We awoke early, in time to get up and get ready to watch the annual spectacle of the Rose Parade in Pasadena. In keeping with tradition (and no one reveres tradition more than the white jacketed Tournament of Roses committee, with the possible exception of the British royalty) the Parade is never held on a Sunday, and thus never interferes with the WASP worship traditions of the committee members. This benefited us by allowing a decent recovery period following our New Year’s Eve revelry (modest by most other people’s standards, but hey, we were up to one AM!)

Today was an exceptional weather day, even by Southern California standards; crystal clear skies, sunshine, and temperatures in the mid to high seventies by the time the last  float passed the reviewing stand across from the Norton Simon Museum, whose wall was appropriately decorated with the stylized Rose emblematic of the event. There has long been a rumor that the Rose Parade organizers had a pact with the devil, guaranteeing no precipitation during the march down Colorado Boulevard. While I would not be terribly surprised to discover that some of these eminent members had at least a passing acquaintance with Old Nick, all I can say is that in the 40 years since I lived here, I have never seen rain befall the actual parade. Sometimes there was rain before the start, occasionally rain after, but during? Never! You be the judge.

I have to confess; as cynical as I may be towards the politics and the motivation of the organizers, there is a beauty and grandeur in the artistic arrangement of the millions of flowers and plants that go into the making of one float, and youthful wholesomeness to the faces of the thousands of young people who come here from all around the world to take part in a spectacle and tradition that is jubilant, festive and uniquely American. Watching this event on television in the cold, snowbound homes of the Midwest and Northeast, I can certainly understand why each year several million people decide they want to pull up stakes, stop shoveling driveways, and move to Southern California. Like most Chamber of Commerce brochures, you have to take this one with a large grain of salt, but there is no denying the appeal of the image that is broadcast into cold and wet homes elsewhere.

The millions of dollars and countless hours of volunteer time that go into this event certainly could be spent more productively and wisely than investing them in this very ephemeral day, but the reality is, they wouldn’t be. If the Rose Parade were to be abolished, I doubt all those people who are involved in its creation would suddenly channel their energies into feeding the poor, or helping the homeless. (In fact, a number of these people do both.) People have the need to create something that is beautiful, artistic, that celebrates life. If they didn’t, I wouldn’t have had the enjoyment of watching the splendid group of kids from Japan infect the crowd with their energy and music, or the pale blond mariners from Sweden squinting at the masses lining the boulevard as they marched for the first time in this granddaddy of all American parades.

Happy New Year to you all,

J.

My “new life” began on November 1, and while the transition hadn’t been as smooth as I had hoped (after a week, my phones are finally working and most of the computers are functioning, though the forwarding of mail is still an issue in negotiation with the US Postal Service) I feel the end results are going to justify the pain, and I feel good about my decision to embark on this new road. Now, I’ll have more time to read (my backlog of books and magazines should keep me busy for several years even if there are no additions to the piles,) write more, and visit some of my neglected blogging friends. I also look forward to more time with friends, more hikes in our local mountains, and a chance to visit my far away son more than I have been able to in the past.
To the few who may still read these words, be well.
J.

One would have to be a complete Pollyanna to not realize the terrors that war, human cruelty and greed, not to mention the devastation Mother Nature brings to the human condition. No wonder that many choose simply to avoid reading newspapers or watching news programs, as we have all become overburdened and desensitized by the amount of carnage and horror delivered daily in front of our eyes. I hadn’t even had a chance to reflect on the earthquake damage in Haiti, Chile, and then New Zealand, especially as it might apply to our own geography, before the tsunami in Japan and the nuclear plant meltdown shifted my focus in a different direction. Now, with the tornado ravaged Southeast competing for news attention with the British royal wedding (a telling assessment of our values based on the time allocated to each,) I cannot recall any recent mention of what is happening in these other areas, though I intellectually know that the people there remain homeless, are still dealing with loss and daily deprivation. Sadly, just as the flotsam and jetsam of their lives have been washed out to sea, their problems are also lost in the relentless never ending news cycle of the media.

I was brought up by my parents to care about the suffering of others, to be grateful for the daily blessings of my life, to share with others surplus which is mine when their needs exceed my own. I still believe that this is the right way for me to live, but I admit, I feel completely overwhelmed by the magnitude of the problems that are daily placed in front of me. I, along with millions of others, suffer from compassion fatigue. It’s daunting to realize that if I did nothing else but devote my entire life, energy and resources to the solution to but one of these myriad issues daily raised before my eyes, it could totally consume me, and still not do more than scratch the surface of the problem. I admire, and attempt to emulate those who have selected one or two worthwhile projects to which they lend their support, and who have remained steadfast in their focus. I continue to be impressed with the generosity of the American people in continuing to give to disaster after disaster relief, even knowing that their money is sometimes misspent or wasted.

I have been very fortunate in my life. All along the way, I have encountered angels in the form of people who have given me financial and moral support, who had literally taken me into their homes as though I were one of their own, who have opened doors for me that would have remained closed without their aid.  There is always more that each of us can do for another, and it is a struggle for me, as I’m sure it is for many of you, to know where to draw the line between obligation of what I owe to myself and my family, and what I owe to someone who has been less fortunate than me. One way to deal with this dilemma, and one which I’m sure all of us have attempted to practice at one time or another, is to attempt to avoid seeing need so as not to feel guilty about not responding to it. Unless you live in almost complete isolation, this is almost impossible in our society. Another is to draw up a budget, setting aside a sum (be it money, time, or both) you feel you can devote to helping others. But what do you do when your budget has been spent, and an appeal reaches you that is difficult to ignore?  How much right do we have to deprive someone close to us of our time or financial resource without their specific consent for what we feel is a greater need? And in the end, just how much impact does what we do have on the life of another? In my personal case, I can give you an easy answer – tremendous! I hope those of you who read these words will reflect on your own situations, continue to struggle with the balance between your good impulses, your selfish needs, and the legitimate needs of your families, and remain generous with the less fortunate.

Be well,

J.

We just returned from spending a couple of days in the mountains, relaxing, eating, hiking, and spending time with old friends. They’ve invited us, along with another couple, two of our dearest friends, to share their beautiful home overlooking a scenic mountain lake. We’ve all known each other for over thirty years. He and I were colleagues until his retirement, and we’ve taken a number of trips together here in the States, as well as around the world. We’ve watched each others’ kids grow up, get married, create lives of their own. We’ve seen the lines of age change our faces, the weight of years alter our movements, and the experience of life mellow our opinions along with our expectations.

To say our friends are hospitable, kind and charming would be gross understatements. We feel very comfortable together, knowing we are accepted, cared for, welcomed. There are no hidden agendas. No one is looking to find favor, advantage, opportunity. We have some shared history, a few common interests, and a tolerance for the other’s beliefs. We seek not to covert the other to our own ideology or faith. We enjoy each other’s humor, and have heard each other’s joke many times over, but we still laugh at each re-telling. We are very fortunate that life, on the whole, has been kind to us, and while we each have had our shares of trauma, we have learned to be grateful for the gift of each day. They are almost a generation older than us, but have retained the gift of play with each other, maintaining at times a degree of childish teasing and joy that gives me hope for our own futures.

Over time, I hope and expect we’ll have other friends come into our circle, but they will never be able to replace the bonds we have forged with each other over many decades. It takes time to get to know people well, to see them in different settings, to appreciate their character in response to the various challenges of life. There is also something to be said about being with a person who knows you well enough to see through the various protective veils we all wrap ourselves in, in front of whom there needs to be little or no need for subterfuge. Old friends become our dearest treasures.

The tragedy of Japan continues to unfold, as more bodies are being reclaimed from the rubble left behind by the twin devastation of the earthquake and subsequent tsunami, while thousands more remain unaccounted for, presumed to be also dead. Radiation continues to seep out from the damaged nuclear reactors, affecting food and water supplies in nearby areas, while continuing to keep the specter of a full nuclear meltdown in the minds of everyone concerned. As engineers heroically battle to cool damaged reactors at the risk of their own lives, we are left with our growing unease about the safety and wisdom of nuclear power not just as a local but a global issue. Can any nuclear plan be built to withstand an earthquake of 9.5 magnitude (the largest recorded quake that hit Chile in 1960) and the tsunami that’s likely to follow? Can human error, and the desire for profit over safety, ever be designed out of any future reactor? Are we now going to rebuild and redesign our current nuclear power systems to meet the greater safety standards that (hopefully) will come from the lessons of Chernobyl, Three Mile Island, and now Japan? If history provides a blueprint for the future, the answer, sadly, is “not likely.” (In one of the not much reported ironies of this tragedy, a documentary movie made by a female Japanese filmmaker pointing out the safety issues uncovered at the currently damaged nuclear plants was playing in Tokyo as the earthquake struck the country.)

Japan relies on nuclear energy for thirty percent of its current power requirements. In some countries, such as France, that number is significantly higher. Unless a hitherto undiscovered means of energy production were to be found, the world at this time is not able to realistically eliminate fission power without major reductions in energy production. For as long as we continue to double our population at the rate we have been doing, we can expect to face not only further energy crises, but also looming disasters in the areas of food production and the rapid destruction of irreplaceable natural resources. In what is a zero sum game, the likelihood of economic and physical conflict will continue to grow, with the stronger wresting from the weaker that which they require for ongoing survival.  The longer people, governments and religions ignore the threats that over population creates, the less likely we are to find an answer that will assure the peaceful survival of mankind.

There are times when the Fates, being bored with the orderly events of our lives, decide to mix things up, and create havoc as only they can do. This seems especially true when men, in their hubris, are reaching out for a long sought goal, unmindful of how easily this can be snatched from them.

Miki and I had been planning a dream vacation to Patagonia, then the Lake District of Chile, followed by crossing the Andes by bus and by boat, traversing those majestic peaks to Bariloche, the famed Argentinian ski and nature resort. A couple I had known for more years than I care to admit were going to accompany us, also excited by the prospect of shared adventure. All the plans had been carefully crafted, hard to get reservations secured at the Torres del Paine, arguably the most scenic of national parks in all of Chile, and we were ready to depart.

A week before our trip, I visited my doctor for a routine office check-up accompanied by an in-office minor procedure. Within two days, I was experiencing fever, chills, and all the signs pointing to serious sepsis. I started antibiotics, informed my doctor, and received reassurance that all should be OK by the time we were ready to depart. After a couple of days, I had indeed improved, but I was far from well. I was then switched over to IV antibiotics pending receipt of the result of the cultures that were done, hoping to rapidly beat this unwanted foe into quick submission.

The IV antibiotics seemed to improve things considerably, and my spirits were buoyed until the culture results came back. Seems as though I contracted one of the worst bug known to our science, a multi-drug resistant organism that was unfazed by any of the drugs I had so far been given, and which requires a 4-6 week course of our most potent (and toxic) medications given IV twice a day for there to be a reasonable chance of a cure.

Needless to say, I couldn’t take the risk of traveling under these conditions to a place that was at least a five-hour drive from the closest outpost of civilization, and a 4 hour flight from there to a US equivalent medical facility. Our trip was already paid for, and most of the money was non-refundable. Our friends had already cleared their schedule for the holiday, and wouldn’t have tackled this journey on their own without our expertise to guide them through it. I convinced Miki that she had to go with them, and enjoy herself despite my inability to partake in our dream. She very reluctantly agreed, and from the sound of her e-mails, is enjoying the holiday.

Since I have to be in the hospital every twelve hours for my antibiotics, I decided I might as well work on a limited basis, which I have been doing. Other than the disappointment of not being part of something I had been planning and looking forward to for some time, I’m doing OK. Taking a shower one-handed is a challenge (try it some time and see) and being poked with needles gets old after a while, but if the infection clears up, I’m more than willing to have this be the worst tragedy of my life.

Friends have been very supportive, calling to check in on me, inviting me over to their homes to share a meal, and expressing their concern for my welfare.  I suppose there is benefit in being reminded of what it feels like to be on the other side of the bed, something most physicians intellectually understand, but not necessarily viscerally experience, until they are anxiously awaiting the result of a test or being subjected to the small tortures of being poked with needles or the more significant pains of the underlying disease. I’m sure I will be more empathic after this experience than I might have been before. There is some good that comes out of everything. Or so I keep encouraging myself.

Be well,

J.

We’ve taken another opportunity to join our best friends for a long weekend in a small beach-side cottage along the Central Coast of California. We have been renting this place for several years in early February, long before the summer crowds descend, and before much of this part of the coast is often covered in fog. There are few things as relaxing as waking in the morning to the sound of surf exerting its rhythmic pull on our psyche, watching the rising sun bring to life the scene of diving birds and scampering sandpipers looking for their breakfasts, along with a few joggers and their dogs loping along the ocean’s edge.

The smell of morning coffee and bacon cooking on the stove never fails to bring Miki awake, whereas she might otherwise be tempted to sleep through this, the best time of the day. (There is always time for a nap after breakfast and a morning walk on the beach.) Mike has built a beautiful guitar, and its mellow tones provide an appropriate soundtrack for our appreciation of the surroundings.

Miki and Jeanine will be spending at least part of the day working on a jigsaw puzzle spread out on the card table, a guilty pleasure they both enjoy, but for which they only find time during these vacations. We’ve brought along several books from the large pile waiting to be read, but based on prior experience, we’ll be lucky to get through one of them. Somehow, having a panoramic 180 degree view of the beach with its rolling surf, as well as the curve of the coast with its verdant gently sloping hills, provides a distraction strong enough to pull the eyes away from the printed page, riveting them instead on nature’s display all around us.

Last night’s sunset was particularly glorious – a perfusion of clouds with progressively darkening pinks to reds, finishing off with a magenta haze as the few distant lights up the coast softly flickered on through the coming evening fog that remains localized to the cove at the bend of the land, signaling the arrival of yet another star filled night.

We are adjusting to the rhythm of the place, rapidly shedding all the vestiges of my usually over-scheduled life, reveling in the easily soluble dilemma of whether we should walk on the sunlit beach before or after we eat a little something, and napping whenever the mood strikes us. This may not be Paradise, but it will do until the real thing comes along.

Be well,

J.

My friend, her mother, along with her father, had graced our Christmas table for a number of years. The mother had a stroke a couple of years ago, leaving her with not only paralysis of her left side, but also with a severe expressive aphasia; the inability to speak. My friend’s father, a retired a surgeon, visited his wife every day at the nursing home, fed her dinner, and kept her company.  Now she’s gone, and another place card will go unused at the next holiday dinner, adding to the rapidly accumulating pile of memories called forth by the roll call of the missing: Ann, Sylvia, Sasha, Kathy, Carl, Marija, Michael, Jeanette – it’s an ever growing list. It’s as if the tides of time are eroding the bulwark of all those we have known and loved, wearing down the security of friends and family who have stood between us and the winds of chaos and entropy.

Saturday also brought with it an occasion of celebration. Another friend was turning 65, and we joined with those who gathered to make it a day to be remembered. Most of those present work with him in the ER, and like any elite military unit, these foot soldiers on the front line of medicine shared war stories laced with the kind of macabre sense of humor outsiders would no doubt find insensitive if not insulting, but which allows those who battle in these trenches to go back to another shift filled with human drama, suffering, stupidity and pathos without being emotionally bankrupt themselves.  He is excellent at what he does, possesses a large heart and a kind soul, but does not suffer fools gladly. All of the staff are fiercely loyal to him, and he to them. I, being one of only a couple of outsiders privileged to have received an invitation, appreciate the value of the esprit-de-corps that binds them together, and have watched as they together have literally saved lives. I was happy to see that the enthusiasm for what they do, as well as for each other, had not waned over the years.

Today, the weather changed, and soon the morning clouds took on a more threatening demeanor.  The snow capped mountains,  so spectacular in yesterday’s sunshine, no longer were visible, replaced by the gray haze that preceded the coming of the rain. The friend I was supposed to go hiking with this morning called shortly before the rain began, letting me know her teenage son had swallowed a piece of meat the night before, and it was still stuck in his swallowing tube.  Since I knew the GI doctor who was working today, I called him, explained the situation, and he agreed to meet her at the hospital to extract the offending item. As it often happens these days, things did not go so smoothly. Since my friend belonged to an HMO, her son needed to have prior authorization in order to have any procedure done. And since this was a Sunday, the only way the paperwork could be accomplished was for him to be first seen in the ER, have tests done, be evaluated by the ER doctor, certified to need a procedure that could not  be put off until the next day, etc., etc., etc..  Needless to say, what should have been a  twenty minute procedure turned into an all day affair that involved a mountain of paperwork, several needless X-rays, blood tests, and the wasted time of a number skilled professionals (not to mention my friend and her son) – all so the bureaucracy could continue along in its convoluted and very wasteful way. And you wonder why medical care has become so expensive? In no small part it’s because the inmates are running the asylum.

Hopefully, your weekend was a good one.

Be well,

J.