Monday, March 24, 2008

I'm retiring

Well, I did it – I sent the letter and will retire at the end of spring 2008. Less than 2 months and one more clinical group to go. It’s time. My work has been a huge and fulfilling part of my life these past 30+ years. I’ve accomplished more than what I set out to do – hospice, refugee work, teaching, community clinics, 3 books and >100 articles and chapters, 1000+ students, and many 1000s of patients. For more than 30 years I’ve put others first much of the time – not now and then or philosophically or whatever, but in hard reality. My goals for the coming years can be summarized in the words of John Muir: “The mountains are calling and I must go.” Now, at least for the next ~9 months, I am laying it down. Glacier, the Wind Rivers, and Southeast Asia are next. Then the John Muir Trail. Below is a summary of my career. It’s long, so you might just want to let it go with this first paragraph above. Photo: At the DMZ - it was about to get a lot worse

Career, part 1

5-6 years after Vietnam I had a store on Sears Street off lower Greenville. It was called the New Store and I and my partners David N. and Jeff W. made and sold waterbed frames, shelves, walls, tables and the like. One day a customer who looked familiar and I were talking and we realized we knew one another in high school. She had dated one of the Catholic guys I hung out with (and who later was badly wounded in Vietnam). She had become a nurse and as we talked I realized that working as a nurse was something I could do that for me would not be a waste of time. (After Vietnam I was completely committed to never wasting the time of my life.)

To get into nursing school I had to take about a year of prerequisites such as organic and inorganic chemistry, anatomy, physiology, micro, and so on. To pull up my abysmal GPA I had to make close to all As. Taking these course was the first time in my life I applied myself in school. I made all As and was admitted to Baylor School of Nursing. The next two years was good. The courses and clinicals were mostly good and to my surprise, my fellow students were among the first people I could relate to after my 13 months of combat in Vietnam. The young evangelical Baptists and the old profane Marine found common ground. Except for the religion course (from the Baptist perspective), I made all As – I mean, what chance did have in that company – I was probably lucky to make a B in that course. I graduated magna cum laude in 1975.

I’ll stop here and express my deep appreciation to Leslie – I’d be so much less without her. Leslie’s love and loyalty have sustained me though some tough times and it’s not been easy for her. She’s stood tall beside me for many years through the good times and the bad. This sounds almost flat – for once I don’t have the words to express all that she has done and my love and gratitude to this woman who changed my life – all for the better. More later.

After I graduated, I worked at the VNA for a year — first as staff, then supervisor. In 1976 we went to Austin for me to go to graduate school. Leslie got a good job in the DHS state office – good in the sense of not having to contend with destructive politics or personalities. I got a M.S. in psychiatric nursing. There were some interesting times working in Austin State Hospital with people who were chronically mentally ill. We lived on 43rd Street and were very happy there. As I think about it, we’ve been happy just about everywhere we’ve ever been.

We wanted to go back to Dallas, but I was having difficulty finding a job in Dallas that I felt was appropriate for my master’s degree status. Then I went to a Transitions Retreat held by Elisabeth Kübler-Ross in San Antonio. The way these retreats worked was they had about 75 people (1/3 terminally ill, 1/3 bereaved, and 1/3 caregivers like myself) in a room to share our lives and selves with the others. We cut quickly through the crap – like, “I’m here because I want to learn how to take better care of people who are dying” – when someone said, “I’m here because I have the problem of judging people.” It turned out that we were all there because of our pain, aloneness, judgments, and so on – we were all there to be healed. Except for meals and bathroom we were in that room from 8 am until 1 or 2 am the next morning. Truth was told and I was humbled. I went back to work as a staff nurse at the VNA because, of course, all I ever really wanted to do was take care of patients. Photo: Tillie, a hospice patient

In early 1978, some friends (Ruby Carter, Tim White, and Johnnie Turner) and I came up with a plan to make note cards with all our names and phone numbers on the cards. We gave the cards to our patients who were dying so that they would always have someone to call when things went bad (no pagers or cell phones in those days). We also started a study group to look at what other people were doing in caring for people with terminal illness. In April the executive director of the VNA called me out of the field to begin planning a program for people with terminal disease.

At the same time I began planning, Jean Saunders asked me to see a friend of hers who was dying. The woman was Jan Viola and for the next several months, along with her amazing mother, Jean Mitchell, I took care of her. Jan had breast cancer with widespread metastases (brain, spine, and eventually lungs and liver). Before I met her she developed spinal cord compression and lost the function of her legs, bowel, and bladder. Her Mom and I went all the way through the journey with Jan and we were with her when she died. Jan was a tough customer and it was a great privilege to care for her.

Meanwhile the program grew from the VNA Terminal Care Program and before I left, it became the VNA Home Hospice Program. During this time it became the largest and one of the best hospice programs in the United States. With two other people I wrote a grant proposal which resulted in the program becoming one of 26 hospice demonstration sites across the U.S. The start-up was a consuming two years. We were blazing a trail and it was a good trail that many followed. Then I resigned as director to work as a hospice clinical specialist. My replacement as director was intolerable to me, so I left. The creation of this hospice – the service given to patients and the influence on the care of patients of other agencies and hospitals – is something I am very proud of.

I went to work teaching community health at TWU. Shortly after I started there (1981) Leslie and I got involved in refugee work. We had contacted some agencies in prior years, but nobody wanted individual volunteers. One day I got a call from Kevin M., an infectious diseases specialist at UTSW. He wanted to know if I wanted to go to a house in Old East Dallas and put in some PPDs for some newly arrived Cambodians. Leslie came too, and we were quickly caught up with Cambodians. It’s difficult to describe what we’ve done. People tend to seize on the most concrete thing, such as a clinic. But it was much more than that. We gave a lot of help to a lot of different people: individuals, families, and community. It was incredible working like this with Leslie – she is a great person in the same sense as Dan F. (all about mercy). We consciously tried to embody welcome to as many people in as many ways as possible. Photo: Francine, a hospice patient

The following was written during that time and I’m leaving it as it was written: For us personally it’s the first time we’ve worked together like this. For the first time in all that I’ve written, I am at a loss for words. It’s been about three years of very intense work; long hours and life and death; steady. Then for about two years, less of the personal work and more organizing, meetings, and politics, at which I am not very good. Leslie and I worked together very well and very productively. The Khmer have been amazing. In some ways they are like people anywhere, and in other ways there is nobody like them.

What stands out for me is their tremendous strength along with their grace and beauty. One thing that sets Cambodians apart is their having been through a holocaust (which of course is far more than just the killing). We learned a lot and for both of us I think it’s the most we’ve ever done or experienced. We’ve spent a lot of time in the apartments on Carroll, San Jacinto, Fitzhugh, Bryan, Annex, Sycamore and Live Oak working it out, figuring it out and filling it out (a million government, etc. forms). We also spent time at Parkland, Children’s and various clinics wheeling and dealing, operating at top speed in some very intense relationships. In 1982/83 we visited refugee camps at Khao-I-Dang on the Thai-Cambodian border, and Aranyaprathet, which is closer to Bangkok.

Community development wise, we were directly responsible for the East Dallas Health Coalition, involvement of the Dallas Police with refugees, the NCJW Khmer Community Development Project, the TWU Project, raising a fair amount of money and providing most of the community education, and so on. As I write this I am aware of how much was done and how lucky we are. But it was what we did in the apartments with individuals and families that will live on in us.

Teaching at TWU was good, in part because I met my mentors, Bets A. and Judy M. there and partly because I was doing the refugee work. I was able to put the teaching and refugee work together and thus amplified both.

Career, part 2

The second day of taking students into the refugee community I was sitting on the back of my blue Toyota pick-up truck behind some apartments when a student came running up, “Mr. Kemp, a lady is having a baby in those apartments!” By the time we got there the other student had caught the baby and everything was under control. We called for an ambulance and they came and took the woman and baby to Parkland. A while later I saw the ambulance was back. We went over to see what they were doing and learned that the hospital had sent them back to get the placenta so they could count the lobes. But in the meantime another woman had put it in a paper sack and into the dumpster and when the EMT reached into the dumpster to take it out the bottom of the sack broke open and the placenta slithered out and down deep into the dumpster. In Texas. In the first week of September. In a refugee neighborhood. Have a good time in the dumpster. Photo: Student with Neth Nguon

Our base of operations was mostly Lay Rith’s and Chneang Roeun’s apartment on Fitzhugh. Cozy, full of children, the transcendental Lay Rith, and the wonderful grandmother – a perfect community health operation. Leslie and I worked together 7 days a week, from family to family. What a job. In other accounts I’ve written more about Leslie. The other major player in all this was Ron C., a police officer who became (and remains) a good friend.

Things were going well at TWU until I wrote a grant proposal for some HIV outreach. Somehow that put me in the line of fire between the dean and associate dean and I was told to resign. That was a hard time, but, you know, time passes.

I started teaching at Baylor in 1989. Though I took students to Terrell State Hospital a few semesters, I was able to transfer the refugee work over to Baylor. Here is something from a website:

In our earliest work in East Dallas (1981-86) we worked only with Cambodian refugees because they presented with the greatest health needs and problems of any population in the area. At that time we were working door-to-door in the community and initially had no physician services. Students conducted in in-depth community assessment and that document was used to obtain agreement from Temple Emanu-el for them to work with us to develop medical services. That partnership led to the East Dallas Health Coalition, which later became the East Dallas Health Center, Dallas' first community-oriented primary care (COPC) center.

Leaving the medical care to medical people, we continued working in the streets. In 1991 we decided to adopt the district health model and shift our focus to the community as a whole rather than a specific population within the community. We took responsibility for providing health care to a culturally diverse (primarily Asian refugee and Mexican immigrant) inner-city low-income community with significant needs/problems. Rather than begin with another lengthy formal assessment (Is it really necessary to again show that this or any other such community has unmet needs?), we began working on one street to assist people in the community to obtain health care and social services. We went door-to-door and every time we found a person with an unmet health or related need, we stopped and figured out how to meet the need. Through the process of assisting people with the problems they felt were most pressing, we were able to develop a trusting and professional relationship with the community; identify needs and problems at all levels of care/prevention/promotion; develop a meaningful understanding of available community services, and become a part of the community of solution


In the early 1990s I began work on the book I had wanted to write since my days in hospice – a practical guide to caring for people with terminal illness. I went with Lippincott as publisher because they had also published Bernard Fall’s work (Hell in a Very Small Place, Street Without Joy, etc.). I thought the best part of the book was a series of tables and text that charted the natural history/metastatic spread of the 18 most lethal cancers. The tables spelled out what to look for as the diseases advanced so that problems could be identified early rather than late. The book, Terminal Illness was published in 1995 and the second edition in 1999.

In the mid-1990s Parkland agreed to send a physician to work with us out of the East Dallas Police storefront facility. We thus had medical services, refugee screening through the Dallas County Health Department, and outreach through Baylor students. Leslie and I were back in business together with her doing the social work and clinic management. We began working with Church Health Ministries (CHM) in the late 1990s and through that relationship, added additional medical services. We moved to a small community church in 1999 and in the spring of 2000 separated from CHM. Photo: Me, Khan Soeurt, Kara (student), and Lance at the community garden

Community Care moved to Emanuel Lutheran Church for a few months. We were in the church house next door to the church on one side and a crack house on the other. They had good-eyes in upstairs apartments across the street – a scene. Estevan G. was our doctor, a wonderful ER pediatrician and good man. One thing he taught me was how to start with a room full of patients and work steady through them.

One day I was at the clinic in Emanuel’s church house, maybe an hour before I was to leave to go to New York to get an award, kind of a crowning one, when the pastor came in to tell me they were severing our relationship. “The elders feel that our relationship is with Church Health Ministries, not this clinic, and have asked me tell you that we can no longer … blah, blah, blah” – it was surreal, unreal, devastating – the destruction of what we had worked so hard to do. It was not really about the church and was not instigated by that church – it was about power and politics, revenge. Heavy stuff. The award was sand in my mouth.

I remember what this one guy – a famous guy, perceived by many to be a spiritual leader and I guess in his own way, maybe he is – said to me as he cut us loose from his so-called faith-based ministry, “I’m a pragmatist,” he said. I thought, “Yeah, that’s exactly what you are.” I think we should be careful about what we link to “I am.”

I went to several places looking for a home for the clinic and we entered a partnership with Agape in the fall of 2000. I remember when we went over to Agape. Dale said, “I’ve suggested several times that you come over here.” I said, “I believe you – I never heard it or I just wasn’t ready.” I remember we had all our medicine in 2-3 drawers of the big brown filing cabinet and when I told Bobbie (the medical director) that we’d keep ours in there she said, “no, just put it in with ours.” They had a 100 times more than we, so it was an extraordinarily generous thing for her to say. As he had done several times before, Martin H. helped move the clinic. He’s been a rock through the years! As he says, “Grace falls on the just and the unjust,” hence the name, Common Grace Ministries. Once when Martin and I were moving some very heavy something I felt this pop in my lower abdomen. Uh oh, another hernia (see how nice I talk these days).

When we moved into Agape I felt like we’d come home.

Teaching at Baylor, like any other job or aspect of life has its good times and its bad times. The best part is that the university has come to understand and support the ways in which what we are doing is consistent with Christian action. The worst part is the judgmental narrow-mindedness of some people there. Photo: Leslie, Maria (with Luvia in lap), Roxanne, and Lupe in the waiting room at Agape

I know many people and to a greater extent that anyone I know in Texas or anywhere else, I have been committed to students as (potentially) essential parts of the community of solution. I have integrated my teaching and my community care and have expected great things from my students. And through their work, great things have happened: the East Dallas Health Center, 1,000s of patients, and good work with countless people. Here is a little something from 1995:

Strange People: In the course of outreach, one of the students made several visits to an apartment where a 60-something year old woman lived with a younger man and woman. The younger woman was very seclusive and every time we were there she had blood in her mouth (but no other evidence of trauma), and would not let us close enough to determine what the problem was. In conversations with the older woman we learned that the man (call him Jimmy) was "helping" a 10 year old girl who lived nearby. Over several weeks the story came out that the girl had a bad home life. Her mother lived with two men and was having sex with both. The girl was afraid of one of the men and so spent as much time as she could with Jimmy. She bathed at his apartment and at least once a week she spent the night with Jimmy, sleeping with him on a fold-out couch. According to the older woman, he and the girl liked to wrestle. Needless to say, when the story came out we took quick action. I remember the student on this case saying in a very serious way, "Mr. Kemp, I think there may be a problem here." We talked with a detective of my acquaintance and he went after Jimmy and brought Child Protective Services in on the case. I don’t know the final outcome, except that the girl was removed from her mother's home and Jimmy was gone, where I don't know.

Career, part 3

One of my partners in refugee work, Lance R. and I had written a print and internet guide to cross-cultural care (the state helped with our efforts). We used that as the basis for a book proposal and in 2004 our book, Refugee and Immigrant Health was published by Cambridge University Press. Again, a practical guide to providing care – in this case, to people from other cultures. Even before that book was out I began working with Tao S. and Carrie K. on a book on infectious diseases of refugees and immigrants. Tao (a pediatrician) and I met through our work with refugees and Carrie (a dermatologist) was a volunteer at Agape. Infectious and Tropical Diseases was published by Elsevier Science in 2006. A distinguishing characteristic of this book is the way it cross-references diseases, symptoms, and geographic areas to help clinicians generate a minimum of differential diagnoses. It also is cargo pocket size, so can be carried into primitive areas. Writing these two books so close together – along with working and volunteering – was very tiring to me. Photo: Vatos in the clinic


A little more on Leslie: Who fights harder for humanity than Leslie? I’m not talking about abstract stuff – feelings and beliefs and so on, nor am I talking about the occasional kindness or being a usually nice person (though she is that). Leslie’s battles are real battles – big battles – for real people and there have been many. I’ll name a few, but far from all: Florence Jessie, Sang Van and her family, Lay Rith and her whole huge family, Yann Sorn, Yuon, Amalia Garcia, the woman with rheumatoid arthritis, Maria de la Cruz, James Smith, the Vietnamese man with schizophrenia, Cesar, the Honduran man with typhus, Clarence W. … And how many 100s of thousands of dollars in medical bills has she gotten forgiven? How many people has she gotten a same day appointment at wherever? I wrote on my website something like, “What is it like to be married to a real miracle-worker?” Well, the answer is that it usually is grand – especially when we’re working together. Of course I don’t think of Leslie all the time as a miracle worker. Sometimes I’m irritated, sometimes upset – but in reality, most of the time feeling happy and grateful. And always loved and loving (except when irritated).

Here is what I wrote about Leslie on the website in about 2004: What does it mean to be married to someone who really does do miracles? I can tell you. We started when we were 16 and here we are today, 45 years later. This from the dedication to my book on palliative care: I lay dreaming that I was in an outdoor marketplace, watching a group of musicians set up to play. One by one they began to tune, softly. Then in a soft clear voice, a woman sang the words, "Who knows ... where the time goes ..." and at that moment I awoke and said, "To Leslie." A true vision. Our life of love and growth. Photo: Leslie in her natural habitat

Leslie had a dream in which she had 20 seconds to say who she is: “wife, mother, daughter, spent my life trying to help other people.”

I went back to school and in 2000 was certified as a family nurse practitioner. I continued teaching community health, and once again, integrated my work with teaching. Teaching and practicing at the Agape Clinic has been a wonderful and rewarding phase of my career. Leslie and I were working together again, and together, we took Agape from a Saturday medical clinic to a Wednesday through Saturday operation with these services …

Agape: Overview of Current Services (2006)

There are a number of free clinics doing wonderful work in the Dallas area. What makes Agape unique (locally and nationally) is the integration of comprehensive services in a medically underserved community, at a very low cost.

Primary Medical Care
The heart of all Agape services (and the means by which patients and community become involved in preventive and other health-oriented services) is primary care for people who are sick (5620 patients treated in 2003). Care includes medications, the average retail cost of which is $45.00/patient. Services are delivered by volunteer physicians, nurse practitioners, and students from Baylor, UT Southwestern, and other schools. Health problems treated at Agape include acute illnesses such as pharyngitis, urinary tract infections, and common skin disorders. Chronic health problems treated at Agape include asthma, hypertension, and diabetes. In addition to treating the more common primary care problems we provide specialty care, including pediatrics, dermatology, psychiatry, and women’s health.

Agape is the only site in Dallas providing immunizations on Saturdays year-round. This matters – a lot – because Texas ranks 46th in national immunization rates and Dallas is ranked even lower than Texas as a whole. Immunizations were in place when we started. Photo: Patients waiting in the hall

Community Health
In 2005 Agape has held five mammogram and other (hypertension, diabetes, asthma, etc.) screening events and is scheduled for a childhood vaccination and screening event. Screening is coupled with health teaching and all patients with positive findings receive follow-up. Through Agape’s partner, Baylor School of Nursing, weekly health-related classes are provided for parents at Zaragoza Elementary School (three blocks from Agape), as well as health classes for Zaragoza students. Baylor students also follow-up on complex patients and provide outreach to more isolated patients. Community partners such as Concilio Dallas offer weekly classes on diabetic self care and how to access CHIP and Medicaid.
Social Services
The health problems of many of Agape’s patients are worsened or complicated by a variety of other issues. From teaching people how to use private insurance to assisting people into the healthcare system, patient advocacy and assistance are key aspects of care at Agape.

Professional Education
Agape is a training/clinical and service-learning site for students from Baylor, University of Texas at Arlington, Texas Women’s University, University of Texas Southwestern Medical School, Dallas Theological Seminary, and other institutions.

Spiritual Care
Spiritual or partially spiritual crises identified and treated at Agape include family violence, poverty, injustice, isolation and a host of other chronic stressors. Through Agape’s partner, Creations of Faith, patients find a safe place for fellowship, prayer, Bible study, and therapy. In addition to care provided through Creations, Agape staff and volunteers pray with patients and give other spiritual care.

Community Development
The recent grant awarded by the Dallas Women’s Foundation brings to fruition ongoing work at Agape to advance the health of the community through community empowerment. Agape has a history of recruiting volunteers from the community served by the clinic (the community served thus becomes the community of solution). The Women’s Foundation grant allows us to train promotoras salud (lay health promoters) from the community to teach and assist patients in the clinic and the community.

Community Partners
Providing comprehensive care such as outlined above requires extraordinary cooperation among different organizations. Agape approaches relationships with other organizations from a working perspective (vs. endless meetings, networking, dialoging, and the like). Community partners include:
- The community itself ... rest of list deleted
So that’s it job-wise for me. Leaving the patients, students, Agape, and Baylor behind and looking to the Winds, Glacier, John Muir Trail, Asia. Life has been much richer than what I wrote above, but this was about my career and it has been a good and rewarding one. Photo: Sunrise, 1/1/2008, Big Bend

Sunday, March 23, 2008

Working in the garden

Thursday and Friday I worked in the yard and garden – hired two men to haul and chop and cut, etc. Except for mowing, watering and the like, I’d let things go since last summer when we were in Asia. The yard and garden have been okay, just a little overgrown – except the back garden has been seriously neglected.

So after a great hike in Big Bend and a day of rest, I wanted to work outside. As retirement nears, my energy is picking up and I’m relaxing some.

After two long days, everything looks great, especially the back garden, which shows again the importance of good soil preparation. I worked very hard on the soil when I put the garden (back) in 7 or 8 years ago, and it shows. The roses seem to be fine. Iris are growing strong. Some herbs are doing well – oregano, sage, germander (whatever that is), mint, rosemary [native is by far the best], lemon grass, and something wonderfully fragrant, but I don’t know what it is. Some herbs have disappeared. Garlic is growing strong and lambs ears okay. In front the Texas Mountain Laurel is blooming prodigiously, purple and sweet.

Wednesday, March 12, 2008

Big Bend, 3/2008

Random thoughts:
- Desert backpacking demands clear communications about water. My mate Jeff said (with 1st hand experience), “Everything is a problem in the jungle.” Same in the desert.
- Take chewing gum next time.
- Dried mango from Central Market is really good in oatmeal with dry milk, sugar, and pecans.
- How about them Mexicans, coming across the desert with poor or no trails, tennis shoes, girlfriend, child! Amazing. David said, How about them Jews in the wilderness! Ranchers out here in the desert! How about them Cowboys! Lot of tough people.
- If you’re urinating more than once/12 hours, you’re drinking too much water. Just kidding.

- We went 3 days, 7-8 miles a day. I need to rest on the 4th day. I'm getting stronger, but have a ways to go. On this route, it’s important to start out early on the first day.
- I can’t wait to hike in places with water. Wash, carry 1-2 liters, have all I want.
- When you’re going to be driving a long way, before you leave, eat a jalapeño with your fingers and don’t wash your hands after you eat. When you get sleepy, just stick a finger in your eye. Just the idea of it kept me awake quite awhile on the way back. Photo: 1st campsite with late afternoon sun bright on the mountains and evening shadows falling over the campsite

This trip to Big Bend started in Houston where I’d gone for a two day primary care conference. I had lunch with David and his mentor, Judy. Thanks Judy! After a harrowing drive through dark hour/rush hour/driving rain in Houston traffic had dinner with David and his friend (and cellist), Lauren at a North Indian restaurant near the Rice campus. Very nice evening, crowned by not getting lost on the way back to the LaQuinta way out somewhere in north Houston. I was the only person there with a button-down collar shirt on and not driving a truck and not smoking. Friday I stayed at the conference as long as I could stand, then headed to David’s around 4pm. Photo: David & Lauren rehearsing

Lauren came over to practice a Beethoven viola/cello duet they’re working on. “But we did it like together and it was awesome” and so here I am in magicland listening to David and Lauren work their way through the duet. Young, serious musicians.
Let’s do it again.” “OK, again.”
Can you do it on the g string so you don’t have to shift so much?” “No.”
Was I slow?” “Yeah.”
Not bad.”

We left Houston a little later than planned, I under-estimated the driving time (with a little help from google), and I couldn’t stay awake driving late into the night so had to stop three times for fitful naps. Getting closer to the park we saw many jackrabbits and cotton tails beside the road and then saw two javelinas (“the only wild, native, piglike animal found in the United States”).

After getting a wilderness permit at the Basin, filling our water bottles, stashing some water at the Homer Wilson Ranch, and losing the map, we finally got on the trail around 10. Weather was beautiful, cool, sunny and the hike up to the pinnacles was stout. When we got to Boot Canyon, a ranger-type guy said (kind of smirkishly) that there was no water, but we looked a little further downstream and found a nice semi-stagnant pool. We missed the turn-off to Juniper Canyon, but doubled back a little way and started back up (panting) and then down down down until we came to what I guess was on old campsite 6-7 miles from the Basin and coming out of the mountains. Got the tent up and dinner fixed just as dusk fell. Had Italian pasta (Pasta Roni brand + a little added olive oil) with a packet of teriyaki tuna for dinner (good) and were in our bags by 7:15, which was just fine because we'd each had about an hour of sleep in the past 36 hours and had a good day’s hike at the end of the 36 hours. David said he thought my stamina was “pretty impressive” – which made me feel very good. Photo: Classic Big Bend - from our 1st campsite. From here we go down and into the desert in the center of the photo.

We both got up to pee at the same time and realized then we were camped in a kind of cirque with the mountains dark masses on three sides and the horizon and sky meeting black in Mexico on the 4th side and the stars like desert stars so many more than one sees in other places and the milky way really milky – part of the reward for hiking into the desert.

Got up 12 hours after lying down for the deepest imaginable sleep. Ahhh – not too sore or stiff, but LOL not not sore, either. Oatmeal with dried cranberries, dried mangoes, pecans, dry milk, and sugar for breakfast (of champions). Coffee me, tea David. Photo: DK In the tent

Broke camp and started off with more downhill to the floor of the desert, then a long level stretch and somewhere along the way David said something about warm Gatorade in the car and that’s when we realized there had been a serious miscommunication because I thought he had those two quarts of Gatorade in his pack. Instead of 8.5 liters, we had 6.5 liters between us. We started rationing what we had and the hiking got harder and we began to get thirsty and a little dehydrated – 20 seconds after drinking and swishing our mouths would be bone dry. We were down to 0.4 liter
when we finally got to Fresno Creek, a small rivulet of okay water. Happy us! Drank the rest of our water and filled our bottles and platypus, straining the water through a t-shirt. After treating with iodine and neutralizer it was still cloudy. Oh well, at this point, no doubt about it, particles or iodine taste or cloudy no problem for me.

That 2nd night by Fresno Creek we spread a ground cover out and lay there a long time watching the stars come out. It seems like you’d blink or look off at one part of the sky and when your eyes opened or you looked back there would be more stars. I slept outside and David in the tent. I didn’t sleep as log-like as I did the first night, but every time I opened my eyes there was the sky, black and sparkling and not a sound. The last time I saw the sky like this was when we were climbing in Arches and Fisher Towers so long ago – good to be back! Photo: DK at Fresno Creek
Another great oatmeal breakfast and refilled our water and saddled up and hit that dusty trail again. There was a huge difference traveling with 6.5 liters of water vs. less than 2 cups. Oh, and it's not as if we were in any great danger.

We drank extravagantly along the trail through the beautiful (in a desert sort of way) desert wilderness. I realized that we had seen one flower the entire time. We would see or hear a bird from time to time and I saw one of those lizards that runs on its hind legs – fast. Up and down, up and down, then a stretch along a dry, gravely creek and then more hills and behind the hills mighty ramparts like (as David said) castles. The trail is well-cairned and there’s only trail and as someone said, If you get off the trail you’ll know it soon enough because it’s all thorns.

Somewhere along the way we topped a hill and rested looking in front of us across the desert and behind us into a bowl in the sere hills rolling down to the place where we’d been. The desert stretches beyond where we can see and the thing is, I don’t know if you can drive to see something like this because what you see isn’t just that thing – there’s also the seer and the relationship to what’s seen and there’s no free rides to this.

As we, or maybe I should say, as I tired, David said, “Just over this hill is a river. With meadows. Green grass. And bunnies. Puppybunnies.” (Family term) Up and down, now traversing the hills and finally we saw a few people up on a ridge to our left (west), but didn’t attach significance to them. Then David said, “There’s a house ahead.” And I realized the people were probably at the overlook over the Homer Wilson ranch and when I saw the house, thought it was that ranch – then below the ridge we saw the bear box with our water in it. That felt good! Photo: Lingam near Fresno Creek

It was about 5 miles from there into the mountains and 3pm on day three we decided to walk up to the highway and hitchhike back to the Basin. The day short of water took it out of at least me, and I was not disappointed to skip the last leg. I’m stronger than I was Thanksgiving, but still have a way to go. Thanks to David for accommodating my slower pace. At least I don’t complain (if you don’t count moaning and groaning, puffing and panting, and so on).

We were hitching and a man stopped who only had room for one person and no packs. So I rode with him back to the Basin. He’s a retired school teacher from Long Island and a long-time outdoorsman. Since retiring he’s spent most of his time on the road in a pickup with a topper or scuba diving. I don’t have in mind as much time on the road nor am I interested in scuba diving, but there were plenty of similarities between us. We had a good time talking. I did feel some sadness thinking about being away from Leslie for a month or so while I hike in the Winds and Glacier. And I’m months from doing it. But in my mind, I am committed, and looking forward to answering the call … as John Muir put it:
The mountains call
and I must go.”
The man took me right to our car - Thanks! I drove back and picked David up and we drove on out. As we pulled out of the Border Patrol checkpoint 40 or 50 miles up the road a javelina dashed out of the scrub, whirled around in the dirt beside the road and then shot across the road looking like a small, weird, narrow, hairy VW with little legs going as fast as they could. A "pig-like" creature. Driving through the scrub desert I thought about the hard lives that people out here lead and the people who’ve tried to tell their stories, Larry McMurtry, Robert Earl Keen, Willie Nelson, Pat Green …
When the sun hits it right on its way down, it was the prettiest thing in our little town.
Every hour I'd sneak a glance over at the plastic frame and cracked glass that holds the picture of Ruby's two sad daughters.
Last mill closed when I was nine and Daddy left and Momma cried again, I spent my nights cleaning Ruby's floors,
Just another café on a wind swept highway the farmers bitched, we're no good at football anymore.

In this land that knows no laughter in this land that holds no water,
We were all in love with Ruby's two sad daughters.

One went way out west, one went way wrong,
one left at seventeen and the other couldn't wait that long.
Neither went anywhere with me, not to the games or the Dairy Queen.
Both split with the first boy who lied sweet and looked vaguely mean.

In this land that knows no laughter in this land that hold no water,
We were all in love with Ruby's two sad daughters.

Why so pretty and forlorn, why so permanently blue
I guess ours wasn't much of a kingdom to rule.

Now when the sun hits it right on its way down, it's still the prettiest thing in our little town.
Every hour I sneak a glance over at the plastic frame and I fix the glass that holds the picture of Ruby's two sad daughters.

Why did hope leave town with Ruby's two sad daughters?

On the road again, stopping (where else) at the Dairy Queen in Ozona where a surly Hispanic kid lounged in a booth, eating french fries and sneaking kisses with the girl who had the headset on taking drive-through orders walking out pretending to do something for a customer and then stealing her moments in the booth. Across the desert with it's big sky and big rigs lit up like houses at Christmas running smooth into the night, into the plains and into San Antonio. Hit fog, heavy at times between San Antonio and Houston. On the outskirts of Houston, getting really tired, there was a beautiful choral Easter mass on the radio, but we could have used something a little more lively ... when the mass was over, the radio announcer said, "Next, a lute concerto by ..." and we just cracked up and put on a country station. Got in about 3am. Showered - ahhh. I slept on the floor, we had breakfast tacos in the morning and I was on the road back to Leslie around 9am.

Walt Wilkins and the Mystiqueros singing Ruby's Two Sad Daughters
I'll post this trip report later at my backpacking page. New links:

Monday, March 3, 2008

Hangin' on

My thoughts on retiring have been almost all negative, except for anticipating what comes next. All I could see was the stress of what amounts to almost two jobs, the inherent stresses of teaching and primary care, the never-endingness of the clinic, my diminished capabilities (slower, less stamina - I hit the wall usually around 2pm), the early deaths of my immediate family and the relationship of that to my probabilities of a long life (even with my healthier lifestyle, who would bet on a long life for me?) and with that in mind, the repulsiveness of working to the end (which wouldn’t be bad if I still loved what I do, but I don’t). Finally, this week I had growing glimmers and then a full re-realization of my appreciation for my work. I credit Leslie and my students.

Last week was terribly stressful, even ghastly in some respects, but Leslie, of course, was her faithful steadfast self and so I gradually turned away from the difficulties. And I finally figured out that my students have done a great job – they’ve probably been better students that I’ve been a teacher. We’ve been a good team – and this week, completely in-synch and doing an excellent job in the clinic, the school, on outreach.

Today, after work, walking along the railroad tracks, heading for the “big black bridge” where David and I spent so many magical hours
Walkin’ down the railroad track
Til you reach the river
Turn around and head on back
When the day is done

(now it’s 30 minutes out and 30 back), iPod going from Lightning Crashes to Oh God Our Help in Ages Past …

Time, like an ever-rolling stream,
bears all its sons away; they fly forgotten,
as a dream dies at the opening day.
O God, our help in ages past,
our hope for years to come,
be thou our guard while troubles last,
and our eternal home.

Today there were railroad cars on the tracks, which I haven’t seen in years – so that was real nice. Thinking about my students (don’t want to name them here) – people with strength, integrity, toughness, kindness, intelligence, motivation. A fair amount happened this rotation! In the end, I realized how good it’s been all along and I am grateful. This was a young group, and within that, extraordinarily mature, a good team, focused.

Today one of the students put on a fanny pack, cardigan, and stethoscope in a wonderful spoof – of someone. Another person stepped up with determination and competence over the last weeks and on the last day pushed her grade up a level, proving once again that it ain’t til it’s over. And there was someone who …
Gets it right.
Was behind at the end of the first week and then went to work and never looked back.
Blew it the first day and marched forward to a good place.
I knew I could depend on.
Found a treasure.
Showed up at exactly the right time.
Like a fellow veteran, has seen some action - blooded …
The list goes on …