click to enlargeMaya was married this weekend.  her folks live in Golden, Colorado, near the grave of Buffalo Bill.  Elevation at their home is almost eight thousand feet.  This means there's 20% less oxygen in the air.  So sea level people like me need to breathe in 20% more to feel normal.  I found my heart racing after I ran up a flight of stairs!

Maya is my best friend from my residency program.  She was the first person I met when I went to Rochester, MN for my interview.  Two years ahead of me in training, she left for fellowship in San Diego after my third year.  Now, she's a well-known Pediatric Orthopedic surgeon who works at Children's Hospital of San Diego.  

She met her husband, Dan, at a Christmas party a few years ago.  It was practically "love at first sight."  He's a terrific man and has an extraordinary 11-year old daughter, Haley.  Here are some photos from the weekend and the wedding. Maya wore the same dress (remade of course) worn by her great grandmother, grandmother and mother.  The dress is more than 100 years old!  Each time it has been remade slightly since each woman had a different shape.  The material had aged to a beautiful gold color.

Maya's parents, Kitty and Rock, have a home in the woods which overlooks beautiful, snow-capped mountains.  Numerous bird feeders set around the perimeter of the house attract all sorts of birds.  It is mating season for the hummingbirds, so we saw scores of them, dive bombing all over the place.  Also, the neighboring herd of Bison had just delivered some babies.  All things bode well for this marriage.

Congratulations, Maya and Dan!  I am honored to have been a part of your wedding and I wish you the very best.

Namaste.

Just yesterday I received an email notice stating that some pins used in total knee replacement are being recalled by the company.  Lucky for me, I have never used these pins during surgery.  However, this and notices like this are a wake-up call to me and others regarding our routine use of man made materials in a human person.

So many people suffer from conditions for which we have no good solutions.  What we don't know in medicine so dwarfs what we do know.  But people do not want to hear this. What they want is for me to tell them "We can fix that.  We can make you 100% again."

Fact is, there is no such thing as making someone "100%. "  And what is One Hundred Percent anyway?  

An old medical joke comes to mind:

Patient:  "Doc, after surgery, will I be able to play the violin?"

Doctor:  "I don't see any reason why not."

Patient:  "GREAT!  Cause I've never been able to play before!"

While we as physicians have come a long way in treating painful and dangerous conditions, we are simply human.  We aren't magicians.   But the perception of physician as magician, or shaman, persists.  There must be some magic formula, some "laser surgery" that can cure our patients.  More than one patient of mine has come to the office demanding an MRI.  These folks believed that an MRI (which is a diagnostic test, used to find out what might be wrong with someone in certain conditions) would cure them.  Cured by a test!

Perhaps we can apply the Heisenberg uncertainty principle to disease.  Perhaps the hunting for them or the studying of them can knock the disease processes out of their orbits.  Just enough to cause a spontaneous cure.

If only.

Truth is, we can do what we know how to do.  We can continue to research problems and find new and better solutions.  We can think and try and hope.  We can believe that one day we'll be smart enough to tackle the toughest problems  and to bring our patients back to that One Hundred Percent level.

You see, doctors want to help.  We become frustrated when we can't.  And sometimes, in trying to help we make things worse.  By inserting faulty pins.  By performing surgeries that don't come out as we had planned.  By doing what we know how to do since we aren't smart enough yet to know how to fix the problem.

Sometimes the hardest thing to do as a physician is to admit when we don't know.  Perhaps a course in humility ought to be added to our medical school curricula. 

  This weekend, we celebrated Jonna's birthday with an "adults only" dinner out.  While this is the norm for me, the three couples at the table all have children between the ages of 13 months and 3 years.  For them, this is an oasis from diapers, Dora and Disney.  Wine flowed as did our conversation.

A: "And what is with those new Burger King commercials?  Where the guy wakes up and there's that freaky King guy in the bed with him?  I don't know about you, but I wouldn't take a sandwich from that guy!"

K:  "I know!  And is this supposed to mean that the Burger King is G-A-Y?"

L:  "Wait a minute.  Did you just spell the word 'gay?'"

K (sheepishly):  "Guess so."

L (looking around the restaurant): "What a relief.  At least you didn't offend any of the gay people in this restaurant who can't spell."

K (looking at her husband): "Well, we don't want the kids to repeat words when they don't know what they mean."

Hmmm.  So it's better to spell words and avoid explanation around children.  Teach them early on to avoid sensitive or controversial topics.  Of course it makes sense to spell things like "ice cream" and "doctor," so as not to create unnecessary angst, but when we begin to censor ourselves, it's time for a check up.

A scene from the 1985 brat pack classic film Saint Elmo's Fire comes to mind.  The Rob Lowe character is having dinner with the family of the geeky Mare Winningham character.  Whenever a "taboo" word, such as cancer, is uttered, it's whispered.  The ice is broken when Rob Lowe is asked where he and Mare met.  His response:  prison.

Does spoken language have such power so as to scare us out of saying certain things?  If these are all just words, then  why are we afraid to have them pass our lips? What will happen if our two year old says the word "gay?"  Are we better off if we teach that two year old the meaning(s) of that word?

Or do we think our children won't understand?  More importantly, will our explanations or definitions reveal our lack of understanding?  For instance, why do parents so dread having "the talk" with their children about sexuality? Are parents afraid their knowledge will be inadequate?

I so vividly remember the way my mother explained things to me.  She didn't seem anxious or nervous at all. That conversation was brought on when I was in the third grade and somebody in school found what they called "a rubber" in the girls' bathroom.

In those days, we eight year olds did not have the TV and movie exposure that exists now.  I had no idea what they were talking about.  So I did the natural thing;  I asked my mom.  It was an ambush.  She had no prep time.

Me:  "Mom..."

Mom (doing a hundred things at her desk):  "Yes?"

Me:  "What's a rubber?"

Mom (looking up):  "Why do you want to know?"

Me:  "Well, somebody found one in the girls' bathroom at school today.  The teacher thought it was a balloon but other kids were calling it a rubber.  And I don't know what that is."

Mom (swiveling in her chair to face me):  "OK.  Well, when a man and a woman want to have a baby, they have sexual intercourse.  This means the man puts his penis inside of the woman's vagina and his sperm mixes with her eggs and they can make a baby that way."

Me:  "OK."

Mom: " And, although it may seem gross to you, sexual intercourse is something that people do because it feels good, even when they don't want to make a baby.  When people love each other, they have sex for pleasure and to show their love."

Me (processing this):  "OK."

Mom:  "So, when people want to have sex for pleasure, the man can put a rubber sleeve over his penis so that his sperm will be caught in it before it can mix with the eggs.  That way, the couple can keep themselves from getting pregnant."  

Me:  "So the sleeve is called a rubber?"

Mom:  "Well, it's real name is a 'condom.'  But the slang term for it is a 'rubber.' Does that make sense to you?"

Me:  "Yes."

Mom:  "But you need to know that sometimes the rubber can break and the woman can get pregnant when they aren't planning to be pregnant.  So it's not 100%."

Me:  "OK."

Mom:  "Do you have any other questions or have you got it?"

Me:  "Got it."

I am sure my mother was nervous and uncomfortable when she had to explain this to me on the spot.  But once she did, I understood.  And I won't need to spell the word "r-u-b-b-e-r" instead of saying it.

When Czar Alexander commissioned Carl Faberge to decorate an egg as his Easter gift to the Empress Marie, in his wildest dreams he would not have imagined what my family does each year at Easter time. 

Easter morning for us means "egg fights."  When my father was a young boy, he and his friends would gather, each holding his respective egg competitor.  The boys would then knock the eggs against one another (round side to round side or pointy side to pointy side).  The egg that broke was the loser and would be forfeit to the owner of the winning egg.  The winning boy would go home with several gems.  Competition was fierce.  Dad tells us he would treat his egg with wax in order to gain advantage.

For as long as I can remember, we've held these contests every Easter.  No longer do we give up our eggs to the winner, but there is surely a sense of competitiveness at the table and beforehand.  We sneak to the refrigerator prior to the day and test eggs with our teeth.  By the time breakfast arrives, we've already chosen our eggs.

Several years ago, during our pre-Easter coloring session, someone cut a photo from a newspaper and glued it to his egg.  This launched yet another tradition.  Instead of simply coloring or decorating our eggs, we now create an egg community each year.  We use feathers, pom-pons, pipe cleaners, eyes, pens, paint and other materials to create characters for the Easter table.  The new recruits are then photographed and placed in our egg archives.

Here are some of our eggs from this year.  Happy Easter!

Found this site through a friend's site.  If you'd like to contribute to my Johari Window, please click here.

Namaste.