Challenged athletes

Tonight I'm stuck on a question- "How do you define a 'challenged athlete'?" It sounds pretty simple but, as always, the devil is in the details. It came up today as my running club, the Bay Area Runners (BAR), struggles to decide which charity is most deserving of the proceeds from the 2011 Joe Cain Classic 5K (JCC), held every year on Joe Cain Day in downtown Mobile. BAR evolved from my old running club, the Bay Boozers, back around the turn of the century, with the mission of hosting the JCC and donating the proceeds to benefit a challenged athlete(s). Over the years, over $90,000 (well over $100K if you take into account donations from the Bay Boozers before BAR was formed) in proceeds from JCC have been donated to individuals or organizations supporting challenged athletes, from Chuck Anderson (our old buddy whose arm was bitten off by a shark while triathlon training in Gulf Shores) to the Mobile Patriots (a wheelchair basketball team), the Special Olympics, The Association for Retarded Citizens and, most recently, the Augusta Evans Challenged Athletes. As I review the donation list from the last ten years, I'm proud to say I've been a part of BAR, despite my rather pathetic level of participation as time and distance have constrained me over the years, but this year I aim to remedy that.

Speaking of which, I'm on the sponsorship committee this year, and would love some participation from the blogoshere. If you or your company are able to assist us in supporting challenged athletes with donations of supplies or good old cash, please don't hesitate to let me know. I am notoriously poor at solicitation (I know- why am I on the sponsorship committee?), so help a brotha out if you can. And to all you athletes or would be athletes, consider coming out on Joe Cain Day for the run. It's a 5K run (3.1 miles) through some of the ugliest parts of Mobile, Alabama, but it boasts the ABSOLUTE BEST post race party in the Port City area, and has grown from its meager beginnings in 1991 (yes, I was there) to become Mobile's largest 5K with over 500 participants.

So, "Who is Joe Cain?", you might ask. Well, it's time for a history lesson. Mardi Gras, the celebration of the beginning of Lent in the Catholic Church, was always met with much jubilation, a time for raucous behavior and excess before making the sacrifices of Lent (in deference to Jesus' forty days of suffering in the wilderness). The tradition had lost much of its lustre until after The War of Northern Aggression (aka Civil War), when Mobile was, like most Southern cities, subject to military occupation and all the trials and tribulations thereunto pertaining. In protest of the strictures placed on Mobile's citizens by the occupying forces, our hero, Joseph Stillwell Cain decorated a wagon, dressed as a Chickasaw Indian (never defeated in war), Chief Slacabamorinico, and paraded through the streets in celebration of Mardi Gras, taunting the unwelcome invaders and raising the spirits of a despondent citizenry. Mardi Gras has been celebrated in Mobile ever since (and has even spread to New Orleans, if you can imagine that) with parades and costumed riders throwing gifts to, again, raise the spirits of a despondent citizenry. So every year in Mobile, the Sunday before Mardi Gras is designated Joe Cain Day in honor of Old Chief Slac. Having read all that, you're probably better off just clicking on the link to Wiki at Joe's name above.

So, the BAR is struggling with which charity, of the many worthy organizations out there, to donate the proceeds of JCC 2011. I can't really provide much input; it's like going to the pound to pick out a puppy- I want to take them all home and can't. But I can offer this much- as long as the decision is made from our hearts, in a spirit of compassion and giving, whatever decision we make is the right one. As I review the list of donations to prepare my pitch for sponsorship, I can't begin to express how grateful I am to be a part of such a great group of "challenged" athletes.

It's official

Yesterday I turned in my 90 day notice as a full time employee of Baldwin Emergency Physicians. Before I get into why, let me tell you why I didn't quit- I didn't quit because I was dissatisfied with the group, the hospitals or the work. I quit working full time because I needed a break from the schedule. So I'm going locum tenens, which is fancy doctor talk for part time. It doesn't mean I'll work less, it just means that I'll set my own schedule, and that I'll be traveling a lot, possibly all over the country to fill in in ERs wherever there's a need. The good news is that I'll get to decide if and when I'm willing to work weekends and holidays. The bad news is that there's no guarantee I'll have as much work in any given time as I want or need. But in the ten years I've been doing medicine, especially emergency medicine, lack of work has never been a problem. I don't expect it to be a problem now, but this is a bit of a leap of faith so wish me luck.

Yesterday I drove to Auburn to see Clay for a few days. He's doing very well, and was VERY glad to see me. I don't know why it is, but I'm very blessed to have kids who adore me, despite the distances of time and space that often separate us. They deserve better than they get from me, and whatever life throws my way I know I'm truly fortunate, and undeserving, to hold my kids' hearts in my hands.

Yesterday was also an important day in my electronic life. I got a replacement for my broken iPhone (YAY!!!) and a new iPad to make me more mobile as I prepare to travel. I'm typing on it even now. What an awesome device! Truly, I see the potential for this gizmo to revolutionize the way we interact with our electronic environment, especially in the field of medical records and data input. Finally, a device that can make bedside, point of care medical records feasible and practical.

I was pleased to see this link. I don't know that I've ever been prouder of my alma mater. It means more to me than a dozen national championships or Heisman
trophies. This is truly what sports is all about, and what I want my kids to learn from athletics above all else.

Clay will be up in a few hours so I suppose I should sleep. Goodbye and good night from the interworld, for now.

The good life

Christina is here for the weekend, and life is good. She flew into Mobile instead of the usual flying into Atlanta for a weekend at my parents with Clay. I have some real reservations about doing it this way. Usually I spend a very exhausting but rewarding weekend getting off work at 7am, sleeping a couple of hours then driving to Auburn, picking up Clay and driving to Atlanta for Christina. After fighting through ATL with a two year old and getting her we drive back to Auburn where, utterly exhausted, we all fall asleep until it's time to go to my parents' Saturday morning. Then Sunday, after a brief weekend, it's time to do it in reverse. Although I love having my kids together, it makes me feel like I don't spend quality time with either of them, so I'm doing it different this month. This weekend it's just me and Christina. Next week I'll go up and spend time alone with Clay. It means I don't see either of them as much and they don't get to see each other, but after a summer of sibling rivalry I just needed to stir things up some. I hope it's the right thing to do.

The pic above was taken at dinner, watching the sun set over Dog River along beautiful Mobile Bay. Afterward we went for ice cream in Fairhope with Andrew and Julie, then it was time for bed. It was SO nice to go through the Mobile airport instead of ATL so we could have time to enjoy ourselves. We were in and out in no time, and parking was a whopping $2. Today we'll go to friends' homes to watch football and socialize, and generally enjoy some dedicated father/daughter time.

Yesterday was a good day all around. I ended my shift in the morning with some fun, but sad, cases. One was a young man from a bad "car vs. house" wreck. His head had broken the windshield creating a large C shaped laceration in his scalp that was bleeding freely. What's worse, he had gone from awake and alert at the scene to barely responsive in the ER. The presumption in that case is brain bleeding or injury, so we quickly stabilized him, stopped his bleeding and sent him by helicopter to the university hospital. Then, on the heels of that case, a man having an acute heart attack came in. That's a cause for excitement because, in those cases, the sooner they can get a heart catheterization, the less heart muscle they lose. So minutes count. I have to say, I was really proud of my ER team in both cases. They functioned well, kept their collective heads and got both of those patients where they needed to be quickly and efficiently. I live for this stuff. It's what I love about the ER.

So life is good this weekend. I miss Clay, but I'll see him in a few days for some concentrated time together. And I have my oldest baby all to myself all weekend. Life is good.

Here and there

Saturday night after arriving in Pensacola I went to a little get-together with my dear friend Julie (Hi Jules!). One of the guys there asked me if I was glad to be back or wished I was still in the DR. How directly to the point; I didn't even hesitate in my response. I would rather be bouncing over a goat trail clinging desperately to the back of a moto doing home visits in Severet than driving my truck (even though I love my truck) along mirror-smooth paved roads on my way to work in an air conditioned ER. I would rather be playing ring toss at Tubagua with Ayaz and Saint Wob, and losing, drinking lukewarm Presidente than flipping through 67 channels of cable TV with an ice cold American beer making rings on my coffee table. Were it not for my family and friends I would be more than happy to be an expat. I can do quite well without all the trappings of our "civilized" life here in the States.

I can't overstate how much I enjoyed this trip, nor can I list all the reasons why. But for starters I have to thank all the dedicated members of Health Horizons International, from my original contact with Craig Czarsty, the doctor who chairs the Board, and whose initial response to my interest in the trip was "In short, yes, we really need you" right down to the translators who patiently suffered my pathetic attempts to habla on my own and unconfused my patients when I mucked it up. But three groups deserve special attention. First, the other members of the team- Lissa, Rachel, Rob and Ayaz were fantastic companions and colleagues. I couldn't have asked for better company and co-workers. Second, the community health workers or cooperadores de salud who labored long and hard to prepare their communities for us to waltz in and play the heroes, and who are now following up on all the patients we saw, cleaning up the mess we made and, in general advancing the health and wellbeing of the people they serve. And last, but certainly not least, the International Program Directors. I may have met a more impressive group of young people in my life, but I really can't remember when. As if their intellect, compassion and cheerful dispositions weren't enough, I was, and am, in awe of Meg, Nicole and Laura's absolute selflessness in doing a job that must, at times, seem pretty thankless. My only regret is that I didn't get to meet Angi, but I feel as if I did, as her impact continues to reverberate through HHI. Somehow I think our paths will cross one day.

All in all I think I'm pretty lucky. Despite its frustrations I still love being an ER doc, and it affords me the opportunity to do what I've discovered I really love- medical mission work. I miss my kids, but I'll get to see them soon and when I do, I hope I can convey to them the importance of finding what you love, then finding a way to do it. It's taken me 47 years, but at least now I know what I want to be when I grow up.

Problems with Picasa albums?

Several people have mentioned they can't open Rachel's albums on Picasa. I had that problem as well, and could only see my own albums when I clicked on the link. I'm sure there are several solutions to this problem, and I would love to have input from those more in the know (Rachel? Garet?), but the way I've gotten around it is to open one of my albums then click on "My Favorites" at the bottom. I could then see Rachel's albums. Please post if this continues to be a problem and I'll try to find a solution. Here's a link to all of Rachel's albums from the trip.

Tubagua Trail

Now that I'm back home and able to post from the luxury of my PC, I'm going to add some posts that just weren't feasible from the iPhone. This link is to a hiking trail near Tubagua Plantation EcoVillage, the wonderful place that served as home base for our trip. The trip was logged on my iPhone using the Trailhead app by North Face. If you do any hiking, running, cycling, boating, horseback riding or any other activity where a trail or path can be documented, it's a nice app to have. It's also available for the Droid. Enjoy!

Back to the States

Back to the grind. It's a tough job, but somebody's gotta do it...

Back where it all started

Wow. Just six short days ago.

Friday morning

This is the view from the dining area here at Tubagua overlooking Mount Isabela de Torres. Spectacular, huh? I had planned to hike Mount Isabela today, but getting there would take too long and I have other things I need to do so I'm just going to hike around here once it's light enough.

Later this morning I have four home visits to do, one for a homebound patient and three for patients I saw earlier this week. Then we have a hospital tour and lunch, then we get a free afternoon for the beach or shopping.

The last two days we've been in Pancho Mateo, a very poor village with a large percentage of Haitians. The conditions are pretty bad, and our first day there we had to deal with a fairly heavy rain as a tropical storm passed below Hispaniola. But we were fortunate (sort of) and the rain stopped early in the afternoon. The unfortunate thing about it was that when the rain stopped and the sun came out, beating down on the tin roof of the little church where we held clinic, it became like an enormous sauna. And to top it off, the power was out, so no lights and NO FANS!!! I would say the heat and humidity were unimaginable, except that the next day the sun was out from the beginning, so it was even worse! But we were saved by the return of electricity and, therefore, air flow, and the last day of clinic ended on a high note.

More pics

Rachel has posted more pics on Picasa here:
http://picasaweb.google.com/m/viewer#album/Rachel.Geylin/5514352278533601969

Sent from my iPhone

Severet and now today

Yesterday was another good day in clinic. Afterwards we went to the home of one of the staff members for some awesome stew over rice and some fresh avocados, which are in season right mow and just hang off the trees. After dinner we rode home as the sun was setting, several of us drinking cold Presidente beer from big 40 ounce bottles.

The clinic was in Severet, a small village several miles from town. The only thing about clinic that wasn't pretty routine was that I got to go on two home visits right after lunch. My interpreter Mark (moved from Haiti in February after the quake and learned Spanish since then), the cooperadores (village health worker) Katherine and I walked about a half mile (hell yes it's hot!) to their homes. The first was a very old lady who had lost a leg years ago but was otherwise remarkably healthy. The second was a tragic case- a 44 year old lady who, five years ago, had suffered some kind of "event " (probably a stroke) that left her with physical deformities, unable to walk and with an altered mentation. Ever since she's had "attacks", probably seizures, but wasn't evaluated until she was hospitalized eight months ago. The family takes good care of her generally, but their understanding of her disease and how to treat it is minimal. It was pretty sad.

I awoke this morning at 4:30 in the midst of a gentle thunderstorm and have written this sitting in the dining area overlooking the valley and the Caribbean Sea while the sun rises and the day unfolds. There are clouds covering the mountaintops, and below me I can trace the river's route by the telltale mist that rises from it as it snakes it's way from the mountain to the sea. The sound and smell of the rain are relaxing and peaceful, and everything feels like it's been washed clean.

Today will be a challenging day, as we'll be in Pancho Mateo, a very poor community with a large population of migrant Haitians. The local sugar factory closed five years ago, and unemployment is the norm, about 80%. the factory and landowners let the fields sit in disarray, and burn off the cane every year or so, but won't allow the local people to grow food on the dormant land. I suppose it pays to keep the labor force starving and impoverished in case they ever need cheap workers again.

It's almost time for breakfast, so I have to run. I'll post more later.

Sent from my iPhone

Tuesday morning

Yesterday was a good day at clinic. After a little understandable confusion getting started, we settled in to seeing patients. In the mornings we see patients with appointments made by their local HHI agents, the cooperadores de salud. They are often continuity patients , folks HHI has seen before and are being followed for a chronic condition like hypertension or diabetes. No such luck for me! I think they were testing the new guy by giving me the tough ones! I had an epileptic lady on trivial doses of Tegretol, a gentleman with an enormous inguinal hernia and an unfortunate lady with a herniated disk who was suffering from progressive weakness in her legs, to the point she could barely walk. All these cases are pretty routine in the US where medications and specialists are readily available, but in the DR access is a real challenge. Our three international program directors, young ladies from the US who are living here to make this program run, do a great job helping us get appropriate care for these challenging cases, and will follow up with them long after we are gone. It's this sort of committment to longer term care that makes me appreciate what HHI is trying to do here.

In the afternoon we saw walk-in patients at a pretty fast clip. Most of it was pretty straightforward- colds, back pain, skin rashes and that sort of thing, but there were a few with interesting pathology. I saw a one year old boy who barely made any noise, and it was interesting to consider all the potential causes. He was an adorable, big quiet kid who reminded me of Clay at that age.

It's time for breakfast then once more unto the breech. More from gorgeous Puerto Plata later.

Rachel's pics

One of our fantastic team members, Rachel has downloaded a bunch of pictures to Picassa. Here's the link:
http://picasaweb.google.com/m/viewer#album/Rachel.Geylin/5513624915954886433

Today was a great clinic day. I'll post more, but right now I'm STARVING!!!

Sent from my iPhone

Morning at Tubagua

Good morning from Tubagua Resort! It's a fabulous place (www.tubagua.com) on the mountain overlooking Puerto Plata. This is the view from my open air, thatch-roofed "cabin" this morning. It's breathtakingly beautiful here.

I apologize for the short posts, but doing this all from my iPhone limits what I can do. Time for breakfast!

Night view

Here's the view from the dining room over our the top of our cabin tonight at Tubagua (www.tubagua.com). I can't wait to see it in the morning.

Dinner at Casanova

Lovely dinner at Casanova, a place on the beach in Puerto Plata. You can see Laura's hands, Ron (former Olympian in canoeing), Ayaz, Lissa, Nicole and Rachel, most of the gang.

Two fisted drinkin'

After our tour was over the group went to la playa (the beach) for a little R&R. Nicole got stuck holding beer for me and Ayaz (ya, riiiight!). The beaches are much prettier on the north coast than in Santo Domingo or San Pedro.

Junk

The inhabitants of Pancho Mateo typically deposit their refuse along the river bank, where it remains until the next flood washes it all out to sea.

Pancho Mateo

When I caught up with the group they were touring lovely Pancho Mateo. This is a typical road in Pancho Mateo.

Worth the wait

Since I had some time to kill...

Waitin' for ma ride

The group was on a tour of one of the bateys (local villages) when I landed, so I had a little wait before they picked me up. Here I outside the Puerto Plata airport waiting.

Puerto Plata airport

Not much, but functional.

A la aeroplano

What beautiful views from >30,000 feet up.

Fritz

What a pleasant flight! I was seated next to my new friend Fritz, who has retired from Trane air conditioners and the bitter cold of Wisconsin to cruise around South America and the Caribbean. Fritz has never been married and has no kids (that he admits to knowing about). He's quick to warn me about the wiley ways of the softer sex. I told him he's more than a few days late and many dollars short.

As I'm writing this on my iPhone, 33,000 feet above the crystalline waters of the Caribbean and the shores of some nameless tropical isle I can't help but wonder what I'll say to the guy next to me when I'm Fritz's age. Heck, I just hope I'm that spry when (if) I get to be his age. You should see this guy working the flight attendants. An artist. Truly, this man is an artist.

Good American beer

What can I say? I'm weak. Right next to my gate there was this Sam Adams bar, so I had to supplement the mojito with my last American beer (they had Presidente, but there's plenty of time for that later). The flight attendant is nagging me so I gotta go. More from Puerto Plata...

Yo ho mo mojitos!

Right after the bus dropped us off in the terminal I knew I liked the Miami airport! You can't read the sign, but it says "Bacardi Mojito Bar". I asked if they made good mojitos and the pleasant young man replied "The best". I was so inspired I had a double.

It wasn't the best mojito I've ever had (Michael's on a moonlight sailboat ride on Mobile Bay was), but it was passable. Now I'm searching for the world's best mojito recipe. Any takers? My favorite Coloradan bartender?

Viva Miami

I made it to Miami (a little late). I woke up in time to enjoy a gorgeous view of the 'Glades coming into Miami, reminding me of scenes from some Travis McGee novel. Despite the outdoor deplaning (in spectacular sunny, cool weather), I liked the Miami airport. Tune in to find out why...

Pensacola Airport

Well, I made it to the airport without getting arrested or turned into a road pizza. It's so nice to fly out of a small, easy airport for a change. ATL sucks.

I have a short layover in Miami, then it's off to Puerto Plata. More later.

On my way!

As usual, I'm headed to the airport at the last possible minute, jammin' out to Layla and hoping Foley's Finest won't harass me. The dude above is my BF for today, Dr. Brad Cottrell, who was good enough to come in at 5am so I can make my flight. Thanks Brad! Now, wish me luck!

Welcome to Mangoblog!

I'm starting this blog at the beginning of my September mission trip to the Dominican Republic. Thanks for logging in. Look for posts tomorrow, when all the fun starts! I plan to post regularly from the DR, but it'll probably all be from my iPhone so don't expect much. Wish me luck!