Friday, June 19, 2009

MasterCard Moments

The sun in heaven methought, was loth to set, but stayed and made the western welkin blush. By my buddy Bill er…Shakespeare. I love running with the setting sun. Much of my time on the high school track and marathon training encompassed these hours when Earth seems to expel a long sigh before nestling in for night. The madness of man slows, children are hauled unwillingly home to sup, Maui, warrior-god, extinguishes sun in sea and Earth reclaims herself. I arrived to a honking fanfare, geese heralding the hour, as birds are wont to do. I run year round at a small reservoir, excepting when snow drives a lioness from the high country to prowl its banks and circumferential dirt track. “How do you know it’s a mountain lion?” Herb asked one February. “Look,” I squatted over its tracks. “See how round these pads are? The entire print is round. And, no toenails.” I nearly covered the print with my palm. “That’s a big cat,” I brandished my palm at him. “Look at this dog print.” I pointed to well defined tracks in mud. “See how narrow and long it is? See the shape of its pads? Plus… toenails. Keep running,” I rose and started again, “I’ll show you her cub.” We stopped to examine a pile of poop. “This is probably coyote scat, see the fur? If there were no fur, I’d say it was dog pooh. See how it’s pinched at the ends? Some of these larger dog tracks are probably coyote.” We continued our jog. “This is probably mountain lion scat. It’s more round than dog and coyote, it’s segmented, there’s fur in it and the ends aren’t pinched." “How do you know all this?” Herb was incredulous. I shrugged, “Coz I spend time in the mountains. Here’s the cub.” We stopped for a small, round paw print that remained untrampled by frenzied dogs. “That makes her super dangerous, if she’s hunting to feed a cub. So I don’t run here alone during the winter, unless it’s bright and mid-day. This is the second winter I’ve seen her tracks.” “Have you seen her?” “No, thank God. I figure if I see her, I’m a mountain lion morsel.” “Have you called Fish and Game?” “I did last year but they were only interested in sightings, not tracks.” That the reservoir abutted a high school seemed of little consequence. Guess that’s just deserts for intruding upon their habitat. Aren’t you gents just a little tardy gettin’ outta Dodge? I addressed the ganders and their flock telepathically in my first quarter mile. As if in agreement, with a rush of flapping, splashing and squawking, they began a short run-on-water that reluctantly released them to the sky. Directly in their flight path, I froze. Wet wings beat a painfully low trajectory. Would they clear the small cliff at the western lake lip? Will they clear me? Two boys fishing from the ledge turned to grin before giving full attention to the low-flying bodies. In-coming! Like zeros on-approach for strafing. The cacophony grew with proximity and pitch. Fighting the urge to duck, our heads turned in unison with geese overhead and then beyond. They circled once, as if synchronizing watches and truing their compass. Tightening their formation, they honked a flight plan en route to a north-north-westerly summer holiday. I watched until their calls faded and formation disappeared, imprinting everything the moment held: Earth washed in burnt umber, the western welkin softly aglow, insects hovering in curtains over glassy water disturbed only by feeding fish. Oppressive heat released its grip on the day and I too, sighed. A southbound airliner, glinting gold, dragged a short con-trail and my thoughts back to running. Another quarter turn round the pond and I surveyed the small inlet where four adults – two couples with six goslings glided in the gathering gloam. Are their hatchlings early or late? No matter, now they would surely stay several months before a not-so-northern latitude beckoned. I thought, and not for the first time, about mates for life. Geese are one of sparingly few animals that mate for life, a long life. In stark contrast to certain insects that mate for a life that ends even as they copulate, bringing new meaning to the words: till death do us part. All of it swirled in my head as I lapped my Walden Pond thrice more and arrived home moments before nightfall. In listening for the knock of the Eternal, dawn and dusk have always held some magic for me, a glimpse through an open doorway, if you will. In seeking connection to the Eternal, running with the setting sun is a sure bet. In having a life fulfilled and one I love, recognizing and replicating such moments are… priceless.

Saturday, June 6, 2009

Déjà vu or Vu jà-dé?

I bolted upright for a coughing jag that produced little but wakefulness. Reaching for inhalers, I heard myself wheeze. Never a bad time for petting, my cat jumped into bed, hopeful. I coughed again and listened to air rumble through mucus-plugged passages long after I stopped exhaling. My bronchial tree literally dripped and oozed in excretia that suffocated, like Spanish moss on deep swamp cypress. I inhaled deeply and coughed forcefully. The wet rattle should have produced gobs of goop. I sound like one of my patients. “Cough,” I encouraged them, “Harder! Cough that stuff up!” It sounds like such an easy fix, moving mucus from bronchioles to bronchus where it can be hawked up and out. I had no such luck; try though I might. In that moment, I saw my end. Ever experience déjà vu; that compelling sense of: I’ve been here before? This was vu jà-dé, the antithesis of déjà vu and presentiment of: this is where I’m going. In the stillness, solitude and silence of the predawn, within the dim dome of a single bulb, I suddenly saw myself: a tiny old woman, ribs protruding, racked by cough. Death by pneumonia; the most common death for seniors. And why not? “If you can’t sleep because you can’t breathe," I advised, "Or if you are afraid to sleep because you’re afraid you won’t breathe, you need to come in.” Well versed in sleeping upright during periods of respiratory distress, I knew the subjective difficulty in deciding when to seek medical attention. I attempted to give my patients an objective measure, a line drawn in the sands of seeking help. After two consecutive days of listening to my barking cough and raspy voice, Dr. Forrester slapped down his pen to ask pointedly, “Have you seen a pulmonologist?” “Five today,” I croaked, grinning. “Would you PLEASE seek medical attention outside your own cranium?” he pleaded. His fatherly advice was welcome and wise. “This is always the dilemma,” I spoke in a halting, hoarse whisper, “When to start steroids? My peak-flow-meter is up 30-points so I think I’m getting better.” “Wait a minute. Didn’t you just say you slept upright last night, for the first time?” he asked. I nodded silently, resting my vocal chords. “You’re not getting better, you’re getting worse. Start your steroids.” I never think clearly when asthma flares. My excellent deductive and diagnostic abilities are inversely proportional to mucus production. For this reason Kaiser has a policy contrary to the adage, Physician, heal thyself. Were I my own patient, I would chart: dysphonia, laryngitis in the vernacular. “I think it’s the propellant in my inhalers,” I said. “This only happens when I’m using my inhalers every three hours.” My physician friends disagreed, shaking their heads, “No, it’s your asthma.” “But I never used to get this way!” I protested. During the last decade my asthma worsened or I am less resistant to its predictable cascade when I entertain a respiratory illness. I say entertain because I am a reliable host for a solid month to a series of sleepless snoozes, the song of sleep deprivation, the dancing bacterial follies, a chorus of antibiotics, and curtain calls to a protracted standing ovation by salvation steroids. That’s entertainment! Emailing one’s doctor daily can purport and support a false sense of wellness. He wasn’t here to hear this… the gurgle so aptly named the death rattle. Sequential nights of coughing fits interrupted by succumbing sleep had wrung all resistance from me. I fell back to my pillow and closed my eyes. I would wake up in the morning… or I wouldn’t. I would open my eyes to my oak tree appliquéd against the sky… or not. Either was okay and no one would know the difference until I was missing from work. The feeling of apathy, complete and utter apathy was astounding. I emailed my doc in the morning and requested a visit: This is day 12. I need better meds for cough suppression. I have bilateral subconjunctival hemorrhages from coughing; I look ghastly and feel worse. Later that morning, he examined my eyes, ringed in vermillion. “You look pretty rough around the edges,” he shook his head. “How long has your voice been gone?” “I think today’s the fifth day.” I proffered my theory of dysphonia secondary to inhaler propellants. “Not your inhalers,” he disagreed, “It’s caused by inflammation of your entire bronchial tree including your larynx.” He stretched my steroidal course an additional week and prescribed narcotic cough meds. “Maybe you should have someone that you check-in with daily,” my Mother proposed, worried and helpless in her island home two-thousand miles away. I had never been so sick, never mucus-trapped to that degree, it scared me and I said so. A daily telephone check-in when I’m sick. It’s a sound plan and one I resist, as if it signals the end of an era of independence toward something more… dependent. I hear the longing you have now for a deeper sense of connectedness and interdependence, a friend wrote. Nuh-uh! I have an automatic way of being called: I do by myself. It is the conversation of a two-year-old. Life does not go well when she rules. In the evolution of man and society, women have never survived independently without a man or tribe. That we do now or think we can… is an illusion. We are pack animals by nature and no different from the days of Christ, we still live in tribes. The two-year-old has grown into a content cave woman. Connectedness and interdependence rise solely in my recognition and disassembly of that which keeps me isolated. A vu jà- presents a jarring opportunity to assess one’s course. I have some years before I am that tiny old woman with protruding ribs, racked by cough, and apathetic to the sunrise. I am 2400 air-miles from my tribe and I am surrounded by kin. I can live alone on the ice flow or join the clan. Welcome to the human race for the grave, one that perhaps produces something meaningful on its way and in its wake. What we remember with relish in the stillness, solitude and silence of the predawn, within the dim dome of a single bulb, will not be our acquisitions but undoubtedly, those relationships of deeper connectedness and interdependence. The richness of life pre-packaged in meaningful relationships.