Z Parade

What I learned curbside, watching the parade - my TENTH patient wean herself from insulin.

1. This project had innocuous beginnings; I didn’t even notice until I shared about Patient-5 and my Kaiser/Landmark colleagues (I call them the Kizermarkians) went wild.

2. When Patient-8 was successfully weaned from insulin, I called seven patients and asked, “Why did you do it?” They universally answered, “No one ever said it could be done.” Clearly, we don’t extend the invitation; we don’t tell patients what’s possible.

3. “I don’t eat that much, I don’t like vegetables, and salads are boring.” I rounded on a post-surgical, open-heart patient last Saturday who weighed 288#.

“About sixty days post-op, I want you to seriously consider doing something drastic with your weight,” I said. “I want you to consider joining Weight Watchers or Over Eaters Anonymous or any such organization and I want you to get some of this weight off.”

“I don’t eat that much,” she said.

…If I had a dime for every time I heard THAT, I could retire in splendor. We have formulas to calculate the number of calories needed to maintain body weight. Do you know how many calories must be consumed to maintain a 300# body? That on an 1800-calorie diet, her insulin requirements were reduced by two-thirds, is telling. ALL ten of my patients dealt with their food intake; there is no magic bullet, no magic pill, no panacea.

4. Who is the likely candidate? Not the skinny guy who is mindful of his food and takes insulin 10 units QID (ten units of insulin four times/day). The successful candidate is one with abdominal adiposity (belly fat), eating typical American fare, willing to try new and different food choices. Studies show we consistently underestimate our intake and overestimate our caloric burn. A surprising finding: exercise recommended but not required.

5. Patients, physicians, and healthcare organizations currently have insufficient support and/or structures to turn this corner. This represents a paradigm shift, a new conversation. And while we tout health maintenance, the bulk of our work is aimed at disease management. Reimbursements are not based on health promotion but disease management. While managing disease effectively does secondarily promote health, disease prevention and reversal is largely not incentivized. Follow the money: no reimbursement, no resources.

Case in point: A recently received email: “URGENT: Looking for PHASE Patients for KP Center for Total Health Exhibit.” (Pause in Think: PHASE is an innovative and successful Kaiser initiative called: Prevent Heart Attack and Stroke Everyday.)

“KP wants to capture a PHASE program patient's story on video,” the email continued, “Asking them questions about their condition and risk factors, how they were introduced to the medication protocol, how they feel about it, and how their health is now. If you have two or three members who you think would be compelling on camera talking about their own story, I would love to speak with them about possibly being a part of this. Please let me know just as soon as possible. Thank you! National Public Relations and Media Consultant”

“I have a patient who is also an employee,” I responded. “She lost 50# this year! We pulled away insulin and oral glycemic agents excepting Metformin. Her last two A1c's have been well below the target of 6.9. She is willing to participate and we would have to coordinate her work schedule.” I sent my story of Patient-8 found here entitled: Sourcing Miracles & Keeping Dreams.

They responded: "Lorin -- thanks, this is an inspiring story. We're looking for folks who were part of the PHASE program, though -- who were on that medication protocol to lower their risk of heart attacks and strokes. Was this person on the protocol?"

ME: "Yes - she is your typical metabolic syndrome Diabetes/PHASE patient who came into Diabetes Care Management and suddenly caught fire. We have decreased all of her meds, stopped insulin, though she remains on low-dose ACE, diuretic, and statin."

They were not interested in her. Of course you’re not, I thought sarcastically. WHO would be interested in patients reversing their disease, driving diabetes into submission, and decreasing medicines?

6. We are so cynical and jaded, patient outcomes beyond the bulge of the bell-curve are inconceivable. Even evidence-based results do not silence naysayers. If WE don’t think it’s possible; it’s not.

“They can’t sustain it,” our Endocrinologists said. Resignation and cynicism are ubiquitous. I vowed to give him a wide berth, to protect the possibility from his cynicism.

Yes, patients fall off the wagon. This is not about being perfect every time. This is about making better choices most of the time, it’s about practice, building the muscle, it’s about coaching them to competence and empowerment.

Driving their diabetes into remission. The first time I used that phrase, a physician friend cautioned, “Those are strong words.” And why not? Suspension of disbelief IS the hurdle.

When people seem uninterested or fail to recognize the impact of this work, the ultimate benefit for patients and healthcare organizations, I dismiss them and label them stupid. My bane, I have little patience for the ignorant AND I hold my profession and colleagues to a different/higher standard. Truth be told, stupid they are not; each has a full plate and nibbles a different piece of this pie.

7. What’s next?

Even the lone wolf is a pack animal. Kaiser stopped their Diabetes Support Group meetings because “the people who attended didn’t need them.” In other words, the patient’s who attended had good blood sugar control and lab values to prove it. Knowing human nature, the truth may have been closer to: their numbers were good because they attended and not vice versa. (That would be easy data to mine from our extensive database.)

As an integrated healthcare system, we at Kaiser Permanente have all the pieces for this pathway to reversing diabetes, heart disease, and erectile dysfunction (collateral damage seldom openly addressed). What we do not have is an established pathway, overseeing provider(s), invitation and follow-up mechanisms.

We COULD; we don’t.

I envision a program utilizing existing resources that shepherds patients from novice to expert, administered by one with prescriptive powers and motivational/empowerment skills (moi’ lest you had doubts).

Perhaps the invitation is extended through a large class format. I envision patient contracts to include participation in the Diabetes Care Management Program and a weight management program of their choosing. Support group meetings held after the basic “Invitation Class” allow prospective participants to observe the next step, the support group.

In that class, we might share food and stories. We could review and practice reading food labels, carb counting, and better restaurant choices. We might critique participant food logs.

To that end, and consistent with “not recreating the wheel,” I am scheduled to visit Kaiser Santa Rosa’s monthly support group meeting in December. I have been in contact with the head of the Wellness Institute at the Cleveland Clinic and am planning a three-day visit in early 2011.

THEN I intend to create a proposal for a pilot program and present it to anyone who will listen. Fortunately, I have generous people with large ears of listening for me.

8. A Larger Parade Marches On:

Study headlines in the last month: “Americans are the Fattest,” “A majority of adults in California are obese or overweight,” “Mediterranean Diet Halves Diabetes.”

None of these headlines surprises me. Halting this parade requires national conversations on many levels and in multiple directions. This surge has more momentum than a simple diet can cure… and a simple diet IS the cure!

Stemming the tide, changing directions, and turning the Titanic requires new, out-loud conversations. It starts in your home, at your table, in your pantry, and with the foods you choose to eat and feed your family.

You COULD start a new conversation around food and health with your family, your friends, your workplace. BE the change.

We are what we eat. Eat Well to Live Well and Be Well.

No problem can be solved from the same level of consciousness that created it. Albert Einstein

Fall's Reflections

The straw-like grasses sloping to the creek beyond my fence are burnt and brittle. Water stagnates, piddling and puddling through the creek’s trough, seeping round small stones with nary a trickle. The oppressive heat of summer has been nudged by cooler nights and honking geese overhead. Still, dawn breaks open sunny-side-up with all the fixin’s of an Indian summer.

My heart too is perennial in its heartbreak, rent with sorrow for another summer past, that season of unyielding sunshine and my desire to bathe in it. I’ll clean house during autumnal rains, do dishes after dark, and run or cycle to beat nightfall home. During summer, my life is lived out loud, outside.

As the distractions of summer ceased, something else arose in me. Niggling thoughts sliced deep, filleting my pericardium wide, forcing me to silent introspection.

How will I occupy my remaining years? What good will I do? Where shall I contribute? With and to – whom?

Some would label this mid-life crisis. Crisis it is not, though inferring my life half over, a time for evaluation and assessment is neither unwarranted nor untimely. Most, by virtue of a common pathway – love, marriage, children, grandchildren, great-grandchildren – face a well-trod path. My trajectory is not that; the trail through my jungle as yet unhewed. Work at Kaiser and homeownership lend a certain predictability. After that, it’s up for grabs and mine to create.

Such was my frame of mind departing into the wilds of both Yellowstone and the Grand Tetons. The region’s bears are unusually hungry for a paucity of their natural food sources. Some Ursidae have turned to predation upon Homo sapiens… an encounter heavily favoring brute and brawn. Two have been fatally mauled and three maimed by hungry grizzlies near park boundaries just this year.

Hungry grizzlies had me contemplative, reflective, and introspective, nose-to-nose with mortality. I have no real unfinished business, only unpaid bills. My relationships are rich, my work compelling. I have loved and been loved. I once experienced love at first sight – for my cat Keo – such a heart tumble as it was. I have been blessed with body and mind that work – my vehicle through this life has served me well.

I called and emailed a short list to hold conversations for completion. My close friends have some experience with this though one became agitated and annoyed. “Why would you go?” he emailed.

“There is inherent risk to many of my excursions into the wilds. While I do not intend to perish in the mountains, it is as good a place as any and far better than most. Know that out there – I play passionately and thrive. You?”

I returned unscathed if only less a few pounds. During that first week back, my tenth patient was weaned from insulin and I received that fateful call: That cardiovascular job for Kaiser at Mercy? Ain’t happening. I mourned its loss, my perceived opportunity to practice unfettered. I felt deflated and forlorn. I told few of the tenth patient – the few that seemed to care – and headed to San Francisco for Kaiser’s Cardiovascular Medicine and Surgery (COAST) Conference.

“Around me,” I’ve declared, “People get healthy and fit.” It’s true enough though the mechanics – the why and how of it – escapes me. My masseuse recently lost fourteen pounds with fifty to go. “I am getting back to my tri-athlete weight,” he said, “Because no one will listen to me if I don’t practice what I preach.” Amen Brother! It is a lesson much needed for us in healthcare and into which Kaiser’s new Live Well, Be Well campaign promoting a healthy workforce, points.

At 0750 on Sunday morning, COAST featured Dr. Esselstyn, a retired Cleveland Clinic (can you say: Mecca for cardiovascular care?) heart surgeon outlined his nationally-renown program for reversing heart disease, diabetes, and erectile dysfunction; conditions of gargantuan healthcare dollar proportion and import. I waited to speak with him and sidled up at an opportune time.

“I just weaned my tenth patient from insulin.” The jaw of a nearby cardiologist dropped. “I have another handful of patients who were never on insulin and I’ve pulled away all their glycemic agents excepting Metformin. Some are living in the zone, with hemoglobin A1c’s in the fives (like people without diabetes, having successfully driven their disease into remission). I have a few that have fallen off the wagon but I think my success rate is better than 70%. But I feel like I’m recreating the wheel and I don’t want to do that.” I said nothing of the myriad of friends and colleagues who have altered their eating, lost weight, begun exercising, and corralled their diabetes.

“That’s incredible,” he said, “And it’s a lot of work when it’s done as only one facet of your practice.” We talked a bit; he asked, I answered.

“Let’s do this,” he said abruptly, “You come to Cleveland and stay at my home with my wife and I. You come to the clinic for several days and apprentice with me. If I don’t hire you away from Kaiser, I’ll send you home with everything you need to create a program.”

We exchanged email addresses and I thanked him for his incredibly generous offer. I felt expansive, excited, exploding within my skin. I could hardly wait to get home and email friends including the beeeg kahuna Jack. Instead, I wrote at the Metreon beneath a warm and bright San Francisco sky released from its customary geometry shaped and framed by concrete and fog. Arriving home, I mounted my bicycle and pedaled twenty just to sort myself out.

I’ve spent the week in communication with like-minded practitioners: two cardiologists from Kaiser-Santa Rosa, an internist at Kaiser-Stockton, and an endocrinologist at Kaiser-Sacramento. I’ve been outside daily, my favorite locale for audience with God.

Swirling, sailing, softly crunching, large and leathery Sycamore leaves overwhelm my green waste bin. Fall is a thoughtful season of reflection. I am called to it with every twisting and twirling photosynthetic colony in it’s Newtonian plunge, with every quaking aspen, with every clattering leaf herded before blustering winds, with every reflective headlight off wet streets.

Here’s what I know: I have little interest in a life of mere survival and existence. I am intensely interested in living life inspired. If it is also inspiring? All the better.

“Will you go to Cleveland?” friends ask.

“Absolutely! When the student is ready, the master appears.”

“Will you move to Cleveland?”

“Abso-NOT-ly! Too far from Hawaii.”

I wonder what my life is for? It is for something like this that comes so easily and contributes so much.

Symptom Management

“Well, we will all have to deal with something,” I said, my voice flat with resignation. “Some will deal sooner than others. Fifty feels a little too soon…”

“It IS!” he interjected, so unlike himself.

I shrugged, “It is, what it is.”

We discussed chronic disease, that we had arrived at the decade when those diagnoses were abundantly bestowed, when we meet the thing to manage, the dance with the dragon… from this day forward, ‘til death do us part.

“I love these,” I held up a two-bite pocket, clenched between chopsticks, for his examination. “The outside is pickled bean-curd. The inside is sushi-rice so it’s flavored with rice vinegar and seaweed.” I bit and smiled as spongy bean-curd gave up an extra squirt of vinegar. “Mmm.”

“I’ve sorta come to view my life like symptom management,” I volunteered.

In medicine, we have a term: symptom management. When medicine is not curative, our efforts are palliative, aimed at minimizing symptoms: pain or immobility or breathlessness or any myriad of ails that, if reduced, might add quality versus quantity.

“And the more I look,” I continued, “The more I realize my whole life has been about symptom management. I am always managing symptoms, be they physical or emotional or spiritual. I am always trying to reduce my discomfort at every level. Only now, some of my friends have real disease and their quality of life is affected and their quantity is predictably shortened and…” Tears flooded my eyes and spilled down my cheeks, “And I don’t want to think what life will be like without them.”

“Now you’re worrying about something that hasn’t happened yet,” he offered, his look sympathetic, his voice pleading.

He was, in every way, the picture of beauty and health. He rarely complained and seldom volunteered health information. That we periodically met for lunch satisfied my need to know that, while his disease progressed in relentless fashion, while he circumscribed his schedule to match energy reserves, his outward appearance remained stable.

“I know,” I smiled weakly. “I don’t go there much – until I do.”

I eyed the deep-fried, crab and avo nori-maki on my plate. “Did you try one of these?”

He shook his head, “I can’t have the flour.”

“Bummer man,” I grinned.

To cut expenses, many Eurasian restaurants use wheat in lieu of mochiko, rice flour. Their tempura is notably soggy though undistinguished by undiscerning palates.

“I shouldn’t have deep-fried but I’ll have just one,” I licked my chops and skewered the disk with chopsticks.

“I asked Laird about his Dad recently and he said, I think he’s waiting to die.” Laird is a hiking buddy trying to assist his Dad in West Virginia, from California. I know the feeling. His words: waiting to die, stopped me, dead in my tracks. Do we reach some point when death is indeed anticipated and welcomed? I think we do. What does waiting to die feel like?

“I saw my Uncle Moon Chee; he’s 96, a tiny, little thing with sharp eyes and a sharper mind. He’s like – this tall,” I held my hand up to about four-foot-ten. “And he’s so frail now. Thirty minutes after touchdown in Honolulu, I plopped on the couch and asked, How ya doing Uncle? And he said, Oh, I’m getting old.” I guess! His body is failing on many levels now.

“And then of course, there’s my Dad. Last weekend I had the DNR conversation with Mom. His Advance Directive says DNR but hospitalized, with discussions of burr-holes, his DNR was rescinded. She said, As long as he enjoys his children and grandchildren, I think we should treat him.”

Fair enough. Not a bad measure. When he no longer knows his family, we withhold heroic measures. Meantime, manage his symptoms to minimize physical and emotional dis-ease.

“So all this is kinda in my space,” I said. Our plates were empty.

“I’m going for some hot Chinese,” he rose.

“You mean that greasy, hot food-line over there?”

“Uh-huh?”

“Nasty!” I grimaced in disgust.

He turned and sneered, “What-ever!” We burst with laughter.

“A friend recently returned to work after lumpectomy, chemo and rads for breast cancer found on digital mammo.” I started again once we sat before fresh plates of sushi, sashimi, green seaweed salad for me, hot Chinese for he. “Her cancer was detected extremely early; her prognosis is extremely favorable.” All that being said, she was not spared the episodic depression and fatigue embedded in the therapy cascade triggered by that diagnosis. She manages her symptoms and dove back into work and life. What else can you do?

The beautiful boy has a curious method of arranging his hand to chopsticks, an intriguing way of standing them upright beneath his left palm while weaving his right fingers around the slender sticks. He did that beneath my watchful eye as I labored toward the coup de grâce. He knows this about me, that things percolate and simmer and finally boil over into our conversations. He let my lament continue uninterrupted.

“I got a devastating email two nights ago," I said, propping my chopsticks on the edge of my plate. "I haven’t slept since.” Following my lead, he laid his down too. “A physician friend of many, many years, almost twenty. She’s me – slender, athletic, and she’s lived well: never smoked, moderate alcohol. Was in her usual state of health – an asymptomatic walkabout. Felt a lump in her belly on Mother’s Day… metastatic ovarian cancer. They did a huge abdominal surgery... they gutted her," my voice cracked, "Total hyster, partial bowel resection, splenectomy, chole, appy, then stripped and de-bulked everything they could for tumor shed.”

I awoke at 0213 in a tearful sweat, my hands pressed firmly into my abdomen, palpating.

“She started chemo the other day. They’re inserting a peritoneal catheter to mainline chemo directly into her belly. Her prognosis is… poor. She said she’s sad for the things she won’t get to do with her boys.” I dabbed my face, transferring a long, thin trail of tears to my napkin. “None of my friends have died yet; I don’t want her to be the first and I don’t want anyone going before her.” We chuckled at the ridiculousness of my statement. They will manage the symptoms of aggressive treatment and hope for the best.

“We’re at that age,” he said softly. Aye matey, we are that.

“Thank you for letting me dump all this on you.” We rose to leave.

“Of course,” he said. “You should. I want to know because it’s important to you.”

His statement rocked me and I responded slowly. “Thank you for holding what’s important to me as something important to you. I know you don’t like talking about your health but I have come to know that sometimes, just sometimes, I can’t hear a word you say until you tell me how you are, how you feel, and how you are managing symptoms.”

“I know this about you,” his head twitched imperceptibly, as it is wont to do in mild discomfort, “And I include it in our game.”

We hugged; his cheek smooth against my lips. I paused and stored for safekeeping, his every nuance.

How do we live well if we must live sick? We symptom manage. Am I living life fully or waiting to die? How do I give meaning to my remaining moments, ‘til death do us part? And what am I doing today to forward that?

Today my life is all about me and symptom management. Today I manage my grief, my insomnia, my wellbeing and physical health. I’ll write, bike and run - dual workouts and triple play, baby! Today I’ll manage my schedule and purchase a round-trip ticket so that I might see my girlfriend and say, I love you. Symptom management at its finest.

Father of Mine - 3rd in a Series

He fell… again, sustaining a mean forehead gash requiring sutures. The medics were called and they raced to the Kaiser ED in Honolulu at 3 a.m. After suturing, a head CT revealed an intracranial hemorrhage. Guess his daily baby Aspirin will be stopped. The internal medicine doctor admitted him to the hospital and he waited there, on a hard gurney in the ED, twelve hours for a hospital bed.

“That’s not uncommon Mom,” I tried to soothe her with helping her understand. “If the hospital is full, someone must be discharged home before he can have their bed.”

Initially, there were hourly neuro-checks and talk of burr holes to relieve the pressure. Technology is amazing. My sister sent a text message, including a photo of the over-bed monitoring screen, asking for explanation and interpretation. It flew transPac and landed in my iPhone moments after being sent: Dad's heart rate, blood pressure, mean arterial pressure, and respiratory rate.

By nightfall he seemed over the burr-hole hurdle. Then abruptly, his laceration began bleeding again. A nurse stood at the bedside for a long time, applying direct pressure to unsolicited complaints of pain.

“How ya doing Dad?” Someone held a phone to his ear. Sometimes he doesn’t know phone or its use.

“Oh, I’m surviving.” His speech was thick and slow, as if he was drugged. We talked briefly, until he quit.

My sister texted: If his forehead is bleeding, what are the chances he’s still bleeding in his head?

Exactly, but no one wants to perform surgery on a demented old man. And it’s not the dementia, it’s that, in medical vernacular, he’s piss-poor-protoplasm for a surgical procedure. He’s old and he’s bleeding. They cut? He’ll bleed more.

Continued bleeding into his head will cause mental status changes. They will monitor his mental status in an effort to avoid surgery. Barring nocturnal disaster, he’d head for the CT scanner again, next day.

This is his path, I tell myself, get used to it. Did you know that 40% of us will die of diseases related to dementia and frailty? We will fall, break a hip, and die of subsequent, hospital acquired pneumonia. Our interest in food will wane and - wither we will. Our families will command that we eat and force-feed us while our doctors enter a new diagnosis into our electronic medical record: failure to thrive.

“How do we help people live well if they must live sick?” our Palliative Care Chief asked recently.

“He is no longer able to independently create moments of happiness and joy for himself.” During my recent visit, Mom and I discussed giving him the experience of having a life of love. “Those moments must be created with him and for him – by us.”

How does Dad live well while he dies? How do we keep him safe without imprisoning him? How do we prevent falls while preserving dignity in the bathroom? How do we create the best quality for his remaining life and his experience of that? What is it going to take to give him the experience of being loved and cared for and how will we do that?

And how will we take care of self? Where do we renew and rejuvenate? Where is that well of compassion and patience for self and others? Oh, were it a dew pond for daily dipping.

A second head CT scan imaged a stable clot. Dad is now being evaluated for discharge home and safety issues abound.

How do we live well if we must live sick? It’s a powerful question.

Sourcing Miracles & Keeping Dreams

Kaiser is seeking short stories for possible publication. Here is mine.

EIGHT!!! The subject line of my email streaked out across the Internet through Lotus Notes, screaming at my friends, Kaiser nurses and physicians all. My eighth patient was off insulin.

I recently queried those patients, many of whom lived with diabetes long before working with me. “Why did you do it?” I asked, “What made the difference?”

To which they replied, “No one ever said it was possible and no one ever gave me the steps to make it happen.”

The book Three Law of Performance would call that a change in their occurring world.

In 2008, I joined the Chronic Conditions Department in diabetes care management and invited patients to take-on their disease by learning to count and restrict carbohydrates and get off their insulin. Eight of them did.

“Number Eight (I’ll call her Annie) is an obese, 56 year-old female and a Kaiser Permanente employee,” my email read. “She has been in and out of my care management program twice. When I run at lunch, I pass her walking and we high-five as I yell words of encouragement.”

I encourage patients to get help and seek support.

"You are not reliable to eat for good glucose control and weight loss. If you were, you would have done it. There are many programs available in and out of Kaiser. Pick one and take your cook along. What appeals to you? Do something; do anything." 


Annie did, she attended the Kaiser's Diabetes and Nutrition Class, learning to count and restrict carbohydrates. The impact was startling, stunning, immediate and we regularly and rapidly decreased bedtime insulin in response to hypoglycemia and fasting blood sugars at the low end of the target zone.

Annie was happy with that result and it carried her through the holidays. In January of 2010 she joined Over Eater's Anonymous. Within days we decreased Glipizide due to recurrent hypoglycemia.

On day thirty-seven of her Over Eater’s Anonymous program, she reported a twenty-six pound weight loss and we stopped all glycemic agents but Metformin.

“I can see my toes!” she looked down and pointed. “The aching in my hands and feet is gone,” she stood in the doorway of my office flexing her hands. “I always felt like I had the flu, kind of achy all over; that’s gone. I had no idea how bad I felt.” She hugged me and said, “I love you.”

SHE HUGGED ME AND SAID, “I LOVE YOU.”

Annie’s new goal is to run a marathon in her 60^th year. I will coach her through lunchtime runs and at least one section of that marathon.

Since then, Patient #9 is off all glycemic agents excepting Metformin and my meager pipeline is working, counting, keeping meticulous records and gunning for their insulin.

I have come to know that I provide an empowering context for these patients; that I am the keeper of this dream. Dreams and goals disappear, they fade in the frenetic pace of every day, they are beaten from us or we abandon them as unattainable. I meet my patients wherever they lie along the continuum of health, acknowledging what they have done. Together we explore small, attainable steps from which they choose.

“I want you to be successful so lets choose something that you know you can stick with. Can you do two five-minute walks every day?”

Most often I direct them into well-established Kaiser or community resources. I never recreate the wheel and it is always our first goal to achieve glycemic control with or without additional medications.

As healthcare providers, when we extend the invitation and provide a pathway toward health, some patients will play for and with their lives.

“In life there are many games we can play,” my email concluded. “We play health and wellness games at Kaiser Permanente. I love and play this game - it brings me to tears and fulfills me in every way. You are the first to know excepting my fabulous pod leader Dr. Huang - who provides a supportive, nurturing environment in which patients and employees can flourish and thrive, including moi’.

BE well and dare I say... THRIVE!”


Lorin Bacon is an Acute Care Nurse Practitioner with Kaiser Permanente in Sacramento, California.

A Birthday in Yosemite-Part 3

The weather broke on Sunday to clear and sunny skies. The forecast was for more of the same gray soup that had settled over California like tule fog. But Mother Nature is not wont to follow the forecasts of man; the day was unpredictably clear and clear means cold.

I rolled over to peek at the clock and everything about me hurt,

e-v-e-r-y-t-h-i-n-g! Auwe! Plagued with chronic low back pain from a career of hauling patients, I always stretch before leaving my warm cocoon… but this was more than back pain. My quads ached so I pulled my heels up next to my hips and laid my knees on the bed to stretch. Try that bilaterally and simultaneously, that’s a feat! I rolled to my tummy for daily yoga favorites: child, cat, camel and rolled out of bed for warriors one and two. My calves strenuously protested the reach for my toes. My shoulder sockets, jack hammered forward in repeated backward tumbles onto outstretched arms, ached and would ache for weeks.

I dressed and headed for my morning cuppa joe. Deep ruts in the heretofore, muddy service road through camp, were frozen solid. Pea-sized, ice-gravel crunched noisily beneath my boots. The air bit and I coughed with temperatures below freezing. Overhead, snow capped Half Dome shined against an azure sky. A great plume of smoke rose beyond Mother Curry’s Bungalow and the smell of coffee permeated camp, pulling me along like a like a moth to light.

In the lobby, I bumped into the young Russians with whom I’d exchanged cameras at the confluence of trails and trail signs deeply buried in snow. We queued for coffee and chatted of our climb and afternoon departures.

Coffee at the Coffee Corner is self-serve. I purchased a large and filled my insulated Starbuck’s cup that would keep warm for hours. Retracing my steps, I stopped outside Mother Curry’s Bungalow. In her day, the cabins of Camp Curry were called bungalows, those at the Ahwahnee – cottages, while those in Tuolumne Meadows were called cabins. They have not upheld that tradition as all signage and maps currently say: cabins. Too bad, some traditions are quaint and sweet; they honor the Ancients and deserve preservation.

Starting again from outside Mother Curry’s Bungalow, I suddenly remembered it was my birthday. I stopped in my tracks and looked about with new and liquid eyes. The valley pocket remained in shadows, the sun insufficiently high to peer over its shoulders. Overhead, granite gleamed in sunshine, promising a warmer day.

I smiled and sang: Happy Birthday to me. Happy Birthday to me. Happy Birthday dear Lorin. Happy Birthday to me. Why am I going home? I could make spending birthdays in Yosemite a tradition. Yes, I just may do that.

I opened the curtains to watch the sky lighten and plopped onto the bed with my laptop. I’d read and write before packing and checking out. At 11:30 I’d be in the main dining room of the Ahwahnee Hotel for Sunday Brunch, my birthday brunch.

My morning was non-descript. I packed my auto after moving it to warm in the sun. As I ferried satchels to my SUV, Cliff peaked through the window. Cliff was my housekeeper, a resident of Merced who had never visited Yosemite until job loss forced him to seek work far from home. He lived in resident housing and worked four days straight before returning to Merced.

“Waaooww!” I said, imagining how yummy Yosemite living could be, “I’d never want to go home.”

Cliff glared, “It ain’t that great here,” he snarled, “You’d wanna go home, trust me.”

Remember my departing email? “Methinks a winter trip to Yosemite is a good sieve. I will meet people like me. I'll probably LIKE THEM!” Remember that? Exclude Cliff. How one can reside one’s entire snuff-chewin’, teeth losin’ life in the shadow of Half Dome and never visit or appreciate is … oh never mind.

I stopped by the Lodge to retrieve and send a few emails. A fire sputtered and spit in the fireplace though it was 10 a.m. I sank deeply into the same log chair I had occupied twelve-hours prior. I fiddled and figured out how to post to facebook from my iPhone, posting my picture at Columbia Rock, shglicked by George. At the registration desk I checked-out, surrendering the oversized, brass key to my cabin. I arrived at the Ahwahnee ahead of schedule and browsed through their gift shop.

The Ahwahnee Hotel is a stunning amalgam of rustic rock and timber, art deco designs, arts and craft styling, and native Indian motifs. The hotel occupies the meadow beneath the Royal Arches rock formation and the former village site of native Miwok Indians – who called themselves Ahwahneechee.

Designed by architect Gilbert Stanley Underwood, who designed the lodges at Zion, Bryce Canyon and the Grand Canyon’s North Rim, it is in retrospect, his crowning achievement. The site was chosen for maximal sun exposure and its iconic Yosemite Valley views: Glacier Point, Yosemite Falls and Half Dome.

As seen from Glacier Point, the lodge is Y-shaped. It was constructed from 5,000 tons of rough-cut granite, 1,000 tons of steel, and 30,000 feet of timber. Its exterior wood and structural timbers are actually stained concrete poured into wood simulating molds. Construction lasted eleven months and totaled USD 1,225,000 upon completion in July 1927.

Its grand public spaces are rich with tapestries, hand-stenciled timber beams and floors, massive stone hearths, log-beamed ceilings that soar to 30-feet, stone patios and expansive lawns. I’ve sat on those lawns in late summer and watched deer feed. Even in winter, buried beneath snow, the south lawn beckoned.

The dining room is notably Five-Star and dinner is a formal affair, by reservation only. Sunday brunch is casual. I checked-in with the maître d'.

“Ah, yes Ms. Bacon, we have your reservation for,” he paused to reconfirm before looking up, “One?”

“Yes,” I smiled reassuringly. I received many an odd look those three days in Yosemite. You have a reservation for… one? A look of puzzlement shadowed their faces momentarily; we are so unaccustomed to women traveling solo.

The maître d' checked himself and smiled broadly, “Welcome,” he parroted, back on auto-pilot, “We are glad you could dine with us.”

Me too buddy; you have no idea. “Thank you.”

Carol stood at his elbow ready to usher me inside. She was a delightful woman in her forties with an eggplant figure topped and coiffed in pageboy. She wore the black pants and white, long-sleeved, button-down shirt customary in food service. The busboys were similarly clad with an additional long, white, Bistro apron. My busboy was Sally, a decidedly masculine young woman with multiple facial piercings and the never-ending pitcher of fresh-squeezed orange juice – which made her decidedly popular as well.

I was seated in the west-facing alcove originally designed as the porte cochère. Yosemite Falls fell, framed in floor to ceiling glass. At my right elbow, towering over my table, The Royal Arches.

I wandered through the buffet area replete with sushi and egg chefs. A skilled pianist tapped ebony and ivory on the periphery. He looked up from his keys; I smiled and nodded as I passed, pondering a song request. That thought disappeared in the myriad of morsels, trays of truffles, dishes of desserts, bushels of breads and cheese, displays of fruits and vegetables, a panoply of epicurean delights Ahwahneechee-style.

As one whose diet is nearly devoid of meat, a buffet line offers multitudinous opportunities to indulge without discarding all but three of an eight-ounce steak. I conned the prime-rib guy out of two-bites. It’s easily been two years since I last tasted prime rib. YUM!

I ladled up cheese, bacon and collard green grits and three-bites of Cajun catfish. Veeery tasty but too-too salty – my persistent complaint of food prepared by others. I salivated at the sushi station where a chef rolled nori-maki sushi on request. I settled for one rolled disk each of seared-ahi and spicy tuna sushi.

The dining room’s entire south wall is glass, six by twelve foot panes edged by six-foot sliders, and all that completely surrounded by craftsman style windowpanes. Incandescent candelabras stood along the walls, their warm glow pallid against sunlight and snow reflection off the south lawn. On gray days I remembered, the cavernous dining hall could be dark and dreary.

I jotted notes in my journal and listened to the conversations around me. The couple against the west-facing window had broken their carb-free diet for her 61^st birthday brunch. The four-top next to me also included a portly and pony-tailed birthday boy. I volunteered that it too was my birthday and that started the patrons of three tables talking.

“What do I have to do to get to the top of that?” Birthday-girl Karen pointed west to Yosemite Falls.

“Walk,” I said.

“That’s my downfall,” she said, “I don’t like to exercise.”

“Do you own an iPod?” They did but were unsure how to load their favorite books into it.

“Have your grandkids help you,” I offered, “They’ll do it in under ten minutes.” They laughed, knowing it was true.

“Then start waking, even if it’s two five-minute walks a day. When you get to two ten-minute walks, combine them into one fifteen-minute walk and increase that by one-minute each day until you are walking forty-five-minutes a day.”

“We’ve both lost forty pounds,” she disclosed, “We’ve got about another fifty to go and we’re gonna do it! We’re back on our diet tomorrow.”

What is it? What always has me at the center of these conversations; as if my forehead blinks neon: Healthy NOW, ask me how! I acknowledged them genuinely and profusely; they beamed slathered in my praise.

Before leaving everyone hugged: the patrons of three-tables-talking, our waitress Carol, our busboy Sally, and promised to attend birthday brunch at the Ahwahnee the following year. Before leaving, EVERYONE HUGGED and I hugged strangers who share my birthday. Do you know how extraordinary that is? For moi’? Curmudgeon-me who does not like to be touched?

“We’ll be a lot thinner,” Karen smiled, waggling a finger between she and her husband.

I wandered to the south patio, to sit in the sun and drink in the Ahwahnee before my departure from the valley. Snow outlined small ridges normally invisible from the ground. My eyes wandered and I imagined the Ancients watching me scour the cliffs in search of their visage – watching me watching them. Clouds rolled in from the west and a cool wind began to blow. I closed my eyes to feel Ahwahneechee and sent a silent prayer of thanks to Heaven (which from Yosemite – is not so far). Climbing into my SUV I meandered through the valley, following the Merced River, stopping at every whim and fancy.

A wolf or coyote protected kill near the roadway. I doubled back for a picture but it ducked before I could center my photo. The Merced flowed low and slow, seeking the riparian trough, exposing alluvial beaches that would disappear with both the thaw and throngs. I shglicked a pic. With nary a ripple and barely a current, tree and beast and rock and sky were eye to eye on its glassy surface. I parked and walked into the meadow - to imbibe its vibe.

Lastly, I returned to the Tunnel View lookout along CA Hwy 41. A brisk wind bit as I marched across the parking lot, mesmerized again by the view that captivated the cavalry two centuries ago. Many photographers littered the sidewalk. Bridal’s Veil fluttered in the wind and dark clouds threatened.

Quietly joyful at my return, I stayed to drink in Yosemite and let her steep, suffusing my cells and etching my memory in her unassuming tea… for later, for me and to honor the Ancients. I watched the gathering gloam until my ears ached and skies cried tears from Heaven (which from Yosemite – is not so far). Only then did I begin the journey home.

E ha’ina ‘ia mai ana kapuana la: This is the end of my story: A Birthday in Yosemite. It was memorable and nurturing in its many moments. It’s valuable methinks, to create moments and memories to treasure.

Mahalo for your readership. This muse was penned merely as a practice and to capture my tale, to be relished, relived and remembered as an Ancient.

May you steep in life's glory, make memorable moments playing in my Heaven and paint on Her canvas. Aloha

A Birthday in Yosemite-Part 2

“Ah yes Ms. Bacon, we have your reservation.”

The registration desk at Curry Village is housed in a brightly lit, freestanding building next to the shuttle stop. Three walls of four are floor to ceiling, multi-paned windows, making it a bright, albeit chilly beacon in a largely unlit park. I pulled open the door to join the short queue and felt welcomed by the rich aroma of coffee. Large canisters of black coffee and leaning pillars of paper cups stood at the ready and I debated pouring a cup to warm me.

“Your last name please? Ah yes Ms. Bacon, we have your reservation.” He found my reservation and took my credit card. He marked a placemat-sized map of Camp Curry with a highlighter and rotated it for my study as he oriented me to the registration desk in relation to my cabin. He laid two large, brass keys on the counter and slid them in my direction beneath his hand.

I slid one key back, “I only need one.”

“How many of you are there?” he asked.

“One.”

“Only one?” He quickly regained composure, erasing surprise from his face. “Very good then, Ms. Bacon. The front desk is open twenty-four-hours-a-day if you require our assistance. Enjoy your stay.”

“I will,” I smiled before turning to foray into the darkness and find my cabin.

Beneath thick cloud cover obscuring a gibbous moon, Camp Curry was pitch black. People walked with flashlights and headlamps. I dug my headlamp from my backpack before sloshing through snow and mud.

Cabin #22A is pressed against resident housing and the row of cabins abutting the cliffs, forever closed by rock fall. The tent cabins of Tuolumne Meadows are heated by woodstove; I anticipated lighting a fire. I unlocked the door and was blasted back by heat of a wall furnace turned up high.

Curry’s log-accented cabins are of single wall construction. Unmilled log beams support log headers for doorways and windows. Board and batten slats complete walls and ceiling. Everything in #22A was painted a sickly shade of Grey Poupon. Lime-green and maroon plaid bedspreads covered the two brass beds. A small nightstand stood between them with a pine tree shaped table lamp. A dresser with unmilled corner posts stood in the corner.

“Honey, I’m home,” I yelled before throwing my stuff on the nearest bed.

I ferried gear from my auto to the cabin. Bear Aware signs were posted throughout the parking lot.

“Aren’t bears still in hibernation?” I’d asked at the registration desk.

“No. There is so much available food that bears in Yosemite hibernate for about three weeks,” he said. THREE WEEKS? “Get everything out of your car, just like in the summer.”

After unloading then sterilizing my auto for the bears (THREE WEEKS?), I sought dinner. Full dining facilities at Camp Curry do not open until April. The Coffee Corner serves continental breakfast then pizza until 9pm - but I seldom, almost never, eat pizza. I drove to Yosemite Village, bought a salad from their food court and spent the remainder of the evening reading, journaling, scouring maps, studying trail conditions and planned a morning climb.

The cabin had once been two rooms connected through an alley bathroom. A second bath had been added against the back wall of my half and the adjoining bathroom’s door was locked off. The single wall separating me from them might just as well been a cotton curtain. Cotton would not lend the illusion of privacy. With cotton they would know that every word, every zipper, every drop of every thing… would be heard. I coughed and shuffled my papers to clue them in. Their conversation continued beyond my bedtime; I sandwiched my head between pillows for sleep.

With Cary Stayner lurking in the dark recesses of my mind – I dreamt I was fleeing, running through the forest as Joie had – I awoke with a start, in a sweat, my heart racing, hammering in my ears. Eventually I slept again and woke to another gray day, as promised.

The Coffee Corner starts service at 0700. I dressed in layers, fleece, gloves, fur-trimmed boots, and my 2002 USA Winter Olympics beret. With temperatures in the 40’s, I stuck to high ground, avoiding the slurry of mud and snow as I picked my way past cabin after cabin.

I passed the communal bathroom as I reached the central village buildings and was thankful for my cabin’s indoor plumbing. I walked through the tent city, apparently abandoned for winter. Two large plumes of white smoke drifted upwards from the river rock chimneys of the Lodge and the Dining Pavilion. I followed the plumes until aroma café became its own siren’s song, luring me into right path finding.

“Nice hat,” someone said as I came through the doors and stood before the log fire crackling in the lobby.

“Thanks,” I smiled before queuing for coffee. Few people moved about at 0700. The log couch and chairs before the fire were vacant. In the café, small groups huddled over coffee and pastries, their conversations hushed by the cavernous room. I filled my cup and retraced my steps. I’d planned for several hours of writing before taking to the hills, to give the day a chance to warm as much as myself the pleasure of writing in Yosemite. With free coffee refills, I’d be back.

I passed a beautiful log home located behind the communal areas of the village. Private Residence, the sign stated. A bronze placard stood at the front gate: “Mother Curry’s Bungalow. In 1917, the first cabins were built with electric heat. After fifty years of living in a tent, Mother Curry got her bungalow.” (FIFTY YEARS OF LIVING IN A TENT?) A bicycle leaned against the front porch. Craftsman inlaid smaller logs around doors and windows, creating artistry in patterns. Smoke curled from the chimney. The home beckoned with quaint and charm. FIFTY YEARS OF LIVING IN A TENT? My mind got stuck like a phonograph needle in… you know… the broken record.

“Hi!” Two little boys played with a toboggan on a small mound of snow outside their cabin. The smaller squealed shrilly as only the very young can, ripping through camp, tearing away any vestiges of sleep and waking the neighbors.

“Hi!” I waved as their mother peeked out.

At 0945 I stood at the Upper Yosemite Falls trailhead. A large and noisy party of young adults congregated. I hustled from the parking lot to out distance them, in my foolish hope that they could not keep pace. The day remained gray with the threat of snow; the sun but a bright spot in the clouds.

“You are alone?” I passed a couple from Japan.

Freedom of the Hills, Rule #1: never, never, NEVER hike alone.

“No,” I smiled, “You’re here; now I’m not alone.” She giggled as I passed.

I expected to meet people on the trail but a danger of hiking alone is that when one does not return, no one is the wiser. None knew on which trail I hiked or my anticipated return. Some of that danger is mitigated with the advent of cell phones and Yosemite has excellent at&t coverage, as I would soon learn.

The lower trail was speckled in snow but primarily carpeted in dried, rusted oak leaves, gray granite, lime-green lichens, illuminated in the low, flat and shadow-less light of the day. Snow clung to the clouds, unable to let go, take the plunge and freefall to earth. The trail quickly assumed the familiar, tight switchbacks of the Sierra that carve a mountain into baby-steps. Hand-hewn granite blocks lined the up-side of the trail, temporarily preventing Yosemite’s reclamation from man’s messing.

It was a windless day; I sweated through my shirts in minutes and removed my jacket though the ambient temperature hovered near freezing. As if my body heat radiated ahead and warmed my path, clumps of snow slid from leaves overhead, dusting me in ice crystals that sparkled and glittered to the ground. Voices fell behind and only the sound of diesel busses growling across the valley floor drifted up-trail.

I stopped to jot a note when something moved on the trail above – I froze, waiting - a seemingly solo man wearing a white, long-sleeved shirt briefly emerged between trees. I eventually overtook George as he bent over his pack at the edge of a cliff. Not wanting to startle him, I called ahead.

“Everything okay?”

He waved before turning around, “Yea, I’m getting my camera.”

George is a computer hardware engineer from one of northern California’s Santa cities: Santa Rosa, Santa Clara, Santa Teresa or Santa Cruz. His wife, a small animal veterinarian, attended a vet conference in the valley.

“We come here every year for this conference,” he said, “Usually its spring.”

George was tall, relatively lean, a bruxor I thought, as his yellowed teeth were evenly ground down. We walked together for a short time before I stopped, offering him the lead, rationalizing that my steps were shorter and my pace likely slower.

George declined, “No, I’ve sped up to keep up with you.”

We stopped for photos at Columbia Rock, 1.3 miles from the bottom and two miles from the top. Shglick! George clicked a pic on my iPhone. The valley floor lay at my feet; snow-covered Half Dome hovered over my left shoulder. With three-bar strength on my iPhone, I sent out another photo: Right here, right now!

George wore a Denali t-shirt. I inquired.

“I’m a wanna-be,” he said. He’d read books on hiking the John Muir (JMT) and Pacific Crest Trails; he attended lectures at REI. I spoke of my experience on both, of 1-week, bite-sized, 50-mile trips. We discussed bear cans and lockers, food drops, ranger stations and enrolling friends as mules to bring in food and entertainment for sections of the trail. Excitement grew in George with the possibility of hiking the JMT in sections.

“Are you planning to stay the night?” George eyed my pack.

“No, but after climbing in Alaska, my daypack grew. I always have enough stuff to stay the night in case I get hurt. I may not be comfortable but I should survive without loss of limbs or digits.”

Both solo hikers, we discussed Freedom of the Hills, Rule #1: never, never, NEVER hike alone. George was sticking to the lower, more populace trail. While he hiked alone, he would not be alone. I on the other hand, was headed for high ground and thin air.

“The problem is,” I justified, “If I wait for others, my life could be over –waiting. If badness befalls me, I figure Yosemite is a good a place as any to die and far better than most.” George applauded my ability and courage. Search and Rescue would call it anything but, were their services required.

The first and last people to pass on the up-climb did so, a young Russian couple that I would meet on top and again in Curry Village. George accompanied me to the base of the upper falls. There, water crystallized during its tumble, forming large snow dunes at the fall’s base. As far as George had ever hiked, it was once again his summit.

Before departing he dictated for me, my journal entry in his regard. “There she came upon George, a man of few words with an engaging smile, his face as cragged as the cliffs of Yosemite.” George smiled broadly, pleased with his work.

“Ooh, very good George!” I acknowledged, clapping. “I’ll need to write that down so I get it right in my journal. To which I will add, and my friends know this about me and will appreciate," I said parenthetically, "There she came upon George bent over his pack, providing her with the preferred view when meeting a man for the first time – his rear view.”

It was George’s turn to howl. “If I see you in Curry Village, I want to hear about the rest of the hike.” I promised to recount the tale. We shook hands and with that, George, computer hardware engineer and mountaineer wanna-be, retreated.

The trail beyond the base of upper Yosemite Falls turned cold with snow and ice. It veered slightly west into a narrow gorge carved by the falls itself until glacial moraine redirected its course and flow to its current location. I grew cold though still sweating beneath my two shirts. Occasionally, the sharp report of rock fall echoed above and looking for cover, I reviewed my protocol for rockslides and fall. Hiking against the cliffs of the narrow gorge, no cover from rock fall seemed to exist. That small "seeming" began to gnaw and I glanced overhead with anxiety.

I slowed with frequent starts and stops. I began counting my steps, discovering the switchbacks turned every 50 – 90 steps. I allowed myself to rest at the next turn or after 75 steps, though usually forcing myself to traverse one complete switchback before stopping. I scoured the trail for overnight shelter and feared being forced to seek such shelter. That being the case, I thought to turn around though there were still many, many hours of sunlight left in the day.

I pictured the contents of my pack and silently inventoried my gear and ability to live through an exposed night on a mountain. Down parka-check. Gortex pants and jacket-check-check. 200-weight fleece jacket-check. Food bars for 1.5 days-check. Space blanket-check. Lighter/matches-NO check! My matches were in the cabin. Auwe! I berated myself for stupidity.

If one can lasso these irrationalities, rein and recognize them as the clanging dinner bell, the beast is broken. It is yet again, another reason to hike with others. Companions may notice goofy, irritable and paranoiac behavior.

I did notice that I seemed unusually fearful and did follow the proverbial breadcrumbs. I stopped, threw on my jacket, groused around for a Clifbar and ate as I walked. I felt better within minutes: cheerful, lively, and sufficiently warmed to remove my jacket once again.

I met two young men on their way down. “Twenty more minutes,” they said as we passed.

“Five more minutes,” the young Russians said as they returned. Someone excavated the four-foot-tall trail signs from the snow and we stopped for pictures at the trail junction. It began to snow in earnest and I donned my gortex jacket.

I summited alone shortly before 1300. Five young adults met me on top: four men, one woman. Two men wore cotton t-shirts saturated in sweat.

Freedom of the Hills, Rule #2: cotton kills. Cotton does not wick water from skin. Cotton clings and cools and draws one’s body heat away. Several wore Cal Poly cotton sweatshirts, where they all attended classes. We assisted one another with the obligatory summit photos before I beat a hasty retreat.

It is in wilderness areas easily accessible by day-trips that one can witness such foolishness. Fortunately, the weather was not awful, they were young and strong and barring injury, would likely return to the valley floor without mishap or hypothermia.

On the lee side of trees, lichens cling and deep tree-wells form. A tree-well is the divot beneath the branches on the lee side, devoid of snow, that provides shelter. I left the summit, the wind and blowing snow and hiked until I found a tree-well into which I could sit upright, out of the storm and eat.

I brought graham crackers with mini Baby Bel cheese wheels as a birthday treat. I devoured an apple and noticed the stippling of snow on a nearby granite cliff. As I sat high on a mountain, tucked beneath the boughs of an evergreen, listening to the wind and watching the snow-fly… my cell phone rang and I Dream of Jeannie played.

Were I not tucked out of a snow storm, I Dream of Jeannie is usually followed by dance and exclamation, “Dance break!” I’ve done that in elevators with strangers, on escalators with friends, on street corners with street people.

I Dream of Jeannie is a reminder that my job is to come out to play, make merry and grant wishes. I Dream of Jeannie provides ballast for the curmudgeon-me that wants to hunker-down and hole-up.

My tree-well was as confining as a bottle, I had neither maneuverability nor inclination to find my cell phone. I listened to two stanzas of I Dream of Jeannie before my caller rolled into voicemail. Amazing, I thought, at&t must have a repeater tower high above the valley.

The trail down was slippery, icy and treacherous. I pitched and flailed like a newbie on ice skates. I wore Teva Snow-Monkey winter sport boots, boots I bought for their name as well as functionality. (I was born in the Chinese year of the Snow Monkey and while I have never ascribed to superstitions and folklore, I confess I am ALL snow monkey.) Mea culpa, I digress.

The soles of my Snow-Monkey Tevas are big snow-tire treads that bite and stick in snow. Nothing but crampons are useful on ice (I didn’t bring mine) and snowshoes did not fit within the well trampled, luge-run trail. I slipped and fell often, landing hard. When I found myself on the ground, I glissaded the run until the slope leveled before standing again.

Back at the base of Upper Yosemite Falls, I dug for my phone buried deep in my pack and returned a call to my neighbor and cat-sitter extraordinaire, Marcie.

“I don’t know why my phone called yours,” she said, “They just wanted to talk.” All was well with my cats. I shglicked a pic and sent it to Marcie: Right here, right now!

For a short time I followed a young couple in a timeless argument, “You don’t care about me,” he said. He turned in a huff and started down, responding to her pleading with sharp accusation.

Talk about NOT being present and in the moment. Standing high above Yosemite Valley, easily one of the most beautiful spots on earth, he pouted and spouted, “You don’t care about me.” It’s an age-old tug-o-war for power and control, of righteousness and domination.

Some years ago a friend admitted honestly, “You always seem like you’re upset with me.” Really? Auwe! He was the last man on the planet I wanted left there! His remark stung. I promised myself that I would be responsible for how he was left, that he would never be left there again.

In response, I invented a game named: No Squandering, a game with no allowances for pettiness and wasting of precious life. That game spawned another called: For you? Anything! In that game, there is no resistance. (I play this game with my pod of doctors at Kaiser.) His remark was a defining moment, a point on which our, and thereby many of my relationships, turned. These are games I continue to play and share with others.

I passed the quarreling couple and sent a silent prayer to Heaven, (which from Yosemite - is not so far) that he would learn No Squandering, to enjoy the moment and her company – soon, before he wore her and his welcome – out.

I hiked the final mile with two young men who, due to work commitments, were forced to return to Oakland same day. Parked side-by-side, we loaded our vehicles at 1500 and I bid them adieu.

I had a hankering for ice cream – my recurring food fantasy conjured in the mountains. I was far too cold to eat ice cream. I walked to lower Yosemite falls and stood on the footbridge visible from far above. I browsed through Yosemite Village to stretch and loosen my muscles. I visited the graveyard and read headstones, most dating to the mid-nineteenth century.

I returned to the food court at Yosemite Village seeking hot food to warm me: mashed potatoes, green beans, and rutabaga/garlic soup. I sat on the periphery to discourage conversation and study diners. Seated near the doorway, incoming patrons stopped to inquire about the soup, which was as good as it was garlicky. I had more conversations… shattering yet again my illusion of self as unapproachable and aloof.

The Lodge at Camp Curry is wi-fi free and the evening gathering spot. I plopped and sank deeply into a log chair next to the river rock hearth, a beer in one hand, laptop in the other. Portraits of David and Jennie Curry hung over the mantle, he on the left and she on the right.

I tipped my beer back and took in the open beamed ceiling and wagon-wheel chandeliers. The room was littered with large, comfortable log furniture and card tables surrounded by four chairs.

The fire was stoked with immense, split logs easily the circumference of my thigh, er... okay, maybe not so immense, and tended by the willing amongst us. A pencil-thin young man stood to return embers to the fire and rearrange logs. Flames rose to lick at fresh fuel even as he returned to the couch nearby.

She possessed the classic features of her people: blond hair in bilateral French-braids, bright blue eyes, creamy skin all the more pale against ruby cheeks and rosy lips.

“You know,” I’ve been known to say, “Y’all that are blond and blue from up-there.”

“You mean us northern Europeans?” my blond and blue friend laughed, requesting clarification.

“Yea, blond and blue from up-there.”

She was beautiful, blond and blue from up-there, Denmark as it turns out. They had planned to head into the high country but were unprepared for winter camping. They would stay through the weekend before leaving for San Francisco.

A group of four played a board game behind me.

“Why are you going to Santiago?” he sounded annoyed. “There’s no disease in Santiago.” Words like Ebola drifted from their huddle as they read cards and moved game pieces around the globe, containing outbreaks of plague, pestilence and deadly contagions.

I checked email, finished my beer, wished the Danes a spectacular trip and departed. The sharp crack of hockey sticks echoed against the cliffs while the unfamiliar music of Gen Y blared from the ice rink. I followed the small circle of light cast by my headlamp. Too exhausted for even the ghost of Cary Stayner to disturb, I slept well and awoke on my birthday in Yosemite.