In Memoriam–Dr. Michael Davidson

In 1994, I was working at my first radiation oncology job in San Diego at Grossmont Hospital when I came into work to hear disturbing news.  One of my colleagues in medical oncology, a compassionate man known for his gentle nature, had stayed late at the Cancer Center the evening before to finish up paperwork.  With his back to his ever open door, he sat at his desk never once considering that he was in danger.  A disgruntled relative of a former patient surprised him from behind, and beat him viciously over the head and body causing broken bones and contusions, and leaving him for dead.  He managed to call for help, and he survived after spending two weeks in the hospital.  He returned to his practice of treating cancer patients after a long convalescence—after all, it was his calling in life.  He died many years later, suddenly at age 69.  I do not know if that beating years earlier contributed to his early death but the knowledge of it certainly changed my life.  I worked late, and was alone in many offices at night after that, but I remained cautious and vigilant about security, never again taking safety for granted.

Yesterday I got a hasty text message from my daughter, who is a second year internal medicine resident at Boston’s Beth Israel Deaconess Medical Center.  She told me that a doctor at Brigham and Women’s Hospital, a fellow Harvard teaching hospital, had been shot at work and that the hospital was on lock down.  She didn’t know how much was in the news yet, but wanted to let me know since I had trained and worked at these hospitals.  I was as shocked as she was, but I should not have been.  The doctor, Michael Davidson, was a highly respected young cardiovascular surgeon—a rising star in his career, and a husband with three children at home.  The gunman, having sought out Dr. Davidson, fired two shots at close range before retreating to an exam room and taking his own life.  Dr. Davidson was given immediate medical attention by his colleagues at his own hospital, one of the top trauma centers in Boston.  He died of his injuries late last night.  As it turns out, the shooter, Stephen Pasceri, had no history of violence and his gun was licensed.  But he did have a history of dissatisfaction with the “medical system” and sadly his mother had been a patient of Dr. Davidson’s, and had passed away two months ago.  Not much has been said in the news about her, but such is the nature of cardiovascular surgery—these doctors do not operate on healthy patients and not every outcome is successful.

When I visited the Hope Institute in Jamaica in 2013, I saw many patients dying of cancer, without the benefits of affordable chemotherapy, state of the art radiation therapy and even without a readily available supply of morphine.  But I did not see anger, in the patients or their relatives, who were cared for under the loving guidance of Dr. Dingle Spence.   Here in America, quite the opposite is true: we have come to believe that every disease is curable, that every outcome should be positive, and that death, in the words of Dylan Thomas, shall have no dominion.  Most of us, however do not take to the wards fully armed, looking for our doctors. Today I am in despair for his wife, for his children, for the surgical residents he would have taught, and for the thousands of patients that Dr. Davidson could have helped if his life had not been taken.

When we graduate from medical school, we take the Hippocratic Oath, which in the modern version not only exhorts us to heal the sick but to exhibit warmth, sympathy and understanding.  Let our patients and their families extend those same traits to us as we complete our daily rounds.  Let our clinics and hospitals be places of healing, and not of killing.  Please, please let us do our jobs.

Addendum January 22, 2015.  This was submitted by a colleague in the Comments section but I want to bring it forward to the actual page.  Please take the time to read and consider signing.

Dear colleagues,

The violent death in Boston of Dr. Michael J. Davidson, an inspiring cardiac surgeon who devoted his career to saving lives and improving the quality of life of every patient he cared for, is a senseless and horrible tragedy.

There was an incident in the past where a patient at a VA hospital made a threat to shoot a physician.

VA physicians are federal employees. Federal employees have enhanced legal protection against violence. The threat of violence toward a federal employee by itself is illegal. Police officers were able to conduct an investigation and speak with the patient. Once the patient understood that the threats could lead to prison, the volatile situation was defused.

Laws protecting federal employees against violence provide an additional tool to help direct an individual away from violence. Unfortunately, this protection does not extend universally to all healthcare providers.

The White House has a “crowd-sourcing” system where the executive office reviews proposals with at least 100,000 signatures obtained within a 30 day period.

http://wh.gov/i220E asks that the legal protections against violence currently provided to federal employees be extended to all healthcare providers.

While no law reduces risks to zero, our effort would be well worth the energy if it could prevent even one senseless death.

Please take a moment to sign this petition, and consider spreading the word. Everyone can sign this petition including your friends and family.

Thanks.

The Curbside Consultation

Recently a friend of my husband’s in San Diego had a mammogram which showed some suspicious microcalcifications in her right breast.  She underwent a stereotactic biopsy which revealed ductal carcinoma in situ, the earliest form of breast cancer also known as Stage 0 breast cancer.  This type of cancer is non-invasive and does not metastasize, however, if untreated it can progress or recur as a more serious type of breast cancer, so at the very least excision of the abnormal area is indicated, and in some cases radiation and/or mastectomy are necessary.  My husband asked if I would speak to her regarding her breast cancer, and somewhat reluctantly I said yes.

 

Why reluctantly, you might ask.  Isn’t that the nice thing to do?  I said to my husband, “I think it’s a mistake to do consultations over the phone.  I have no access to the mammograms or pathology report, and I cannot examine her.  These things are important to have and do to give someone an informed opinion about her case.”  He said, “But can’t you just talk to her a little bit and recommend a surgeon, and maybe give her a bit of information about radiation therapy?”  I agreed to do it.  A few days later we connected by phone.

 

Having practiced in San Diego for twenty one years, and having a major interest in breast cancer, I know every surgeon in San Diego and Riverside counties who specializes in breast cancer.  Likewise, every radiation oncologist and medical oncologist.  I am a virtual referral encyclopedia—tell me where you live and I will tell you where to go.   In this case I recommended the surgeon whom I would choose to operate on ME, if I had breast cancer.  Same thing for radiation oncology.  I did this for my husband’s friend, and we discussed her case at length.  Because of her relatively young age, excision alone was a bad choice, so we discussed the pros and cons of excision plus radiation versus simple mastectomy with or without reconstruction.  At the end of the conversation she thanked me, and then mentioned that there were actually TWO areas in the breast that were biopsied and were positive, and they were not particularly close together.

 

That little fact, which I would have known if I had had her pathology report and her mammograms in front of me, changes everything.  If a woman has multifocal disease, there is a good probability that she may be better off removing the breast.   I backtracked and covered that point, but I worried that I had made an anxiety provoking situation much worse by confusing a new breast cancer patient.  In the end, she sought the care of an excellent breast cancer surgeon, and I know she will be fine.  But I have the lingering feeling that in trying to do the nice thing, I did the wrong thing.

 

Think of this when you stop your doctor friend on the street to ask about a friend or relative who has recently been diagnosed with cancer.  Curbside consultations do no one any favors.  If you or a friend or relative need an opinion, get an INFORMED opinion—present to the consulting physician with your history, your radiology, your lab work, your pathology and your body to be examined.  Then, and only then, you will be assured that the recommendations that you receive are the ones you should truly follow.  It could save your life.

They Shoot Horses, Don’t They?

“I may not know a winner when I see one, but I sure as hell can spot a loser.”  Rocky

On Saturday night, thirteen horses were saved from kill buyers at Mike’s Auction in Mira Loma, California, by three rescue organizations—Forgotten Horses Rescue, Inc,  HiCaliber Horse Rescue and Joey’s Home Animal Rescue.  Here in the United States, we consider horses companion animals.  We don’t eat horses.  In other countries, that is not the case.  When a horse is used up—too many losses at the race track, or no longer fit for work, or too old, too lame or too tired to be useful, they go to auction.  Despite the withholding of federal inspection funds in 2007, when horse slaughter was essentially banned in the US–funds were restored in 2011, and three states including Missouri, Iowa and New Mexico have been trying to reinstate their slaughterhouses.  The result of the 2007 ban has been the unintended consequence that horses are now shipped to Mexico for slaughter, transported in crowded railway cars without food or water, and then, if they even survive the journey, they are bludgeoned to death with sledgehammers.  This is not death with dignity befitting a once beloved family pet, or a money winning race horse.  But it happens at Mike’s.  Once a month, on a Saturday night.   Do not blame the auction house—they, like all of us, are just doing business.  Blame the folks who treat animals as commodities instead of living sentient creatures.

My old horses, Dash and Norman, are now 30 and 27 years old.  They have lived a good life—one, Dash has been a children’s show horse since he was three years old.  He is lame as can be, but his old eyes still light up if you put a small child on his back and lead him around.  The other, Norman, was born and bred at Disneyland where a small breeding band of pure white Lipizzaners is kept to pull Cinderella’s carriage.   He didn’t take much to pulling a carriage, and was pulled off duty to be trained under saddle.  At age 14, the sorrel Quarter Horse Dash became my son Brandon’s show horse, competing in local western horse shows.  When he retired from the show ring, he became my trail horse, until finally by age 22 he could no longer be ridden without fear of stumbling.  Norman became my 12 year old daughter’s dream horse—trained to fourth level dressage, but plagued by a congenital bone lesion in his left stifle.  He too was retired a few years ago.  Both horses lived at home in my backyard as pampered pets until we moved to New Mexico in October.  They are now under the care of Dash’s former trainer in Del Mar, California, where they will remain at least through the winter.  I miss them terribly.

I never thought much about horse rescue until I got a letter in the mail five years ago from The Horses of Tir Na Nog, a San Diego horse rescue group.  Apparently, unbeknownst to me, my husband had given them some money.  He is not known for his charitable heart, so I figured he must have been on to something worthwhile and important.  So I kept giving them money, and then one day I saw a Facebook page that made me feel like I had been punched in the stomach—for Forgotten Horses Rescue, started by Trish Geltner when a starved horse named Spero came into her care.  Spero didn’t make it, but Trish vowed that he would never be forgotten, and she has kept her word.  Then I found HiCaliber, founded by Michelle Cochran, a formal San Diego Animal Control officer who got involved when she intercepted an auto accident involving a former racehorse.  Before that, she had “only” been involved in rescuing much maligned pit bulls.  It took me a long time, but I have finally realized that not every equine is treasured and treated to a loving life of retirement.  So I am doing my best to see that the old, the sick and the lame are spared a miserable death in a cattle car.   It is my small way of giving back, and being very thankful that I have the means to be the owner of 30 year old and 27 year old retired horses.

My heart breaks when I see starving, beaten and abused horses, dogs and other companion animals.  I know that yours breaks also.  So please, people—if you have a beloved animal companion warm and safe at home–a dog, a cat or if you’re very fortunate, a horse—find a local shelter or rescue and do what you can to support it.  It may not be much—a few dollars or a few hours of your time.  But trust me, it will mean the world to those you support.  Thank you.

When Cancer Comes To Call

A patient story tonight, from Jackie:

 

It was one of those days.  I had been to the gynecologist the week prior because I somehow knew the sporadic bleeding which I had experienced was NOT a simple Urinary Tract Infection for which I had been treated three times.  My doctor did the scrapings and biopsies and had me run down the hall for an ultrasound.  I’d had lots of ultrasounds during my pregnancies – especially with my twins -  but this one wasn’t fun.  There was no cute baby to smile at.  This time it was a transvaginal ultrasound which involved the insertion of a rather large tube into “that place” to look at the uterus.  “My what a big wand you have” I joked with the sonographer.  She didn’t smile.  That’s when I got a bit nervous.

Of course my doctor put a positive spin on everything – prior to the biopsy results.  He said it was probably just an over thickening of the uterus, Hyperplasia.  So I decided to wait until there was something solid to review and went on about my life.  I had a dental appointment a few days later.  My dentist announced I needed a root canal immediately and sent me to a nearby Oral Surgeon.  As I was pulling up to the Oral Surgeon’s office my cell phone rang.  It was my gynecologist.  “Well, there is a malignancy….”.  The words hung in the air.  We had a brief conversation – darn, I thought – I had researched  Hyperplasia thoroughly and knew all the right questions to ask.  I felt like I had studied for a test and then the test changed.   He said I needed to contact a special Gynecological Oncology surgeon and that his office would tell me what’s next.  So I called and left a message with that doctor but said I couldn’t talk for a couple of hours because I was just about to go in to have a root canal.  One thing I will say about those specialists’ offices; they run like a well oiled machine.  As I walked back to my car 2 hours later there was a message on my cell phone.  It was Jay, the Office Manager for the Gynecological surgeon I needed to see.  He was calling to schedule my appointment.  He paused and said “Good luck with the root canal. Sounds like you are having a great day”.   And so it went.

My life was forever changed.  May brought the diagnosis.   June brought the scheduling of the hysterectomy.  July 1 was the surgery.  July 10 came the pathology report.  Not what we had hoped for– the “once and done” hysterectomy revealed some naughty cells lurking within the uterus that have a tendency to “jump” into other areas.  Chemo or Radiation? My case was submitted to the Austin Gynecological Oncology Tumor Board for review as recommended by my Surgeon.  I was overwhelmed.  I didn’t know what I didn’t know.  As is often the case when you do get the “C” diagnosis; you are thrown into a blender of emotions but when the dust settles the appetite for knowledge takes over.  And so it was decided that radiation was the protocol. After I healed from surgery, radiation began.

So here’s the thing:  it wasn’t that horrible.  For anyone who has been through tough times, worked hard and experienced inconvenience or sadness – you are mentally strong and prepared for this challenge.  It is definitely a Mind Game.  I decided to fight and endure and not to whine and whimper.  For 6 weeks my life revolved around daily visits to the Oncology Center.  The treatment wasn’t bad.  The hardest part was drinking 40 ounces of water prior to treatment.  The side effects clicked in about 3 weeks in; lower GI issues.  But oh well, diarrhea is not the end of the world.  My pubic hair fell out which I found fascinating. I met wonderful friends in the waiting room.  The therapists and nurses and doctors were wonderful.  My neighbors and family rallied and emotions ran high.  Food and flowers poured in.   My sweet neighbor who had just finished two years of breast cancer diagnosis, surgery, chemo, radiation, reconstruction – I was at her door daily for her battle.  Now, she was at mine.  Life sifts down to the basics of priorities: Faith and Family and Friends.

I finished my radiation on September 15 and got to Ring the Bell which is special to all cancer patients because it means YOU ARE DONE.   My sweet family and a few friends showed up.  Tears flowed.  My husband pushed through the group to shake the hand of my Radiation Oncologist and choked “Thank you for helping my wife”.  I was ready to start my new healthy life.

Check-ups will continue for a few years and I will see both my Surgeon and Radiation Oncologist often. That’s okay.  My Surgeon is cute (I think he is almost the same age as my oldest son) and my Radiation Oncologist is an incredible mother of four who never seems hurried or distracted and makes me feel like I am THE most important patient in her practice.  I feel so blessed to have been in such capable hands.

I feel wonderful.   Celebrating my December birthday was more special this year.  Welcoming the New Year signaled almost a palpable relief to make a fresh start.  I take nothing for granted and try hard to live in the moment.  Ever the planner, this has been my most challenging goal.

For Christmas this year my daughter gave me a beautiful silver charm.  On the front it says “Faith”.  She told me to turn it over.  On the back was engraved 9-15-2014.  My final day of radiation.  It has been the most horrible of years, but it has been the most wonderful of years.  When Cancer comes to call you rise up and fight the good fight.  And then, you go on.

Siskel and Ebert

I have always loved the movies.  Like every grade school kid watching reruns, I cried when Bambi’s mother died, and when starry eyed Judy Garland clicked her heels and said, “There’s no place like home!”  But when the big budget films hit the screen in my early pre-teen years—Ben Hur, Camelot and Lawrence of Arabia, I was irretrievably hooked.  Sitting in a dark theater, I could escape from actual or imagined troubles.  Some people prefer live theater, but for me it was always the big screen, where I could pretend to be Guinevere as Lancelot leaned in for a kiss, or Holly Golightly, or Cleopatra, up close, more real than in real life.  By high school I was reading the film critic’s reviews in our local paper, and by college I had my favorites.  Pauline Kael was far too esoteric for me—my “go to guys” were Gene Siskel and Roger Ebert with their trademark “thumbs up” or “thumbs down.”

I was channel surfing last night and I just happened upon CNN which was airing a documentary film about Roger Ebert, his career and his struggle with cancer called “Life Itself” from his memoir of the same title.  I had been aware that Ebert had been battling head and neck cancer for years before his death but I was not well versed in the details of his illness.  Roger Ebert was diagnosed with papillary carcinoma of the thyroid in 2002, typically a rather low grade cancer treated primarily with surgery. Unfortunately he was unlucky and the cancer recurred, ultimately necessitating removal of his lower jaw with subsequent loss of his larynx, and his ability to speak and swallow.  What was unique about Mr. Ebert was that unlike many public figures, especially those in the visual media whose jobs sometimes depend on facial appearances, he chose not only to go public with his illness, but to ENGAGE his many fans and followers in his day to day struggles via his website, his blog, and his Twitter account.  He allowed Steve James, the documentary filmmaker, to film him not only on his best days, but also on his worst.  He smiled and joked for the camera nearly immediately after his radical mandibulectomy and neck dissections, even as he was being suctioned for the secretions which if left untended would choke him.  His wife Chaz, his stepchildren and grandchildren were equally generous, at a time when the family was undergoing much pain and hardship.  He clearly had his demons and his days where he wanted to quit, but ultimately he was buoyed by the support he received from not only his fans, but from directors and actors he had at times panned.  To see Martin Scorcese pause to wipe a tear on camera when discussing his friend was a window into what this person meant to his friends and peers.

What I had forgotten, and was reminded of while watching the documentary, was that Ebert was not the only member of the Siskel and Ebert team who suffered from cancer.   Gene Siskel was operated on for glioblastoma, a malignant brain tumor, in the spring of 1998.  Only his wife knew of the diagnosis—he chose not to even tell his children.  He was back at work nearly immediately, and only when he became symptomatic again in early 2009, did he request a leave of absence from his show.  He died of complications of a second surgery to deal with recurrence in February 1999.  His friend and colleague Roger Ebert only learned the truth about the disease on a Friday, just days before he died, and had planned to see him on Monday.  Siskel died that weekend.  Ebert and his wife were devastated that they had not known, and had not been able to convey the love that was in their hearts.  I can only imagine how his other friends and family felt.

In my career, I have seen it both ways.   I have had patients who have their entire families with them for each treatment, who have written books about their illness, who have blogged about it, who have made public appearances and who have been pillars of support groups.   I have also had patients who were absolutely adamant that no one, sometimes not even spouses or children, should know about their cancer and treatment.  The reasons have been many—fear of unemployment, fear of upsetting loved ones, fear of being seen as weak or ill, and in one case, a minister who feared that his congregation would see his illness as punishment for prior sins.  But the common denominator was always one thing:  fear.

My patients generally have made up their own minds about what to reveal and to whom.  I respect their decisions and support them in whatever way that I can.  But when they do ask me, I always tell them that it is better not to take this particular journey alone.  Not every movie has a well-executed plot or a happy ending.  But as Siskel and Ebert would always say, there is joy in the characters you meet and love along the way.

Love Letters

Another guest post tonight, from my friend Jackie Widen:

I miss letters.  Rather, I miss sending AND receiving letters in the mail, real letters on stationery.  Our cultural communication has been reduced to tweets, posts, texts, emails and Facebook messages. Another part of growing older is remembering and cherishing this simpler method of communication. I guess I am old.

I have always been a letter writer.  I remember as a child writing to both of my grandmothers who lived in California.  Both were widowed and led quiet lives, and at the time I just thought it normal to correspond regularly with them.  Now I realize how much they must have enjoyed receiving my crudely crafted letters.  The news to share was probably silly in hindsight; what grades I got on my spelling test (yes they actually tested for spelling back in the day) or what our pets were doing or how pretty was the dress my mother had recently sewn for me.   The postal rates were regular mail and air mail, and of course air mail was preferred. There were “air mail” stickers to plaster across the envelopes and to keep postage down we wrote on flimsy air mail stationery so that long letters were lightweight and could pass under a single unit of postage. Of course we used fountain pens.  Oh and don’t forget the sealing wax.  For my 8th birthday I received a set of stamps and sealing wax candles.  I can still smell the wax as it dripped onto the point of the envelope seal, and then I would select (quickly) the stamp of choice and stamp firmly, leaving a distinct initial or fleur de lis.

My father dutifully wrote each week to his mother, as did my mother to hers, but somehow I remember my father’s efforts more.  Phoning long distance to California was a luxury – forget unlimited talk or cell phone freedom – and so perhaps I observed his habit and incorporated it into my own routine.  When I left for college in 1970 my father wrote to me every week, and I loved opening my mail box in the Student Center and seeing his distinctive script scrawled across an envelope.  The letters were short, scratched out on tablet paper that I recognized from his work, and he always enclosed a few dollars for a treat. Usually our correspondence revolved around how the Dallas Cowboys had fared recently, or how his golf game was or just stuff about the family.  I saved every one of his letters and gathered them with ribbon.  Thank heavens in all the purging my parents did during retirement they didn’t throw out my special box of college mementos.  While cleaning out my mother’s house last spring I found all of MY letters that I had written to him.  He had saved them all too.

Preparing my 90 year old mothers’ house for sale was a tough project.  But there were treats along the way.  Packed carefully away in an old trunk were three sets of letters, bound up in aged ribbon and yellowed with time.  The first set were letters written to my grandmother from her then fiancée, the grandfather I never knew as he died when my mother was 12.  The paper was filmy onion skin, the script exquisite in its fluid loops and dips.  Why did we stop teaching penmanship in schools?  His cursive was amazingly beautiful, from a different era – I was dropped back in time into 1918.   I felt almost guilty reading about the anticipation about their upcoming nuptials.  The letters were sweet and innocent and filled with fervent passion about their future together.  The next set were the letters my grandfather had written to his daughter (my mother) while she was at camp – the summer she was 12.  A smaller stack, but the poignant part of that keepsake was the final letter written just before he was scheduled for surgery from which he did not survive.  The letter arrived after he passed away.  My mother put that final letter on top and bundled them up.  I am pretty sure she never revisited that correspondence.  She confided years ago that her childhood ended that day; that she felt old and heavy at the young age of 12 as she was an only child and felt enormous responsibility to care for her mother, a 42 year old widow who had never worked a day in her life or finished high school.  She was her mother’s caregiver until my grandmother passed away at age 98.

The final set were letters my father wrote to my mother during their courtship.  I recognized my father’s scrawl immediately.  It was more legible back then; hard to believe he had already served during World War II, gone to college on the GI bill and was just starting out at Shell Oil at the ripe old age of 30. He and my mother were engaged and he had been transferred out of town; so writing letters was the way they kept in touch.  Again I felt like a voyeur, but it was a wonderful piece of our family history that was indescribably beautiful.

As I ponder the New Year, I think about the ways I would like to make my life more meaningful.  I can lose a few pounds and exercise more, play more and worry less – but it occurred to me that I would like to write more and spend more time with pen to paper.  My calligraphy lessons have infused me with a new passion for the beauty of the printed word, but I know also the simple act of writing a letter to someone will give them more pleasure than it gives me.  So for my lovely mother-in-law and the elderly lady in California who we enjoy helping out – there is a fresh stack of note cards ready to be filled.  All I need is the sealing wax.  Amazon Prime is taking care of that.

The Library

“Books are a uniquely portable magic.”  Stephen King

If books are a uniquely portable magic, the same cannot be said for hundreds and hundreds if not thousands of books, but port them we did.  The first thing that my husband and I noticed about the house we ended up buying was the library—a room completely lined from top to bottom with built in bookcases.  I have lived in many places, and set up makeshift bookshelves from salvaged boards and cinder blocks, and later, the do it yourself–put them together to watch them fall apart IKEA models—but I have never had a library.  Say it with an affected British accent if you will—the “lye-brahr-ry”, or feign embarrassment and call it the “TV room”, this library has become the focal point of our home.

I consider myself fortunate—my family has always revered books.  I have two volumes from my mother’s childhood, Mary Poppins and Mary Poppins Comes Back, reprinted in August 1941.  You don’t remember Mary Poppins?  Let me jog your memory of a far more innocent time: “If you want to find Cherry-Tree Lane, all you have to do is ask the Policeman at the crossroads.”  At the end of the second chapter, the children Jane and Michael ask Mary where she’s been on her day off.  She replies, “In Fairyland.”  They are baffled when she tells them that she did not see Cinderella or Robinson Crusoe.  They proclaim that she could not have been in THEIR Fairyland.  Mary Poppins gives a superior sniff and replies, “Don’t you know, that everybody’s got a Fairyland of their own?”

My own Fairyland was created by Walter Farley, and Marguerite Henry and Albert Payson Terhune.  Farley wrote the famous Black Stallion and Island Stallion series of stories about Alec and The Black, an Arabian washed ashore with the young boy who tames him after a shipwreck, and Steve Duncan and Flame, the chestnut stallion he discovers on the mythical Caribbean island of Azul. Henry wrote Misty of Chincoteague, and Stormy, Misty’s Foal, inspiring little girls of my generation to long for their very own ponies.  Terhune wrote Lad, a Dog which I read when I was ten.  Twelve years later, while in medical school, the first puppy I ever bought on my own was a collie.  The dreams and myths inspired by a childhood of reading never really go away.

And so, when my children were young, I bought books upon books, and since I worked during the day, we read them together late into the night, before Harry Potter, which they were old enough to read on their own, and before video games, and computers and Facebook. The kids had their favorites—one was The Ox-Cart Man, describing the rhythmic seasons of life in colonial New England, by Donald Hall who later became poet laureate of the United States.  They also loved Wilfred Gordon McDonald Partridge, about a young boy who helps an elderly lady in a nursing home regain her memory by bringing her objects from the past, and of course The Giving Tree, by Shel Silverstein about selflessness and unconditional love.

When the kids grew up, and graduated to their own taste in reading material, I put away the children’s books—packed them lovingly into boxes and put them out in the shed by the barn.  And there they sat, quiet and safe, until the movers from Allied Van Lines retrieved them and brought them here, to the library.  As I unpacked all the boxes, the memories of childhood—my mother’s, my own, and my children’s came back full force as I indulged myself by opening and rereading nearly all of them, until I came to my own favorite, written and illustrated by Barbara Cooney in 1982, two years before my daughter was born.  It’s called Miss Rumphius, about a little girl named Alice who grows up and travels far and wide, but comes home to a city by the sea, where she plants lupines and becomes known as The Lupine Lady.  As a little old lady, she tells stories of her adventures to her great niece, also named Alice.  Little Alice says, “When I grow up, I too will go to faraway places and come home to live by the sea.”  The Lupine Lady says, “That is all very well little Alice, but there is a third thing you must do.”  “What is that?” asks little Alice.  Her great aunt replies, “You must do something to make the world more beautiful.”  “All right” says little Alice, who then reflects, “But I do not know yet what that can be.”

If books can inspire our children to make the world a more beautiful place, then they are indeed magic. I am so glad I kept all of ours.

It’s Been Awhile

Back in late September, my friends asked me if I was worried about the upcoming move to New Mexico.  I replied, no, it would be a piece of cake compared to my earlier cross country move from Boston to California.  After all, in 1993, I said goodbye to our babysitter of nine years and packed up three kids, a dog and a cat to move to a city where I did not know a single soul.  I will never forget walking into the principal’s office at our new elementary school, filling out the registration forms, and realizing that for the first time ever in my life, I had not a single name to fill in the blank space which said “Who to contact in case of an emergency.”  I was starting from scratch.

As it happens, I had seriously underestimated the effort required to detach from a home I lived in for seventeen years, from my accumulated belongings and from my youngest son and my elderly father, neither of whom desired to join me on my journey.  As sentimental as I am, it was impossible to merely throw things away—old photographs had to be examined and scanned, stuffed animals and dolls needed to be hugged one last time, old movie ticket stubs and playbills needed to reawaken memories before being tossed.  Each time I carried a large green trash bag out of the house, the closets, nooks and crannies seemed to refill themselves.  In the end, I ran out of time, and the movers packed what was left, which amounted to an entire moving van filled with our furniture, and over 300 boxes.  My culling was not very successful.

My biggest concern about the move itself was how my four dogs, especially elderly Magic in congestive heart failure, would handle the displacement, the two day 1,000 mile road trip and climb to 7000 feet in altitude, and the uncertainties of new territory.  As it turned out, the one that I worried about most surprised me with what appeared to be a new lease on life—clearly the cooler crisper mountain air seemed to rejuvenate him.  It was the little guy, Yoda, my tiny rescued Chihuahua-terrier mix that had some unexpected issues.

Yoda was picked up as a stray in Oakland, CA two years ago at Christmas time.  Starving and loaded with tapeworm, he jumped into the arms of a good Samaritan who stopped traffic on Fremont Avenue to pick him up. My veterinarian friend there made a search for an owner, but when none came forth she neutered him, wormed him and sent him down to me.  He quickly adjusted to life with the three jolly grey giants.  Playful and loving, he never met a soul he didn’t like and never caused us a moment of trouble–until the move.

For the first time ever, on arriving in New Mexico, Yoda suffered from severe separation anxiety.  When either my husband or I would leave the house, he would cry piteously and endlessly, despite the fact that the other of us was still there, along with his Scottish deerhound buddies. He was inconsolable. Amidst the doggy distress, fear and consternation, one thing became clear to me—at some point in his short life, he had been left behind.  And he did not want it to happen again.

Yoda has settled down now and he knows that if we leave the house we are coming back.  But his little trauma has left me with a New Year’s wish for us all:   Be brave!  Make a change.  Take a short trip, or a long journey, with your best friends and your family.  Yoda wants what we all want in our own way–to live, love and laugh—and never, ever to be left behind.   Happy New Year everyone!

A Not Quite Requiem for Big Red

Some of us think of the automobile as a means of transportation and nothing more.   Others, like me, see the car as something else entirely—an extension of ourselves, and an expression of identity.  Growing up I was influenced by my dear old Dad—our childhood was marked by a succession of American made muscle cars from the 1966 Ford Thunderbird convertible which met its sad end on the 610 freeway in the rain, to the Pontiac Firebird Formula 400 I drove out to Big Bend National Park, reaching its top speed of 160mph on a lonely stretch of interstate 10 before my new husband cried “Uncle!”  The first car I ever bought myself was a 1975 Chevy Camaro, V8 engine, bright red with white vinyl upholstery.  I was 21, and I was GOING PLACES.  I enjoyed that car for seven years until one too many spin-outs on Route 9 in the snow after I moved to Boston convinced me that it was time for something more practical.  The day I drove my brand new front wheel drive bronze Nissan Stanza out of the lot was the day I knew I had made a big mistake.  I was born for red cars with big engines.  I like people to see me coming.

Sometimes, however, we have to be practical.  By 1991 I had three children and a growing menagerie of pets.  I got my first Chevy Suburban, known then and probably now as the “National Car of Texas” on a company lease, and from then on I was hooked.  That car was indeed “like a rock.”  I drove it until the lease was up and then got another, this time the heavy duty three quarter ton with enough power to tow my house.  The menagerie had grown to include horses by then, and I wanted a car that I could both  live in and drive with three kids, 2 horses and an assortment of dogs.  There was nothing comparable to the trusty Suburban in the automotive world. A bemused trucker watched me struggle into a parking space at a truck stop and actually taught me how to park my behemoth.  By 2001 I realized that the horses were safer with professional drivers and big rigs, and I “traded down” to my current Suburban, affectionately known as “Big Red.”  That was in the spring of 2001, and I was in love—with a big red car.

I’ve had Big Red for nearly 14 years and 230,000 miles.  Shortly after the model year 2001, Chevrolet in its infinite wisdom decided to turn the historic first true sport utility vehicle into a soccer mom-grocery shopping car.  Gone was the bench middle seat, replaced by “captain’s chairs” for easier access to the third row.  Gone were the “barn doors” which opened from the middle out, one at a time, replaced by the hydraulically lifted single back window-door, which may have provided better grocery access, but was entirely impractical for those of us carrying three to four hundred pounds of dog, all wanting to exit the vehicle at the same time. Gone was the middle seat that folded entirely flat, allowing the entry of two 700 size dog crates, the only passenger vehicle to this day which had that much cargo space.  In my distress over the changes to my beloved Suburban, I spent an hour on the phone with a Chevy customer service representative from India, who duly noted my concerns, but had no idea what I was talking about.

Last week I covered a practice in El Centro, about 140 miles east of my home in Rancho Santa Fe.  I felt Big Red shudder and heave going over the Laguna Mountains.  For the first time ever, cars were passing me to the left as I struggled to maintain 55 mph. My good friends at Quality Chevrolet have been patching the air conditioning compressor together for years, but this was something entirely new.  Fearing the worst, I took the car back to the dealer today, with clear “Do Not Resuscitate” orders.  All day I waited, and finally around 4 pm I got a call from service.  Bill said, “Ma’am, I think your engine and transmission are okay.  We found a faulty oxygen sensor. We’ll replace it tomorrow.  You’ll be good to go.”

Good to go to New Mexico?  I sure hope so.  I don’t want a new car.  I love Big Red.  I am loyal and I persevere. The Chevy Suburban no longer comes in red.  My family thinks I’m nuts.

Lighting Out For The Territory

“But I reckon I better light out for the Territory ahead of the rest, because Aunt Sally she’s going to adopt me and sivilize me and I can’t stand it.  I been there before.”

Mark Twain, Huckleberry Finn

 

While I wasn’t looking, someone snuck up behind me and bought my house.  Well, not exactly “bought” yet, but all contingencies are removed and the closing date is set for October 3.  This wasn’t supposed to happen.  My realtor told me that our place is “special”, a euphemism for “old run down house with wonderful horse facilities.” She said it might take a year to sell, and that the right buyer would come along—someone who wasn’t too house proud, but who wanted to “live the dream,” as I did seventeen years ago.  Someone who had always wanted a horse of her own and had waited a very long time to get one—or two or three or maybe even four.  Someone, in short, just like me.  And let’s face it folks—how many people are out there who are just like me?  Apparently quite a few.  The house sold in ten weeks for close to the asking price. And there are back up buyers, who just didn’t get back to see it for a second showing in time.

For seventeen years, I put off having friends and family visit. I had no dinner parties because we were embarrassed.  The house was a mess.  The carpet was old, and pet worn and smelly, the roof leaked, the kitchen was hideous, the “powder room” was a disgrace with orange and brown tiles left over from the 1970’s. But my children, my dogs and my horses were blissfully happy with the place.  It was home. When my friend Catherine passed away in late 2012, she left me a little bit of money, which I used wisely for a new paint job, new carpet and curtains, a stunning garage renovation (after all, it belongs to my dogs!), a bathroom facelift and some nice hardware for the newly painted cabinets in the kitchen.  Friends began to visit.  They said, “We love your place.”  As I walked around the vacuumed soft carpet and outside among the newly trimmed hedges, pruned eucalyptus, reseeded pastures and freshly dragged arena, I said to myself, “They are right.  I love this place.”

But there was sadness here for me as well—the tack room with photos of children long grown and horses long passed lining the walls, the empty bedrooms, and the dogs dearly departing, one by one.  And the cost of maintenance in drought stricken energy gridlocked southern California was a daily reminder of the fact that in March of this year, I retired from my full time job so that I could experience a little more life, and a little less death.  It was a good decision, and one I don’t regret, but a reduction in cost of living was a necessary corollary.  So the house went on the market, and here we are.  I need to find a place to live and I don’t have much time.  My youngest son, and eighty nine year old father are still here in San Diego, but I yearn for the open spaces and big skies of the west.  New Mexico, with its spectacular sunsets and mix of cultures has indeed been the Land of Enchantment for me.

It’s not clear yet, but I may, like Huck, be soon lighting out for the territories.  I hope you will all come and visit.  Wish me good luck!