Category: Day in the Life

Or, The Pleasures of Paradise.

You’ve weathered Alaska and Colorado with me, sharing adventures during work assignments. The US Virgin Islands, though, was a true vacation! No work for 10 days. YAY! Come along to my favorite Caribbean island—St. John!

Why is it my favorite? For one thing, it’s pretty hard to get to, which means not too many people go there. A plane ride, a ferry, and a jeep. Takes a bit of planning, and a lot of time. You really have to want to go there. And we did.

Second—the majority of the island is national park, not only on land, but underwater, as in, snorkeling. In fact St. John is one of the best places in the world to snorkel, especially just off the beaches, which are all public.  With so much untouched wilderness, there is limited housing, and likewise, people, which suits me. Mostly I like my vacations away from garish displays of humanity. Don’t get me wrong—I love people! Even better when they’re not close.

We splurged and rented a castle. (Princess=castle=prince. See, it all fits.) Just so you’ll know, the castle was not extraordinarily expensive—by island standards, a bargain. It didn’t take long to figure out why. The road to the top of the mountain it was perched on was a mile-long, steep, as in suicidal, dirt track with occasional “paved” concrete patches and pocked with craters to rival the surface of the moon. Even with the jeep in 4-wheel-low it was impossible to go slow enough not to dislocate a hip, or dislodge a kidney. One day, we just stayed in rather than risk it.

Lots of animals run free on the island, leftover from the days sugar plantations thrived there. Donkeys turned the mills, chickens, roosters, goats, mongooses (yes, that’s the plural)–round out the large animal ecosystem. Little sugar-loving, yellow bananaquits. We had dinner with a goat wandering the restaurant one evening.

 

 

 

 

 

 

 

There are no window coverings—glass or screens—on most restaurants or homes. We had mosquito netting over our bed and fortunately, not much action from the mosquitoes anyway. (We were more worried about dengue or chickungunya than zika, just coming into the news as we returned.) The sense of living out doors while simultaneously feeling safe and protected is extraordinary. No need for air-conditioning because the breezes on top of the mountain were lovely. We left doors wide open at night too and the sporadic rainfall was hypnotizing.

The castle is actually pretty new and designed by a couple with a great imagination. So fun! A traditional living room and deck with spectacular view, separated by a courtyard from the “tower” which has a kitchen on the first level, master BR on the second, and life-size chess board on the third floor with a view to rival anything I’ve ever seen in my travel to all seven continents.

 

In fact Rob and I spent the entire time trying to decide if that 360 degree view of the sea, the British virgins, the mountains and the sky was the best view we’ve ever had or merely in the top 5. We finally agreed the distinction was not important, and that we had a wonderful time conjuring up the other panoramas in contention. Over our last bottle of wine we decided we would risk hip and kidney to do it again.

 

Cheers!

 

PS – if you go, let me know –I’ll give you some tips.

 

 

 

 

 

Cordova, Alaska

October 25, 2015

Friends have said that my Alaskan adventures remind them of the popular TV series. I found the comment amusing at first, but it’s kind of true. Cordova feels a lot like that mythic place setting. In a town of 1500 a newcomer sticks out like a polar bear in Ohio. People of all ages strike up conversations in the grocery store, with me and each other. The one sit-down restaurant, The Reluctant Fisherman (known simply as “The Reluctant”), serves as a neighborhood gathering opportunity as much as a place to have a meal.

I ponder the naming of The Reluctant as I sit down to dinner after a walk around town to stretch my jet-cramped legs. The fishing vessels moored in the harbor make their own statement, but the restaurant, sitting on a bluff overlooking the bay, evokes an entirely different perspective, one that sums up all the minuses of the fishing life in a single word, and I suddenly realize it reflects some of my own feeling this time around.

Scheduling a couple weeks in Alaska seemed like such a good idea at the time, but working away from home for 4 out of the last 10 months has caught up to me. Yet the feeling is not just about wanting to be home.

I was anxious the first time I came to Cordova, knowing I’d be the only doc here for a month, afraid I’d not measure up to the patients who presented themselves to my care. I didn’t have too long to worry because the worst case scenario appeared almost out of the starting gate: a patient with multiple trauma whom my team and I successfully coded for 5 (that’s no typo) hours before being airlifted out. I had no idea a patient could balance on the knife edge between life and death for that long. Most people who survive codes do so in the first few minutes, and most codes are stopped within 20 to 30 minutes if the patient does not recover vital life functions of breathing, pulse and blood pressure by then.

But a physician’s job at a critical access hospital like Cordova’s, without advanced diagnostic or therapeutic technology, is to stabilize the patient for transfer to an institution with those capabilities. We did our job and we did it well. Unfortunately, the patient died later that day. Why the angst? Heaven knows we lose people all the time. Doctors do not confer immortality. But I discovered that day that there is a difference between how you feel when you lose a patient despite all the tools of modern medicine, and how you feel when you lose one without all the tools being available. I accepted the limitations of this location when taking the assignment, yet this was a new pill for me to swallow. Despite years of experience, I’m still surprised at how my brain can’t always prepare me for what my heart will feel.

Thank goodness I had nothing else that compared to that case. Just bread and butter medicine from pediatrics to the elderly: pneumonia, COPD, kidney failure, diabetic crises, angina, chronic pain, gastroenteritis and ear infections, end-of-life care, and the sad but universal cases of dwindling elderly patients who can no longer care for themselves, complicated by an equally dwindling number of people they might depend on for help. I was thrilled to be practicing the full range of medical skills I’d acquired over the years, with patients whom I also had time to get to know. Just like the pain of childbirth, I suppose, it was only the thrill I remembered when I was asked to come back.

I recognize in hindsight that only as the time to leave home approached did reluctance creep in, a victim of my naiveté destroyed in the effort to save my unsalvageable patient. I am reluctant to be in that position again—to confront perhaps a salvageable patient—one who might benefit from better skills than those I, or any one person in this remote place, can bring to the infinite disasters that might appear on a gurney delivered by the local ambulance. A word of advice: do not enter medicine if you cannot face the demons of self-doubt.

Yet Cordova itself is the tonic. Amidst all that professional baggage is the unaccountable delight that I am back here. With each step on a mossy mountain track, every soaring eagle and snow capped mountain, every sea otter and salmon, even the torrential rain: I love this place, its wildness, its isolation, the splendor, the grandeur of the vistas, and the genuineness of the people. As Cordova seeps in, reluctance fades. I desire more than anything to be worthy of the privilege of being here.

Denver
Sept 6, 2015

I’m sitting in the Denver Botanical Gardens, a 60+ acre oasis in a city of abundant oases, trying hard to stay awake. Water barely slips over a pedestal of native red rock, and the burble and splash are soothing as a lullaby. The late afternoon sun angles in over the front range and lays like a blanket on me and the quilted floral palette that surrounds me. Intoxicating aromas of spruce and pine, flowers and spice, conspire to knock me senseless.

 

 

 

 

Oh. Yes. Hmmm. Where was I?

 

 

Lovely bike ride this afternoon. If you’ve been to a major city anywhere in the world in the past few years you’ve seen the future—bicycles and cars for rent to anyone (well anyone with a credit card). This is the first time I’ve tried the concept and I loved it! After swiping my card, I pulled a bike from the rack, adjusted the seat (very easy) and pedaled off.

I downloaded the app for b-cycle locations, and found my way to the Cherry Creek Trail, a many-miles long path that runs along, you guessed it, Cherry Creek. Like all the outdoor spaces here, this one is well-travelled but big enough that it doesn’t feel crowded. More like, you’re out there enjoying life (and exercise) with like-minded people (and the occasional stoner).

I rode from the gardens to downtown, through several parks, neighborhoods, and along the Platte River. I traded my bike in every 30-60 minutes at a new kiosk. Here’s how it works: you pay 9$ per 24 hours to rent a bike, then nothing more if you return the bike to any kiosk within 30 minutes, a dollar more if you keep it 30-60 minutes. Frequent breaks were good for a little rest, a drink of water, or a look around.

Downtown I abandoned the bike to stroll for blocks through the shopping areas and Union Station, where the Amtrak trains come and go. This was so convenient –not having to go back to where I parked, just picking up new wheels at another station when I was ready to take off. Every bike has a basket, so I could take water and my purse. Very handy.

The only bad part is I wanted to stop for food or drink at every restaurant I saw. There were happy hour specials on grande lime Margaritas shouting “Hola!” from awning-covered terraces as I pedaled past in the 85 degree heat (but it’s a dry heat…); there was butterscotch ice-cream for free if you made a 15$ donation to a local charity; and “our famous char-grilled grass-fed bison burgers” being consumed by happy customers seated at umbrella tables; and don’t even get me started on the pastries. I would be the heaviest person on earth if I indulged all my eating whims. I indulged none that afternoon…but boy am I hungry now! How about you?

But that reminds me to tell you of my meal at Tamayo last night. Downtown. Outdoor deck. Beautiful view of the mountains. Upscale Latin chef recently toured Mexico and was showcasing a Guadalajara tasting menu. That’s what pulled me in: for a limited time only—guacamole from different regions—try a sampler platter! (Rob will tell you I am a pain to go out to dinner with in strange cities. I drag him from place to place reading menus. If I don’t like what I see we continue to wander until I find a menu that’s appealing, or we faint from hypoglycemia. Actually, he wouldn’t tell you that at all, he is that indulgent of my gastronomic obsessions. Or maybe the low blood sugar has an amnesiac effect…).

There were 8 different kinds of guacamole to choose from. Who knew? There was baja, and sur, and other geographically named options. One had kiwi and strawberries, another had pineapple and onion. There were inviting and peculiar combinations, each with a bewildering mix of peppers and seasonings. I choose the sampler, as the chef intended. They were quite busy, and it was loud, but most likely it was just distraction on my part (seeing the rockies at sunset always induces awe in me, which can be mistaken for idiocy), but I forgot to ask the waiter to explain exactly what the description grasshopper meant on one of the items. Leaping into my head was a wonderful dessert called grasshopper pie which is a minty, chocolatey ice-creamy thing. My Rocky Mountain high revelation was grasshopper = green! I mean, it’s guacamole! By the time I escaped my mental detour, the waiter was gone.

I think you know where this is going.

The platter arrived with fresh tortilla chips and scoops of creamy avocado delights, surrounded by delicate porcelain spoons full of chopped tomatillo and pickled onion, roasted tomatoes and herbs. I had already warmed up my palate with a house margarita—lime and chili pepper salt on the rim—mmm, mmm, good. But I was not so lubricated I couldn’t recognize the little decorations on one of my green mounds as insects. Even if they were french fried.

Now you can say that a word like grasshopper describing a menu item is not one you would ever miss, or fail to clarify before ordering. And I would believe you. I am very particular what goes into my mouth with regard to health and calories. But not so much exactly with what it is. I have tried blood pudding, brains, pancreas, intestine, snails, haggis, liver and kidneys. Love liver and kidneys. And the haggis. The rest, not so much. I wasn’t sure where insects fit into my world view.

I peered at them, this way and that, marveling at how such slender legs could make it intact onto the plate. I picked one up. It was crispy. Didn’t know if that red was a natural color, or L’oreal. I was examining it as though I was about to do a dissection when the waiter happened by. “They taste like chili and lime!” he laughed. Hmmm. Well.

What would you do?
You know what I did.
The real question is, would I do it again?

Denver, May 11, 2015

Every muscle in my body hurts.

Okay. I’m exaggerating. Just my breathing, walking, sitting and laughing muscles. Just those.

Who knew that riding a horse was a workout…for the rider? Yessiree! You can bet your spurs on it!

From the get-go things were not promising. My assigned horse for the weekend, “T,” a beautiful mocha guy with a black mane, was a mite huge. I know my memory is not what it used to be, and evidently neither is my bod, because the last time I went riding I’m sure I didn’t have to use my arms to pick up my thigh to insert my left foot into the anchoring stirrup. (Admittedly that was 15 years ago, but still…) Once the toe of my boot was securely in place—I swear my foot was up to my belly button and my knee was under my chin—I knew it was a simple task to grab the saddle and swing my right leg up and over to mount the beast. I took a respectable leap. Aha! And was dumbfounded that I failed. Was it my quads that gave out mid-vault, or my arms? No time to debate—too embarrassing! Give ‘er another go.

Heave, and ho! Are you kidding me? My right boot splashes back in the muck. T cast his giant head around and gave me a baleful look. To keep the hot young wrangler next to me from power-lifting my butt into the saddle I threw myself once more at the titan and success was noted by all.

Did I mention I signed up for the intermediate group?

Six intrepid riders set off behind Jeremy, the dude part of the dude ranch, who was charged with getting us back to the corral without a lawsuit. I’m sure he surveyed the lot of us with some trepidation as we yanked at the reins of our mounts trying to show them, after the sorry display of skill at the stable, who was boss. In our group we’re supposed to know how to “post” a trot, and “sit” a lope. Even though Jeremy looks like he was born about two weeks ago, he has the wisdom to go over a few of the finer points of intermediate riding before we motley veterans head off into the wilderness of Pike National Forest.

We walked for a while, getting our bearings, building illusory confidence, the slow rock of the pelvis of each rider responding to the unique gait and rhythm of each horse. Heels down in the stirrups, toes up, balancing a bit on the balls of our feet. There were dapples and grays, fawns and Appaloosas gently parading us over the trails, nipping a bit of grass here, a slurp of creek water there, testing us, teasing us really, into thinking we were in charge. Smooth. Sweet. We’d become the cowpokes we fancied ourselves, strumming Red River Valley in our minds while we clopped along.

Then came a trot to jolt us from this reverie. (I think this is where the old neck started to go.) There’s a bouncy gait for you. Hard to believe when your trotting that the animal beneath you has only 4 legs. Feels like 8, doing a tap dance. The rider’s job is to make it look smooth, because honestly, if you just sit there, it looks like you’re having a seizure. So I bounced up and down in the saddle, trying to make it look like I was standing on every other beat, counting 1-2, 1-2, 1-2, whilst not running into the hindquarters of the horse in front of me, and keeping my teeth from cracking against each other up and down, up and down, without losing the reins, or the idea of why I thought this was going to be such fun and worth spending a small fortune on.

Jeremy brought us to an abrupt halt and we all tried to pretend we didn’t crash into the unforgiving piece of hard leather that is known as the saddle horn. (I’m pretty sure that’s when I bruised my pubic bone.) He eyed us like the experienced old prune of a ranch hand he’s become compared to us, to make sure we were ready for the next exhilaration. The horses snorted and stamped their approval. Despite our challenges with trotting, the high alpine forest was alive with consent. Giddy with anticipation. We were going to lope!

For you non-equestrians, a lope may also be called a gallop, though, in the right hands the lope is a milder, gentler, slower version. A lope would be an English lady on a tour of her estate, whereas a gallop is how Secretariat won the triple crown. The idea in this gait is to keep your bottom securely fastened to the saddle. You become one with the horse—a centaur-worthy vision of grace in flight. The lope is my favorite. It’s why I risk life and limb to do this crazy thing. I love it. It’s fast, but it’s smooth. It’s thrilling. It’s like flying. On a horse. Through the trees and the meadows, up the hills and over the brooks. It’s amazing.

Jeremy has reminded us to use our legs to squeeze the horse a bit, to keep our feet close into the side of the mount, to stay back from the horse in front of us to allow room for swerving around obstacles and the odd clout of dirt kicked up from the flashing hooves. Ready? We nod, smile. Oooh-ahhh! is the ranch cry and we hoot back at him. He gives two clicks with his tongue and off he goes.

The Derby doesn’t start any better: our six horses take up the challenge immediately. They love to gallop as much as we, but even more, they love to race. We know this. We knew it from the last time we visited this ranch, each and every one of us, and yet, here we are, wildly trying to stay in the saddle and hold onto the reins, as the Aussie says, at the same time!

Well let me tell you, instruction notwithstanding, there was a lot of daylight to be seen between those six pairs of buttocks and the saddles. Style-be-damned! Feet and stirrups a-flying, arms flailing and hands grasping wildly for the sturdy anchor of the saddle horn, we threw reins and caution to the wind. My thighs were gripping that gelding like we were about to mate, and to no avail. (I’m pretty sure that’s when I injured my knees, thighs and abs.) We kept this awesome display of ignorance and bliss up until Jeremy had the good sense to grind to a halt, throwing each of us back into the aforementioned horn.

We all remained astride I’m proud to note, despite several more forays into “intermediate” horsemanship. We sashayed back into the corral two hours later, the beginners and advanced beginners green with envy at our comfort in the saddle.

I dismounted, dandily I might say. Looked like I knew exactly what I was doing. When my boots hit the ground though my knees gave me a “Danger Will Robinson, danger!” kind of warning. I dared not move. I swear they did not hurt, not one little bit while I was on that horse, but I suddenly could not lift either leg to step. Like the tin man I wanted to cry out, “Oil can!” I steadied myself momentarily on T’s broad side causing him to cast his eye and judgment on me once more. I gave him a couple pats and clutched his sturdy mane to hide my lurching limp as I tied him to the rail.

We ambled on unsteady legs, wishbone-like, into the dining room for lunch, regaling each other with tales of our accomplishments, which amounted chiefly to not falling off. We have two more riding sessions in the next 24 hours. I hope T will be ready.