the Wimbledon finals, Nadal jumped to a two set lead and seemed poised to win in three sets. But Federer, regrouping during some timely rain delays, came back to win the third and fourth sets, setting up an epic fifth set that stretched beyond anything that Wimbledon's storied history had ever seen and into the deepening London twilight. In a fifth set of a final there are no tiebreakers, and so the match went into extra games, with the champion being whoever could string together two straight victorious games. Finally, Nadal broke Federer to take an 8-7 lead, and then he served out his final game to claim the victory as he collapsed along the baseline. When he arose, his face was streaming with tears of triumph and exhaustion. Federer graciously congratulated him as they both accepted their trophies.

Tennis is virtually alone in the world of sports in its intra-dynamics, a one-on-one direct competition, two competitors facing each other across the net, directly interacting, slugging it out and trying to beat each other. No teams, no court-side coaches, no timeouts (unless you're lucky with a rain delay). And in a five set match, there is so much time for momentum to build and ebb, so many turning points, so much endurance required. What made this final so singular was that it was a face-off of the two unquestioned best players on the planet, each at their prime (though perhaps Federer is on the backstretch of his greatness while Nadal is still coming off of first turn of his), with each playing flawlessly, relentlessly past all boundaries of normalcy, each refusing to lose, until finally Federer, in what could only be total mental and physical exhaustion, showed the slightest chink in his armor, and Nadal, the ursurper to his throne, rushed in with the dagger to finish him off.

It's hard to say at this point who is the number one player in the world, as the margin between victory and defeat was so razor thin. The edge would have to go to Nadal, but no doubt Federer has several more good years left, and still has the tools and the mental toughness needed to reclaim his throne.

I, along with tennis fans around the world, hope that over the next few years this rivalry, just like this match, continues to ebb and flow, back and forth between who has the upper hand, who is the world's greatest. It is a study in contrasting styles, of how competition can propel rivals to new levels of greatness, of grace versus power.

It is a thrill to behold.

Long live the kings!

Waiting for the End

I have a very pleasant patient who is slowly dying of end-stage emphysema. He is on very high levels of oxygen and a number of medicines, but there is no cure for his condition, no remedy that he is willing to consider. He will continue to experience a slow decline until he finally succumbs and dies.

I've been caring for him for the past twelve months, when I inherited him from one of my partners. Yesterday, he came to see me again, feeling generally miserable, short of breath, and utterly fatigued. We discussed his specific symptoms, which all revolved around his incurable underlying condition. Finally, his well-meaning, relatively healthy, and somewhat frazzled wife cut to the chase.

"Doctor," she asked, "how much longer is this going to last?"

"You mean until he feels better?," I asked.

"No," he answered for her, "she means how much longer until I'm going to die." He spoke this final word with impatience.

I paused for a bit, collected my thoughts, then said as honestly and compassionately as I could, "I don't know. It is very difficult to tell in these cases." They looked at me expectantly. "Based on where you are today, I would say probably six months to a year." I waited for a response.

"Six months?" His wife gave an exasperated little half-chortle. "That's what they told us two years ago!"

We all laughed at that for a bit, at the absurdity of living a life in suffering with the sole purpose of waiting around until one day you finally die. This sort of situation invariably raises the spectre, in my mind at least, of physician assisted suicide. First of all, it's illegal. But that doesn't mean necessarily that the idea is wrong. In fact, in specific cases such as this one, it is very hard to argue against it from a medical ethics point of view. (That may come as a surprise to some, but medical ethics is full of shades of gray, and because in our western medical-legal paradigm the principal of autonomy typically trumps all others, it is hard to build an argument that would preclude a rational patient with an incurable, agonizing disease to voluntarily take their own life.)

But this encounter did not devolve into an esoteric discussion of medical ethics. Rather, this was pragmatic, a patient suffering who wanted some sort of reassurance or comfort. I felt compelled to morph into Missionary Mark, to share in a non-denominational way some of my personal religious convictions, as I will sometimes do when religous patients come to me for comfort, and medicine has nothing else to offer.

I suggested to him that God appoints our times and seasons, when we live and when we die, and that the fact that he's still alive must mean that God still has some purpose for him. I encouraged him to try and view each day as a gift and to find meaning in it, even if that was only holding his wife's hand or writing a letter to a grandchild or appreciating a flower.

Then I raised my hands to the heavens, shouted "Hallelujah!" and asked him for an alms.

Not really. But I did feel some sort of spiritual inspiration, and my patient and his wife were noticably moved.

He will still suffer physically and emotionally, will likely die within the year, and I'm under no false pretense that my one minute sermon will dramatically affect his end-of-life care. But I did have a feeling of satisfaction that, rather than offering lethal doses of morphine, I was able to offer my terminally ill patient words of comfort and perspective.

Chicken Run

For the last nine months, we've been amateur chicken farmers. But due to our imminent summer vacation and upcoming move, we gave our eleven chickens away today. It's a rather poignant moment: the end of the Chicken Era.

Last fall, we joined ranks with another family in caring for eleven hens that were housed in a chicken coop on a ranch outside of town. It was a great opportunity for our city family to get involved in some real-life agri-culture (farm work, chores, getting down and dirty), not to mention to get some delicious farm fresh eggs.

Jim, one of the dentists in town, had a spare chicken coop sitting on his beautiful ranch, and he was gracious enough to lend it for our chicken endeavors, and so twice a week we headed out to his coop nestled in the cottonwoods by a pond to feed our frenzied feathered friends.

There were four Rhode Island Red hens, four salt-and-pepper Plymouth Rock hens, and four plain old white hens, prolific egg layers all, putting out sixty to seventy eggs a week between them. Due to the egg surplus, Joy and Grant got to start their own little business, "Foster's Farm Fresh Eggs." If they collected the eggs and took care of the chickens, they got to sell them and keep the profits. Quite a business, I must say. The kids are rolling in the dough. Even Justin grew to love going out to feed the ever-bustling, ever-interesting (to a one year old at least) chickens.

Eventually, we took over sole ownership of the chickens, and finally today we bequeathed them to another young family. The whole chicken business was quite a bit of hassle, especially in the winter when it was 28 below zero, but I must say that I feel rather sad at the close of this chapter. It started out on a whim, and ended up becoming an integral, earthy part of our Worland life, a vignette of what our future might have held should we have chosen to stay in Worland longer.

But hey, they still need eggs in Colorado, right? Do you think our new suburban neighbors would mind if we erected a chicken coop in the back yard? Would eleven clucking, stinky chickens be a problem?

Come on, Colorado. Time to put that "Locally Grown Food" movement to the test!

But in seriousness, I know there is a vestigial farmer in me. I feel him clamoring to be released whenever I've been tangentially involved in farming or ranching. We hope to own our own small ranch someday: some acreage, some horses, and--gosh durn it--some chickens!

Spontaneous Wipeouts

A young child is ambling on without a care in the world. Suddenly, through a mixture on incoordination, head-size disproportion, and just plain bad luck, they collapse in a heap.

Cue the crying.

Elizabeth and I refer to this sudden, catastrophic collapsing malady of childhood as the "spontaneous wipeout." Our children are masters of the art.

Joy may be routinely brushing her teeth, and suddenly she has fallen violently, wedging herself between the toilet and the trashcan.

Grant may be eating his breakfast cereal, sitting flat on his bottom, and suddenly, without any obvious impetus, he has toppled head first onto the hardwood floor, scattering soggy cheerios to the four corners of the kitchen and sustaining a large goose egg on his forehead.

Justin, being only a year old, can be forgiven his frequent falls, but I have no doubt he will soon be following--or should I say falling?--in his siblings footsteps.

New light was shed onto the origins of this phenomenon last week. Joy was standing still in the kitchen, not moving in the least, when suddenly she crashed through the screen door, ripping the screen out of its frame, scraping her foot and bruising her arm in the process. In my ultra-calm but deadly serious voice, I questioned from the couch, "So, Joy. What happened there?" She whimpered plaintively from the porch, "I don't know, Dad. I just went out of balance."

Ahhh. So that explains it. Going in and out of balance without a moment's notice.

In medicine, there is a condition known as Benign Paroxysmal Positional Vertigo, or BPPV. But this is not that, for this may be paroxysmal, but it is by no means benign.

This is the Spontaneous Wipeout. Who knew gravity could be so malevolent?

Breaking the Bad News

I don't have to diagnose patients with cancer very often, thankfully. But the last few weeks have brought a grim procession of cases where I've been the one that's had to break the news.

Two of these patients have been very elderly, very frail, and while a cancer diagnosis is always devastating, they and their families have met the news with a sense of resignation mellowed by dementia.

But two of these patients have been fairly young (in their fifties), otherwise healthy and brought into the doctor's office by fairly minimal symptoms. In both cases, I initially pursued a conservative work-up, but through a mixture of clinical intuition, defensive medical practices, and plain old blind luck, I ended up ordering special imaging studies. Both patients ended up having particularly large and aggressive tumors; both now face a horrifying gauntlet of major surgeries, radiation and chemotherapy, all of which appear unlikely to prolong their lives.

Ugh. It's enough to make me want to do an MRI of my whole body, just to be sure there isn't something sinister simmering in my tissues.

It's a little bit like hearing about a plane crash: when you see something so horrific, you suddenly feel vulnerable, even though your odds of suffering the same fate are exceptionally small. (Unless, of course, you fly on Great Lakes Airlines.) Compound that by paranoia by witnessing first hand the disaster several times in a short span.

When I'm faced with an x-ray report that reveals a likely cancer diagnosis, I feel devastated for my patients as well. I dread having to be the messenger, though I do appreciate the importance of my role in reliably and empathically conveying the information. Knowing I will have to answer a deluge of panicked questions once I break the awful news, I go do as much research as possible to try and educate myself and be prepared. But oncology is such a specialized field now with such specific diagnoses, treatments and prognostications, that whatever meager information I impart will be utterly insufficient. This is especially true when I am breaking the news of an as yet unconfirmed cancer, as you never diagnose cancer off of an x-ray, but rather under a microscope once you get a tissue biopsy. It's all a very hopeless feeling for me; usually the best thing I can do is convey the information, offer compassionate solace, extend an invitation to hope for the best, and then expedite a referral to an oncology center. It's not like treating an ear infection: easy diagnosis, excellent prognosis, concrete remedy.

It's more like dredging a lake for drowning victim: emotional paralysis until the awful discovery confirms your worst fears.

I guess that's why I've had a Tim McGraw song humming in my head all week:

He said, "I was in my early forties, with a lot of life before me
When a moment came that stopped me on a dime.
I spent most of the next days, looking at the x-rays
Talking 'bout the options and talking 'bout sweet time."
I asked him when it sank in, that this might really be the real end.
How's it hit you when you get that kind of news?
Man, what'd you do?

He said,
"I went skydiving
I went rocky mountain climbing
I went two point seven seconds on a bull named Fu Man Chu
And I loved deeper
And I spoke sweeter
And I gave forgiveness I'd been denying
And he said, some day I hope you get the chance
To live like you were dying."

Circle of Five

I sat semi-dejected at my desk late last week, trying to clear my head after a difficult day at work. In addition to typical patient issues--chronic pain, terrible social problems or unsolvable health issues--I was also dealing with a more personal matter: having to tell my patients that we are leaving Worland this summer.

This is harder than it may seem. I feel a strong loyalty towards my patients, which they largely reciprocate. (Of course, some of them don't care a bit, and I'm sure a few are glad we're leaving.) But I give my patients my best everyday--empathizing, listening, suffering, educating and hopefully healing. Doctor-patient relationships, by nature, are complicated things: formal and professional, yet deeply private and sensitive. A day at clinic can sometimes seem like a day at war, usually fighting disease alongside my patients in a Band of Brothers way, yet sometimes fighting against them, or at least against their habits, their preconceptions, their stubbornness.

But I've assumed an important role in my patients' lives, and so announcing my imminent departure has triggered strong feelings. Most of my patients have expressed unqualified support, happy for me and my family and the opportunities that await us. But some, usually the sickest and neediest, have been upset, even distraught. Tears have been shed, harsh words spoken. I am someone who prizes loyalty in relationships, and so knowing that I have given cause for such strong feelings of betrayal in those who have trusted in me creates some internal tension.

Thus, there have been some tough days as of late, and last week I sat at my desk late in the afternoon with a headache, a stack of unfinished paperwork, and an unsettling feeling that leaving Worland was possibly the wrong thing to do. This resonated deeply within me, my mind wrestling with the question of whether my life was my own to live, or whether I owed my time and energy to others.

Sighing, I glanced towards the far side of my desk, where my three beautiful children's faces beamed at me from their photo frames: Grant Guy, with his boyish exuberance; Joy Bear, with her serene intelligence; and Justin (a.k.a. Soggy Muff) with his blithe cuteness.

I felt an unexpected two-directional rush of familial love, first from me towards them as fatherly affection. But then I felt their love flow back towards me as a fountain of strength. These kids love their imperfect Daddy, and no matter what happened at work today or what mistakes I had made, in a few minutes I would walk through our front door and they would dash to greet me.

There was strength in their goodness, in their innocence, in their trust . . . even in their sheer numbers. They trust Elizabeth and me to make the right decisions for our family, whether that's about what's for dinner or about where and how they will be raised. It's a blind trust that is all the more remarkable considering the strong, independent, and consequential people they are bound to become. As I gazed at their photos, I felt strength, perspective, and resolve flowing into me. This is it, I thought, this small, intimate circle of five human beings that forms our family. The biggest questions suddenly seemed easy: my perspective and purpose must shaped and focused here, with my wife and these children. As all parents do, I know what it's like to need to be strong for my children, but I don't know that I had ever felt such strength reflected back to me.

Paradoxically, this was a twist of that same feeling of my life not being entirely my own. But this was different, as the lives of my wife and children are so inextricably intertwined with mine that there is little discernible separation.

I left the unfinished work on my desk, threw my jacket on, and raced home. I entered the front door in my typically triumphant and silly way. Grant sprinted across the room and leaped into my arms; Joy looked up from her book on the couch and beamed demurely; Justin shrieked in excitement from his playpen. Elizabeth greeted me cheerily from the kitchen; something smelled delicious.

It was all very vivid, very soft and warm, maybe too perfect for some, but utterly real for me. I picked up Justin, who squealed with delight. Elizabeth gave me a hug and asked, "How was work?"

"Tough day," I said. "But it's good." I glanced around the room, which seemed to be glowing with love. I gave her a kiss and said, "I'm just glad to be home."

Planet Erf

"It's just an inch from me to you, depending on which map you use."--Jewel

Maps, like telephones, have always fascinated me. I've been known to stare at a road atlas for hours with no particular objective, just for entertainment. Museum exhibits with maps are invariably my favorites. My wife gave me an atlas for my birthday a few years ago because she couldn't figure out what else I would like and knew a map would be a surefire winner.

It's something I can't explain, but maps allow me to place myself somewhere in the here and now, to feel like my future destinations are something known to someone. Maybe I'm somewhat of an agoraphobe, but maps serve as a comforting anchor point in the otherwise frightening vastness of the universe. "It's okay," my inner child says, "Somebody's already mapped this out . . ."

So it's no wonder I love Google Earth. (Or as my son says, "Google Erf.") If you've never spent an hour surfing through this virtual world at supersonic speed, touring actual satellite images of every important structure you've ever been in or every mountain you've ever climbed, then you're missing out an exhilarating experience, and your life is the lesser for it.

The effect of Google Earth is dizzying. The opening screen starts with a panned out image of the whole planet. Type in any destination, and then watch the earth automatically rotate towards you and seamlessly zoom, zoom, zoom through the atmosphere until an image from a satellite reveals the round, blue baby pool in your backyard and your silver truck parked out front.

Go to the Grand Teton and tilt the image so that you are looking at the same looming facade that Ansel Adams captured a hundred years ago, and then rotate wildly around it to catch its every contour from every angle. Zoom in and the pan around to track the exact route you will be climbing this summer.

Go to the new home your hoping to buy and check if the neighborhood has got sidewalks, how big the trees are, if the backyard is landscaped, whether it's got a covered porch or room for a garden.

The images aren't real-time, but they are vividly detailed, and the real magic is in the program's seamlessness. There is no choppiness, only a smooth ride around the globe on your very own Google magic carpet. Go to Brazil, Russia, Africa, China, Iraq--but be aware that the army has blurred the images over militarily sensitive areas due to their extreme accuracy.

So if you haven't already, go download Google Earth. It's free. Check it out for an hour and see if, by the time you're done you don't think the world is just a little bit smaller, a little more personal, and little more precious. Maybe you'll even want to give your tree a hug, your neighbor a cookie, and your distant friends a phone call.

It's a small world, after all. Happy Earth Day!

Decentralize Yourself

For many people, few things provoke more anxiety than public speaking. How many times have we all heard a semi-lame joke from a trembling church speaker about how, when the bishop called with the assignment, they wanted to run from the phone?

I don't think that the anxiety is typically induced by the content of the message one is giving. Rather, it's the self-presentation, the exposure, the potential for total public humiliation, that causes such terror.

But it doesn't need to be that way. In fact, I think its entirely possible to enjoy public speaking, and to do a good job of it.

The key is what I term "decentralizing yourself." This means to shift the emphasis of your talk from the messenger to the message. It's amazing how easy it is to confuse these two things.

When all eyes are on us, we have a tendency to feel the collective pressure of the audience, to palpably feel the social judgment that is likely being cast on us, and to ask ourselves, "Do they like me? Do they think I'm a stammering idiot?"

But here's the key: it's not about you. Or at least it shouldn't be. Let your message take center stage. The first crucial element here is to have something worth talking about. But assuming you have that, then take yourself out of the center of the frame -- "decentralize" -- and let the importance of your ideas take center stage. Let your persona be only a conduit that allows the subject matter to entertain, educate, and inspire.

In my experience, paradoxically, it's only this self-decentralization that allows you to really shine. It's the temporary abdication of ego that lets the self shine most brightly, a spiritual truth that applies to much more than just public speaking.

So next time you have to give a talk, remember this: don't tell a lame joke about how much you have dreaded the occasion; have something worthwhile to speak about; and as you prepare and before you actually speak, tell yourself over and over, "It's not about me. It's not about me."

Then go stand and deliver, baby. Give 'em something to remember.

A.C.H.O.O. Syndrome

I have a disease, a genetic disorder that causes me significant distress. Regretfully, I have passed this diabolical gene on to my two sons.

What is my condition? In short, I sneeze--suddenly, violently, frighteningly--when exposed to bright sunlight.

Do not laugh at my affliction, commonly known as A.C.H.O.O. syndrome, or Autosomal-dominant Compelling Helio-Opthalmic Outburst Syndrome. (Read here for details.)

My suffering has been lifelong, yet my journey towards understanding and acceptance began in the relatively recent past while in medical school in Arizona. There, I would spend many long hours in our quiet, darkened library with my head bent over my textbooks, drooling onto the pages in peaceful slumber. In rare intervening moments of lucidity, the assorted medical minutiae would flutter in and out of my droopy eyes like cactus wrens at dusk. Then, my jejunum would emit borborygmi and I would awaken, knowing that it was time to go home and partake of some delectable morsel, such as Top Ramen, Mac and Cheese, or perhaps an Oreo cookie.

I would stuff my books into my tattered backpack, and I would step out of the dark library into the brilliant afternoon Arizona sunlight. Then, as reliably as flipping on a switch, my nose and head would suddenly explode into sneezing, always three distinct and uncontrollable sneezes. Then, having purged the demons, I would experience a somewhat pleasant feeling of catharsis.

For over a year, I assumed that these sneezing fits were induced by pollen allergies due to the flowering bougainvillea that surrounded the library's entrance. But in our second year, while studying neuroanatomy one day, my professor digressed in his lecture on the cranial nerves. He discussed A.C.H.O.O syndrome, a genetic condition in which a strong, sudden light stimulus triggers constriction of the pupil, which overstimulates of the optic nerve. This overstimulation--in certain people--causes an inadvertent cross-stimulation of the trigeminal nerve, the nerve which controls sneezing. Light-->pupillary constriction-->SNEEZE!

There was no cure, he intoned, only diagnosis. But with that, there came understanding, and thus a measure of peace.

I knew it was true. I was living proof. He asked if anyone in our class who suffered from these symptoms. About 20% of us raised our hands, and I no longer felt so alone.

My brother, Jeff, suffers from this same condition, as do my two sons, though it is not a gender-linked trait. I have a friend whose parent's both have A.C.H.O.O. syndrome, as do all eight of their children. Imagine their trips to the beach.

The Spanish word for "to sneeze" is "destornudar." In Portuguese, it is "espirrar." These are evocative, slightly onomatopoetic words, and they are wholly immaterial to our present discussion. Yet I include them here anyway for your enlightenment, and to highlight the fact that I, in likely contrast to you, am tri-lingual.

I suppose we all have our crosses to bear. A.C.H.O.O. Syndrome is mine. I am currently filing for disability; Uncle Sam will hopefully have compassion, concur with my self-assessment of total medical debilitation, and thus send me a large monthly check. You, American taxpayer, can support me in my disease.

Failing that, I plan on opening a posh medical clinic dedicated to supporting those who are similarly indisposed, where I will educate them on the nature of our disease, commiserating with them for the low price of $125 per fifteen minutes. Thirty minutes of seeking solace and you get a ten percent discount. Or perhaps I will provide "concierge" medical services: $5000 per year, and you have me at your beck and call, providing year-round, expert, and individualized consolation. Perhaps I will take the liberty of prescribing you an antihistamine, which could dampen the sneeze reflex ever-so-slightly. Never mind that similar medications are readily available over-the-counter: this will be a hand-written prescription, and thus will carry presumptively stronger therapeutic power.

In this way, I hope to turn my medical misfortune into an opportunistic source of either free or scandalously cynical income.

So do not weep for me.

Rather, dear friends, sneeze away.

Willpower

"What drives someone to accomplish a difficult task against great odds? To defy convention, command or even coercion in order to hold true to a deeply held principle?"

These are questions I asked my eight month-old son, Justin, the other day as he and I battled yet again over The Bottle.

The Bottle has become a milk-bone of contention in an otherwise wonderful relationship between my son and me.

To me, The Bottle symbolically represents an appeal to rational thought, a pragmatic solution to the pertinent question, "How shall my son get milk? How shall I give my poor wife some relief?" My attitude towards the bottle is informed by my adult certainty that nearly all babies take bottles with very little difficulty, benefiting from the nutrients and calories they imbue.

But to Justin, The Bottle is cast in a very sinister light. It represents the compulsory enforcement of artifice, blatant denial of his most cherished perceived needs, and the ultimate insult to his human dignity. With resolute disdain and rage, he will resist at all costs--to the very limits of his physical capacity--any attempt to introduce the darned thing into his mouth

Now, I am a huge proponent of mothers nursing their infants, and Elizabeth has done a fantastic job of struggling with and then succeeding at this noble task. Quite literally, every ounce of fluid that Justin has ever received, save a precious few ounces that he may have inadvertently swallowed while spewing the remainder of a bottle in my face, have come from his mother's milk.

We didn't recognize this bottle-phobia would be a problem until he was about two months old. At that age, we figured he was just confused by the different feels of bottles and nipples, and so we tried a variety a different brands, searching for one he would accept. He rejected them all wholesale. He had made up his mind: he would never--ever--take a bottle.

But I continued to hold my own stubborn and deeply held belief: that no baby or child will willingly allow themselves to starve to death when they have ample food placed before them. (The corollary of this belief is that if children have a choice between eating their vegetables and starvation, they will choose the veggies.)

Being somewhat obstinate myself, my strong-willed son and I were on a collision course, and at about four months of age, he, I and The Bottle sat down together to have it out. When Justin became hungry, Elizabeth was asked to leave the premises, and I took Justin to a comfortable room where lullabies played softly and there were no distractions. I spoke soothing words, cradling him lovingly. I had an array of bottles, nipples and formulas before me to handle every contingency.

Three hours later, I stumbled in a crazed stupor from the room, having endured relentless, mind-shattering shrieking for the entire time. I handed the frenzied boy to his concerned mother, who promptly satisfied his every need. That same scene replayed itself on three successive nights, and finally I surrendered, intending to wait until he was older and perhaps more reasonable.

That was five months ago. We still skirmish occasionally, just to see what will happen, but these Bottle Battles are now much shorter and less dramatic, and The Bottle and I always lose. We've basically lost hope in The Bottle and have resorted to passively hoping that sippy cups will one day catch on. We have been heartened by the recent discovery that he will take medicine from a dropper: might we deceive him into taking formula that way?

Through these struggles, Justin has held two aces in his hand. The first is that he is exceptionally cute and otherwise good natured, quick to smile and laugh, and has woven himself inextricably into our hearts. The second is that he has an incredibly patient and loving mother in whom his absolute confidence to provide for all his needs, no matter the personal costs to her, is always rewarded.

When he is finally weaned from nursing, Elizabeth will deserve a gold star, a congressional medal of honor, a national monument on the Washington Mall, a symphony written in her name. Her devotion and love to her son has been truly inspiring.

I, too, love Justin very much, and he is very similar to my other two wonderful, cute, independent and strong-willed children, though neither of them had the bottle issue. I know that in the end their evident willpower, though leading to numerous parenting challenges in the interim, will serve them well in life. Or so I'd like to think.

In honesty, this strong will is partly a personal attribute, inherited from my parents, that I am proud to pass on to my children. I'd like to think that for me it has been a net positive, helping me doggedly persevere to overcome difficult challenges and attain worthy goals.

But with deeper reflection, I'm also aware that this very willfulness has gotten me into trouble, and has sometimes transformed into an inflexibility that has prevented me from embracing other opportunities, from accepting a palatable alternative, or from enjoying a worry-free existence.

But as far as I know, it never prevented me from taking a bottle. I mean, come on, son! You would like it if you would only try it, I promise. Pretty please?

Well, I know full well that no amount of begging or cajoling will work. But this much I have to say: watch out, World. Our little J-Man is going to try to impose his will on you. And considering how things have started out, I wouldn't bet against him.

Going to Extremes

Ten days ago, I boarded a plane in frigid Salt Lake City with my young family. It was ten degrees and snowing as we took off and punched through low gray clouds into a brilliant blue sky. We zoomed through the icy atmosphere,but as we headed southwest, the clouds dissipated, revealing thinning snow cover melting into expansive deserts. After a shockingly incident-free flight (only one spilled drink, no crying baby), we began our approach into San Diego, which shimmered in vibrant greens, pinks, yellows and blues before us.

As we disembarked, we felt the warm sea breeze fluttering through the causeway. We scampered for our bags, then walked outside to catch our shuttle. The sunshine splashed in our eyes (Grant, Justin and I all sneezed in unison--ACHOO syndrome, our genetic affliction. Ask me about it sometime); the light and warmth quite literally took our breath away. Elizabeth and I couldn't stop laughing, gushing about how wonderful it felt. I danced a few joyous steps as I pulled our bags along, garnering suspicious glares from parked taxi drivers.

We then enjoyed a spectacular winter getaway in San Diego: the beach, SeaWorld, Legoland, In-N-Out Burger and mostly five consecutive days of blessed sunshine. Against my medical judgment, I allowed myself to get sunburnt, wanting a lasting mark from the sun before we trudged back to Siberia.

That's what Worland feels like these days: Siberia, or maybe some remote glacial plain in Antarctica where the penguins huddle together to survive the bitterest weather on earth, and if the father penguin lets the egg drop, then boom!, you've got a dead egg, just like that. (This is, sadly, an accurate analogy, as our poor chickens on the Gilman's Ranch continue to lay eggs that freeze solid and crack before we can retrieve them; I threw away twenty two cracked eggs today.)


Two days ago, Worland received the ignominious distinction on Good Morning America of being the coldest spot in America. We had reached 28 below that night, the same night a power line in town literally snapped from contracting in the cold and left half the town powerless for an hour an a half. In that ninety-minute span, our house temperature plummeted from 68 to 58 degrees, getting colder by the second, frozen air knifing through our ancient single-pane windows, which provide about the same degree of insulation as a sandwich bag. We had piled all of our blankets onto our bed and planned on having a family snuggle session to make sure we kept warm, and then the lights and furnace finally kicked back on. (The kids were disappointed.)

Today the temperature reached a balmy 12 degrees, which, if you think about it, is a 40 degree temperature swing from 2 days ago--the same contrast you'd notice if it went from 30 degrees to 70 degrees.

But we have actually done the extreme reverse of that, going from 72 degrees in San Diego to -28 in Worland within 4 days, making a perfectly round 100 degree change in weather. A week ago, I was wearing shorts and building sand castles. Today when I opened the door to fetch the paper, my nose hairs instantaneously froze and my lungs wheezed and seized like a cow dipped in a vat of liquid nitrogen.

So it's been very, very, very cold. It's amazing that we live in a day where travel technology allows us to experience such extremes of weather in such short periods of time. Evolutionarily, the human body isn't built to process such abrupt changes. We're accustomed to the gradual ebbs and tides of seasons, not the shock therapy of San Diego to Worland.

I think it's bad for my health. So I'm writing a doctor's order for myself to take another trip to San Diego . . . until sometime in April.

Soggy Muff

I am a big-time Dr. Seuss fan. Maybe it's the whole "doctor fraternity" thing . . .

One of my favorite Seussian books is Sneetches and Other Stories, a collection of four short, silly and didactic stories. Kids love them for their imaginative zaniness, but you can read fairly profound messages into each of them. "The Sneetches" conveys powerful lessons in the foibles of identity politics and the parasitic greed that drives our popular culture and fashion; in "The Zax" there are truths about hyperpartisanism and gridlocked government; in "What Was I Scared Of?" we learn about how cultural misunderstandings can transform into irrational fearmongering.

But the shortest story in the book, "Too Many Daves," is my favorite, not for any subtext railing against overpopulation, but because of its pure silliness. It's the vignette of a harried mother who names all twenty three of her sons Dave, which causes trouble when she calls Dave home for dinner. Then, just because it's his book and he can do whatever he wants, Dr. Seuss launches into a riff of hypothetical alternative names they could have been given, all of them totally absurd and hilarious.

I've read the book a hundred times, and still the kids and I can't help but laugh out loud every time we get to this line:

And one of them Ziggy. And one Soggy Muff.
One Buffalo Bill. And one Biffalo Buff.

Why is that so funny? I don't know, but it cracks us up everytime.

Our other favorite names are Stinkey, Bodkin Van Horn, Snimm, Sneepy, and to finish off the silliness, he gives us Zanzibar Buck-Buck McFate, which always garners a benedictory chuckle.

To me, this lesser-known Seuss story is perfectly emblematic of his genius. Sure, The Cat in the Hat and Green Eggs and Ham are his signature works, but in a minor story like this you can glimpse his joie de vivre, the pure delight he took in his own silly imagination. Kind of like seeing paintings by Michaelangelo: you can appreciate his artistic mastery in the Sistine Chapel, but if you could see what he painted on his kids' bedroom ceiling, you might get a better picture of the man's true soul.

So here's to Mr. Dr. Seuss, a visionary genius who joyfully revolutionized children's literature.

Thank you, thank you, thank you!

From your biggest fan,

Soggy Muff

Ski Frog

Yesterday was the first day of ski season for my six-year old daughter, Joy, and me at our little local hill, Big Horn Ski Resort. (Suggested motto: Two lifts. No people.)

We were both blessed and cursed with a major snowstorm that was tapering off as we headed up the mountain. Blessed, because there was nearly a foot of fresh powder, the trees were blanketed, and hardly anyone else had braved the roads, so we had the whole mountain nearly to ourselves. Cursed, because the deep powder on the mostly ungroomed trails came up to Joy's knees and made the skiing much more challenging. (Doubly cursed, because our Honda Pilot would slip into a ditch on the way out and now sports a crack in the bumper.)

But mostly, it was a great day for skiing, and Joy and I had been anticipating it ever since our final ski trip last March. Last winter, Joy had turned the corner in her skiing skills in a big way, and we had ended the season by cruising down blue runs together at a good clip. She became skilled and fearless, and we had had great fun together on the slopes.

All started well on this trip, as at the top of the mountain the trail was groomed and the slope was gentle. We started our usual game of "Ski Frog," which is like leap frog, each taking turns angling down the hill, passing the other, waiting, then passing again.

















But when we hit the deep powder, Joy's memories of last winter's successes transformed into fear. A couple of biffs, a ski coming off, a runny nose . . . soon Joybear's tenuous courage wavered as her anxiety surfaced.

As her Dad, I sense everyday Joy's great potential in so many areas, but I am also aware of her proclivity to search for the exits when the going gets tough, to whine, and to have her parents bail her out of tough situations.

Hey, I know, she's only six. But still, I feel a fatherly impulse to guide her away from this whining and dependency and steer her towards problem-solving and mental toughness. (At home when she comes to me to bail her out of any of the myriad problems a six year old faces--"My feet are cold," or "I'm thirsty," or most typically "Grant's bothering me"--my usual refrain is, "Joy, you need to solve your own problems. Daddy can't always fix it for you." Sometimes, this is parenting genius. More often, this is during the fourth quarter of the big game.)

Regardless, I tend to take a laissez-faire approach when Joy gets whiny, and she most always responds well to this and finds she can indeed solve her own problems.

But now, as I leaned on my poles a dozen yards down the slope, she was having none of my non-interventionalism. She was in deep powder and couldn't get her skis under her. I started calmly calling out instructions to her as I shuffled back up the slope. But she started thrashing in frustration, then shrieking in anger at me, quickly exploding into full-blown hysterics. She hated skiing, it was the worst day of her entire life, and she wasn't going to move until she got home: three epiphanies that she vocalized to me as I climbed towards her.

When I arrived, there was a four inch string of snot hanging from her nose and her face was flushed with frenzy. I cleared the snot away with my glove as she reiterated her above-mentioned epiphanies. I stayed calm, reminding her that she could do it. "Just one step at a time, Sweetie." I reached to help her up and she began to pummel my chest with her engloved fists.

I, on the other hand, felt cool as could be, absolutely certain of her capacity to handle this minor difficulty, but her hysteria wouldn't let her see past the moment she was stuck in. I knew I had to intervene, so I mustered my stern Daddy voice (which usually reduces her to mush), and barked at her that this was unacceptable, she was better than this, she had to get a hold of herself. I then pointed out the essential impossibility of her going home without moving. This initial command briefly phased her, and then she resumed the hysterical whining. I intensified the voice, locked her eyes on mine, and said forcefully, "That is enough, young lady! You are not going to make another sound, you are going to get up on your skis right now, and we are going to ski down this mountain. That is the only way. If you don't, I'm going to have to spank you."

Instant silence. She has never been spanked, and that threat has only been pulled out on the most rare of occasions; in times past, I have felt horrible at seeing the fear in her eyes that this could even be a possibility.

But I didn't see fear now. She knew that Daddy wasn't going to spank her, yet the threat seemed to snap her out of her hysteria. What did I see in her eyes, then? Truthfully, I saw trust, as if I had spoken some secret code between us that said, "Look, I'm not going to spank you, but I own this problem now, so you do what I say and trust me to solve it."

I reached down and lifted her up, hugged her, and set her on her skis. "Now, just follow me down the mountain. Go as slow as it takes."

And that's exactly what we did. She had one more minor fall but bounced right back up. We made it back to the groomed trail, and by the bottom of the hill we were ski-frogging again; she zoomed and laughed like she had last winter.


We loaded onto the lift again and headed up the mountain. I still felt unsettled from the confrontation, that awful feeling of having to discipline your children sternly, of having to break them down to build them up.

But Joy apparently felt none of that, as she beamed at me with her rosy cheeks and crystal blue eyes.

"Are you having fun, Sweetie?" I asked.

"Yeah, this is awesome!"

She leaned into me and gave me a big hug. "I love you, Dad."

I smiled at her as I shook my head quizzically. "I love you, too." I thought of what else to say, wondering at her resilience. To validate what had just happened, it seemed I had to verbalize a teaching moment: "Now remember, when you have a problem that seems too big and you get scared, you have to stay calm. Just do one thing, and then do the next thing, and then pretty soon you'll be all the way down the mountain."

"OK, Dad," she smiled politely if somewhat dismissively, then hugged me again, tacitly acknowledging that I, as her father, had to perform this perfunctory teaching duty, but really, it wasn't necessary. The sun burnt palely through the lifting clouds, but the heavy snow persisted, huge flakes now sifting silently through the still air, clinging to our eyebrows. Joy eyed the big flakes and exclaimed, "Hey, Dad, let's catch snowflakes on our tongues!"

And we did.

Ode to Johnny D

Here's a shout out into the Great Beyond, to Henry John Deutschendorf, Jr., better known to all of us as the late and great John Denver.

This salutation comes from me hearing a lot of John Denver recently, as his Muppets' Christmas album figures prominently on my iPod Christmas playlist. Sweet, silly, even saccharine, it speaks to Mr. Denver's post-60's sentimentality and his kid-friendly, parent-approved, save-the-whales public persona.

Perhaps because I often can be overly sentimental myself, John Denver's entire musical portfolio and the earnest innocence of his worldview engender in me a deep sense of appreciation for the man and his music.

When he died in a plane crash on Oct 12, 1997, I shed unexpected (and rare) tears for a man I had never met, but whom I felt I had grown to love through his music. I remember feeling awed that a man with a guitar, three chords and a smile could reach down through the years, through my stereo and, singing only simple melodies and simplistic messages, coax my embittered heart into hoping for a better future.

For the children and the flowers are my sisters and my brothers,
Their laughter and their loveliness could clear a cloudy day
And the song that I am singing is a prayer to non-believers
Come and stand beside us, we can find a better way

What exactly, Mr. Denver, is this better way? Who knows? But every time I hear Rhyme and Reasons I feel it deep in my heart that our troubled world can be led out of the desert of post-modern despair by John Denver, a troupe of flower children, and Kermit the Frog.

You can't hardly hear a vintage John Denver song and not smile, not appreciate a little bit more the beauty of the earth or the wonder of childhood or the exhilaration of love. Sometimes I'll be weighed down by the cares of the world and a good John Denver tune will come on, and suddenly I've got sunshine on my shoulders. (Doesn't make me cry, however.)

To make music that stands the test of time, that transcends generations and modern cynicism, that gets the world to stand and sing in hopeful harmony--what a legacy for a man born as Henry Deutschendorf.

The Incredibly Fantastic And Amazing Telephone

For as long as I can remember, I have had a casual fascination with telephones. Casual, I say, because I've never been fascinated enough to actually devote significant time or brain power toward fathoming their deeper mysteries.

Yet something about them will from time to time suddenly mystify and inspire me. At such moments, I will stare into the heavens and laugh a sly, wistful little laugh, marveling at their magic. (Then I will remind myself to--at some point--get a life.)

One such time was in December of 1994. I was in Londrina, Brazil, sitting in a small office of our local church, staring at a bright red rotary phone, waiting for it to ring for my semi-annual phone call from home. Having previously given my parents a daunting string of numbers to punch in from Colorado, I could now only sit and hope and pray that the darn thing would ring. I waited, fretted, considered that my parents may have botched the timing of the call due to time zone confusion, or that maybe an earthquake in Guatemala had snapped the telephone wire like a thread . . . and then it rang.

I picked it up desperately, composed myself, and then suddenly I was coolly speaking to my admiring parents and worshipful little brothers and sister as if they were sitting across the room. (Of note: my parents and siblings, as best as I can tell, continue their idolization of me to this day, unabated and magnified.)

How could a voice, speaking into a plastic and copper device from the other side of the planet, be transmitted in such perfect clarity (save for an incessant background clicking noise), without appreciable delay, into my homesick ears? How could sounds be instantaneously converted into electrical impulses, then relayed across tens of thousands of miles of copper wires precariously strung through mountains and jungles, across oceans and third world dictatorships, and then be reconverted into sound waves that so perfectly reproduced vocal tones and subtle inflections that I could easily discern the individual voices of my gaggle of pre-teen brothers, whose squawking sounded to me only like spasms of incomprehensible, guttural screeching?

How could it be done? It must be magic, I marveled briefly. And then I continued picking mango shreds from my teeth.

That event happened a relatively recent thirteen years ago, before the full advent of the now ubiquitous cell phone. (I believe in that same year my father had an attached company "car phone" that was roughly the size of a small microwave oven.) Cell phones have only made the telephone mystery exponentially more mystifying. How can I be sitting in my car in Chugwater, Wyoming, hit two buttons, wait for a few rings, and then be speaking to my sister in Littleton, Colorado for a brief second before she puts me on hold because she has to say goodbye to another one of her giggly friends?

What sort of genius was Alexander Graham Bell or Fred P. Motorola to figure this thing out?

Wait, don't explain it to me. First, I probably wouldn't understand it.

But second, there's something I like about not knowing, something mesmerizing, baffling, even humbling about such technology. To know how it works? That might diminish the allure, they way the thrill of a magic trick dissipates once you know the secret.

And the telephone is just one of a thousand technological marvels of our daily lives. From the time I flipped on a light switch this morning to the time I'm posting this on the internet from my home computer at night, and all of the medications and computer programs and automobiles and refrigerated foods and Sportscenter broadcasts and YouTube "debates" between sanctimonious Republican candidates in between, everything around us is a technological miracle, evidence of mankind's genius and creativity.

Some guys who are just like me (other than being a lot smarter and wealthier), figured this stuff out, harnessed the elements and the laws of physics, and brought these wonders into our living rooms.

But I'm fine not knowing all the details. Mr. Arthur C. Clarke once famously remarked, "Any sufficiently advanced technology is indistinguishable from magic."

I love a good magic trick. So allow me the pleasure of suspending my disbelief in this one thing, of being awestruck by the quotidian telephone.

Now, if you'll please excuse me. My phone is ringing . . . again.

The Memory of Fish

Two straight posts about fish?

Not really. This one is about memory, but it was partly inspired by our resilient goldfish, Foxy.

Foxy came into our lives about two and a half years ago when some friends went on an extended trip and left him/her--how do you tell fish gender, anyway?-- with us to fish sit.

They never came back for him.

Fearing that Foxy would feel hurt and abandoned, we took him under our wings and tenderly cared for and nurtured him until one day we went on a five day trip and completely forgot about him. Upon returning home, Foxy was floating belly up in the fishbowl. I dropped some food in the bowl to see if he was really dead, and then left to find my little green fish net to transport him to his final ride down the porcelain express. But when I came back, Foxy was zooming around the bowl, lunging lustily towards his nibbles, making frisky little blooping sounds with his mouth. What a joker! Since then, I call him Resurrection Fish whenever I think about him, which, frankly, is about once every 2 months when his bowl, depleted to less than one-third its volume and coated with a murky green scum, needs cleaning.

That's when I pull out my trusty green fish net, chase Foxy around the bowl, dump him in a plastic cup with some water, and then proceed to de-slime his brackish environs.

How Foxy has survived this long, I don't know. (How long do goldfish live, anyway?)

Foxy and I don't have much of a relationship, but I am probably the second most important being in his very, very small world. The most important is Elizabeth, who feeds him everyday. I am second most important, because I am the deus ex machina that swoops down from the nether-worlds every two months, snares him in a green tractor beam and places him in solitary confinement. When Foxy emerges from this alien abduction, he is placed back into a world that has been cleansed every wit, even as if by fire.

The point is . . . what? I can't remember, which actually IS the point: remembering.

And now here is my profound thought: does Foxy remember any of this? In the midst of our little bi-monthly Master / Fish interactions, I sometimes think I can see some trace of anticipation in Foxy's beady little eyes when I lug his bowl towards the sink and produce the Green Wand of Mystical Powers. There seems to be a little more swagger to his swim, more purpose to his puckering, more flibber to his jibber. But in reality, I think I'm fooling myself, and I think that he experiences this infrequent ritual entirely afresh every time.

Perhaps this deep thought occurred to me because I had just finished reading a fascinating article in this month's National Geographic about memory. The well-written story bounced between analyses of the neurophysiologic basis of memory and the captivating stories of two real persons with extraordinary memory disorders. One woman, referred to as AJ, has the most perfect, photographic memory ever tested; she remembers, quite literally, almost everything that has ever happened to her. But to her, this is a tormenting phenomenon, as if the past is continually in the forefront of her mind, not allowing her to escape her ever-present regrets, mistakes and embarrasments.

The other person, a man known as EP, had the neuro pathways in his brain eroded by an bizarre infection, and now has absolutely no memory beyond about ten seconds. Imagine every ten seconds awakening entirely anew to the whole world, with no memory or insight into where you were or who you are . . . and not even the slightest awareness that this complete naivete was, in fact, abnormal. But EP, in contrast, is not tormented in the least. He appears quite happy, care-free, an unwitting Zen Meister living unencumbered by the past, unaware of any future, and entirely in the now.

These extremes of memory highlight the miraculous nature of that organ where we all live out our lives: the brain. In medical school, I remember a fellow student asking our neuroanatomy professor a "why" question about the brain. His response went something like this: "I cannot answer any 'why' questions about the brain. In this course, I will teach you the what, where and how of the brain. But for the answers to the why questions, you'll need to speak with a theologian or a philosopher. Because, frankly, I don't know why this miracle exists."

Three pounds of flesh. Three trillion synaptic connections. The home of genius and madness, of symphonies and psychosis, a computer, a soul, a muse, a miracle. The most powerful tool in all of creation.

I'm talking, of course, about Foxy's brain.