Tuesday, December 13, 2011

Falling for Portland - Thrice

My conference began Friday evening, leaving the entire day to poke about Portland. The Rose Garden had been recommended.
“You’re a week late,” the concierge reported, “They dead-headed the Rose Garden last week; it’s nothing but stalks now.” 
Plan B: The Columbia River Gorge is of great interest – but I didn’t have a car (yes - I could have rented) or companion. I thought the Columbia River Gorge should be shared… so I saved it for someone. I may never see it - and I didn’t want to see it alone.
Plan C: I dressed for winter – wind-block, fleece jacket and scarf – and left in search of a Chinese congee breakfast. Congee is the ubiquitous rice porridge of Asia, the equivalent of oatmeal in the West. Cantonese call it juk (pronounced jook). 
A Chinese dragon slithering down a wall stopped me in my tracks 30-paces beyond its perch. I retraced my steps and entered. The DragonfisH serves dim sum during lunch but an American breakfast. Bummer! I had their Asian, vegetarian omelet with Shitake-shrooms, green onions, tofu and stiff coffee while scouring the map and planning my day.
Portland’s is located at the confluence of the Willamette and Columbia rivers. The mighty Columbia divides Oregon and Washington states. Portland’s downtown is divided into five sections: Southeast, Southwest, Northwest, North, and Northeast. The Willamette, a tributary of the Columbia, divides Portland into its east and west sections. Burnside Street provides the north/south dissection.
Buddy Keoki knows I am an avid reader. I usually (and currently) read three books simultaneously. 
“You have to go to Powell’s bookstore,” he recommended, “You’ll LOVE Powell’s bookstore.”
I located Powell’s Books on the north side of Burnside Street and circled it’s picture on the map. Columbia, the outdoor apparel and product company, located one of only three stores nationwide near my hotel in the SW sector. Mountain Hardware - a favorite gear brands - is next door. Sooo excited! I circled them both. Northface, REI, and Keen are located in the NW sector.  All, by the way, are located along Fareless Square, that free-zone encompassed by MAX, Portland’s light rail and bus line. I planned to walk but knew if the hour got late, I could hop MAX to the Hilton.
I began with an after breakfast stroll through half of South Park Blocks, a nine-block park located at the southern end of the SW sector. It was cool, a nearby digital display flashed 48•. Old trees bent gracefully, their leaves beginning the annual trek across the color-wheel from green to yellow, orange, peach or red. Bronze statues of the famous and fallen dotted the park: Martin Luther King, Abe Lincoln, Bobby Kennedy.  Their loss felt weighty and all the more oppressive under gray skies.
My first foray was into the Columbia store where I spent 90-minutes, learning about new fabrics and ways to keep warm in winter. The great thing about company stores like this is their salespeople - who are schooled and knowledgable in the product line. It’s like buying an Apple product at the Apple Store versus big box. Big difference! Back to keeping warm in winter: Omni-Heat® Thermal Reflective helps regulate your temperature by reflecting and retaining warmth your body generates. Columbia’s new fabric Onmi-Heat® looks to be lined in tinfoil - titanium actually. It provides warmth without bulk. No more Michelin Man fashions!
“It’s all engineering,” Fred said the previous night. “These new fabrics; it’s all engineering.”
I am always in the hunt for the ideal travel shoe. My constant traveling complaint is packing more shoes than clothing: running shoes, sport sandals, dress sandals, pumps, and slippers (flip-flops) - the flowered, Aloha ones when island bound. 
At Columbia I found a sporty, low profile, approach shoe: a light-hiker good for trail runs and limited street running. A new heel-cup design allows for the low profile while the sole is stiff, sticky rubber for schmearing rock - and they’re ooh-la-la chic. Ka-ching! Score! I learned the latest in trail-running-shoe technology and sprung for a new pair as my Salomon’s have holes. 
“Is that an Arcteryx pack?” I carry a small backpack when traveling. It fits nicely beneath an airplane seat and usually holds my laptop. I purchased it on clearance at REI in Seattle - the best place in the world to buy packs. I’m just sayin’.
“Uh-huh,” I nodded.
“Nice pack,” he said.
Eventually I meandered next door to Mountain Hardware where I learned that both Mountain Hardware and Sorel are subsidiaries of Columbia. I didn’t know that; did you? (I apologize to the non-gear-heads amongst you.) 
“Is that an Arcteryx pack?” Okay - I have NEVER been stopped for my Arcteryx pack - EVER. 
“Uh-huh,” I nodded.
“Good gear,” he said. He was a long and lean, Japanese man - over six-feet tall. Peering from behind John Lennon glasses; his smooth, black hair was pulled, Samurai-style, into a spiky top-knot. He was willowy and striking with an engaging smile filled with piano-key teeth. What a handsome kid!
“You oughta know,” I said, “You guys make the best gear.”
“That’s very kind of you,” he said, almost blushing. We fell into conversation and he was complimentary of Sacramento, having visited once.
Just then the lead in my favorite mechanical pencil exsanguinated and expired. I consider this a minor disaster and referenced the map for a store of genus-CVS. Eventually deciding my pen would suffice, I tarried forth though not without pencil-perseveration and angst.
I made my way to SW 10th Ave. and walked north to Powell’s Books, three-stories of new and used books. Y’all know I LOVE used bookstores. My heaven will be a used bookstore with Starbucks attached, the fragrance of roasted beans mingling with the musty scent of old and cherished pulp.
In a recent conversation about Steven Covey’s book, The Seven Habits... I was critical. “I think we can all agree with his premise but he gives you no access to change. He gives you lists but no access. One of the real strengths of Landmark is it gives you access to real and lasting change by providing insights into beliefs and behavior normally hidden from your view.”
“Have you read Pema Chödrön?” Keoki inquired, “The Buddhist nun?”
“I’ve heard that name but no, I haven’t read her.”
“Pick up one of her books,” he said, “You’ll like her and she gives you access.”
Seeking Pema, I climbed the broad, wooden stairwell to Powell’s third floor. Steeped in the smell of books - a stranger finds comfort in a strange land. I purchased a small book, Practicing Peace in Times of War. It is excellent and Keoki was right, Pema provides access. 

With great effort, I pried myself from Powell's and hoofed it cross-town to visit REI, North Face, and Keen, finally turning toward my hotel at 4pm. Daylight waned, temperatures dropped, and trees brightened with strings of white lights. It was so very festive with the feel of Christmas in the air.
I strolled along North Park Blocks, a six-block park in the NW sector of town before making my way back to SW 10th Ave.
A beautiful, brick edifice consumes the city block at 12th and Burnside: HW Weinhard Ice & Power Plant. I remember drinking Henry Weinhard’s Private Reserve  while living in Alaska. 
The backfill: It all started in 1856 when Henry Weinhard, a German brewer, arrived in the Pacific Northwest. His brewery prospered, diversifying into root beer to survive Prohibition. Today Henry Weinhard’s is owned by Miller Brewing Company and Brewery Blocks, occupying five city blocks at Burnside, still houses Henry’s Tavern. 
There was a hint of sadness in the soot stained, red-brick smokestack against an evening sky, a silhouette that harkens to an era past. It tugged and gave me pause. Masonry and brickwork are virtually lost arts though we are seeing a resurgence in newer freeway walls. I leaned against the building across the street, stopped in thoughtful appreciation.
I passed through the old, industrial area of the city, cobbled streets turned niche boutique. Old loading docks hold tables and chairs for outdoor eateries and she-she boutiques fly banners from abandoned hoists. A computer school and its 40 cycling students found its home inside an old warehouse. A Cadillac drove by with the smacking, sticky sound of studded tires against cobble. Snow season must be upon Portland.  
I walked leisurely and reminisced on the cities I have explored solo: Hong Kong, Denver, Seattle, Cleveland, Chicago, New York, Santa Fe, Portland, and probably a few others I’ve forgotten. While I welcome company, my full day foray into outdoor-gear shops would have been intolerable to all but a very few of my friends. 
I returned to my hotel to freshen up for my dinner meeting.
Ya know how I always seem to land in the right place at the right time? Remember my recent Chicago diabetes conference when happenstance had the conference moderator, a highly respected and beloved endocrinologist from UC San Diego, join my lunch table? Not one to miss an opportunity, I spoke with Dr. Edelman about disease reversal. 
“Well obviously, we have to do it,” he said. He shared successes and failures. “Run it for five-months. When you’re trying to change habits as ingrained as eating, you’ll have better results with a longer program. My best results came from a program that we ran for five-months.”
Upon my return I called an endocrinologist to share his information.
“I had lunch with Dr. Steve Edelman.”
“Oooooh.” Yeah, like I said, respected and beloved.
Back to the right place at the right time. This was a small conference of thought leaders: pharmacists, endocrinologists, primary care, NP’s, PA’s, and one RN. Me? A thought leader in diabetes? (It’s inconsistent with my picture of self.) I spent the day sitting next to the gentleman who co-chaired the Chicago meeting; Dr. Polonsky of the Behavioral Diabetes Institute in San Diego. We discussed disease reversal. Of course! How could I not? His presentation essentially encompassed successful strategies for enrolling patients in increased self-care. Disease reversal in diabetes does not occur without patient empowerment and complete responsibility for increased self-care.
We got the sneak preview of a glucometer awaiting FDA approval as-we-speak.  About the size of my little finger, it docks to an iPhone. It is black glass with stainless steel trim and a single round button - very iPhone-ish, very sexy, very user-friendly. It will run off an App and will graph blood sugar trends, individual blood sugar readings, food logs, weight, exercise, and allow for emailing that information from the iPhone. 
That launched a long discussion called “we’re not ready for this amount of data and how do you deal with email?”
Kaiser Permanente is one of the few healthcare organizations that actually has a system in place to effectively and securely manage patient email. I shared my workflow using email as a provider at KP. People were incredulous and clearly saw themselves as waaay behind the power curve.
The proposed App was insufficient in that it was not linked to a food database and thereby unable to produce food logs. Nor did it include a place to log weight and exercise - integral parts of self-care. It will now. 
Why iPhone? “We realize it’s a niche market but it is also a tech-savvy market and for this to work, it has to get into the hands of techies.”
The key will be the cost of test-strips. For patients in managed care, notorious late-adapters not known to embrace new technologies for a small, nouveau niche, the barrier for patients will be the cost of strips, which will be independently borne. Strips are expensive, approximately $1 apiece.
Conference complete, I was shuttled to the airport, home by 9 pm, and in the hospital the next morning at 0700. I emailed my manager on Monday, sharing Dr. Polonsky’s ideas for behavioral change. I am on the departmental meeting agenda in January to share that with my colleagues.
One of our endocrinologists is running her second disease reversal program. The first was wildly successful albeit a brief eight-weeks. I have not shared Dr. Polonsky’s conversations, insights, and research - but I will. She is forging a new path at KP and I am head cheerleader.
The purpose of my trip was to attend a diabetes conference. All the rest - Fred and Tina, exploring Portland, chic approach shoes - is cake. Writing it is cream cheese frosting and being alive twice. Mahalo for the opportunity to practice this craft called writing. Mahalo for living in my present and in my being-alive-twice moments as well.
Mele Kalikimaka to all e Hauoli Makahiki Hou!

1 comment:

  1. I so love your stories Chick-ka, especially the way you paint pictures with words.

    "Just then the lead in my favorite mechanical pencil exsanguinated and expired."