Bread, Hope

Bread I’ve baked in recent months:

Yeasted French (Acme Bread Company recipe from Glezer book)*
Yeasted herb slab (also Acme)
Sourdough,* San Francisco style from Reinhart book*
Sourdough, French (we liked the SF better)
Sourdough with kalamata olives
Sourdough with pepper jack cheese – a breakthrough!
No-knead French*
No-knead sourdough
No-knead French with rosemary
Whole wheat (Tassajara and Reinhart recipes)
Banana bread (not yeast or sourdough)

*Books include Artisan Baking by Glezer, Artisan Breads Every Day by Reinhart, The Tassajara Bread Book by Brown. Sourdough starter made from recipe in Glezer book. No-knead bread is from NPR recipe here.
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Photo: And dreams emerge - a photo of Hong from Alison in Hanoi & Australia

Some of my notes from a church school lesson. Reading the notes again, I’m amazed and uplifted. Things in parentheses are my additions.

People need an upward vision in order to find an earthly place to stand. Purpose in life not solely self. Faith (and experience) gives us a spiritual place to stand.

If you want to save your life you must lose it.

We are called to put on love in all its manifestations. Love is hope-bearing. We’re in the business of bringing hope/vanquishing despair.

A story about a young man, dying from AIDS, asking his father, a Baptist minister (a religion and role associated with a lot of judgment), “Daddy, will you come lie in the bed with me like you used to.” Choosing the heart of his faith over theological judgment, the father lay down with his son and held him as he died.

A metaphor for living a sacred life is building Jerusalem – where we live. William Blake wrote a poem on this and it became the hymn, Jerusalem. We are in the business of bringing hope AND building Jerusalem – in our life/heart, our family, our church, our community, our world.
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I don’t know who this is from: Our entire universe is contained in the mind and the spirit

The patients that stood out to me today

The patients that stood out to me today were:

55 year old woman with no way to get into Parkland and 1) uncontrolled insulin-resistant diabetes, maxed on all the oral hypoglycemics we can give (metformin, glipizide, pioglitazone); 2) bipolar disorder controlled on olanzapine and fluoxetine; 3) hypertension managed with lisinopril; 4) hyperlipidemia marginally controlled on simvastatin; 5) OA, for which she takes ibuprofen; 6) and she’s also taking aspirin and multivitamins.

6 year old girl c/o 2 week history of red eyes with exudate and dry skin on her hand. As the encounter unfolded, she said she was crying every day, had headaches, and insomnia. Her father is in jail since February and it’s unclear when he may be reunited with his family. Photo: Nora and me

21 year old woman in NAD from Burma (Karen) c/o cough and feeling warm at night. The first thing I noticed was head lice, then a normal exam until her lungs, where I auscultated rhonchi in all fields – what!? Renee listened and found the same thing. So she walked in with a cough and out with pediculosis and community-acquired pneumonia, probably mycoplasma. I started her on a challenging regimen of clarithromycin, prednisone, albuterol, ibuprofen. Also permethrin for the pediculosis.

Mary saw a woman I’d seen 3 weeks ago. At the time she was in respiratory distress and I called 911. They declined to transport her to a hospital because she didn’t have any symptoms other than SOB (lungs clear, no fever, etc.). Nora took her to the Baylor ER, where she was admitted (for >week) with a pneumothorax.

We ask all patients, have you ever been physically or sexually abused? It’s not an uncommon question, but we take care in how we ask it, trying to create a space where people can say yes vs. just tossing it out and then on to the next question. And here I was in exam room 2, with Nora and a 32 year old woman who answered, “Yes.” She was raped when she was 18 and this was the first time she’s said anything about it. And so there we were and after I worked her up, left so that Nora could sit with her, listening, the woman crying, Nora talking in the soft connecting way she has. Paroxetine, regular visits, “You came to the right place.”

How long, how long must we sing this song, how long, how long?

What I said at a graduation ceremony yesterday evening

Congratulations. To the graduates who worked so hard for this wonderful achievement – the FNPs and this, the first group of DNPs from Baylor – the first BSN to DNPs in the nation! Congratulations to the families of the graduates who supported them and sacrificed to help them. Congratulations to the faculty who taught and mentored the graduates. And congratulations to Dean Lott, Dr. Brucker, Dr. Faucher, Mrs. Kurfees and everyone else involved for creating the DNP program. What a great day this is. Photo: One of the DNP graduates when she was an undergrad - outreach in the community garden

What great opportunities lie ahead for all of you.

You/We have the great opportunity to heal the sick. Like anyone else, we can (and should) be kind and gentle. Like anyone else we can pray for and with others. Like anyone else we can support and contribute to the efforts of people working to heal the sick. But in our case we also touch people physically – with kindness and gentleness. We can often heal the body, and even play a part in the healing of the spirit.

I’m still just overwhelmed by this – by this daily contact with the suffering and need and hope of the world. And it seems such a privilege, such a wonderful thing to talk with a person, examine that person, and then understand what is the problem, why it occurred, and best of all, what to do to manage or heal the problem – and then do it! I well remember the first person whose illness I cured. She was about 50 years old and looked about 60 – a person who’d had a hard life. She had been treated as an outpatient at a major medical center for pneumonia, but the treatment was unsuccessful. I gave her clarithromycin and it worked! We were both very happy.
And so we do countless variations on this – people with diabetes and hypertension and pharyngitis and otitis and asthma and acne and along the way we ask questions like, have you ever been physically or sexually abused? On most days are you mostly happy or mostly sad? Is there anything else? What questions do you have?

Here is something one of my students wrote in her journal: “When she admitted to having thoughts of killing herself it just added to the weight in my heart … when we prayed it was the first time I participated in spiritual care. I didn’t know what to do because while Lupe was praying I started to cry, but tried to stop because I had to get through the rest of the day.”

So we work to heal the sick and lift up the oppressed and as we work to provide holistic care to as many people as possible, we must remember that there are others waiting to be seen and if we take the time to do a 100% job in all dimensions with one person, another person may get nothing. So we work smarter and faster and learn to deal with priorities, but still, there is much to do, much left undone. – there is a deep ache in the world, a groaning inwardly while they wait, while we wait.

Let me read to you what I wrote in my journal last week – about Albert Schweitzer:

• Schweitzer suffered from major depression while he was in a French POW camp. Through his depression he became aware of “the fellowship of those who bear the mark of pain” – and he further realized that all people bear pain – and in this way (and other ways) he understood that we are One.
• He discovered that the ideal is the human capacity to experience and express reverence for the miracle of life … and to act on that reverence.
• The greatest happiness is through seeking and finding ways to serve. And he discovered that people who set out to do good should not expect others to help move boulders out of the way; in fact, others will sometimes move boulders into the path of those trying to good.

Like Dr. Schweitzer we all see things that need to be done.

Who and what will you see? People who are hungry? People who are thirsty - who thirst for freedom and justice? People who are strangers in a strange land? People who are naked – naked of dignity and of hope? People who are sick – sick in body or sick in heart? People who are in prison – in prison like Paul or in prisons of a different sort. What will you see and what will you DO.

Here is something else from my journal – about a woman in prison …

A middle-aged woman came into the clinic today. Her chief complaints were diabetes and asthma. The promotora who saw her in intake asked two depression screening questions and on the basis of the woman’s answers then administered a more complete depression screen, which also was positive. When I saw her she said that “something happened” when she was 8 and 9 years old. It turned out that she had been systematically molested when she was a child. She had not told anyone other than her mother until today. One of her children has been asking her, “Mommy, why don’t you ever hug me?” The answer, which she hasn’t been able to say, is that she cannot. There is something about physical affection between family members… because, naturally, it was a family member who molested her. She and I talked for awhile and it was intense there in exam room 4. When we were done, I told her I was glad she came in and that she had come to the right place. I gave her medications for the diabetes, asthma, and depression (or more accurately, PTSD). She’ll see our psychiatrist next week...

There is much left undone by the ones who went before us, by the Apostle Paul, by Maimonides, by Albert Schweitzer, by Mother Teresa, by countless people – and these people, dear ones, are our colleagues, our brothers and sisters in faith and works. They would ask that we carry on; that we see the poor and the afflicted and that we do something about them – that we do something about the individuals who cross our paths AND that we create even greater opportunities – programs for adult survivors of abuse, for children whose potential is swallowed up in the hard life of poverty, for prostitutes, for drug addicts, for people seeking to break free from so many different prisons. So much left undone.

'Come, you who are blessed by my Father; take your inheritance, the kingdom prepared for you since the creation of the world. 35For I was hungry and you gave me something to eat, I was thirsty and you gave me something to drink, I was a stranger and you invited me in, 36I needed clothes and you clothed me, I was sick and you looked after me, I was in prison and you came to visit me.' Photo: The students had a shower for this Karen woman who was pregnant. You can see the guys are having a great time.

You/we have the rare opportunity to heal the sick. To relieve suffering. To help the world be a better place. To be a part of the great dream of mercy and human dignity.

I’ll end with the Oath of Maimonides* (gender-adjusted)

The eternal providence has appointed me to watch over the life and health of Thy creatures. May the love for my art actuate me at all times; may neither avarice nor miserliness, nor thirst for glory or for a great reputation engage my mind; for the enemies of truth and philanthropy could easily deceive me and make me forgetful of my lofty aim of doing good to Thy children.

May I never see in the patient anything but a fellow creature in pain.

Grant me the strength, time and opportunity always to correct what I have acquired, always to extend its domain; for knowledge is immense and the spirit of a person can extend indefinitely to enrich itself daily with new requirements.

Today we can discover our errors of yesterday and tomorrow we can obtain a new light on what we think ourselves sure of today. Oh, God, Thou has appointed me to watch over the life and death of Thy creatures; here am I ready for my vocation and now I turn unto my calling.

Written at other times

Things written in March or April or some other time.

Six months ago I bought a book, The Hill Fights: The First Battle of Khe Sanh. I was holding it for the right time and this (the day after getting home from hospital) was that time. As I read about this terrible battle that I’d been in, I thought about how over the years Jeff would say things to me about the way I was in Vietnam. Reading this book I began to understand what he was saying. About 1 in 7 (~15%) Marines actually fight. Of that 15%, not that many are what you would call true hard-chargers. The book made this clear and then I read this: “As soon as I told them I was wounded, they crawled over and patched me up.” I was one of the two that got to him. I even took his photo (situation described pp. 94-95). I was a hard-charger. And here is an amazing thing: so is Leslie. She is straight out of the Book of Five Rings – she’s burnt out and beat down, but never conquered. Photo: Taken at the Hill Fights
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Written 2 days before I went to the hospital. Today I heard a talk by a distinguished physician (Harvard faculty, Director of Ethics and Palliative Care at a major medical center, and President of the Albert Schweitzer Fellowship). The speaker talked about service and about Albert Schweitzer, who, before becoming a physician, was a noted New Testament and J.S. Bach scholar and a well-known organist (recitals still available on CD – here is example: http://www.youtube.com/watch?v=tSQSgwDRT84&feature=related). What stood out most to me … Photo below: The reason why

• Schweitzer suffered from major depression while he was in a French POW camp. Through his depression he became aware of “the fellowship of those who bear the mark of pain” – and he further realized that all people bear pain – and in this way (and other ways) he understood that we are One.
• He discovered that the ideal is the human capacity to experience and express reverence for the miracle of life … and to act on that reverence.
• The greatest happiness is through seeking and finding ways to serve. And he discovered that people who set out to do good should not expect others to help move boulders out of the way; in fact, others will sometimes move boulders into the path of those trying to good.

I thought about some of the people who put boulders in my path. What I wrote about this seemed unseemly, so it’s gone into the void of deleted.
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About a week after I got home from the hospital I found out I'd been on a vent for a day & night. I had no recollection and still have none. I also realized I was 11 days in the hospital.

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From 2007 trip to Burma

Pulled into Moulmein about 2pm. It's hot as blazes today - the first day without rain since we got to Hong Kong. Taxi man said 2000 kyats to hotel. I said, last time 1000. He said, Okay 1500. It turned out to be about a 1000 kyats ride to the Thanlwin Hotel. The closest room to what we wanted was a big room with shared bath and aircon that barely worked and a fan that turned at about 20-30 RPMs.

We caught a tuk tuk shared with two Chinese women with all kinds of gold and heavy perfume on to the Aurora guesthouse where they had no rooms available. Photo: The Breeze

We're really hot by now and everywhere involves at least one long flight of stairs and we're a little dehydrated since we've had only a few sips of water on the long bus ride knowing that there would be 2 stops at most. Actually the bus stopped once for lunch/toilet break (sorry I didn't get a photo of the toilet at the bus stop - which wasn't bad at all, for a squat toilet). So anyway, we're standing outside the Aurora GH, dripping with sweat, (I'm) feeling dizzy, wondering what we'll do if we can't find a room. I left Leslie sitting, dripping on a suitcase on the sidewalk while I took a moto to check out the Breeze GH. They had 2 rooms available, one for $15 with aircon and one really big one with 20 foot ceiling and big windows overlooking the river, but fans only for $18 - "natural aircon" says the man showing me the room. I say we'll take the aircon, but my wife will decide for sure. Back I go to Leslie and we load ourselves and luggage all into one trishaw - oh we were a sight to see! Photo: From the Old Moulmein Pagoda exactly as Kipling wrote: "By the old Moulmein Pagoda, Lookin' eastward to the sea,"

Lonely Planet says the Breeze is "funky, but adequate." By now we understand part of how things work, so asked if they turn off the electricity at night. He tells us they have a generator, so we take the aircon room. So here we are, in a room with tile walls like a giant bathroom (photo above) and glad to be here - especially given the ceiling fan that moves briskly. The Breeze is funky but okay and it's right on the huge Thanlwin River and our room very conveniently has a bowl for spitting betel nut juice into - what more could you want?

Several times on this trip Leslie has said, "My father would not believe it if he saw me now." I guess this continues that tradition.

Cali! Roses!

In mid-April we headed for California – a couple of days in Berkeley, then I went to San Jose for a conference while Leslie stayed in Berkeley with David, then a few days in Berkeley, a few days in San Francisco, back to Berkeley, and then home. Photo: Sidewalk in front of Star Market. Where the dogs are is where we sit and drink coffee

Ahhh, Berkeley, the land of my dreams, where almost every yard looks a lot like ours, where almost all the houses are old and graceful, where Walmart isn’t, where drivers always stop for pedestrians, where developers aren’t running hog-wild through communities tearing down homes to build mac-mansions and even bulldozing whole blocks. Of course it helps that our life in Berkeley consists of fixing breakfast, walking to the Star Market or Semi-Freddie’s Bakery for coffee and pastry, walking on to Safeway to shop, bus back to David’s, fix more food, read, take it easy … We had a very good time with DK (who is working very hard). Photo: The future is now - CK and the shopping cart he shares with Leslie

San Francisco was good. We took the bus from David’s to the BART station, except while we were standing at the bus stop a woman pulled up and offered us a ride to the station. How great is that! BART went straight to downtown SF, we got off at Montgomery, and walked to the hotel. Photo below: Sidewalk in front of the Star Market in Berkeley, on Claremont

We stayed at the Grant Plaza in Chinatown - $69 base rate with windows overlooking Grant Avenue. We could walk north on Grant a few blocks and cut up the hill to Stockton and except that the buildings are just a few stories high, it was almost like being in Hong Kong. We ate twice at the New Moon Restaurant – a huge plate of roast duck and pork on rice. Once we got BBQ pork, the crispy skin off the half a pig hanging at the end of the counter and once we got char sui, which is what we wanted. Also a 20 minute walk to the Yummy BBQ Kitchen on Broadway and vast quantities of dim sum 3 pieces for $1.50. A few minutes past that is North Beach where we checked out cafes and groceries, hung out at City Lights, spent a few minutes at the park, and had an espresso at Café Trieste.

Walking south on Grant for four blocks we caught the bus to Japantown to shop at Ichiban, then transfer to Clement Street, the “new Chinatown” where we made it to cheap dim sum Mecca, Good Luck Dim Sum, where we feasted on more than we should have eaten for $7!!! We had an espresso at a depressing electronic gambling place, spent some time at Green Apple Books, then went back to Good Luck for just one more round of chive dumpling with shrimp. Photo: Dim sum at Good Luck

Back in Berkeley, David and Matt fixed linguine and clams for us for dinner, and that was nice. So were the chocolate chip cookies I made. Had a leisurely packing, picked a lemon from the tree by David’s balcony, and caught the shuttle to the airport. Had we had one fewer bag, we could have taken BART, but we were bringing things home for David so took the van. Photo: Mirror shot at the New Moon
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There are 15 or more roses in our front yard. There are bushes, ramblers, and climbers. A few, like New Dawn (1930) and Don Juan (1958) are more modern, but most, like Zepherine Drouhin (1868), Cecile Brunner (1894), and Perle d’Or (1884) are old garden roses. The fragrance is intense, with the classic rose scent of Maggie and the delicate bouquet of the New Dawn in magnificent bloom on the arbor at the walkway to the house and again over the front door mixed in with the Confederate jasmine climbing with countless tiny star blooms all the way to the peak of the roof.

There’s a place I can sit on the front porch where even in the daylight hours I’m almost invisible to any but a person with a keen and searching eye. I look out and see the herbs and perennials blooming to the arbor with all its roses and in the evening, the “welcome lights.”

Last night I saw my first firefly of the year and tonight, a hummingbird at the delphiniums.

Leslie Retires (Mercy and Justice)

On retiring, good to look at what you’ve done these past years…

Working together, from the Police Storefront to St. Joseph’s to the very difficult days at Emanuel Lutheran - evicted from the storefront, evicted from St. Joseph’s, then evicted again, this time from Emanuel (thanks to the manipulations of a minister and his doctor buddy) and all these evictions in the span of about 18 months! And through the whole sorry mess, working together to heal the sick and lift up the poor. Doing that before these times and still at it.

I’m not so much writing about your work with Cambodian refugees as I’ve written about that elsewhere, but why not a little more here? We worked together seven days a week, apartment to apartment, “my friend” to “my friend,” street to street. Extreme stuff, extreme situations, extreme effort and actions Lay Rith, “Grandmother,” Sang Van, the man with no face, Fitzhugh, San Jacinto, Carroll, Live Oak, Bryan, mean streets, mean apartments, crowded. Good God it was crowded! Sany, Meng, the man who died in the night, searching for a naked crazy girl, miscarriage, birth, death, New Year! Mattresses piled 5 high, curtains around the beds, Christmas lights, Kao Sanh, and then Tep Kim Suar and the refugee agency guy saying, “I can go maybe $200” (for the funeral), Parkland, Children’s, WIC, Food Stamps, children finding a dismembered prostitute in a dumpster and a (different) refugee agency guy saying, “Well, at least the Cambodians are used to that sort of thing,” Yuon, Mao, sweet Mao, Rann Soth Rith, Yan Sorn with her little white tennis shoes saying, “Yesss” and her boss saying, “See, she do too speak English.” You and Alison saving, literally saving 3 children (and the molester got life without parole).

What stands out more than anything, though, is the immense good you’ve done. The woman with rheumatoid arthritis crying silently. The refugee, nice guy, completely psychotic who is still to this day reaping the benefits brought by you. The man with cancer on his nose. Lines of people, 100s of people, 1,000s of people – literally – passing by you, Leslie at the desk! Burying people, driving people, having security called to “remove you from the premises,” battling, like some mythic heroine, against the forces of evil and inertia and just not caring. Bruised and bleeding for Justice. Investing in Hope. Helping students. "Maryam" – dying from breast cancer in that little apartment, with her cousin and her mentally ill brother and the psychiatrist saying why are you calling me? Diane, true heart, doing the heavy lifting on that deal. Valeria, with her new (pink) wheelchair. Names that can’t be named here – lives touched so deeply and even into generations. Entire families on Parkland HealthPlus. Karen man who, by the time his new leg arrived, was already gone. Someone’s brother, with AIDS and quite a collection of opportunistic infections, treated successfully and 7 or 8 years later, doing well. Elsie in a dirt-poor trailer, bad craziness, long hair. Guadalupe S., living in the corner house and her husband having a jalapeno taco and a beer for breakfast. Bills from Children’s, Baylor, places all over. Appointments – how many people got what they needed when they needed it! A refuge for the wounded. Teaching hundreds of people how to do mercy – and I swear to God, some will do mercy. And this just part of the past 10 years.

Complete dedication to justice, hope, doing good and guiding me to that consciousness and then giving entering into boddhisatva consciousness when you gave up the joy of doing good to work all the time for a milieu where others could do good. And doing a superb job of that, building the clinic, building a surplus, creating a financially healthy organization now poised to go forward to a new day.

"The King will reply, 'I tell you the truth, whatever you did for one of the least of these brothers or sisters of mine, you did for me.'"

Thank you to the many people who were and still are a part of this dream of mercy and justice. Martin, Allison, Pat, Jackie, Patrick, Meg, Mack, Dan F, Mary Ann, Vuong, Kelley, Aaron, Diane, Chuck Hudson, Jim Carvell, Kim, Tammy, Renee, Aletha, David Kemp, the Promotoras, and especially Nora and Mary – all these people dreaming dreams of the reality of mercy and justice.

And through it all, a great mother and wife.

I saw an expert on human behavior interviewed in relation to an incident where someone was hurt and no-one intervened. He said, only about 5% of people intercede in these and other situations! No wonder we’ve pissed of so many people!

10 days in the hospital

"Don't worry; be happy."

(Later I realized it was 11 days) Sunday morning I was showering, thinking about Sunday school and having deep thoughts like wondering if we would sing Happy Birthday to our teacher who just celebrated his 84th birthday. I began having some abdominal pain and when I finished showering, told Leslie I was going to skip church – which was okay, because I’d been in Houston the previous four days and spending the morning with Leslie sounded good. The pain continued to worsen and in a few minutes I told her I thought what I really I needed to do was go to the ER. So we saddled up and headed to Baylor. I checked myself in while Leslie parked and shortly we were headed into the labyrinth. The pain was considerable and much of what happened from here on is a daze and blur of disconnected events and memories:

• Abdominal exams that I don’t think were positive for rebound tenderness.


• Several times people asking the fateful question of does the pain go into your back?


• Gagging on the NG tube insertion and indicating that sure, I’d rather have the stiffer tube, for which I paid a price down the road.


• The surgery resident saying that she thought they needed to go ahead to operate and me saying, no, Dr. L would decide on that and the resident arguing with me, saying that Dr. L. only did colorectal surgery and me saying, we’ll let him decide what to do. Now I wonder how it was that Dr. L agreed to take care of me as he really is a colorectal, not general surgeon. Regardless, I’m enormously grateful.


• I kept thinking that I was going to end up diagnosed with cancer and have an ileostomy. But why was this all so acute? And wondering why no nausea and vomiting? Why no rebound? Thinking I knew enough to know that I didn’t know what was going on except it was bad – amazing pain with little relief from morphine. There was no doubt that I would end up in surgery.


• I remember saying to Leslie that I was glad she and I are current – no love unexpressed, no secrets, nothing undone.


• It would be a mistake to think that the main thing happening was fear of dying or cancer. Which is not to say I’m unafraid to die. I don’t know, but we’ll see. Mostly I was thinking about Leslie and me; I was thinking about David and the joys and difficult things we’ve shared; wondering about the etiology of what was going on; wondering how much impact all this would have on the rest of our life together; glad that Leslie is retiring in a few weeks; being grateful that we’ve lived as hard and well as we have.


• CT scan and the tech saying “Try to lie still.” “Uh-huh.”

At some point – probably Monday evening – Dr. L was standing by the bed saying that he needed to operate that evening. I was ready.

I know this is out of order and there are probably other mistakes and certainly there are omissions, but this not about the order of battle; it’s about the battle – two different things.

In recovery and critical care I was in a lot of pain, which the nurses and physicians managed very well. In fact, everything went well. I especially remember R, who had high levels of clinical excellence, confidence, and kindness. I felt very connected to her. I remember telling her something I learned in hospice – what a great thing it is when you can entrust your body (or that of a loved one) to someone with high levels of qualities like these.

The diagnosis as I understand it now (better Dx in a few days) was obstruction caused by a torsion of my intestine. Why it happened in the absence of adhesions or tumor is not known.

I went from the unit to the GI floor and again the care was good except maybe the first night (not sure on this – I could be thinking of my 2nd night in the hospital) when I couldn’t get the nurse to just bleeding tell me what she was doing/giving, even after I’d asked her to tell me. Every time I had to ask how much of what she was giving. I viewed it as controlling and marginalizing – “Your pain medicine” doesn’t cut it. But overall ...

• L was as competent and kind as R. She also quickly established the sort of collaborative relationship that R in the unit did. Her focus was always on how I was doing and what was best for me.


• M was always right there, always patient, always ready to explain and to offer encouragement – a good man to see coming in the door late in the night when I’m freaking out on Ambien, seeing malevolent colors and falling asleep now and then only to have truly bad dreams like walking into a dark room where I knew there were black mambos and having to keep on going or dream waking to realize there’s a lion in the bed with me, realizing it can rip my guts out with no effort at all. Calling for help and spending the rest of the night with lights on.


• M (the tech) who took stellar care of me, was kind and gentle, and who was always ready to seek opportunities to serve and learn – not exactly universal qualities.

And what can I say about Dr. L? He is a well-known surgeon (Chief of Colon-Rectal Surgery) with a reputation of brilliance. At some point I used the word competent, which is a compliment, but still, sorry, man. I’ve been around for awhile now and have some thoughts on surgeons. In many cases, all they can do is the surgery. I mean, it’s a Big Deal to cut another person’s belly or chest open and fix whatever is wrong in there. So competence or even excellence (as in an even higher level of skill or advancing the science) in that is often what you’ll get and it’s enough. A higher level is that plus skill in managing or preventing symptoms related to the surgery, because, you know, it hurts. A still higher level is all that plus the patience and kindness to support and explain and take precious minutes from finite time to do it some more. In this work there is never enough time, never enough resources, never enough anything. So, for your excellence, skill, and time, brother, thank you. And I want you to know that I too work hard to get it right and to be kind and patient. Hahaha – at one point he says exactly what every Cambodian tuk-tuk driver says, “Don’t worry; be happy.”

Leslie, my wife, the center of my life, my rock, my partner - always there, a true hard-charger.

I called Jeff, croaking around the NG tube, telling him what was going on, including waiting on pathology re esophageal lesion. He drove on down from Tulsa area “to see your face.” I don’t remember whether it was on the phone or when he was in the room, when he said, “Well, hell, the worst that can happen is you’re gonna die (and you have to that anyway).” Oh, good one man. I cannot imagine a more comforting thing to hear. “… know the truth and the truth will make you free” John 8:32. He stayed about 2 hours; it was a wonderful visit.

The pain was well managed, thanks to dilaudid via PCA and other meds via the nurse. I recall so clearly long ago several hospice patients who got great relief and some euphoria from dilaudid. I thought then I’d like to try it some day. It wasn’t that great for me, though. Maybe if I’d been despairing I’d have gotten more than analgesia. Larger doses via the central line in my neck (!) always gave me a jolt of nausea, but I learned that that passed in minutes, so quit asking for Zofran. Photo: CK looking good with on day of discharge

John came in for a few minutes. It was pretty emotional as he’s one of the ones who thinks I’m bullet-proof, not to mention the love and his own struggles.

A day or two post op they took out the catheter. Having it in wasn’t bad, but having it out was better. It was also good in that I was forced out of bed to stand swaying beside the bed urinating into the urinal. I was so loaded up on fluids that I was peeing every 15 minutes, literally, which got old after just a few hours. It was around this time that they gave me Ambien, to which I had the previously described bad reaction. Small wonder; other factors in the bad reaction included no food for days, poor sleep, surgery, anesthetics, dilaudid, the bleeding NG tube, just the whole hospital scene.

Ice ax up and across a steep snow field and finally standing alone on a high col (~12,000 feet) in the Wind Rivers, two days since I’d gone off trail or seen another person (and three days since I’d seen a tree) and nobody ahead of me for the next few days, glaciers all around, knowing then it was epic and now in this hospital room, thinking I may never be in a place like that again and grateful that I got to that col.

Finally, while Bruce B was in the room (“He can stay, he’s used to this stuff” - or not) the NG tube was taken out – unnghhh! Immediately I was feeling better, though my throat hurt for days (and still does). That evening I had a very good visit with Tom – thanks for coming by, man.

Nora and Anthony and Julio came to see me. Anthony and Julio were pretty subdued and later, while the nurse was taking out yet another tube I was telling Leslie about that. She told me then that Dr. B had died a few days before and maybe the boys were thinking the same might happen to me. My first response was to smile and feel glad about his life. What a man. 80 years old, motoring around the clinic all bent over like he was, going up the ladder in the pharmacy, taking care of patients almost every Saturday, focused, tough. Later I cried several times – the first time when I was listening to Oh God Our Help in Ages Past on the iPod. Though we were not close (I’m not a Saturday guy), Dr. B was always an inspiration to me. I know Bobbie will miss him deeply.

Finally all the tubes are gone and they’re wheeling me out to meet Leslie at the patient discharge place. Spring came while I was in the hospital, and though I didn’t really enjoy the ride, still it was pretty and green. Home! Photo: the view from bedroom window (cedar waxwings and robin redbreast)

Wednesday, 10 days later I awoke at home next to Leslie and listening to a mockingbird’s sweet song – followed by a cardinal's and in a flash of red, Mr. C landing on the feeder. I doddered outside to put the seeds on the feeder at our bedroom window.