Where did I put my summer?

I've been out of the blog-o-sphere for the last two and a half months. Katie came for the summer and it seemed like every waking minute was packed. We went white water rafting, she had friends come to visit, and we spend a few days in Pagosa Springs. Katie got some babysitting gigs and took art lessons. I got a new bike, a fabulous Bianchi Volpe that I ride all the time. I rode in two charity events in Albuquerque; one for the American Diabetes Association and the other for NM AIDS Services. In September I'm planning to ride the century in the Durango Fall Blaze and Celebration. Hopefull, 'll be up for the mileage and the crazy climbs!

My twenty year high school reunion was last month. Whoah! That was a little weird. There were a few folks with whom I was glad to reconnect, most I already had via the magic of Facebook, but others I didn't remember. It was like one of those strange dreams where you are supposed to be taking a test, but it's in a language you never studied.

Anyway, the activity isn't looking like it's going to slow down. I'll get some pictures up pretty soon and try and keep the blog interesting for the three of you who read it.

New Mexico has some of the best weather in the United States. Over 300 days of sunshine, relatively mild winters at the lower elevations and, north of Albuquerque at least, summers that aren't painfully hot. Consequently we are weather wimps. We don't know how to drive with anything wet or white on the road. Most of us have dry rot on our windsheild wipers and umbrellas are something we buy when we get ready to go out of town.

Yes, we have our summer monsoon season; those lovely afternoon thunderstorms in the summer that cool things off and keep things green (as green as it gets in most of the state). But at most those storms last for about an hour. We consider them more like mood swings than real weather trends.

For the last few days, it has been cloudy and rainy here in Las Vegas. This is great because our moisture has been pretty sporadic since January and we were looking at a nasty fire season. A collective sigh of relief has gone up across Northern New Mexico. That sigh lasted until this morning when we looked out side and said "What the hell? Why is it still raining? When is it going to stop? Are we going to have to build an arc?"

The forecast calls for thunderstorms through the weekend and 80% chance of showers daily through next weekend.

WHAT?

My Stars

This is my friend Lillian. Lillian is one of the most wonderful, formidable women I know. She's a single parent to a gorgeous, talented, athletic daughter. She's the second generation operator of a 1200 acre ranch east of Las Vegas. I'm not sure how many cattle she has but she tends them diligently. Her little cabin was a stone barn that she and her daughter restored, plastered, and expanded by hand. It has no electricity and no running water, just a cistern, a wood burning stove, and a lantern. The two of them created roadways on the ranch with a pick and a shovel. Whenever she and I get together we laugh like little kids. She was my first friend here in Las Vegas.


One of the interesting things about Lillian, but certainly not her defining feature, is that she has Multiple Sclerosis. However, she doesn't define herself by her illness. To her, it's a reason to creatively adapt.

Because she know's she won't be able to manage the strenuous responsibilities of ranching forever, she's created a plan. She's opened her ranch as a photographer's retreat and gives tours for other people as well. So far, besides the photographers, she's hosted botanists, hikers, and archeologists.



She's also restoring a one room schoolhouse on her property to serve as a bed and breakfast so that guests can stay for a while.

One of the things I love about Lillian is her cheerfullness. She always has a positive attitude, even when she's out of energy for the day. I think this is what has kept her mobile despite her illness.

So, if you're out our way, see if you can book a little tour with Lillian.

More Love Lessons from La Loma

Mrs. R. came in today for an exam and a mammogram referral. She's been in to see me quite a few times for other things and we have a nice, relaxed rapport. The exam was "unremarkable" (though no woman wants to hear that her breasts are "unremarkable", even at 67). We joked a little bit and she made a comment about being a nun. It turns out that her husband of 48 years had a massive heart attack a few years ago and that was the end of physical intimacy.

Now, at this point I was running a bit behind on a very busy morning. So busy that I spent lunchtime working on charts and finishing prescriptions. But Mrs. R. kept talking and I kept listening. She told me about the love she and her husband had for each other. How they still make each other laugh after almost 50 years together. How they occasionally bicker about stupid things and annoy each other. But that's what you have to put up with for that kind of longevity and those kinds of rewards.

I've been doing a bit of reading and thinking about being single and being in relationship. An article I read this morning about the tendencies of Gen X-er's to marry late or not at all said that we lacked the ability to commit, we're always looking for the end of the rainbow. If you've ever looked for the end of the rainbow, you know that it's elusive. So elusive that it doesn't exist. We're searching for a perfection in another person or a situation or a job that we do not have in ourselves. We have little tolerance for frustration. Ergo, we may have even less success at relationships that our parents, the baby-boomers. Hard to believe, I know.

So, committment means is standing still with an open heart. Not standing with one foot out the door, ready to run at the first sign of trouble. It's taking the laughter and the fear and the mess and the joy altogether.

Gearing up

Sundays are sort of the abyss of the week. The weekdays are full up with work and preparing for work. Saturday is full of errands and social engagements. Sundays are different. There may be something going on in the morning, a walk or sunday pancakes or catching up with laundry. Towards the end of the day, though, it gets very quiet especially if your domestic partner is a dog. Thoughts of work start to creep into your head.

Last week was particularly rough, work-wise. We're out of cold and allergy season and people are actually coming in because they have real problems. Very real, very complicated problems. They are sick and scared and have been asking questions so difficult that I don't even know where to begin. On top of that, sometimes I feel that my grasp of basic medicine is not very firm.

Friday night I went salsa dancing with some friends in Albuquerque. It was a benefit for the American Association of Minorities in Medicine. We met up with a few other friends; Seema, who is rounding the corner of her first year in Physician Assistant school at UNM, and Jose, who was set to graduate the very next day. Seema is in the stressed out, ready to fall apart portion of PA school where the end seems so far away that you can't even imagine what it will be like when you don't spend every waking moment studying or worrying. Jose is in a rosier place than that. He's done with the worst part. Now all he has to do is prepare for the certification exam, pass it, get his license and then a job. No problem.

Then its the job. The first year of working as a PA you know a little bit off the top of your head and know where to look up the rest of it. A full year after my own graduation I know I love what I do, but sometimes I don't know if I know what I'm doing. My mentors, who've been practicing for 20 and 30 years, tell me this is a normal thing. Sometimes, after all these years, they still don't know what they're doing.

So, the trick with Sunday nights, and maybe with all of the nights is to stay in the moment and not worry to much about what's going to walk through the door the next day.

Like Ginger Rogers sang in "Swing Time"; Pick yourself up, dust yourself off, and start all over again.

The Dead Horse I'm Kicking

Today was busy. At the La Loma clinic I saw twice as many patients as I usually do. This is a good thing. Our organization has been a little short on numbers for the last few months and there has been some whispers about being unable to keep the outlying clinic open if the trend continued. Rumors are worth the air they're spoken with but still... Its hard to believe that a clinic that makes its living from medicare/medicaid, state childrens health insurance programs (SCHIP), and sliding scale payments would find the number of visits slipping.

Several patients have told me that they can't get the medications I prescribed because their insurance will only cover a small portion or won't cover the cost at all. Even with the discounted medications at Walmart and Walgreens and our prescription assistance program we can't cover everything.

My freind and colleague A told me about his bout with malaria while he was in Kenya as a student. His stay in the hospital and medications came to a grand total of $90. He felt his care was a good as any he'd recieved in the United States. The same hospital stay here would cost thousands of dollars.

I'm not sure what is the best solution for health care in our country but we can't keep doing the same things and expect the situation to improve.

the single girl and the geographic cure

I went to Colorado/Wyoming over the weekend to visit the Katie and my other crazy relatives. Wanda the wonder-shepherd rode shotgun and didn't vomit once! We got a homeopathic remedy for last fall that seems to have rid Wanda of motion-sickness and has radically changed the way we travel. She can now ride in the car longer than an hour without nausea and actually napped in the back seat!

Another milestone on this trip: my little red subie turned over 100,000 just south of Cheyenne. On the ride back through snowy Raton Pass I decided that I would drive the ruby-subie for another 100k then get a new one. Maybe by then there will be hybrid impreza's! That all-wheel drive is pretty handy on bad roads.

The first thing Katie and I noticed about Cheyenne, besides the wind of course, was the smell of the refinery. I must say I prefer the cow manure smell of western Nebraska to the gas refinery smell of southern Wyoming. However it did make for cheap fuel; $1.79/gallon. That's a full thirty cents cheaper than it is here in the other Las Vegas.

I have no pictures of this trip as I was depending on my mother's excellent communication skills and sense of timing and left my camera in my backpack which I left at her place. Oh well.

Katie and I had a nice, mellow time and she survived her nearly terminal boredom. We saw the family including my brother Aaron and his family. Funny how having kids will make you want to spend time with the rest of your family. I also got a travel buddy for Jazzfest! My uncle's girlfriend, Ruth, is going to go with me. Woohoo! I have a feeling she and I could get into a little trouble together...