Dreams

She has said to me within the last month.....

" Where is my typewriter? I need to "clip off" some letters to people."

" I'd love to get back in the classroom again to teach."

" I'm thinking of asking [them] if I can put together a Christmas choir but wouldn't want to start something I couldn't finish."

"I know you've had such a rough day at work; could I fix you a nice meal tomorrow?"

I don't say much, just listen and acknowledge. In some ways, it may be healthy that we never give up our dreams for if we do, there is nothing.

Irregularly Irregular

The "irregularly irregular" rhythm of atrial fibrillation is one of the most common abnormal rhythms of the heart. Caused by the erratic firing of the cardiac conduction system and unpredictable patterns of capture, the heart rate and rhythm is disorganized and difficult (or next to impossible) to tame. The beat may be fast or slow but always characterized by its own whimsical pattern, totally indifferent to consistency. This particular heart rhythm stands as a metaphor for life in general and the practice of medicine in specific. Predictably unpredictable.

This has certainly exemplified my experience with Medicine and I'm routinely reminded whenever I live through another four day tour of duty as the on-call physician. Friday night and Saturday were a breeze with long times of quiet, work that flowed in an orderly sequence, and a clear sense of planning, purpose and outcome. Sunday was the polar opposite; hellish, disorganized and punctuated by three separate trips back into the hospital. There appears to be no pattern and no way to predict much like this "irregularly irregular" heart rhythm. This weekend might have been insanely busy from start to finish or could have been the reverse, or some combination of the two. The day of the week, the time of the day, the month of the year matter little. There simply is no predicting although some people attribute the variability to cycles of the moon. I do not agree. Cyclical oscillations would impose a pattern on this energetic giant and that's simply not the case.

Recovering today from my four days and nights "on", I'm emotionally tired, cranky, and frustrated by the reoccurring realization that when things go smoothly in medicine, that's the miracle. It does happen. Sometimes. The norm is so much less glitzy than a scene from "ER" or "Grey's Anatomy". A TV show depicting the plodding struggle of a large land turtle making its way through wet sand (or jello) would be a more accurate depiction of what it feels like to function in the trenches. No one would want to watch this sort of medical drama and who could blame them? There is often little that is really exciting. Usually it is the hum drum punctuated by moments of adrenalin rush and extreme sadness as we struggle to understand, intervene, perhaps fix things before they go seriously awry. This is likely NOT a comforting thought to readers and I must emphasize that these are my feelings, honed by 30 years in the profession.

The amusing part of life in Medicine (suspect it is true for all professions but would love to know) is that just when you think you've seen or heard it all, every possible combination of insanities, you have not. Hear me again: have not. Another scenario breaks on to the scene carrying a new twist unlike anything experienced before. I have several examples from this past weekend alone. I will never get to the end of SNAFU and FUBAR. I suppose the beauty of this "irregularly irregular" pattern of permutations and combinations is in warding off boredom and a sense of complacency. The undertow lurks just beneath the surface ripple.

Attempting to tame the beast who will not be tamed, I become evermore frustrated. Ironically, the patience for the irregularly irregular beat shrinks with each passing year. I truly believe that the new, younger generation of doctors are better equipped to accept the constant chaos. I used to go with the flow and ride that wave with more grace and agility once upon a time. Where the youthful frenzy and enthusiasm for the ride went, I know not. I am no longer willing or able (as we often say in this field) to "bend over and spread 'em."

I'm drawn in by The Great Gatsby quote, the final line of the book when Fitzgerald writes; "so we beat on, boats against the current, borne back ceaselessly into the past". This desperate attempt to control that which cannot be controlled, a super heroic effort to fight the undertow beneath the wave is an exercise in futility. I realize from a deep place of knowing that my time and efforts in this most noble of professions draw to a close.

Cour d? Lane

My daughter is off on an overnight camping trip with friends from school; "somewhere in Idaho, Mom". She's driving herself and three others from Spokane with tents and sleeping bags and they plan to meet up with several dozen other students from her "Business Fraternity" for their annual camping event.

She knows by now that a retort like that about "somewhere in Idaho" will be followed by a merciless list of questions on my part, especially when I learn that she can't let me know when she arrives "cuz it's out in the middle of no where". Admonishments by text message stating, "don't drink" were followed by responses like, "don't drink where?" which translates to an agreement not to drive while under the influence but leaves open the possibility of drinking at said campsite. Ahhhh. Deep breath in; deep breath out. Then, my mind drifts to the next adrenalin fix as I consider the typical association between camping sites and bodies of water (and drinking); another ominous mix. So, I texted her again with a second admonition, "promise me you won't do anything involving water; water and drinks are as bad as DUI" to which she responded, "Yea, I won't go in water."

The best part was her text to me: "check ur email". She had promised to forward me the driving directions she'd be using to navigate to the campsite so that I'd have some idea in what general area of the great state of Idaho she might be pitching her tent for the night. I've learned that it is northeast of the delightful township of "Cour d? lane". Looks like the apostrophe key morphed into the question mark key on this keyboard and the proud city of Coeur d'Alene has a new American cousin. Gotta love it!

Directions to the campsite
1. Take East I-90 towards Cour d? lane
2. Keep going past the city towards Kellogg
3. Take exit #43, Kingston/Thomson pass (if you make it to Kellogg you went about 10 miles to far)
4.-6....etc etc.... (I omitted the boring in between details)You will see signs that say campground, DO NOT FOLLOW THEM)
7. Pavement will end. Drive slowly and watch for potholes (they?re really hard to see).
8. Its 5.2 miles in on the left from the left hand turn. I will post a sign for you all to see. If your car is low to the ground you may want to leave it on the road. Good Luck!!!!

Oy.

Preparing for BlogHer

Designing, ordering and anticipating the distribution of these blogging "business cards" are signals to me that this blogging stuff is more than a trivial interest of mine. This post today is # 170; I never considered that there would be fodder for more than a dozen posts back in August 2007 when I launched with thoughts about my Triathlon experience. That I'm also signed up for a three day weekend trip to San Francisco in July 2008 for the BlogHer Conference is another tip off that this might be something serious. Mary Margaret attended the BlogHer conference last year in Chicago and shared with me the importance of having cards to pass out. That would make sense; what a great way to get the word out there. MM didn't have cards to hand out last year but she does this time around so we're both prepared and, I might add, very excited about attending the conference together this summer.

Blogging my random thoughts on Ahead of the Wave has always felt like practice for something else but for exactly what purpose remains a mysterious, undefined entity right now. This feels exciting. The new title, Ahead of the Wave, energizes me. At once a metaphor for my life, I also appreciate that the title offers so many possible interpretations. Some days staying ahead of the wave is easy and the energy harnessed from the powerful force exhilarating. Other days, steering the course is exhausting and scary. The ominous and ever present feeling that I must look over my shoulder to keep my eye on the wave represents another facet. But, to balance that dark interpretation is the knowledge that the wave is eternal and infinite energy, a force so powerful that it emanates from the Source.

My thoughts carry me in many directions today with imagery of the wave. Waves come in many forms. In Aruba, the gentle roll of waves pressing towards the shore at Baby Beach contrast with the roiling foam of sheer force that pounds the northeast coast. From ripples to thunderous momentum; they are all waves.

A Feather

This post makes me very sad; I'm not quite certain I should be writing about these thoughts but have decided to push the boundaries a bit. An issue that never strays far from my awareness; these thoughts are always close at hand.

Let's start with feathers. I don't often see feathers on the ground when I'm out and about. Spotting one is surprisingly rare, even when I walk in the park, perhaps because my gaze is higher and not so close to the ground. When I do happen upon a lone feather, I startle inside and think, "Oh no, not yet, not now, not this feather.....". My thoughts immediately go to my Mother.

Why? Because, once upon a time several years ago Mom told me in a flight of fancy that when she was "gone" she would send me a message from the beyond to let me know that all was well, that her journey was fine, and that she was OK. This is so like Mom, always concerned about letting family know that the destination has been reached safely. Her communication, she explained, would take the form of a feather. There were no other details, just a feather. I doubt that she would even remember this conversation were we to discuss it again. And yet, I'm so tempted to confirm, to seal the deal, to re-establish that promise between us.

These days the mere sighting of a feather invokes a burst of adrenalin; I wonder where Mom is and if she's just sent me her message. I experience an overpowering urge to call her on the phone to find out if she is OK.

I'm trying very hard to explore and embrace the concept that all of life is energy, at one with the the Divine. When we change from the form to the formless, our consciousness lives on. The opposite of death is birth. Life has no opposite because it is infinite and limitless.

Postmortem on Ivanhoe

Last night was great; I was able to WALK to my book club meeting although the gusty, cold wind and raindrops had me wishing that this crazy weather would take a hike. I was determined not to default to the car and made tracks on foot in record time getting there about ten minutes early. The evening was fun; eight of us met to enjoy wine, dinner, dessert and good conversation about books in general and Ivanhoe in particular. I didn't feel too bad that I hadn't finished the book; only three had read it cover to cover but those three gave it a great review. Apparently there is a break point where one gets into the flow of the story and cannot help but finish. That point must be somewhere after page 89. A compelling romance, an adventure tale, a view of medieval 12th century England all in one. Maybe I'll re-tackle those pages and see for myself. The PinkMonkey.com pointers on Ivanhoe (see Ssshhh), paid off. No one else had used this site but had logged on to Wikipedia instead for their overview.

Sir Walter Scott wrote Ivanhoe in 1819 and has been described by some as "the father of historical fiction". He was a prolific writer, penning some thirty books during his lifetime. Ivanhoe is his most famous and remembered book. If literary types (Gillen D'Arcy Wood) state that " [Ivanhoe] had a tremendous impact on the revival of Victorian interest in the Middle Ages, and this fascination with the age of knights and chivalry has lasted into the third millennium", I had best pay attention.

I'm tempted by Ivanhoe, the movie, from 1952 starring Elizabeth Taylor, Joan Fontaine, and Robert Taylor. The BBC has a more contemporary made-for-television version which sounds interesting too. Maybe I'll soak up Ivanhoe passively and save my reading eyes for this growing pile of books on my nightstand.

A Teenager No More

As Laura celebrates her 20th Birthday today, I had a (brief) twinge of sadness musing that the teenage years, that triumphant (?) rite of passage speckled with intense highs and lowly depths and a whole lot of just plain living, growing, maturing, and the acquiring of savvy, have drawn to a close. Chris passed over to the other side (of being a teen) several years ago but the event never hit home until my last child was in the same position. I am now the parent of "twenty-somethings". That must make me old. Face it.

Thursday April 21, 1988, a date burned into my soul, is the day Laura Ann arrived on the scene, ready to fill our hearts with the joy of her energetic spirit. I knew this gal meant business early on. Striving to be out in the real world long before she was ready to draw breath, she pursues life with an energetic fervor that leaves most of us in the dust. She never ceases to amaze me with her fortitude and tenacity for personal goals, her quirky sense of wit, and her passion for living each day to the fullest.

Laura, I remember when you were but a wee one strapped into an infant seat. I thought at that tender age, I could leave you on the floor in that silly seat while I turned my back to tend to something else. So eager to be free of physical barriers, you quickly figured out that core muscles were your key to freedom, of sorts. It wasn't long before you were able to twist those lats and and flip yourself and that pesky seat 180 degrees. Once you found yourself on the floor, face down with a plastic infant seat strapped to your back (the turtle image is burned in my memory) you weren't quite ready to crawl but you were able to let me know of your displeasure with being "held back" by that dumb seat. It was your time; to be held, to be fed, to play but never time to just sit and watch the world go by. Some things never change my love.

Hoping you have a wonderful 20th Birthday!