Learning to Fly Without Wings

For Morgan

Two days ago, one of my daughter’s best friends from childhood lost her beloved horse Rumba.  This young woman is now a yoga instructor and for the past year she has been traveling and working in Australia.  The strange thing about this story is best said in her own words:

“I never sign up to go on trail rides when I travel because I know I will be disappointed when all we do is walk. But something drew me to this ride, it was for “advanced riders” with promises of cantering. I wanted to go a few days ago but it wasn’t available so I had to settle for yesterday morning. They gave me a horse named Big, I felt that was appropriate since I am used to riding my big mare. We rode for 3 hours through the streams, by the blue lake water and galloped across a field. Towards the end of the ride the horse started prancing back towards home exactly as Rumba would have done on a trail. In that moment I thought I was riding her and maybe I was. Maybe that was the moment she passed away. She was with me and I was with her.

I may not have wanted to buy her but we did anyways. I may not have liked her in the beginning but I rode her anyways. She taught me how to be strong and courageous. It seemed at times we had the same bitchy personality and in the end we knew each other better than anyone else.
I spent this last day with myself. Sometimes crying, meditating and just existing. I treated myself to some spa time, cupcakes and most importantly yoga. I’ve read all the loving comments and messages from near and far. And I am finally starting to feel better. Thank you all for the love and support. It literally means the world to me.”

With these words on Facebook she published several photos of herself riding her old horse.  In one of the photographs, they are mid-jump over a high double oxer– a difficult jump—together as one.  I can only imagine how she must have felt, airborne, in the split second it took the large bay mare to clear that jump.  It must have felt like she was flying.

I think that we all imagine ourselves flying as children. We dream about it and we try to live it.  From the first viewing of Peter Pan, to the teenage pursuits of riding racing bicycles, or motorcycles, or horses, or learning to sail or ski, we all grow our imaginary wings, and for the times that we are doing what we do, we feel pure joy:  we are limitless, unbound by gravity or sadness or sorrow.  We have wings.

For most of us, growing up is learning to fly without wings—to find satisfaction in our friends, our families, our pets, our careers, and our hobbies.  If we are lucky, we find solace in the daily small pleasures that surround us—the scent of a blooming rose, the wag of a tail, the taste of good food or fine wine.  My daughter’s friend is learning this now, traveling alone in a strange land far from the familiar neighborhood she grew up in.  The day after her horse died, she put another picture on Facebook, of a beautiful rainbow arching over the New Zealand road she was driving on.  I’ll never know for sure, but I think it was Rumba, telling her everything is going to be okay.

Make Yourself At Home

I try not to sweat the small stuff.  Really I do.  But when I leave home, and leave my menagerie in the care of a house sitter, I am nothing if not explicit.  The directions for the care and feeding of my four dogs and two horses (the cat got a reprieve from his Boston eviction until May 9th) come to a total of four printed pages, small font, single spaced with nice paragraph indentations and bold headers like EMERGENCY!!   A walk through prior to the departure date is mandatory, to demonstrate the intricacies of the garage door and the cable TV.  The house sitter is equipped for every possible natural disaster. The keys to the van, already loaded with dog crates, are left on the kitchen counter and the van itself has enough water, canned goods, leashes and dog food to last a good month. Thermal blankets are located behind the driver’s seat, just in case hell freezes over here in sunny Southern California.  Flashlights are industrial quality, and batteries are included.  You could say that I am a “Be Prepared” kind of person.

Last week the rare occasion occurred where my husband and I had different trips planned at the same time.  He was going to Japan on business, and I had plans to meet a friend in Albuquerque for a three day getaway.  I tried to round up the usual suspects for housesitting, but all were previously booked. So rather than cancel my trip, I took the plunge and hired someone new.  She came over a week before the trip, loved the animals, memorized their names quickly, and took notes on top of my printed instructions.  She said she would leave her own dogs at home with her daughter and that she had no prior commitments during the time that I was to be gone.  I left home with a sense of relief that finally, I had found the right person for the job, and my parting words were, “Use the latches on the doors leading to the living room and please do NOT let those dogs pee on my brand new living room carpet!”

As I pulled through the gate onto my own driveway on Saturday night, the first thing I noticed was the horse trailer sitting inside.  A horse trailer?  My horses haven’t traveled in years.  I briefly considered peeking inside the trailer, but I could see my own horses down at the barn, and decided to go inside.  My dogs were lying down, relaxed, fed and happy–no worse for the wear.  So far so good.  My house sitter was seated at the kitchen table.  She beamed at me and said, “I enjoyed staying at your house SO much!  It was like having a vacation.  I should be paying YOU to stay here!”  She then elaborated, “I hope you don’t mind that I brought my horse over.  He didn’t get along with the white one so much, but he was fine with the chestnut!”  Seeing my look of surprise, she said, “I only wanted to take a little ride up the street to see the neighborhood.  I hope that was okay.”  I nodded numbly, wondering how far behind my horses were on their vaccinations.  She then went on cheerfully, “The dogs all got along great—my Great Pyrenees managed to go swimming in the muddy stream, so my daughter and I had to hose him down with the garden hose but we got him clean, and washed all the towels.”  I resisted the urge to run look at the certain hairballs in the washer and dryer.  She stood up and said, “I’ll come back ANYTIME!”  As she walked out she grabbed a large blue accordion that I had somehow missed on the way in.  She smiled and declared, “The dogs loved my music!”

As the horse trailer crunched out the driveway, I decided to have a look in the living room.  The stampede of pawprints were unmistakable, as were the large yellow spots on the white carpet that kept me occupied until around nine pm, when the sound of geysers through my open kitchen window led me outside. A trail of broken sprinkler heads crushed by the wheels of the swaying horse trailer created a fountain effect not entirely dissimilar to the fountains at Bellagio.  Unfortunately the water was not falling on the grass.

Multiple applications of pet odor and stain remover plus one brand new Bissell vacuum later, along with a hefty repair bill for the sprinkler system, parts and labor, all is well with the world.  My traveling companion said, “Did you call her?  Did you yell at her? What did you say??”  I shook my head.  As I said, I try not to sweat the small stuff.  After all, the “kids” are all right.  Anybody know a good house sitter?

Two Hundred and Nine Short Essays Later

 

Here I am in Boston, on the eve of my very first writer’s conference, feeling a bit like an imposter.  After all, the extent of my writing so far has been this blog, apart from thousands of histories, physical exams and treatment plans over the last thirty-nine years since starting medical school.  It occurred to me that someone might actually want to know what it is that I write about.  And then it occurred to me that I had never actually thought about it.  So I did, and this is what I came up with.

 

WHAT I WRITE ABOUT:

Cancer                                                                                                                           Radiation Therapy                                                                                                                 Dogs                                                                                                                                   Cats                                                                                                                                     Horses                                                                                                                                   Being a mother                                                                                                                         My kids                                                                                                                                 Travel                                                                                                                                    My father                                                                                                                               My mother                                                                                                                             Being a doctor                                                                                                                         Life

WHAT I AM TRYING TO SAY ABOUT LIFE

Cancer patients inspire me and motivate me                                                                       I’d like to explain a few things about cancer                                                                         I’d like to explain a few things about radiation therapy                                                     Cancer is evil and is not selective and makes me sad                                                 Cancer patients can be funny and they also make me laugh                                   Sometimes people do really stupid things when it comes to cancer treatment         Sometimes simple people can be heroes                                                                         Dogs are good therapy for me, my cancer patients, and my kids                                     Ditto on cats                                                                                                                       Horses are beautiful, liberating, dangerous and always expensive                                     You can be a mother AND a doctor and it’s going to be very hard                                     Your kids will forgive your shortcomings                                                                            Your kids will make fun of you                                                                                           Your kids will be successful if you EXPECT them to be and don’t harass them              Travel is enlightening and sometimes difficult and sometimes funny                                    My surgeon father is both an inspiration and a source of extreme annoyance                       My mother had a hard life and a hard death, despite appearances                               There’s always someone worse off than you                                                                   There’s always something to hope for

 

WHAT I AM TRYING TO SAY ABOUT BEING A DOCTOR AND ABOUT MEDICINE

Examine your patients—it’s important                                                                               Think for yourself and follow your gut instinct                                                                Beware of templates.  They tempt us to cheat                                                                     The Rules of the House of God still apply                                                                      Doctors make mistakes.                                                                                                       Be very selective about who you hire and set a good example for them                             Be the captain of the ship                                                                                                     Try not to whine, even if you fail                                                                             Communicate with your referring doctors and with your patients                                     Take the time and make the time                                                                                         Learn to speak slowly and clearly in layman’s terms                                                           Try not to say no, and never say “never”                                                                             DO NOT DROP THE BALL when dealing with cancer patients                                           And finally, answer your goddamned phone calls

Did I leave anything out?

A Brief News Update From the Animal House

If you’ve been reading this blog for a while, you know that I have quite a little menagerie here.  In my animal loving prime, when I had a lot more energy than I do now, we had 5 Scottish deerhounds, one Brussels Griffon, two cats, two guinea pigs and eight horses, at least one of which I kept a secret from my husband who I feared would think that perhaps things were getting a little bit out of hand.  One day at the barn, he spotted a horse that he just KNEW I would love, and he inquired of the trainer whether the horse was for sale.  She didn’t quite know how to tell him that I already owned that particular animal.

The zoo has been winding down a bit here, mainly because the kids are gone and I am less prone to temptation without their little voices clamoring for that kitten for sale in the parking lot at the grocery store.  The cat with nine lives, eighteen year old Timmy Tom, was put to sleep in August when we could not control his thyroid disease, weight loss and vomiting.  Many of the horses have moved on to greener pastures elsewhere, where new children could learn to ride from the safety of their well-trained backs, and some of the best have passed on to that great green pasture in the sky.  Stormin’ Norman, the little Lipizzaner who carried my daughter through many a dressage test, left in late June to be leased by a beginning dressage rider.  In August she called to say she wanted to extend the lease to six months.

So I was surprised yesterday to get a call from the trainer to say that they would like to send twenty four year old Norman home.  She said that no matter how much she fed him, she couldn’t keep weight on him, and besides, an old stifle problem was recurring.  Fearing the worst, I went over to the boarding/training facility last night to have a look at him.  Now, mind you, this is a horse who has lived in my back yard for the better part of twelve or thirteen years.  Always a personable animal, with a beautiful expressive face and eyes, he knew me as well as any horse can know a person.  So I was surprised last night when I approached him with a bag of carrots and I heard no welcoming whinny.  His head shot up, and if horses can glare, this one positively glared at me.  His expression, plain as day, said, “Where the heck have YOU been, and when are you getting me OUT OF HERE?!”  And then he munched on his carrots.  He looked a little thin, but otherwise fine.

Norman’s coming home to join twenty eight old Dash on Wednesday, and I must say I’m glad.  The two old souls deserve a nice retirement, despite the fact that they really don’t like each other. And Labor Day weekend I visited a friend in Albuquerque who had a litter of eight week old deerhound puppies– it was hard to leave without one but they were all spoken for.  One day soon, I might be hearing the pitter patter of new little feet around these parts. After all, what’s a new carpet for?

If Wishes Were Horses

For Missy

Is there any woman alive who can’t recite the old nursery rhyme “If wishes were horses,then beggars would ride”?  The line is etched into the memory of every little girl who ever wanted a pony, but its true lineage dates back to James Carmichael’s Proverbs of Scots circa 1628 when the original read  “and if wishes were horses, then pure (poor) men wald ride.”  In my post entitled “Nana”, I recounted my short though blissful riding career at age 10, ended prematurely by the illness of my grandmother.  During a brief college fling with a polo player (yes, he had a string of polo ponies and yes, his name was Julian, and yes, his family were Hungarian emigres of questionable political  heritage), I was treated to a ride at breakneck speed that started with an innocent giddyup and very nearly ended in my demise.  Ultimately I decided that I would prefer life and limbs intact and gave up on Julian and his horses that handled like Ferraris, but without brakes.

Twenty years went by– medical school, two residencies and three children later—I found myself as the Radiation Oncology director of a community cancer center equidistant between Cape Cod and Providence RI.  One day, I saw a young woman in her early thirties who had been diagnosed with breast cancer.  She had elected to have a  lumpectomy and radiation, and when I saw her for the first time she had just completed her adjuvant chemotherapy.  I noticed two things about her immediately—the first was that despite her hair loss and other effects of her chemotherapy, she was beautiful, athletic, confident and in control of her body, her life and her situation.  The second thing I noticed was her bracelet.  It was perfect—a golden circle made of beautifully worked horses heads, eyes alert, nostrils flared, ears forward, manes flying, the horses of my dreams .  There was no way that I was going to ignore that bracelet. But first things first—the cancer.  We spoke about radiation, the risks, the benefits, the course of treatment, the side effects.  She told me her biggest concern was her little girl who was only three years old—she wanted to make absolutely SURE that I knew that she was going to make it, because she could not bear the thought of her daughter growing up without her.  I told her I understood perfectly, and I did.

At the end of our session, I could restrain my curiosity no longer.  I asked her about the bracelet.  She told me she had always loved horses, and that she had grown up riding on the Cape. The bracelet was a gift from her husband, as was her horse, Percy.  She told me she rode that horse every day, rain or shine, stopping only briefly for her breast cancer surgery, and continuing on right through her chemotherapy.  She said, “He keeps me sane”.  She asked me if I rode horses.   I said, “No, but I always wanted to—I just never had the money when I was a teenager, and as I got older, with career and kids, I just never had the time.”  She looked me in the eye—and said to me, “Well the time is now.  You never know what is going to happen.  You could end up like me, with breast cancer or something worse, when you least expect it.  If you’re ever going to do it, you should start NOW.”

That was it—my wake up call from a patient who was smart enough to see what I had missed and game enough to point it out to her physician—that the only time and the best time one is ever guaranteed is right now, right here.  The following weekend, I got my 8 year old daughter out of bed, made a beeline to the girls boarding school riding stable near our suburban home, and signed us both up for riding lessons. My 5 year old son followed in breeches, knee straps and short stirrups, and my 2 year old– ever the cowboy—well, when he turned three and got his helmet, he loped Old Ellie around Far West Farm much to the shock and dismay of the other boarders, to see such a small boy piloting such a huge animal, completely on his own.

Twenty one years have passed since I saw and treated that patient.  I left the practice to move out west in 1993.  But every year, at Christmas, I get a card from her wishing me well, and thanking me.  Always included in the card are photographs of her, usually on her horse, though Percy is long gone, and also photographs of her daughter, now grown and a beautiful young woman in her own right.  And there is always a gift, a little something “horsey” chosen specially for me– a picture frame, a Christmas ornament, a beautiful box of stationery, a silk scarf—with ” clouds of white stallions with bright fiery eyes”. Every year, without fail, there is that renewal of our friendship, and a reminder of what is important in life.

As for the horses themselves– Rosie, Lucky, Veronica, Harmony, Sissy, Romeo, Truffles, Oscar, Shorty, Besty, Norman and good old Dash—they’ve served my family well over a period of twenty years, carrying us over miles of trails, and through both adolescent and midlife crises. They are the best therapists—they listen without comment or criticism, and they never mind when you cry into their thick strong necks. Winston Churchill said  “No hour of life is wasted that is spent in the saddle.”  But I still think that J.D.Salinger said it best in The Catcher in the Rye:

“I’d rather have a goddam horse.  A horse is at least HUMAN, for God’s sake.”

Nana

When I was ten years old, there were only two things in life that I loved beyond question:  horses and my Nana.  Nana, whose real name was Jenny Silver, was my maternal grandmother.  She and my grandfather, known of course as Papa, lived in Augusta, Georgia on a tree shaded street in the true heart of the deep South.  I was sent to visit them in the summers, and to me their house was paradise, with beautiful wallpaper depicting knights on horses in the dining room, and carpet the color of teal on the floor.  Their backyard seemed vast, especially since we had no yard then—my parents and two siblings shared a 2 bedroom apartment in Texas.  Running the length of that yard gave me a true sense of freedom, and privacy behind the low brick walls that lined the yard, cool with the scent of magnolias.

That summer of 1963, when I was turning ten, was to be a special summer for me.  After years of being begged, my parents finally succumbed to my pleas to let me take riding lessons, and I found myself at Pin Oak Stables, home of tall , genteel and beautifully gaited Saddlebreds.  I was assigned to a nondescript brown gelding—an old school horse named Toga.  I was taught to put the bridle on and to lift the saddle to his slightly swayed back and to fasten the girth.  As I climbed on from the mounting block ( I was far too small to get on from the ground), my proudest moment was when I confidently pronounced the words, “Walk on, Toga!”  It would be many years before I heard the Arab proverb, “The air of heaven is that which blows between a horse’s ears”, but from my vantage point on Toga’s back, I knew the meaning of happiness.

That happiness was to prove to be very short lived.  One hot afternoon, as I arrived home from my weekly riding lesson, my mother greeted me at the door.  She said, “Your Nana is very sick.  She has cancer.  We are bringing her to Houston to be treated at a special hospital for cancer patients called MD Anderson Hospital.”  It turns out that Nana, who was 59 years old,  had been having abdominal pain all summer.  She was treated for various ailments including ulcers and a “nervous stomach”.  There were no CAT scans and no fiberoptic endoscopies back then.  She was losing weight. She had fevers and night sweats.  Finally, in desperation, the doctors took her for an “exploratory”.  It was, as they say, an “open and shut” case.  Her abdomen was loaded with tumor, which was biopsied and found to be lymphoma.  They closed her up.  There was nothing they could do.

But they didn’t know my Nana.  She was determined that at 59, she was NOT ready to die.  She had my Papa to take care of, and she had, by that time five grandchildren.  She was going to go to the ends of the earth to fight this thing, and that is what she did.  At MD Anderson, a new chemotherapy drug, Cytoxan, had been developed, and was in early clinical trials to determine the appropriate dose and schedule.  Nana was assigned to a high dose arm, and her lymphoma began to melt away.  She had tremendous side effects, bleeding from her bladder being the most difficult for her, but she persisted.  Needless to say, my parents were far too preoccupied by her illness and her appointments and her medical expenses to take me to my riding lessons, and I knew better than to complain. By the end of that summer, her cancer was gone. By late fall she was able to return home to Augusta, where she lived another 22 action packed years.  She was a feisty old lady as she aged—at 75 she insisted on having breast reduction surgery.  She said to me, “I didn’t survive cancer to drag these old bags around for the rest of my life!” Until she died, she proudly invited her granddaughters to take a peek at her perky uplifted remodeled breasts.

It was Nana who taught me about grace under pressure, about stoicism and about courage.  She taught me other, quite practical things like how to knit (I’ve long since forgotten), how to appreciate good jewelry and to be sure to meet the parents of any man I dated. (“The apple doesn’t fall far from the tree, dear!”)  She also told me “It’s just as easy to marry a rich man as a poor man.”  (Obviously, I didn’t listen to everything she said!)  Her proudest moments were dancing at my wedding, and meeting my daughter, her first great grandchild.  When she finally passed away, in her early eighties, her entire community mourned, and my grandfather, who lived to be 93, was never quite the same.

In medical school, I had the opportunity to do electives in many different specialties, and there were many that I loved, especially those that required enhanced visual skills and spatial orientation—I liked “looking”, and “seeing” to make a diagnosis.  Dermatology fascinated me, radiology was fun and easy, and plastic surgery was beginning to merge the boundaries between art and science, with the advent of microvascular techniques in reconstruction of birth defects and trauma victims and the reattachment of severed limbs.  But in the end, it was the memory of my grandmother’s fight, and her victory that drew me closest and keeps me where I remain, taking care of cancer patients.

Nearly 30 years passed after that fateful summer before I got back on a horse.  In the words of the late Vicki Hearne, in one of my favorite essays of hers, “Oyez a Beaumont”……that was the soonest I could get to it, what with one thing and another.