A Tall, Cool Drink

“Our usual spot?”

His car slipped into the parking stall while he chatted, seemingly engrossed, in animated conversation. He emerged leisurely, sauntered slowly in ritualized pacing through phone calls: toes sharply angled to forty-five degrees precede a decisive heel strike. His movements are liquid and graceful. Gravel grinds underfoot and, leading with his hips, he shifts forward. The trailing leg swings, toes angle, decisive and deliberate, strike, plant, soles scuff, hips shift, trailing leg travels. 

The cut, warp, and weft of his garments often catch my eye as they mime his movements. Pleated, chestnut, poly-blend slacks top cordovan loafers. A cotton, pullover sweater in navy opens at the neck; white striping edges his upturned collar. Only the diamond stud piercing his ear hints of the radical rocker contained and constrained beneath conservative couture.

I love watching this tall, cool drink of a man.

I left him pacing the parking lot to snag our usual spot, a high table next to the window, our overlook of the river reflecting the welkin slide from blue to peach, to cayenne, to gray, to blue - midnight blue. High, striated clouds suspended in opalescent fire, forecast the changing sky.  

I had barely settled before Tall Cool Drink flowed in like a surging tsunami, flooding my present, short-circuiting every synapse, obliterating all but Now.

Geron is a soft spoken man of few words. Muted, tenor tones march out in crisp and carefully selected sentences. I like to say he is long and lean: six foot four, broad through the shoulders and narrow of hip. Honed, European features are softened by curls highlighted in silver. Geron doesn’t walk - he glides: chest out, shoulders back, spine straight, only his legs move in the practiced gait of a ceremonial soldier. He is meticulous in appearance and thought. Presence - it is that that floods the bar - heads turn, forks fall, and a hush descends upon the din.

I vaulted from my barstool to hold him briefly, brushing his cheek with my lips, inhaling his scent, absorbing each biometric, drinking him in in every sense, with every sense.

We ordered our usual: a Hefe Weizen for me, a Marzen for he, and chicken nachos with extra condiments.

Our beer arrived - amber ale in chilled, sweating pints over which we exchanged niceties, the how was your day dear trivialities that update and warm one to conversation.

I slipped my iPad from its tote for a Keynote demonstration - Apple’s version of Power Point. Opening an insulin presentation, I started through the slides.

“And look, you don’t need a pointer.” I pressed my finger to the screen, “See the red dot?”

“No.”

“Oh, I’m probably blocking it with my finger.” I rotated the tablet and he watched the red dot travel across the picture with my fingertip.”

“Cool,” he exclaimed between sips.

“I want to ask you about writing,” I wasted little time.

“Okay.”

“In December, we had a conversation about writing. You hosted that Deck the Halls program and wrote your talk and a poem.”

He nodded, “You asked me to share that with you.”

“I did and you didn’t.” Truth be told, he denied several requests and multiple people. “People want to know you Geron,” I’d said at the time. “Your writing is one way.” He was unrelenting. 

“You said you weren’t finished with it,” I returned to the current conversation, “That is was written for that time, for that performance, and it wasn’t the kind of thing to share.” I paused briefly.  “And you said you worried a little - wondering if you wrote well enough, if you were good enough. So my question for you is this: what do you want to write?”

Geron exhaled nasally, noisily, and blinked long as he is wont to do when a thoughtful or troubling response is required. 

“I don’t know, that’s one of the problems,” he frowned, “I don’t know what I want to write. I liken writing to playing the guitar, which I long to be skilled at but,” he exhaled again before the remaining words tumbled out in a rush, “That desire is often fleeting. And... and I don’t know if  I can bear to hear myself play poorly. And,” he cocked his head and raised a brow with an expression of surprise, “If writing was in me - I’d write. I’d make time for it. Most writers are compelled to write; they have to write.”

“Exactly,” I nodded. “I often write because unless I get the story out of me, I’ll not sleep.”

“Yeah, I’m not like that,” his head quivered in a nearly imperceptible shake no. “You know, I own a fraction of all the good poetry that’s been written and when I read it I think; what’s the point?”

Our nachos arrived: a steaming platter of chips drenched in dripping cheese, dotted with square chunks of chicken and ramekins of sour cream, salsa, and guacamole on the side. We hungrily pulled sections away; hot cheddar stretched unbroken to our small plates. I scooped out large dollops of sour cream and guac, and drizzled salsa. 

“You may see it differently when you don’t have the pressures of work. Who was it that became famous in retirement? Michener? Clavell? Clancy? One of them. Things may look different in retirement, which quickly approaches.” I opened wide for a fully garnished chip.

“It gets closer day by day,” he said, head tilting left to feed himself.

We lapsed into silence for a short time, feeding our faces with our fingers. 

I licked mine clean and continued. “A friend of mine began to blog. He writes corporate policy so technically, he’s proficient. But proficiency is not what carries the reader forward. He posted to his blog and asked me to critique it. And - it has no heart.” I stopped prying and chiseling my chips apart and laid down my fork, brow furrowed. “There is nothing of him in it. His writing is mechanical; it lacks soul. And that’s the thing Geron,” I leaned in, “You write for yourself and then - can you muster the courage to share what is deeply buried in your heart with others? Coz that is what carries the reader.” 

I straightened and leaned back, “It takes something,” I paused. “That fear in me?” Wide-eyed, my extended hand signaled Stop. “I don’t think it will ever go away.”

“No,” he interjected, “It probably won’t.”

“And I post anyway,” I said in earnest, “I post my piece anyway. To be a writer that’s going to touch people, you have to be authentic and transparent. And then,” my  hand covered my heart, “You must be willfully courageous to share that which is at your core.” 

His head shook, “I don’t share my writing much.”

“I know,” I folded my arms, briefly tucking fingers beneath my chin, “I’m inviting you to, encouraging you to. Coz really Geron, if you can’t share it with me?” My sentence trailed off.

Geron wrinkled his face and swiveled a quarter turn, throwing his left arm over the back of his chair to look away. It is a posture he assumes when our conversations penetrate. Pivoting places the sinew and bone of his shoulder between us and shields his core, ostensibly providing some semblance of safety. It is unconscious and automatic, a clanging bell, a red flag - a call for kindness and kid gloves though he fends for the uppercut.

“I know,” he stared off to his left, “If I can’t share it with you,” he turned to bore through me with dark eyes, “Who can I share it with?”

I nodded in tacit agreement.

Our waitress openly flirted, disclosing her schedule, inviting his return.

“She’s dangerous,” he said with a wry smile, gesturing with his chin once she left.

“Your pretty face opens many doors,” I smirked. Geron scowled and growled.

“Don’t tell me you don’t know and don’t notice." I sprang forward, instantly animated. "OH WAIT! You do but you pretend you don’t!” I cackled and clapped, applauding my veracity before lifting a line from Saturday Night Live, “Yeah, yeah, that’s the ticket.”

He grinned sheepishly, shoulders bobbing with laughter.

I want to see The Descendants,” I abruptly changed topics. “The people of Hawai’i love that movie.

“It was too much like real life,” Geron grimaced, “And you don’t need to see it on the big screen. George Clooney gives a strong performance though; if you like George Clooney.”

“C’mon!” I gave him a look of incredulity. “What’s not to like about George Clooney?” I shrugged, “He’s easy on the eyes, in any case.”

“You would say that.”

“I’d say that about you too,” I was sophomoric and giggly, batting my lashes.

“You need your eyes checked,” he scowled again in feigned disapproval, loathe to be mistaken for one who adores being adored.

“You won’t like it,” I sing-songed back, grinning Cheshire. “It’ll be a bummer for you-u-u-u,” I sang. “You’ll say, ‘You mean I’m not drop-dead gorgeous anymore? Bummer man, I loved being drop-dead gorgeous.’”

“Doink!” his finger poked in my direction. “Okay!” his tone was one of exasperation. His arms spread in a wide, welcoming  gesture, opening his core to the sucker punch. “Any other buttons you wanna push?”  We laughed heartily, uncontrollably, uncaring if we disturbed others.

Just then our waitress returned to light the table votive. “I’d like to light your fire, if I may.”

“Sure,” he said absently, “Please do.”

“Wow!” I exclaimed, “You’ve never said that to me!”  We doubled over in peals of laughter. I dabbed at tears with my napkin.

“It was the ‘if I may’ part,” Geron defended.

 My turn, I poked a finger in his direction, “Doink!” 

“Yeah, right.” He was at least bemused, if not amused.

Note to self: use phrase “if I may.”

Nachos snarfed, he waited while I guzzled my brew.

“You look particularly dapper tonight,” I said, lightly clutching his arm as we exited. “You look lovely,” I smiled, “If lovely is a word that can be applied to men.”

“I’m used to it,” he was jaunty, “You’ve trained me.”

“Yes,” I shoved him, “Cringing all the way.”

“Hey,” he stopped in his tracks, arms splayed, “I’m still here!” 

“Goodnight honey” he said as I kissed his cheek and pressed into it with my own. 

Goodnight honey, it was an unusual thing for him to say.

“Goodnight Geron.” I stood behind my car and watched him go, slurping the last of the Tall, Cool Drink. 

He turned, “Talk Thursday?”

“Yes, take good care,” I called out. “Goodnight sweet man,” I whispered.

Flood waters receded as his car raced uphill toward home. I sank deeply into the leather of my car. The wind blew, the night deepened, the moon rose and pulled tides, and earth assumed its onerous rotation once again.

The aftermath is always the same. I am beached with the flotsam and jetsam of our rendezvous - tasked with sifting, sorting, remembering, uncovering, discovering, retrieving, and treasuring. Some days later, I may write. Once called, I write because to do less dishonors that which brings peace. Often something is revealed that was there all along, hiding in plain sight.

Such is the nature of writing authentically, transparently, and courageously sharing that which is at my core.

“What’s the point?” he asked.

The point: There is a vitality, a life-force, an energy, a quickening that is translated through you...  and because there is only one of you in all of time, this expression is unique and if you block it, it will never exist through any medium and will be lost... the world will not have it.

It is not your business to determine how good it is, nor how valuable, nor how it compares with other expressions... it is your business to keep it yours clearly and directly, to keep the channel open.”    ~ Martha Graham


Capiche?  ~ L

Where East meets West

The western world doesn’t get more East than this methinks as I pull the blinds open to pre-dawn dark. I want to see this city that will waken me with strange sounds and sirens. I want to watch its phases: streets illuminated in tidy rows of yellow light that fade with dawn, the freeway and its steady stream of bright beams, early morning cloudbursts watering the valleys, the afternoon sun that bakes this tropical land into a sweatbox, the golden glow of a sun, harnessed by warrior god Maui, sinking slowly into the Pacific to its last - green - beam, and nocturnal rains that bathe from the isle the soot of man’s machines. I want to watch it all, feel every nuance, every thick breath, every sight and every sound, every scent, drinking it in as if I were parched, for I am.

 Stuttering headlights wind their way down Alewa Heights, high beams interrupted by homes and vegetation. The  river’s edge is dotted in golden puddles, street lamps reflecting off the dark swath that snakes through Chinatown. A half-moon too, shimmers silver on its surface as it slithers silently south - to the sea. 

Before the Shinto temple and its giant gong facing the river, local denizens gather in twilight for tai chi. From my cat’s perch on the 29^th floor, their shadowy figures move slowly, rhythmically, silently.

At the edge of Honolulu harbor, marine diesel exhaust permeates the air with an unpleasant scent that wafts through Chinatown, competing with sandalwood incense. An occasional boat wails long and low as it pulls from the dock. Cruise ships will leave later, their marine horn blasts reaching far across the island to echo off the Pali. The fish market is open and I am home. 

Back home in the islands, in the middle of the sea.

The open market will spring to life. Fresh greens and fruits displayed in crates, or cardboard boxes, or from a tarp on the ground tended by a tiny Tutu (grandmother) squatting over her goods, swatting at flies with a palm frond.

I lace my running shoes and head toward the water. The smell of char-siu (red, sweet pork) and huli-huli (roasted) chicken rises with the steam off the asphalt. Chinatown is teeming with shoppers eating steaming bowls of jook, the ubiquitous rice porridge known throughout Asia as congee. Square, gray and white, faux marble tabletops wrapped in aluminum with matching chairs, clutter small cafés. Waitresses, always uniformed in black and white, scurry and call out in sharp, chopped Cantonese. The chatter and clatter of Chinatown competes with the cacophony of tropical birds in the coco palms overhead.

After my run, I too will eat a steaming bowl of jook - out of ritual as much as desire. Its white, thick paste reminds me of my roots and informs who I am as much as any learning. In Asia, rice is life. In Chinatown, rice is tradition.

The sooty sidewalks of Chinatown are uneven with lifts and chinks; the pavement wet with rain. I am careful with my footing, traversing its streets to the sea. Deserted are the small, seedy bars crowded with empty tables, chairs, and barstools. Their doors are thrown open for cleaning and fumigation, their doorways hosed of urine. I turn left at the harbor and pass a fishing supply store. Inside, its windows are stacked ¾ high with cardboard boxes that seal a baseball-sized hole to the outside. Narrow, dim, and I fear, rat-infested alleyways house rickety staircases wending up.

Ahead, a man crosses Nimitz Hwy, my final barrier to the sea. I sprint to make the light, catching him as he steps upon the opposite curb.

“Tanks braddah!” I said as I slowed and jogged past.

He jumped aside then smiled through missing teeth. “Eh seestah, you wen scare me,” he laughed.

“Sorry brah.”

“Eh!” he called as I out distanced him, “Hauoli Makahiki Hou!”

“Hauoli Makahiki Hou to you!” I turned, yelled, and waved, before spinning and sprinting toward Aloha Tower.

Sacramento Bee Submission

No-Strike Nurse

Last year, CNA’s (California Nurse’s Association) chief negotiator strutted proudly before packed cafeterias and conference rooms, detailing the new contract negotiated on behalf of Kaiser’s nurses. When Kaiser called it generous, they weren’t kidding. The contract includes raises without take-aways. We were to a (wo)man - thrilled.

Union membership comes with the job at Kaiser Permanente. While I labor under a brand-spanking-new contract that arguable makes me one of the highest paid nurses on the planet, I often find myself at odds with the advice and tactics of CNA.

The work stoppage of September 22^nd is a good example. Twenty-two days into the newly minted contract, nurses were asked to honor a one-day work stoppage by a “sister union.” 

Page 116, Article XL, Section I of said contract is entitled “No Strikes or Lockouts” and clearly states, “There shall be no strikes, lockouts or other stoppages or interruptions of work during the life of this agreement.” I found CNA’s request shocking and divisive.

“How does CNA justify calling for a work stoppage when the contract clearly states we’ve agreed to a no strike / no work stoppage clause?” I questioned the union representative who came to my workplace bearing strike literature. Her response included “past practice” and that “everybody knows you can honor another union’s strike.”

I notice no such contract verbiage. Call me simple, raised in a time that touted: your word is your bond, I do my best to uphold that creed.

On January 31, 2012 CNA once again called upon its membership to honor a one-day work stoppage. The strike literature cited a CEO raise, executive compensation plans, Kaiser profits, and the current tenor of contract negotiations underway between Kaiser and NUHW. This rhetoric incites and as it has no bearing on my contract, is not germane in my decision making process.

My union, the CNA, negotiated a contract with Kaiser Permanente - to which I am bound and beholding. That contract is a binding agreement between me and my employer. In honoring my contract, I report to work: no strikes / no work stoppages. To do less, justified with legalese and maneuvering, dishonors my word and my agreement. To do less jeopardizes the very contract under which I labor.

I am deeply grateful for the contact negotiated by CNA. I intend to honor it.

Lorin Bacon MS, RN, Acute Care NP

Kaiser Permanente

CNA member

The Applicant

“What you’re describing is commonplace,” he said, “Business as usual. The applicant is unimportant.”

“It’s so inconsiderate,” I frowned, “So dismissive. Society in general is more callous; we are less attentive to the other. I am supposed to know that if they don’t call - even though they said they would - I didn’t get the job. And I do know - but I want to have a conversation - and that’s socially awkward.”

My friend Martin works in an ancillary industry to my own. His broad shoulders withstood my tears. “One of the ways our managers are evaluated,” he offered, “Is by how quickly they respond to phone calls, emails, requests, and applicants. They have 48-hours to respond, even if it’s to say, ‘I have no information and will have to call you back.’”

Brilliant. His company uses customer service as a measure for competency. I think most companies do. It breaks down internally when we do not consider employees customers - and treat them as such.

Five years ago, three nurse practitioner (NP) jobs at Kaiser were surgically excised from the budget to stem the flow of red ink. My termination notice arrived via email. (Yes, that raised more eyebrows than my own.) No exit interview, no apology, no semblance - even feigned - of care. I felt no administrative concern for my welfare. 

Courageous are individuals and organizations who can look within, identify weaknesses, and take steps toward remediation. If we are unable to accomplish change within our own lives; how quickly do we expect an organizational response? Organizational intelligence is hard won. Make no mistake, I believe Kaiser is an intelligent and responsive organization and employer AND we both have work to do.

Over the years I have applied for two nurse educator positions, a peri-operative NP position, and interviewed thrice for a position on a proposed cardiovascular team. They always say, “We’ll call you next week.” They never do. 

Kaiser’s cardiovascular (CV) team has experienced many setbacks and hiccups and is finally being assembled. I interviewed, yet again, in early December for a CV NP position on said team. The interview panel wore their best poker-faces and were difficult to read. 

“You don’t admit and discharge; do you?” I realized that my CV NP workflow at Mercy is exceedingly narrow and specific. I lack the broader skills an NP should have, like admitting and discharging. Nothing I couldn’t learn but in the current job climate, employers need not train. They can seek and hire persons able to don scrubs and start work.

“There could be resentment and animosity toward a Kaiser team inside Mercy. How would you handle that?” The questions went round-robin.

“There is resentment and fear already,” I said. “One of the cardiologists refers to Kaiser as the gorilla in the building.” 

“The gorilla in the building?” they snorted.

“Here’s the thing,” I continued, “They know when you put a full team in place, there will not be enough work to support all of them. I’ve already heard that docs are interviewing cross-country. They’ve been here many years; they thought they would work out their careers here and raise their children. Now they are looking at moving and uprooting their families. I have lots of compassion for that. But I never hear their frustration directed at people. They think highly of your surgeon so he is a good ambassador for Kaiser.”

“But how would you handle it?” someone pressed.

“Head on, by asking questions like, You seem irritated. Is there something I need to do for you that I’m not doing or something I’m doing incorrectly? Or is there something else? You know, I’ve been there for years; I know the people. There is nothing that can’t be handled in a conversation. It’s all about communication.”

The interview wore on. They showed little enthusiasm for my skill-set or what I could bring to the team.

“We’ll call you next week.”

Neophyte no more, I clarified, “Either way?”

“Yes, either way.” 

I left that interview feeling inadequate and unqualified. 

Something didn’t feel right. “These interviews my be a ruse,” I told friends, “A fulfilling of their contractual obligation to post and interview for NP jobs before hiring PAs (physician assistants).”

“Remember,” a sagacious friend offered, “They will make selections based on organizational needs that may have little to do with you.”

While vacationing over the holidays, CV NP jobs #3 & #4 were posted on our jobs website. Though I had already interviewed, I applied for them all. They cannot say I wasn’t hired because I failed to apply. Just how many CV NPs work in Sacramento? A handful, I probably know them all. How many CV NPs at Kaiser? None. If we hire four people, one would think I was a shoe-in.

Regardless of words to the contrary, I knew she had no intention of calling me and she did too. I’ll call you next week is a social lubricant to get us over a sticky wicket. From the applicant’s perspective, continuing to see jobs posted without a word from the interview panel is very weird. They have no idea... After a month had passed I committed a social indiscretion, I called.

“I keep seeing jobs posted on the website and I haven’t heard from you so I thought I would call to touch base.”

“Well, I am not prepared to offer you a position today.” Her irritation was thinly veiled.

No duh! “That’s clear and not the purpose of my call.” I did my best to remain gracious, to check my ego and feelings. “What is going on?”

“We think we want people who can help in the OR and you don’t have that skill-set.” She was curt, pointed. 

“I can see that,” I said. And I can. Few NPs have operating room training. “If you are looking for people with OR skills, you will be better served by PAs.” I thanked her for her time and ended the call.  …as I suspected.

There is sadness for me in that I have worked split days off for five years, keeping a particular skill set alive, waiting for Kaiser to build a cardiovascular team. That time is now, the team is being assembled, and obviously, I will not be tapped. I am deeply disappointed. I don’t have to fix this for there is nothing to fix. Can I be with my sadness? 

I had hoped to discuss the interview. Most nurses are unskilled interviewees for lack of practice. We have had the good fortune of being highly sought and readily employed. I would love to use the experience to grow and expand myself. I was stopped by her abrupt tone. I may yet have that conversation elsewhere.

We are, for the most part, uncomfortable with the discomfort of others. We deal with our own discomfort by avoiding and fixing. Demonizing the perpetrator is common. Do I think they think the applicant is unimportant? No, though clearly not a priority.

Can I be with my disappointment? Can you? Can we include my disappointment without clichés like: Something better is coming? Maybe it will, maybe it won’t. Can I include that interview panels never place follow-up phone calls to applicants? Can I do that without thinking them inconsiderate boors? Though they are? Can I treat the new Kaiser team members with the same consideration and respect for which I am indignant when absent? ‘Tis a bigger game; is it not? Who am I in the face of uncomfortable circumstance?

Last week, my twelfth patient weaned herself from insulin. TWELVE! And while twelve is a drop in the bucket, the social and financial implications of what I can cause and create – is gynormous.

I’ve received several offers to create a web-based program. One offer comes from a Silicon Valley software engineer with whom I would partner. Beyond organizational restraint and constraint is likely the place for a non-traditional path, the road less traveled.

In looking toward my next best place – 

it may well be precisely where I am planted- 

the confluence ancient wisdom & modern medicine. 

The doctor of the future will give no medicine, but will interest her or his patients in the care of the human frame, in a proper diet, and in the cause and prevention of disease. ~ Thomas A. Edison

Bacon's 2012 New Year Letter

Baconz 2012 New Year Letter 

Hau`oli Makahiki Hou!

For the past 30-something years, my next line would read: May the new year find you in good health and spirits. That sentiment still resides in my heart for you AND I am learning that good health is relative and unattainable for some. This has been an area of focus this year, that of thriving and the created dimension of wellness despite bodily limitations, failure, and the absence of good health. Or to say it newly: optimal health and wellness despite one's circumstance.

This year I've learned that my patients feel hopelessly doomed to a life of amputation and heart attack. I've begun to acknowledge and address that in my classes. Then I paint a picture of diabetes control, management, even reversal, and invite them to play.

"It's not for everyone," I say, taking it away, "But if you desire better diabetes control and the health benefits it confers, Kaiser has an enormous department of people like me to help you. Here's what you need to do to engage us."

The doctors of  Medicine-3 (my docs) say their diabetes statistics are their best ever.  (I doubt it's true but they say it nonetheless.) There IS mucho energy and juice for me in empowering patients to effectively manage a disease that has had them by the tail. Retiring resignation and empowering patients toward optimal health and wellness despite their circumstance IS the name of the game. 

I attended three conferences this year, all included at least one session focused upon disease reversal. For a full accounting of my trips to Cleveland Clinic, Chicago, and Portland, see my blog (address provided at end of this letter.) You've heard idioms alluding to: you are what you eat and the company you keep. A plethora of scientific evidence favors the adage. Choose your foods and friends with care.

Kaiser is finally assembling a cardiovascular team for which I interviewed, along with two others. While one would think this is a slam-dunk, it is not. This job is in interventional cardiology; there are skills I would need to learn and master. I left the interview feeling anxious and inadequate. "We'll call you next week," they said over a month ago.

The Holidays are difficult for me. It seems like a time for couples and families. I feel alone, left out, and that my tribe is elsewhere. This, by the way, has no basis in reality as I am surrounded in friendship and love. But post-interview insecurities compounded by seasonal blues created two days of angst and sleeplessness. It had me reexamine some of my life's choices and contemplate a change in direction.

I am more and more convinced that upon retirement, I'll return to the islands. That being said, I have ten years to create something juicy and exciting in California. I released my suffering over it all. Nurtured by family, flowers, and culinary delights of Hawai'i, my attachments are more easily identified and released.

Most of you know my father died this year after a protracted decline with Alzheimer's disease. His death was a blessing as his mind had long dispossessed its withering shell. He died at home with family in attendance.

In Home Depot recently I heard a young boy holler, "Hey Dad!" I was instantly overcome with tears in the realization that I will never-ever direct those words to my father again. Still, my remembrance of him is sweet. While he was a man of his time - stern and reserved - he possessed a clear moral compass and provided for my mother in ways she continues to discover and appreciate.

Mom is doing well. She continues to attend Look Tung Ken, her 6am Chinese exercise class on most days and has begun a weekly practice of Tai Chi. She is amazingly mobile at almost-87 and we are planning a fall trip to China.

Yes, I continue to backpack. (See bear print?) Last fall we explored north Yosemite Park one week before the gates of  Tioga Pass were bolted for winter. The Sierra high camps had been disassembled and removed. We placed our base-camp at their scenic sites next to lakes and thundering waterfalls for extensive day-hikes surrounding Glen Aulin and May Lakes. We also stayed one night at Hetch Hetchy, providing a glimpse into that luscious valley,  the object of John Muir's last battle.

John Muir lost that battle, allowing the City of San Francisco to flood Hetch Hetchy valley for drinking water. The war however, was won, forever changing national policies and never again permitting such pillage of a national park for private use. (For the record, I favor dismantling said dam and returning Hetch Hetchy to pristine wilderness.)

What's in store for 2012?

Travel: China.

Backpacking: To hoodoos and red rock swirled like water; the parks of Utah.

Music: My Kamaka ukulele, a 10th birthday gift from my parents, visited its Kaka'ako birthplace (factory) in 2011 for restoration. I intend to take ukulele lessons in 2012.

Professionally: I am creating a 5-month curriculum for heart/diabetes disease reversal. I have preliminary support to run a trial. My friends and  colleagues at KP- Santa Rosa run such a program for heart patients. Methinks it would be neato-keeno to work in that arena. (Actually, this kind of work is more inspiring and far-reaching than daily rounding for the CV team.)

Exercise: the Tarahumara Indians of Mexico are known for the absence of heart disease and ability to run hundreds of miles - barefooted. In recent years I have decreased my mileage and frequency of running secondary to post-run, pelvic bone/joint pain. I am changing my foot/heel strike to the softer landing of the Indians and hope to resume a more regular running regimen once again. Last year I took a beginners yoga class and LOVED IT. I intend to resume that practice more regularly. Still riding my bike - natch.

Writing: still crafting. Follow my blog at:

  http://lorinzmuze.blogspot.com/  Contact me if you want posting notifications.

Spirituality: I continue to dwell in that confluence of a spiritual walk, in a physical body, on terra firma. My goal: to leave people empowered with an experience of love. It's a tall order, one requiring a focus on others. It's a practice - and boy do I need practice.

Community: say YES more often. YES shatters the status quo. YES is the door to new possibilities.  YES allows me to more fully live in community with others. In 2012, I intend to say YES more often.

Golf: saving it for my golden years.

Many Mahalo's to  you for your cards and well wishes. LOVE your newsy updates.  

Lokomaikai hoomaikia ia maluhia ia oe ka oukou - a no la a me mau.  
Bountiful blessings and peace unto you and yours - now and always. 

Lorin
Hau`oli Makahiki Hou!

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. 

See Pema at http://www.youtube.com/watch?v=m7qFi52FX1Q

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!