Wednesday, June 30, 2010

My Mentor

Dr. Clayman
Last weekend we travelled to Irvine, California to attend a fund-raiser and surprise party for Ralph V. Clayman, M.D., the dean of the medical school at University of California, Irvine and my mentor. I had the privilege of being a fellow with Dr. Clayman at Washington University in St. Louis from 1992 to 1993. That experience changed my life. Ralph is the most extraordinary person I have ever known. What he has accomplished goes beyond what most celebrities or politicians can ever hope to achieve. He has the unique capacity to inspire in others greatness beyond their natural capacity. Before I met him, I did not know how to write. For him, if it can be dreamed, it can become reality. But he doesn't do it alone. Among his accomplishments, he was the first surgeon to remove a solid organ; a kidney, laparoscopically. That would be like using chopsticks to cut a T-Bone steak and remove it through a keyhole. However, unlike most brilliant inventors, he included and credited as many people as possible, such that he taught 100's of doctors who then went worldwide to teach thousands of other doctors that could then save and improve the lives of millions.
And yet, when you meet him, you feel like you are the most important person in that moment. Barbie and I were invited by his wife Carol to a brunch at their home in Irvine. We haven't seen them in eight years and, as we visited, my memory was flooded with the past experiences and morsels of wisdom that he had given to me. Without my year with Ralph, I would never have been hired at Yale. It was a difficult year. I felt like I was running in front of a locomotive and feared that tripping would find me run over. However, when I finished, no one was more supportive of my career than Dr. Clayman.
I have met men that, when I ask them if they have ever had a mentor, they respond, "No." I find this very sad. For these individuals can never become more than that of which they are personally capable. A mentor can see talents in you that you did not know even existed. You can't hire a mentor; but if your personal pride blinds you to their presence in your life, then you are lost to mediocrity. Just pray that divine providence will place them in your path and, when you meet them, stop and listen.


Thursday, June 24, 2010


Yesterday I attended an noon conference at work and to my surprise found it very difficult to remain seated for the duration of the meeting. Dr Shelly Garone was the speaker. She is the director of palliative care for Kaiser in the Sacramento area and is an expert in dealing with and teaching about end of life issues. Five years ago she taught a two day seminar, required by California law, on death, dying and managing pain. She asked the question "How would you like to die," and gave options followed by a show of hands. In a room of 150 physicians, I was the only one who chose to die of cancer. This caught her attention. I responded describing how my father had recently died of cancer, and even though it was painful, he died at home with his mental faculties intact until the end. This was what I wanted. Well, I didn't 'technically' get cancer, but the end result will be the same; or so I thought.
This has been a difficult year for we members of the Northern California Amyloidosis support group. A significant number of us have died in the last few months. I always thought that I would die like most cancer patients; of malnutrition possibly coupled with a fatal infection. However, it seems that these amyloidosis patients may have gone a different route. I do not know all of the details but there seems to be a common pathway that includes dangerously low blood pressure with falls, strokes and probable fatal arrhythmias. But none of them had had heart transplants. I guess I won't really know how I will die until just before I do; like everyone else. (As long as it is not drowning)
Dr Garone taught that palliative care is not hospice care. It begins whenever it is needed in order to help a patient and a family develop a life-plan (as opposed to a death plan) and may occurs years before the inevitability of death. When she spoke of life-plan, I lost it. It was all that I could do to contain myself from sobbing uncontrollably out loud, in a room full of doctors gobbling down there Chicken Parmesan. I thought to myself, "I review my life plan every day."
For the first year and a half of my diagnosis, my disease and prognosis were ever present in my consciousness. Since January of this year that has changed. I now expect to live forever just like everyone else and I plan accordingly. I am not in denial as the former awareness now resides approximately 18.7 milliseconds below my consciousness and can surface at any time. "Why today?'" I thought, "Oh it must be the steroids, today is Wednesday." But what she said really struck a nerve and memories begin to flood my brain. Everything she put in her PowerPoint, I knew. I had lived though every bullet point. Did I need to make an appointment for a palliative care consultation? One of the things that I love about Kaiser is that we don't just care for the whole patient. We also take care of the family.
I do have a life plan. To me my first goal is to keep my family secure; physically, emotionally, financially and spiritually. Once that is done, any excess left over I want to use to fill my senses with new experiences. I want to see as many of natures innumerable beauties as I can. I want to feel sand between my toes. And food; well, the world's greatest chemist cannot describe a molecule with the unique delicacy of a single taste bud. I relish the sense of smell and the persistence of memory that it evokes. The sounds of music, birds, wind in the trees, rain on a tent, the sweetest voice I have ever heard when Barbie says "Hi honey, how was your day?" My life plan is to go as many places, meet as many people and experience all of the diverse beauty of life as my lame body will allow.
I think about it every day.


Sunday, June 6, 2010

On the Road

Pikes Peak
My body has to go where my itinerary takes it. Since the wedding, we have been quite busy. Last weekend Barbie and I attended the AUA (American Urologic Association) meeting in San Francisco. It has been six years since I have attended a medical convention. It was wonderful to reconnect with friends and colleagues that I haven't seen in years. We stayed at the Hotel Nikko and Barbie caught up on a years worth of shopping that has eluded her while she has been overwhelmed with school. We sampled the best ice cream (Mitchells) and the best chocolate (TCHO) in San Francisco. Back for one and a half days to do surgery and get chemotherapy; then off to Denver for the itinerant wedding party. In the third and final installment of this perpetual celebration, we were guests of Jason's parents, Bob and Pam Hammond. Rebecca has truly married into a wonderful family.
To introduce us to the mile high city, we climbed (in a car) another 10,000 feet to admire America the Beautiful from atop Pikes Peak. I generally get anoxic atop a 6 foot ladder, let alone gasping for oxygen molecules at 14,110 feet. The deep blue azure sky overhanging an unobstructed view for hundreds of miles in all directions was to inspire awe. As we searched the far reaching horizons of space, I thought of Rebecca and Jason as they break forth together toward their horizons of time. The opportunities seem limitless. The next day they continued their eastward journey to Chicago where Rebecca will begin her summer internship in advertising.
The reception in Highland Ranch was beautiful and, as an added bonus, we were able to visit with Barbie's Aunt Renie and her husband Ed. We were also thrilled to see the Fluckigers from Connecticut, who now live in Parker, Colorado.
The timing of the chemotherapy on Thursday was inconvenient and I had to frequently sit down, but life doesn't wait.
The race isn't over yet; two more weddings this week, a family reunion next week and on it goes. I wouldn't have it any other way.


This is a link to the wedding photos for those who are addicted to smiles:
Wedding Photos