Reflections on Life, Being Human, and Medicine Archives - Page 19 of 51

I grew up eating everything well done. Eggs were over hard. If there was the least bit of runniness to the yolk, it was not done enough. In college they sometimes made the scrambled eggs runny. I still don’t like runny institutional eggs, but now I like my fried eggs over medium.

I was in Key West. It was over 25 years ago. We were on a detachment to do counter-narcotics operations. Our airborne radar planes were a key asset to track drug runners trying to fly their drugs into the US. For this detachment we were positioned at Key West and our crews would fly surveillance over the Caribbean each day.

This was a quiet morning. One of the pilots and I got up and walked from the BOQ (Bachelor Officer Quarters) downtown to breakfast. We settled at a nice little place that had a street front patio. We were seated at a table in the morning sunshine. We ordered our breakfasts. My companion ordered his eggs over easy. They came out and were really runny. But he cut them up and merged the runny yolks with the hardened whites, adding salt and pepper as he did so. It looked appealing. My eggs were a little bit runny also and so I tried the same thing. I liked it.

That moment has stuck in my mind. Why is it that there are some memories or moments that replay more than others? There was nothing remarkable about it. It was not an earthshaking or key defining moment for me or my life. It was just a quiet day, sitting in the sunshine, drinking coffee and eating eggs that were a little bit runny.

Duval street in Key West, FL. https://www.oceansir.com/real-estate/617-duval-street-key-west-fl-33040/581804/62514358

What is there about this moment that makes it come back to me?

Maybe it is the simple quiet. I was not in a rush. I did not have a huge agenda for the day. I could enjoy the moment and “just be.”

Maybe it is the idea of simply enjoying the simple things of life that are in front of you?

There is a quote I have a on little card in my office that reads, “You have to be bashed a bit by life to see the point of flowers, pretty skies, and uneventful ‘boring’ days.”

I pulled that card out as I was rounding in the hospital a couple of months ago. My mind was filled with all the worries about COVID 19 and the stresses of the immense changes that were happening at the time. It made absolute sense to me.

I looked out the window. It was a sunny day. Some people were exercising out on the track by the hospital. I saw others walking down the street in the sunshine. I thought about how my patients in the ICU would just love the chance to be freely walking around outside, breathing the fresh air with warm sunshine on their shoulders.

I thought of the odd anxiety that we all feel of social distancing and these crazy COVID 19 times. I took a picture of the card with the expression to somehow capture the thought for myself. I too get stir crazy at home. Why can I not always appreciate an uneventful “boring” day? Can I not be wise enough to remember the “bashings” in the past to appreciate the good of today?

I looked and read the card again.

“You have to be bashed a bit by life to see the point of flowers, pretty skies, and uneventful ‘boring’ days.”

I resolved to walk outside to my car at the end of the day. I was going to do so slowly, savoring each step and breathing the spring air. I was going to look at the sky. I was going to be happy to just be healthy and outside and free to walk to my car.

Who knows what the future might bring? Whether illness or grief or other problems? I might soon deeply long for a “boring” day. I should savor any chance I have to just be outside walking around, breathing the air, and feeling the warm sunshine. Or perhaps, to be sitting having a simple plate of eggs and some coffee with not much to do for the day.

My CT scan report said two lymph nodes. One had grown. The other was new. They could be nothing. When I first wrote this I was waiting to hear back from my doctors. The thoughts of what they could mean disturbed me. They could mean complexity and changes in ways that I do not want. They could have a powerful impact on my life. They are not a boring simple day. They pulled at me and created a deep ache inside that I struggled to push aside as I wrote this.

But that morning I made eggs. I made them over medium. The white was hard, but the yolks were a little bit runny as I put my fork into them. In an instant I was back and sitting on a patio at a café in Key West. I cut my eggs up so that I could mix the yolk in with the whites. I added some salt and pepper. I enjoyed them.

For just a moment, there was a feeling of sunshine and warmth. There was a little patio at a café in Key West. I was young and the world was good. It was nothing dramatic. It was just an uneventful boring morning. But it was good. The feeling was good.

I am going to enjoy that moment. The quiet. The eggs. The lack of rushing to something else.

And in that moment I am okay.

A quiet walk in the woods. Just me and the dogs.

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.

Let’s see: The sun comes up in the East. So that means we are headed … Southeast? Oops. Guess we better come about!

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.

It was exciting to see the Chicago skyline as we finally made it to Chicago!

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.

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