March 30, 2007

Healing a Breaking Heart

It's rare that I truly heal anyone.

I am an ER doctor. My days (mostly nights, actually) are spent treating coughs and colds, patching wounds created by drunken falls and flying bullets, and battling off the inevitable progression of chronic disease.

Sometimes I get the feeling that some people expect me to be a healer, which I'm not. I can give you antibiotics to make an infection go away, but the medicine does the healing - not me. I can fix the nastiest gashes and cut open your chest and sew your heart back together, but almost all wounds heal with simply the prescription of time.

The one thing I feel like I can sometimes heal is despair.

An early-60's lady with breast cancer that had moved to her spine and pelvic bones came by ambulance to my ER last night. She said the pain in her pelvic bones and hips had been so severe the last several weeks that she wouldn't eat or drink anything for fear of having to walk to the bathroom. Last night, weakened by severe dehydration, she stood up and collapsed to the floor and broke her hip that already was being eaten away by cancer.

When I saw her, I first was struck by her lips - parched, cracked with several layers of dead grey skin that needed to be cleaned away before you could even see their natural pink. The next thing that struck me was how pleasant she was. This lady had every reason in the world to be pissed off and frustrated at her plight, but she was appreciative and nice and even may have let loose a slight smile.

Later when I talked to her about staying in the hospital to get hydrated and have an orthopedist take care of her hip, I realized there had been no family with her.

"Do you have family nearby?"
"I guess I do..."
"Hmm, what does that mean?"

I could sense a wave of disappointment in her at the recognition by someone else that she was dying lonely.

"Well, I only have a son left, and I've been trying to call him for a month but his phone message just says he isn't taking any calls. I had my neighbor try to call him and she just got the same message."

I can't describe the emotion that was pouring out while she was saying this. If you have kids you hope your kids will be there for you when old to return the favor of their life and childhood. I can't imagine the feeling of abandonment and anger when they are not. This is what she was feeling, and it showed.

"He has a 3 year old son too..."

I don't like people to emotionally hurt. I've experienced enough of it to know that misery, and it hurts me when people hurt like that. So I sat down in her bed with her, and I held her hand. And we talked...

We talked about her son, and her only grandchild. We talked about her mom and her dad that died in WWII. We talked about God, and we shared a short prayer that her suffering might be eased. We even talked about dying, and she told me she wasn't ready to give up yet even if it meant having to tolerate intolerable pain.

I spent way too long with her. But it was worth it. I think it helped her, and I know it helped me.

I assigned my social worker the task of finding her son and getting him to the ER. The local police found him in his apartment and had him with his mother within an hour. After he arrived, she smiled more than anyone I've ever seen with a broken hip.

Time heals, in most cases. But sometimes the burdens of disease make it impossible to heal the complicated social situations we encounter today.

Last night, I think I really healed. I healed a heart that was starting to break inside an already broken body.

If you have a mom or dad, call them, thank them, hug them if you can. They miss you more than you know...

Thanks for joining me for My Daily Spin.

March 29, 2007


Speak to me
your clarity,
and tell me the secrets
I need to make you mine.

Show to me
your curves,
and give me the strength I need
to endure your climbs.

Give to me
your sights and sounds,
and let me smell
the brilliance of your dew.

Feed to me
your energy,
and let me taste
warm rain on my tongue.

Take from me
my naivete;
in September,
our time will come.

March 26, 2007

ING Georgia Half Marathon Race Report

Yesterday was the inaugural running of the ING Georgia Marathon and Half. 15,000 registered runners packed the Atlanta streets on a warm day with race start temperature near 70. It was the largest inaugural marathon event in history.

Anna and I arrived in Atlanta Saturday afternoon. We went over to the Americas Mart for the race expo, and we were impressed! Aisle after aisle of vendors and sponsors. OMG the free snacks - Anna was in 3 year old bliss! I was a little surprised the expo closed at 6 - that seemed a bit early; but fortunately we got in and out just as they were closing down. Amazingly, despite 15,000 registered runners, I didn't have to wait ANY to get my race packet/number.

We shunned the traditional pasta pre-race dinner due to lack of any walkable kid-friendly options, and dined at a nearby Quiznos sub shop. The shop owner was incredibly nice, letting us stay an extra 15 minutes after his 7 pm closing time so Anna could finish. Thanks Quiznos guy!!

I woke about 2 1/2 hours before race start and went for a brief run, then grabbed a bagel and yogurt for breakfast. Then I sat on the balcony and watched downtown Atlanta come alive while stretching.

The race started at 0700, and it took me about 3 or 4 minutes to actually get across the start line. I was a little surprised that there were no corrals or staggers, but everyone seemed to move pretty well. I had given up on inching my way toward the front pre-race, and instead was in the middle with the 5 hour pacing team. So, the first mile was weaving in and out of thousands of people trying to find room to run.

After the first mile, I realized that my Garmin wasn't recording anything except time. I had set it for auto-laps at each mile, but I'm not techno savvy AT ALL, and well, I wasn't getting any distance info from it. Oh well, it became a funny looking watch...

The run was essentially uneventful. I just tried to keep a steady pace and practice hill management. I had never been on the course before raceday, but it was rather hilly. Nothing major, but some longish gradual inclines. With each hill I shortened my stride length while increasing my turnover, and that seemed to work perfect.

There was a large cheering crowd, and it was rare for there not to be someone cheering for you. I carried an American flag with me for the entire race, part of my efforts toward Operation Rebound, and that seemed to garner a lot of extra cheers from the crowd.

The final mile was about 0.6 uphill (ok, that one hurt a little) and the last 0.4 was a downhill sprint toward the finish. My chip time was 1:40:38, or 7:40 pace (275th overall, 85/1317 age group).

This was simply my long run for the week, but I was quite happy with my PR time (easy PR, since it's the first half mar for me). Most importantly, as I write this the morning after, I have a little calf soreness but no other aches or pains. Next race - Powerman Alabama in just under 3 weeks!

March 23, 2007


I realized this week that I'm not going to become an Ironman.

You see, I took the kids to the beach for a few days this week. We go a few times a year to Sandestin, on the Florida panhandle. It's an easy drive but a world away.

Although they are young, the kids feel ownership there. They've explored most of the couple thousand acres beachside and bayside. They know which is our table at Roberto's, the pizza place where we go at least twice each trip a couple hundred yards from the condo. They know every nook and cranny of the mega-playground also walkable from the condo. It's their place... No, it's our place...

I wish more people, moms and dads, had the chance to spend several consecutive days uninterrupted with their kids. It is an amazing experience. I'm talking EVERY minute of the day with them. I think that's a rather unusual thing these days to spend every minute of the day with your kid. The rewards are priceless.

My 3 year old Anna has recently learned to create and tell stories. Now she's heard me tell countless stories, always starting "Once upon a time." Hers always start "Once a little time..." I smile every time because she knows she is so right. Her stories usually are about mommies and daddies and little girls named Anna (surprise!). But she weaves into the plot monsters and tornadoes and houses and volcanoes. She gravitates toward destruction, which is 180 degrees contradictory to her sugar sweet demeanor.

And she always wants you to guess what she is going to say.
Today, she was telling us a story, "And then the su..."
And I'm supposed to guess the word she is going to say.
Me: "Sun."
Anna: "no, sunn....."
Me: "sunny"
Anna: "sunnd.."
Me: "Sunday"
Anna: "no, sunday..."
Me, now laughing "I just said Sunday..."
Anna: "Nooooo... sunndyday"
Me: "Sunny day?"
Anna: "Noooo... sunndyday"
Me: "It's not sunny day?"
Anna: "Noooo.... sunndyday"
Me: "I don't know then."
Anna: "Guess daddy!!"
Me: "I don't know what it is, what is it Anna?"
Anna: "It's sunny day!!"
Me: "But I said that a bunch of times..."
Anna: "But I didn't hear you..."

And the story goes on...

I had 2 occasions this week when I was struck with the idea that my life is absolutely beautiful.

The first was Tuesday when we were building a sandcastle just out of reach of the ocean's waves. There was no time, only the moment. The kids were quiet, each digging, pouring, and shaping the sand. There were people around us, but the sea breeze and the crashing waves drowned all other sounds. The only noise - wind, and waves. Kids working diligently, healthy and beautifully happy. Middle of a weekday when most people are sitting at a desk. And my thought - I'm here. This is where I've worked to be. I don't need anything else, because I have it all right here.

The second moment was of similar thought process but it occurred this morning when we were all in the hot tub. 9 am. Azure skies. Quiet. The only noises were the water jets and the kids' laughter. And my recurring thought - I'm here.

We often get trapped into always looking toward the future. Our goals for the future too easily control our lives in the present. But we can't shortchange the present or we'll end up with an unappreciated past. And you never know when the future will stop following the present.

On June 24 I'll complete an Ironman. But I won't change. I won't become an Ironman.

I realized this week that I don't need to become anything - I am everything I want to be.

March 18, 2007


I think I finally realized the source of my increasing fatigue.

You see, I am an addict.

There, I admit it. Now that's the hardest part, right?

And now since I've taken that first step, let me explain. I've battled this caffeine addiction for years. It started when I was in high school, innocently, with a sporadic cup. By the time of junior year I would go through phases of an entire pot of coffee a day.

In college, I was largely caffeine free, which I suspect had something to do with the fact that if I was drinking something, it was almost always beer. If it wasn't beer, I wasn't drinking it.

But since medical school, me and coffee have been best buds. There have been a couple of short-term caffeine-free phases, but none for several years now.

At the end of last week, I took a caffeine count. On average, I drink about 40 ounces of coffee and about 24 ounces of diet Mt Dew each day. WAY. TOO. MUCH.

I think my caffeine levels stay so high that any little dip during the day makes me feel tired. And thus, I declare myself an addict.

Friday morning I put it down. I finished my coffee, and that was it. Done. Finished. No more.

Saturday I felt awful. Slept the day and night away, and when I wasn't asleep I was a zombie. I didn't get the headache, but only because I was alternating tylenol and ibuprofen every few hours.

And then, this morning, I woke at 0800 and felt almost great. I've felt little fatigue, and I still haven't had a headache despite having no analgesics since this morning.

I'm hopeful that I can continue caffeine-free. It will help my training by letting me feel a more honest fatigue so I will know easier when to rest. It will help my wallet by avoiding all those damn Starbucks trips.

And it will help me, because I don't want to be an addict to anything.

March 15, 2007

Time Management

"You will face new challenges at each step along the way to becoming an Ironman."
This wise warning was offered to me by an experienced Iron(wo)man when I started this journey to Ironman last fall. And as I get further into this process, I understand clearer and deeper the significance.
The challenges come in many forms - the challenge of preventing and overcoming injury, of financing the sport, of finding the motivation to train when all I really want to do is sleep.
But the most immediate challenge to me right now is the challenge of time.
How do I find more hours to make increasingly large deposits into the Ironman bank?
When the sessions were rather short but frequent, it was easy to manipulate everything else to accommodate the training. But now there is little I do that doesn't require at least a dedicated hour, if not 2 or 3 or more. And it won't start to decrease until taper, which is still a long way away.
Last week Emma and Anna started soccer practice, and this has committed me to 5-7 hours a week previously (relatively) free. Tess started cheerleading - 1 1/2 hours a week. This is in addition to the 2 hours a week of ballet, the 3 hours a week spent sitting in carline, the 5 1/2 hours a week spent driving to pick up kids or drop off kids (to/from school, to/from their mom's house), the 42-44 hours a week that I spend teaching and treating in the ED.
As the family obligations stack and the training volume increases, the thing most easily sacrificed is sleep. But that's what I probably need more than anything to help absorb the increased training.
Many regard nutrition as 4th triathlon sport. For me, right now, I feel like time management is becoming just as much of a sport as the swim bike and run.
I just need to find more hours somehow. And more sleep.
Thanks for joining me for My Daily Spin.

March 14, 2007

Blogger Lunch

Mr. Blogger ate my post. Grrr.

March 12, 2007

Spring Haiku

Blue skies and warm sun,

No more chill to keep me caged.

Now it's time to ride.

March 9, 2007

About Me Changes

My "About Me" needs to change.

No, I won't admit to having changed. But my environment has changed, and I can definitively say that I am happy with the changes.

First, I've reached a kid milestone - they all are out of diapers! My youngest finally has graduated to the underoos. No more wet wipes, no more late night trips to Publix when I realized at their bedtime that I had used the last pull-up, no more diapers to pull from the washing machine when someone decided to help with the laundry, no more little swimmers, no more... Diaper free!!!!

Second, I no longer can claim to be trying to learn how to swim. Know what?? I know how to swim! When I was first introduced to this triathlon thing back in July, I had never once swam a lap in a pool. Never. My first sprint tri included a 600 yard swim, and I was doggie paddling/back floating for about 3/4 of it. In January my longest non-stop swim was 750 yards. My long swim this week was 2000 yards straight. 2000 yards!! I'm certainly not fast, but I'm steady. And last time I checked, steady finishes.

Finally, I must admit that I'm starting to enjoy running. I've always been a decent runner - I could do a 5k with no training at any point in my life (although I rarely did). But I always have hated to actually run just to run. But it slowly is growing on me. I think when I ran without a real purpose in my non-training life, I would always run at the same speed and about the same distance over and over and over. I could never go farther, because I would run too fast. Long runs, tempo runs, interval runs - all foreign concepts. Now, I know I can run slow if I need to run long, and that will help me run fast for shorter distances. My favorite runs now are the mid-distance tempo runs - not too fast, not too slow, lots of ground covered.

Time passes no matter our reaction to it. We can exist, or we can live. We can stagnate, or we can train.

Little things like learning to use modern plumbing are just as monumental to me as swimming for more than a mile straight. It's progress. And progress lets me know that I'm not just existing, I'm living.

Thanks for joining me for My Daily Spin.

March 7, 2007

Bike Crash

Can you imagine the adrenaline surge just before the frame snapped!!!???

March 5, 2007

One Step at a Time

Life doesn't happen in leaps and bounds. It happens one step at a time.

That little idea kept creeping into my mind yesterday when I took 10 miles worth of little steps on the treadmill.

10 miles running for me may as well have been a marathon this time last year. And I never, not for a second never had a thought of it wasn't even considering it, would have thought that right now I would be running 10 miles at a time, and 25 miles a week. Not to mention cycling for 30 or 40 miles at a time and swimming a mile at a time. Unthinkable.

Someone at work last night was talking among a group of us about running, and he said that "5 miles is nothing when you're an Ironman like DV..." Wow! Even though I am not, not yet anyway, that was the first time I received this nod of Ironman respect.

You see, Ironman is about more than the distance. More than about the 2.4 miles, the 112 miles, the 26.2 miles. The distance is the leaps and the bounds.

But Ironman is about the baby steps. It's about putting one foot in front of the other consistently, and routinely. It's about learning how to swim without a lesson, and then practicing for hours on end until you are swimming straight mile repeats. It's about finding those 10 or 12 or 15 hours a week to train when you have no extra hours to offer. It's about accepting that even though today's training session was crappy, the fact that there was a session today means progress. It's about tossing the superfluous and embracing the necessities.

It's about doing what you believe in to become what you don't know if you are.

It's like life.

And life doesn't happen in leaps and bounds. It happens one step at a time.

March 2, 2007

I Believe

I believe that falling repeatedly makes me a master at picking myself up.

I believe that before every training session I have the choice of being a coward, and going home, or being an Ironman. Coward, or Ironman.... Coward, or Ironman... It's been a long time since I skipped any training.

I believe that the things we appreciate most are earned through patience, perseverance, and sweat. Keep your gifts; I'd rather work for it.

I believe that expression is the most underrated quality of a person. I marvel at a person who, unlike me, can do it consistently, clearly, and concisely.

I believe the children are our future. Teach them well and let... (oops, got carried away... uhm, no, I will not admit that I actually know or like this song. All apologies, Whitney. And remember, crack is wack...)

I believe that newly-learned techniques and movements proceed at lightspeed, until they become habitual, and then they proceed at snailspeed. Minor tweaks with major results always happen at snailspeed; never at lightspeed.

I believe that the more I hurt when training, the less I will suffer when racing.

I believe that given the opportunity to walk away or persevere, there will be a time when I am so weak and weary, so tired and hungry, that I will consider the former, but choose the latter because I have chosen each day to be an Ironman, not a Coward. An Ironman, not a Coward...

I believe.