Category: Medicine

This is the third in a series of posts about sailing across Lake Michigan. On July 12, 2018 we sailed overnight from Holland, MI to Chicago, IL. We did a second overnight crossing on October 4, 2019. On the first trip we left around 8 pm. We planned to arrive around noon. In reality we didn’t get in until about 4:30 pm.  

Oops. What went wrong? Answer: The wind.  

On our second trip I applied lessons learned from the first. We sailed through the night leaving at around 4 pm and arriving at around 5:30 am. I planned a lot of extra time. The straight distance from Holland to Racine is about 70 miles. With tacking back forth we travelled about 90 miles. It took us about 14 ½ hours. We were powered entirely by the wind. 

For our trip to Chicago, I had great plans. For weeks before I plotted out the distance and thought about when we would leave and arrive. Everything started out perfectly. We had a west wind. We needed to go southwest to Chicago. That meant that we were on a close reach. That is a very nice and fast point of sail. 

I used the iNavX App on my iPhone and iPad. It was tracked our progress. It continually told me an updated ETA (estimated time of arrival). The close reach was pulling us along so well that it said we would arrive by 10 in the morning. That was earlier than I planned but I loved it. I hoped the marina would let us into a slip or place to tie up early. We would have more time to walk around Chicago and shop and for JJ to connect with friends.

Then the wind shifted to the southwest. That meant that it was right on our nose. That meant that if we tried to head straight to Chicago we would be in the “no-sail” zone. Our boat can sail anywhere from about 35-40 degrees off the wind or more. Closer than that the sails “luff” and the boat stops moving. I had to shift our heading off to the south. 

As I did the iNavX App started showing me a later and later ETA. The ETA became noon, then 2 pm then later. Through the night I trimmed the sails in tight against the boat. I held the helm into the wind as tight as the boat would handle and still be powered by the wind. That is a called being “close hauled.” 

At one point it, in the middle of the night, it became clear that our plans were going to be upset by the wind. I started the engine. The engine is positioned directly by the stern bed. The old diesel engine clanged away. In spite of the soundproofing in the box around it, it is loud for anyone in the stern bed. Eventually the face of one my crew popped up from the cabin and complained that it would be impossible to get any sleep with the engine on. I turned it back off and continued trying my best to get as close as possible to Chicago. 

Early in the morning JJ was on watch with me as we watched a glorious sunrise over the water. We snapped pictures and enjoyed the rich colors. As we did so I noticed a problem.  Hmm. The sun comes up in the east. So… if we see the sun positioned as it was in the picture below, our bow was just a little bit off of the east. That would mean we were pointed south (or maybe even southeast). We were not pointed toward Chicago. We were pointed toward Indiana. I was going to have to come about (turn the boat through the wind onto the opposite tack) to correct our course. 

JJ and I prepared to come about. The rest were sleeping (or pretending to do so) down below in the cabin. We turned the boat through the wind and trimmed the sails to the new heading. We  went from being on a starboard tack to being on a port tack. This meant that the boat went from being hiked up (angled) onto its port side to being hiked up onto its starboard side. As it did so we heard “roll, roll, cathump!” I am not sure who fell out of bed but clearly they were not pleased! 

An hour or so later, Sarah came outside to the cockpit in the morning with a look of optimism on her face, “Can you see the Chicago skyline?” 

Uh. Well. No. 

We have a little bit longer to go.  

How much longer to go?

Like maybe another 8-9 hours to go.

In the end we made it to Chicago. We did end up motor sailing part of the way. But we made it. And we did our best to use the wind that we had. 

The principle lesson: You have to sail the wind that you have rather than the wind you hoped for.

For our trip to Racine, I did a few things differently. First I brought only two other crew members. This gave us more options for sleeping. We could better angle or prop ourselves to counter the hiking up of the boat under sail. We could also move away from the engine if we ended up needing to motor sail. I also planned a large cushion of time without any real agenda for after we arrived.

On October 4, 2019 at around 4 pm in the afternoon we left Holland, MI. As we got into Lake Michigan we hoisted the sails. At the start the wind was at our back and to one side. We were on broad reach. Later the wind shifted to being directly behind us. This meant that we would be on a run most of the way.

You would think this would be ideal. It actually is not. It can be a challenge to find the best sail configuration to handle it. The heavy waves would cause the sails to luff (sag) in spite of fairly steady winds. They would luff from the waves and then fill with wind again. When they filled with wind they would jerk straining all of the rigging on the boat. If I kept directly on a run (wind directly behind me) there was a risk of an inadvertent jibe. A jibe is when the sails suddenly shift from one side of the boat to the other. As the boom swings around it can carry tremendous force. It can injure the crew or seriously damage the rigging on the boat.

I ended up with only the mainsail up. I had it extended far out to one side. I had the genoa (large sail on the front of the boat) out for a while at the start of the trip. It would keep collapsing with each large wave. Eventually I pulled it in. For the mainsail I rigged a jibe preventer. That is a line that is attached to the boom to prevent it from jerking backwards. That kept the rigging and mainsail from luffing as we went through each rise and fall and roll of the waves. I kept us on a broad reach. I sailed as close to our heading to Racine as possible but yet off the wind just enough to still have enough force on the mainsail to keep it from luffing as we went through the waves. 

In order to make it to Racine, based on the winds, we needed to tack back and forth a few times. With each tack I needed to undo and re-rig the jibe preventer. I was careful to always be clipped into a safety harness whenever I left the cockpit. I didn’t take chances. With the waves between 4 and 6 feet it was a challenge, nonetheless.

I think I like sailing because of these challenges. You have to sail the wind you are given rather than just the wind that you hoped for. 

Life is the same way. We can spend a lot of time bemoaning what we have been given or not given. It doesn’t change anything. A truly wise person is one who is able to see the truth and respond to it. Can I be wise enough to accept the challenge of the circumstances that are in front of me and come up with the best response?

By wishing I could not get the wind to shift 30 degrees to make the journey easier. I had to think through the various options available to us and then put a plan in action. The principles are clear: (1) Find the facts as much you are able. (2) Think about your options. (3) Act on them. 

The COVID 19 pandemic has been a huge and unexpected shift in the wind for all of us. What can you do to respond to it? What options or choices do you have? It does little good to only complain that the circumstances are not what you want. How are you going to handle the reality that is front of you? 

Sarah and I have been asking, “What is the Lord doing in our country and our world through all of the stuff that has been happening in 2020?” It has been a crazy year that I could not have anticipated in any way. It is only natural and important for us to ask this. We haven’t come up with any good answers. In the end we have been left with this: God is in control. We have to sail the wind we have been given rather than the wind we hoped for. 

For the past month I have had a resurgence of my symptoms of adrenal insufficiency. I don’t know what has brought them on. At times I have had fatigue that stops me in my tracks. With it I have had diffuse muscle aches. I also have been feeling lightheaded again. Sometimes I have felt “presyncopal”. This is a medical term that means feeling like you are going to pass out. I have noticed my vision gray out or starting to tunnel if I stood up from my chair or changed positions too quickly. I messaged my doctors. They did labs. They indicated cortisol and aldosterone deficiencies. They had me start back on a low dose of hydrocortisone. Later they added some fludrocortisone. These medicines have helped some. I also have made a point to rest more. That has helped a lot. 

I don’t like it. I have things that I want to do. I don’t want to have limits on me or my stamina at work or at home. 

Several years ago, one of our nurses described me as being like a duck. She said that I would look calm and still on top. But underneath my feet would be madly kicking away to drive me to my goal. In the midst of starting and building our ventricular assist device and heart transplant programs, I set a personal goal of getting at least 5 hours of sleep when I was not on call. That meant that I could stay up late and yet still get up early to keep up with everything I wanted to do. I can’t do that anymore. I am being forced to go to bed on time and not get up early. There are things that I am not getting done. My email inbox fills, and I cannot empty it. 

In July 2018 we sailed from Holland to Chicago. As the winds shifted we found that it took us a lot longer than we had hoped or planned. A year later we made the trip to Racine. For that trip we sailed the entire way. On that trip the winds were more favorable, and we made it in 2-3 hours ahead of what I had planned. Each journey required different sail trim and techniques. I didn’t get a choice in what wind we had. I had to sail the wind that existed rather than the wind that I wanted.

So also, in life there are a lot things that we don’t get any choice about. Sometimes the circumstances will mess up our plans. Sometimes it means that we end up going in the wrong direction for a while. Sometimes it makes us late and we have to change our plans. Sometimes it requires us to improvise and come up with new ideas or techniques. Sometimes it pushes us to things earlier than we had planned.

I don’t like the conditions that COVID 19 has imposed on us. I don’t like putting a mask on whenever I walk into a store. I don’t like wearing a mask all day at work. I want to travel. I want to gather with groups of friends. But the question is not what I want, but how I am going to handle the conditions that are in front of me.

I don’t like not having the endurance or stamina that I used to have. It occurs to me that I have lived my life with my adrenal glands cranking out cortisol to keep up with my internal drive. Now I have only one adrenal gland and it is not willing to keep up with that schedule. I don’t like that. But the question is not what I want, but how I am going to handle the conditions that are in front of me.

I guess it means that I need to sail the wind I have rather than the wind that I hoped for.

This is the second in a series of posts about sailing across Lake Michigan. On October 4, 2019 we sailed 90 miles over 14 ½ hours making the trip from Holland, MI to Racine, WI. We were powered entirely by the wind. We sailed through the night planning to arrive in the morning. We set out on our journey at about 4 in the afternoon. All was good in the light of day. Watching the sunset was enjoyable as we sailed along. But then the darkness came. 

In sailing, and in life, the night can bring a lot of challenges. Everything is harder in the night. Problems loom larger. Solutions are farther away. How do you survive the night? 

We took turns on watch.   Rule 5 of the COLREGS states: “Every vessel shall at all times maintain a proper lookout by sight and hearing as well as by all available means appropriate to the prevailing circumstances and conditions so as to make a full appraisal of the situation and of the risk of collision.”  This means that you need to keep someone awake and looking for other boats.

Every couple of hours we would rotate who was on watch. Most of the time the autohelm was running. All that was necessary was to ride along and watch for other boats. I have an AIS (Automatic Identification System) attached to my GPS/Chart plotter. All commercial vessels are required to electronically transmit their identity, location, speed and heading. This information will show up on my chart plotter. I turned on an alarm so that any vessel coming within a mile of us would sound an alarm. This is a nice safety feature.

It was a dark, cloudy, moonless night. The cool October air was chilling me. I started the evening in a long sleeve t-shirt and a light jacket. By the time of my middle of the night watch, I had put on every coat that I could fit. The air was cold, and the wind whipped around me. I had on 4 layers plus heavy gloves and a hat. On top of this was a Cat 5 life-vest and safety harness. Hooked to that was a tether connecting me safely to the helm. Jim and Joel were below trying to get some sleep. It was very dark. I could see the green and red shadows from the bow lights and a dim glow off of the chart plotter but not much else. I couldn’t see the water or anything around the boat.

All alone in the middle of the night in the pitch dark you can begin to see and hear things. I saw lights. Strange and fleeting lights would appear. Sometimes I thought I saw police or fire strobes. At other times, I could swear there were other boats that I saw off of our bow. One minute I would see what I thought were their navigation lights and then the next minute I would not.  I would check the chart plotter for any AIS data. No boats were indicated. It was eerie and strange.  The lights would appear and then disappear, likely the result of some strange refraction of light off of the overlying clouds. We were all alone in the middle of Lake Michigan. There never were any boats there. But at times I was sure I could see some.

I heard things. This was perhaps even more disturbing. All alone at 3 am in the pitch-dark night I was surely hearing things that I shouldn’t have. Without an engine running to drown them out, the sounds were more evident. There were, of course, the creakings and sounds of the boat, the sails and the rigging. But in the quiet, dark, and alone moments I heard other things. I could swear I heard a child talking. The voice was just off of the side of the boat.  It sounded like it was just 10-15 feet away off the starboard side of the boat. What was it? I would strain my eyes, but everything was black. I couldn’t see anything. And then I wouldn’t hear it anymore. I would laugh to myself. Of course, no one was there. Right?

I have read many of the wild stories of the sea. Sailors have claimed to hear all sorts of things. In the dark, deprived of sight, you begin to focus too much on the sounds. I suspect it was likely just the wind and the waves and the fatigue in my brain. Wasn’t it?

There is such a thing as too much focus. Obsessing can cause a loss of objectivity. There are those games where they show you a picture which is zoomed in really close on an object. Zoomed in too close you cannot tell what it is. The irony is that the harder you look the more likely you are to get confused. The truth can be lost in those moments of obsessive focus. It is only after you pull back the zoom that you are able to again see everything in perspective. When you pull back and relax your focus, then things become clear again.

We must beware the deceptions of obsessing. Kate Bowler^[1] is an amazing author and speaker. She is a historian at Duke Divinity School. JJ has been working on her staff. At a young age and as a young wife and mother she was diagnosed with incurable metastatic colon cancer. The irony is that this diagnosis came in the middle of her PhD studies on the prosperity gospel. As she faced an enormous personal challenge, she was plopped in amidst people telling her to “just have faith” or to “name it and claim it.” She has developed a powerful message of truth and reality that goes beyond platitudes of optimism and positive thinking. In her words you can see a faith that is not naïve, but which is intensely honest, strong and real.

Kate Bowler has a rule that she cannot deal with anything serious or sad after a certain hour in the evening.  It doesn’t do any good. You don’t really solve the problems staying up all night to worry about them.  There are times when you just need to rest.

I am someone who has lived his life by solving problems with his mind. But some problems cannot be solved just by thinking about them. Cleverness can only get you so far. In the middle of the night, when things are silent, it is possible to focus too hard. In the middle of whatever storms or darkness life brings, sometimes the wisest thing you can do is to not try to solve everything. Whether it is the physical night, or a more figurative night, there are times when you need to just sit back and let the boat sail on.

In those dark and quiet moments, the wind can sound like a child talking. There is no child there. But the harder you listen, the more convinced you become that you hear him. The darkness can make your thoughts go places that are not real. You become unable to be objective. You cannot solve everything. Maybe in those moments you cannot solve even anything. Maybe you shouldn’t try. Instead you should just sit back and let the boat carry you. You don’t have to figure everything out or understand everything. The boat is doing the work. The autohelm is programmed and set and is following the course. Whether you understand or not, you will be carried forward. There are times when you need to just “be.”

On call in the hospital at night I learned a similar lesson. In the middle of the night, problems would seem enormous and unsolvable. I would look and think and dig and try to find solutions. It has always amazed me how the “middle of night problems” will consistently melt away in the morning. With daylight and the rest of the team returning, the enormous problem of 4 am becomes more easily solved. All becomes well again. Time and daylight can be our friend.

An abnormality on my CT scan pulls me into the night again. There is no answer other than that I need to wait and watch. I desperately tried to find an answer. I went back to the ACC (adrenocortical carcinoma) Facebook groups. I searched and read other’s experiences. I tried to pull them into my situation. I went onto PubMed and into the medical literature. I tried to somehow find answers to what those two lymph nodes could mean. 

In the dark, the harder I tried to find information the less I knew. My obsessive focus was not helpful. Later came the answer from the tumor board and then Dr. Hammer. The nodes may or may not mean anything serious. We just need to wait and look again in 3 months. The right thing to do is nothing. I need to settle down and just sit back and sail on. The Lord knows my future and at the moment my course is clear. Wait. I don’t have to know any more than that. 

The child was talking again just off of the starboard bow. I shined my handheld floodlight off at the dark waves. There was no boat. There was no child. There was just a vast large lake all around us. I laughed at myself. “This will make for a nice story someday!” I told myself.

The Lord is in charge. He has a course plotted out for me. I am comfortably in His hands. The best thing for me to do is to sit back and let time carry me along. Knowing or not knowing will not change my present or my future. Sometimes stray thoughts will come. In the night, when I am tired, it is ok to hear them and then ignore them. Maybe I can even laugh at myself and think, “This will make for a nice story someday!” 

Kate Bowler is wise. The nighttime is not the time to solve things. There is a time when you should not think or talk about serious or sad things. Give yourself a break. Put the thoughts away for the evening. You can pick them up tomorrow. 

Peace child. Be still. The daylight will come in the morning. Wait for it. You can work on or think about everything then. For now, just sit back and let the waves and the wind rock you back and forth and be calm.

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^[1] https://katebowler.com/books/everything-happens-for-a-reason/