The Best Medicine

Play Ball!

2010-04-25T19:02:00.000-05:00

I was in the park yesterday playing ball with my kids. It was a beautiful day. The sun was shining on my face and a cool, crisp breeze was giving my mind a much-needed sense of clarity. I stared down at the baseball in my hand. My first two fingers covered both rows of red laces and I wondered if I could still throw a curveball. I tossed the ball towards my son, but he barely got the wooden bat off his shoulders before the ball bounced off the tree behind him. As he swung the bat, his whole body followed along and he made a complete revolution. “Good swing, William. Just keep your eyes on the ball.” He slung the bat back up on his shoulders and almost tipped backwards. “This bat is kind of heavy, Daddy. Is this the one you used when you played?” I pondered the question for a few moments and, like many times before, was instantly transported back to 1976.

1976 was a life-changing year for me. Not only did I get puked on during my school play (see “Places!”) but I also began playing Little League Baseball. I’m not sure whose idea it originally was, but my Dad was clearly more excited about it than I was. I enjoyed watching the Yankees play on television with him, but putting myself out on the field just didn’t seem like a natural progression. “What do you have to be nervous about?” my Dad would ask. A few of the words that popped into my mind included, PAIN, FAILURE, HUMILIATION, REJECTION, but my mouth would always sum them up by saying, “I don’t know.”

Before opening day, my Dad and I went out shopping for supplies. There were only a couple of left-handed gloves to pick from, so that was pretty easy, but getting my hand into it took a little twisting and shoving. “I know how we can break this in”, my Dad reassured me. When we got home, he took me to the garage and found a can of 3-in-1 oil next to the lighter fluid. With a rag, he lubed up the glove pretty good, placed a baseball inside and bundled the gooey pile of leather with twine. I was perplexed by this whole turn of events, but was also energized by my Dad’s excitement. He then took the glove and placed in down in the middle of the street. “Now stand back, Billy.” Just when I thought I could anticipate all of my Dad’s next moves, he surprised me by revving up the engine of our sky-blue, 1966 Dodge Dart and running it back and forth over the glove as it bounced back and forth on the pavement trying to escape.

The first game took place on a cold weeknight in March. I looked sharp in my new uniform and blue hat. My Dad and I hurried over to the field in the Dodge, which was missing the door handles on the passenger side as a result of an unfortunate encounter with a garbage truck. It was also completely deficient in seat belts, so I slid freely from left to right on the vinyl front seat bench as the car rounded each corner. When we got to the field, my Dad gave me a box of orange tic-tacs to hold in case I needed a snack during the game. For that entire season, I was known as the player who made a strange clicking sound when he ran, as if I was packing a secret set of maracas under my uniform.

My coach put me out in right field for that first game, and it didn’t take me long to realize that nobody had the skills yet to hit the ball out that far. Boredom began to set in, but as the game proceeded, I learned various ways of amusing myself. I looked around and noticed that my glove was the only one with tire treads on the back. I took it off and placed it on my head. It was still pretty greasy, and smelled like the inside of a gas station, but it certainly was velvety soft. It fit on my head quite nicely and my right hand welcomed the ventilation. I reached down to pick a bouquet of dandelions and danced around right field like a principal dancer at The Met. Suddenly, my fantasy was put on hold when I heard the nauseating crack of the bat. One of the opposing players, whose parents had obviously slipped some steroids into his applesauce, had swung for the stars and the ball was headed right towards me. Actually, it was headed right over me. I dropped my bouquet and peddled backwards, my eyes as wide as saucers. I looked all around for my glove before realizing that it was still on my head. I grabbed it and tossed it in the air like I had just graduated from the College of Baseball Incompetence. Through some miracle, it made contact with the ball and deflected it onto a completely different trajectory. Long after the player made it around the bases, I was still rummaging through the dandelions looking for that stupid ball.

The next inning, it was my turn at the plate. We were hitting balls off a stationary tee instead of having it pitched to us. I stepped up to the plate and spit into my palms because I had seen players on television doing that. It didn’t work out so well for me, but I quickly cleaned myself off and took a couple of practice swings. I swung as hard as I could, but instead of hitting the ball, I hit the tee, launching it like Sputnik over the infield. I looked down and saw the ball lying at my feet. The shortstop, confused about what to do next, ran towards me and tagged me with the large, rubber tee as I stared at him and remained perfectly still. Back in right field, I was re-evaluating my career path. Suddenly, my nerves and the cold air got the best of me and my bladder muscles began to twitch. This quickly turned into intense pressure, and I crossed my legs for as long as I could before taking definitive action.

I ran off the field to where my Dad was sitting in the stands and explained my dilemma. We rushed across the parking lot to the back of a Chinese Restaurant, and I was running so fast that my tic-tacs were no longer in rhythm with my footsteps. The heat of the kitchen and the smell of wonton soup were welcomed by all of my senses as I relieved myself in the small, bathroom off the kitchen. As I emerged, my hands were still painful and throbbing as the re-warming process continued. “Ready to go back?” my Dad inquired, but the look on my face was all that he needed to see. We walked back to the Dodge and drove home in silence.

I was determined to make it to the next game, and the next and the next. And for that matter, my Dad made it to all of them as well. I had many good times over the years, but I got nervous before and during each game, and my Dad was well aware of that. Sometimes I wondered whether I kept playing to prove something to myself or to him, but in the end it did not matter. I played until I reached High School and in the last inning of the last game I ever played, I was in left field. I chased down a high fly ball and caught it perfectly as it made a dull snap in my glove. It’s similar to the sound a book makes when you close it fast, which made sense because I knew that I had finished that chapter in my life and a weight had finally been lifted.

“Come on, Daddy, pitch the ball!” I realized that I had taken too much time thinking about the past. I threw the ball and William had timed it perfectly. “I think it’s a double, William!” “Maybe a triple”, he added. After I had retrieved the ball, I paused before pitching it again. “So William, do you want to join Little League?” He thought for a moment as the bat wobbled back and forth. “Nah”, he concluded. I looked at him and smiled. “OK, here it comes ...”

Pi in the Sky

2010-03-29T21:46:00.002-05:00

I’d like to wish you all a happy belated Pi Day. You know what I’m talking about, right? Every March 14th (3.14), families across the land gather close to honor the most special irrational number in the world. Everybody has their own way of celebrating. I change all the batteries in my calculator and bake, well ... pie. Sure, it doesn’t get all the publicity that Christmas or Thanksgiving gets, but it’s still one of my favorite holidays. I was in the card store just the other day looking for Pi Day cards, but I couldn’t find any. I guess they must have sold out. Wow, and I thought Valentine’s Day was big!

I tried to spread a little Pi Day cheer while I was walking down First Avenue the other day. Most people just looked at me like I had something large and green in my teeth, but one man actually put a quarter in my coffee cup. Too bad it still had coffee in it. One man with multiple tattoos of fire and skulls looked at me and said, “%@#$ off!” I felt bad. The holidays are such a stressful time for some people.

As you may know, π is the Greek letter for pi. If you multiply pi times the diameter of a circle, you’ll get the exact circumference. How cool is that! But it’s all one big lie, just like the Easter Bunny or a conservative Democrat, because pi is actually an irrational number. That means you can’t determine its exact value. I think that is why pi has always had a special place in my heart. I can also be irrational at times and there have been many times I have questioned my exact value.

As a child, I became obsessed with finding the exact value of pi. The computers at the time had calculated it out to thousands of digits, but I knew I could do better than that. I though that my 8th grade math teacher might hold the key to this mystery, so I approached his desk one afternoon like Apollo reaching the oracle of Delphi to ask him my burning question. He didn’t look up, but his bushy mustache twitched as he paused between marking red Xs on the paper he was grading. “Just divide 22 by 7.” My mouth was wide open as I slid out of the classroom in silence, stunned by the profound simplicity of his answer.

I rushed home that day, found the largest piece of paper I could find and began dividing 22 by 7. I was dividing like crazy for about an hour when I realized that the answer kept repeating in a pattern every 6 digits, 3.142857142857142857 and so on. I was broken, but not defeated. I figured that I could get the answer by working backwards. I found my Mother’s finest china plate, which I figured was the most perfect circle, and measured the circumference with a string and ruler. Then I measured the diameter and was planning to divide this into the circumference when my Dad walked into my bedroom.

He was perplexed, staring down at his son sitting in a pile of cardboard, string, tape, markers and fine china. “What are you doing, Billy?” I quickly thought up a few feasible stories, but settled on the truth. My Dad contemplated the situation. He was not a man who would dance around a topic. He was always able to cut through the murky waters of confusion with surgical precision and provide clarity where there was none, leaving everyone around him wondering, “Why didn’t I think of that?” He was an amazing problem-solver, so I anxiously awaited his assessment at that moment. “Billy, this is a futile exercise”, he calmly stated and walked out to of the room. I followed after him, shutting the door and throwing myself down on my bed. I rolled over, grabbed my dictionary from the dresser, and quickly looked up the definition of “futile”. Angrily, I opened the door and yelled, though not loud enough for anyone else to hear, “It is NOT futile!”

The First Time

2010-03-07T22:25:00.001-05:00

How did I get up here?

I contemplated this question as I stood at the top of that snow-covered mountain. I was wearing more layers of clothing than ever before, but the wind seemed to find a way through each layer. To make matters worse, my outfit could not even pretend to be color-coordinated. It looked like I had closed my eyes and grabbed garments at random during a frantic trip to the flea market, but the truth was that I borrowed most of what I had on. This was my first skiing trip in Junior High School. My friends had finally convinced me to come along and they each lent me an item that they no longer used. Jeff had donated his bright green ski pants, while Kenny provided the orange jacket. I’m not sure where the red gloves came from, but that was OK because nobody was asking for anything back. I convinced myself that at least I would be easy to spot in the snow.

My parents dropped me off at the bus waiting in the school parking lot early that morning. They had never skied, and were not completely in approval of my new sport, but went along with it just fine. My mother was already discussing ways to accessorize my motley wardrobe, and my dad came right to the point with, “Don’t kill yourself, Bill”.

I started feeling butterflies as the bus wound its way up the snowy mountain road. At the mountain, I picked up my boots and skis. Most of my friends owned their own equipment, and I immediately realized that my rentals were not exactly the top of the line. With every step I took in my boots, it felt like a wild animal was chewing at my ankles. My skis were thick and looked like they had been built in the early days of fiberglass. Instead of the fancy springs on the bottom of the skis that would turn them over if they got loose, mine had frayed, canvas straps that fastened around my ankles.

I ran in place for about five minutes before I learned how to walk in my skis, creating so much friction that it melted away all the snow beneath me until I was standing in the only patch of bare grass within a 10-mile radius. People readily moved out of my way, and I wondered if my outfit had anything to do with it. Once the crowds had parted, I found myself at the red line waiting for the lift to come. But as I turned to ask the assistant for instructions, the metal chair swept me up and sent me up to the top, sprawled out on the seat with my skis pointing skyward as I held on to any piece of metal that I could find.

I had equally little instruction when it came to getting off the lift. I didn’t realize I had to stand up, so I went down the ramp like a catcher in a baseball game until my skis slowly parted and I planted my face down into the snow. With every skier that came after me, I was buried deeper until I became nothing more than a Technicolor streak in the ground. My friend, Andy, dug me out and began explaining how to stop by putting the tips of my skis together. Unfortunately, I was facing with my back to the slope and a stiff wind pushed me slowly to the edge until I finally tilted backwards and began accelerating downwards. “I’m going down!” I declared. Andy looked on in horror. “Wait, Bill, I’m not done yet!”

I remembered him saying something about pointing my skis, so I crossed them, but this sent me spinning like a helicopter across the mountain. Snow was flying everywhere, but I tried to make the best of the situation. I rationalized that some people have to ski for many years before mastering a trick like this. The mountain suddenly dropped out from under me, and in the next moment I found myself surrounded by rubber tubing. I looked up from the hole that I was sharing with the snow machine and saw bright, blue daylight. My skis should have come off under these circumstances, but the antique, and likely rusted, bindings held strong. I took my skis off and tossed them up, one at a time, past the rim of the hole. I scurried up to the surface and made it out just in time to see them sliding all by themselves down the mountain in different directions, the canvas straps whipping behind them. One landed softly in a pile of snow on the other side of the slope, while the other launched about 20 feet in the air and struck a tree, sending it twisting back to the ground with a cracking sound.

I collected my skis, and half an hour later I was getting close to the bottom of the mountain. Some of the time I skied, some of the time I walked, and some of the time I slid. But most of the time I just fell. It was a painful and demoralizing experience. The tears were frozen to my face, and I repeated over and over again that if I ever reached the bottom, I would never go back up again. I took a break from feeling sorry for myself just in time to look up and see a class of small children gathered at the base of the mountain. They didn’t realize that they were in a direct collision course with a multicolored asteroid. I tried to slow myself down the best that I could but, of course, my skis popped off, sending me tumbling over and over down the mountain. My skis were still tethered to me by the strap and they flipped all around me like a helicopter blade as I gathered snow. I skidded to a stop in the middle of the class as the children now realized that I was a skier and not just a large, badly dressed snowball.

I looked up and blew the snow off of my face. All around me were stunned kids with rosy cheeks and mucus dripping from their noses. One little boy stepped forward, wiped his nose with his mitten and said, “Hey mister, you gotta make a pizza wedge!” I thought to myself, “It doesn’t matter, kid. I’m not gonna need the advise anymore.” But on my way back to the rental shop, I hesitated a moment, turned around and ran back to the lift.

_____________________

Last month, I took my wife, my daughter and sons up to Massachusetts to ski. This was only their second year on skis, but they did better that I could have ever hoped and we all had lots of fun. And every time I see them laughing their way down the bunny slope, or ride with them up the lift, I can’t help but smile as I think back to that first time.

Places, Everyone!

2010-01-31T22:56:00.001-05:00

Recently, I had the pleasure of attending a play at my kids’ school. They were sitting next to me because, well, they refused to play a part in the production. I turned to the right and spoke in hushed tones to my middle child, “You know, Matthew, you should be up there.” He popped a couple of Skittles in his mouth and silently shook his head back and forth. I turned left to speak to my oldest daughter (let’s just call her the Queen of Tween) and found myself staring at an empty seat. She found a friend on the other side of the auditorium and escaped without a sound while I was looking the other way. I was annoyed and became determined to find someone who could pay the emotional bill I was quickly running up that evening, so I turned back to Matthew and continued my one-sided conversation with him. “Why don’t you want to join the Drama Club?” My question perturbed him enough that the Skittle he just tossed hit him square in the cheek and rattled through the chair into the abyss of the auditorium floor. He shrugged his shoulders, closed his mouth and pretended to chew on an imaginary candy. Going along with his charade, I continued, “You know, I was in plays when I was your age and I had a great time. In fact, I remember the first time I acted on stage ...”

The year was 1976, the Bicentennial year of our great nation. Disco didn’t suck yet and my entire wardrobe was red, white, blue, and loud plaid. I had leisure suits, but didn’t even know what the word “leisure” meant. I was in the second grade and my teacher informed us that we would be performing the Revolutionary War play, “Sam the Minuteman”, for the entire school. She read us the book, and then handed out the parts. I closed my eyes and prayed, “Please don’t call me. Please don’t call me.” But then Mrs. Scheim was up to the lead role. “... and Sam will be played by Billy Reisacher!” The blood drained from my head, making me look even paler than usual. I was still in shock as I strode to the front of the class to accept the script, which was damp with pungent, blue ink. She must have sensed my apprehension as I took the pages because she leaned down and whispered in my ear, “Don’t worry sweetheart, you’ll do fine.”

When I arrived home that afternoon, I grabbed my pillow and went to lie down on the couch, my only place of refuge when the world was caving in on me. My mother immediately knew something was wrong, but I think I gave it away by watching a TV set that was not turned on. “Billy, what’s wrong?” she said in a soft, soothing voice as she stroked my light blonde hair. I explained the entire predicament to her and, as usual, she had the solution in her back pocket and instantly put my mind at ease. “But Mom, what if I forget my lines?” She picked up the script that I tossed on the carpet next to the couch. “Don’t worry, Billy, we’ll practice every day.”

The night of the play finally arrived and I was as prepared as I possibly could be. I knew my lines backwards and forwards. I was dressed in classic Revolutionary-style clothing, but was most proud of my hat, which was my Dad’s when he was a child. I saw my friend, Marcia, backstage and asked her how she was doing. “I don’t feel so good. I’m really nervous and my Mom is sick at home.” She was a member of the chorus, which sang in the background on stage. I wanted to calm her down, so I tried in vain to make her laugh. “Places, everyone!” Mrs. Scheim frantically called as we assembled in the wings and watched the lights dim. The curtain rose and the spotlight followed me to the center of the stage as the narrator began, “This is Sam ...”

The play was going perfectly. Everyone in the cast was hitting their lines, and the audience was loving it all. At one point in the story, I was supposed to lie down on a cot before waking to hear Paul Revere deliver his famous warning. On my mark, I placed my hat behind the cot and pretended to go to sleep. I had only closed my eyes for a few seconds when a horrible sound emanated from the chorus. It was a guttural, retching noise accompanied by the sound of water pouring from a large pipe. I felt a small splash reach my face and I opened my eyes. To my horror, Marcia had just become violently ill, but my concern for her shifted when I realized that my hat was the sole victim of her stomach malady.

Mrs. Scheim rushed onto the stage and escorted Marcia out of the auditorium. We were now without a director, and both the audience and cast were frozen in stunned silence. I knew that this was my defining moment. I could either rise to the occasion and become bigger than anything the second grade has ever seen, or shrink away forever into the lonely shadows of mediocrity. I stood up and faced the crowd. Staring back at me with wide eyes and open mouths were my parents, sister, friends, teachers, the PTA. Slowly, I looked down at my hat, soiled and deflated on the wooden stage as I thought, “We’re going to need a lot of Ajax for this.” I realized that, just like the foolish ways of childhood, my father’s hat was of no use to me anymore. So I picked it up, carefully balanced it like a bowl of punch as the crowd gasped, and I carried it offstage. Returning to the stage, I took a deep breath and delivered my next line.

The applause were still ringing in my head as I snapped back to the present and realized that the play at my kids’ school was over and the audience was on it’s feet, clapping, screaming and snapping pictures. I jumped up and Matthew reflexively followed, spilling the remainder of his Skittles. He stood up on his seat and spoke to me, but all I could do was read his lips. “Daddy, my stomach hurts.” We stopped off at the bathroom before heading home and conversed through the stall door. “Daddy, maybe I’ll join the Drama Club next year.” I thought about it for a moment and replied, “No need to rush into anything. How about trying the trumpet?”

It's History

2010-01-03T20:10:00.000-05:00

I walked up the front steps of City Hospital and navigated my way through the revolving door. I was wearing my short, white jacket and the overstuffed backpack on my right shoulder almost got stuck as I emerged into the crowded lobby. I stopped at the security desk and explained, “I’m a medical student from Mount Sinai. I’m supposed to meet Dr. Goldstein in room 324.” The security guard motioned me towards an elevator bank, “Make a left on the third floor. It’s on your right.”

Across his large, wooden desk, Ronald Goldstein, an internist, was explaining what I was supposed to do for the day. “Learning to take a good history on your patient and perform a complete physical exam are the most important skills that you will learn in medical school. And this is the first time you’ll get to do this on a real patient ...” He was in his 50’s and the chaotic piles of papers and journals on his desk matched perfectly with his wrinkled clothing, disheveled hair and two day old beard. His monotone voice sent me into a daydream, but I returned just in time to catch the critical details. “Mr. Pal will be your patient for the morning. He’s in room 561. Drop off your history and physical in my office when you’re done.”

I took the elevator to 5 South and followed the rooms, 558 ... 560 ... 562. Across the hall, I located Mr. Pal’s room, straightened my white jacket, took a deep breath and knocked. Hearing nothing from inside, I started knocking harder, but once my knuckles began to throb I decided to push the door open. The room had a stale odor and the sheets on the bed had been hastily pushed to the side, but, so far, no sign of my patient. I knocked tentatively on the bathroom door, but instead of a human voice, the response of a five gallon flush thundered through the door, almost throwing me backwards. Mr. Pal burst triumphantly from the bathroom. He seemed startled to see me right in front of him as he quickly closed his robe and smiled politely, “Hello.”

Mr. Pal was a 40 year old Indian male who was admitted to the hospital for pneumonia. I explained my mission and he was delighted. “Go ahead; ask me anything you’d like.” He leaned in a little closer to me and whispered, “You have no idea how boring it can get in here!” Without hesitation, I began to take a history. With each question, I probed deeper into every aspect of his life from his family history to all the medications he ever took. No stone was left unturned and within a short period of time, I felt like I knew him better than I knew myself. He started answering the questions with long-winded answers, but before long, he was able to trim his responses down to one or two words. He had a hard time with a few of the questions. “Well, I’m not exactly sure how much roughage I get in my diet, but I guess I could ... uh, why exactly is that important?”

I was taking my detailed history of Mr. Pal for approximately one hour, and the reason I knew that was because he pointed it out to me. He kept glancing at his watch, so I added that observation to the twelve pages of notes I had already accumulated, “Patient seems to have a nervous demeanor. Consider ... Neurology consultation.” I assured him that I was about to begin the physical examination, but his eyes began to shift from side to side. “I think I have to go for an X-Ray ... or something.” “Don’t worry, Mr. Pal, we should be able to wrap this up within the next hour.”

I opened up my backpack and began choosing the instruments I would need to perform a complete physical exam. With this vast arsenal of tools, which I had accumulated over the first two years of medical school, I could not only uncover any subtle physical finding, but also fix a variety of appliances. “What are you going to do with that”, Mr. Pal inquired as a pulled out a sewing needle. “I’m going to test the sensation on your legs.” Mr. Pal replied, “I don’t think you need to ... OUCH!” We stared at each other in silence for a few seconds before I looked down and scribbled quickly in my notepad, “Nervous system intact.” For the next hour, I probed and explored every space and surface on Mr. Pal’s body that I could reach and took detailed notes on all my findings. He was watching TV and for some reason, settled on the channel that had a clock ticking. Suddenly a nurse entered and informed Mr. Pal that doctors would be coming soon to perform a spinal tap. Fortunately, the only things left for me to do were palpate his liver and spleen. He perked up and said, “Oh, good ... I mean, OK, if you must.”

I sat at the nurses’ station for the next hour, compiling all of the data I had collected during the morning. When it was finished, I was so proud of what I had accomplished. I tried to staple all the pages together, but the staple wouldn’t go all the way through, so I settled for a paper clip. I went back to Dr. Goldstein’s office and placed Mr. Pal’s history and physical on his desk, but as I turned to leave the office, it slid down one of the piles on his desk and landed on the floor.

Exposure

2009-11-22T23:36:00.001-05:00

1995

I was just starting to doze off on the large, leather couch in the resident lounge when my pager went off. I put down my copy of “The Secrets of General Surgery”, read the number that flashed on the device that was starting to dig into my hip and picked up the phone. “Hey Marie, is the patient in the holding area? OK, I’ll be right there.” I grabbed my white jacket and hustled down the corridor towards the operating room.

I arrived at the preoperative holding area and found Mr. Kingsford lying on a gurney either counting the holes in the ceiling tiles or making his final plea to a higher power. He was a previously healthy man in his 50’s who recently found out that he had a cancerous polyp in his large bowel and was undergoing a lengthy surgery to remove it. “Don’t worry. We’re going to take great care of you. I’ll go out and talk to your wife when you’re in the recovery room.” He forced a smile and I gave his hand a reassuring squeeze.

“Hey, Bill, are you ready to cure cancer?” My Chief Resident smiled at me outside the operating room and I quickly returned the smile and said, “Let’s do it.” When Mr. Kingsford was finally under anesthesia, I went out to the sink to scrub my hands and arms. Returning to the operating room, I prepped his abdomen with an iodine solution and placed sterile drapes over him, leaving an open space for the large vertical incision about to be made down the middle of his belly. The anesthesia machine was beeping along with the patient’s heartbeat and the intense overhead lights made the steel scalpel gleam as it was passed to my Chief Resident.

“Bill, can you pull on that a little harder?” The sweat was pouring down the side of my face and the muscles in my shoulder screamed in pain as I pulled on the retractor in my left hand and moved the small intestine out of the way. We were two hours into the case, and the Attending Surgeon and Chief Resident were close to removing the tumor. As the Junior Resident, my primary job was to provide exposure. That meant holding retractors, suctioning blood and generally making sure that the others could see everything they needed to see. Sometimes it was an impossible task, requiring many more appendages than God gave me, but sometimes retracting was just plain boring. It was not uncommon for a resident to lean back with all of his weight to keep the retractors in position and grab a few winks in a move referred to as “waterskiing”. During a slow point in the case, I found my mind wandering. I just couldn’t escape the feeling that I had been in this situation before...

1978

“Hey, Bill, are you ready to barbeque?” My Dad was standing in the kitchen wearing his New York Giants apron that he got for Christmas the year before as I replied, “Let’s do it.” While my Dad watched the start of the football game, I rolled our circular barbecue to the middle of the patio and wiped off all the cobwebs and leaves. I then dragged a 20 pound bag of charcoal around the side of the house from the garage to the patio. I dumped the briquettes into the grill, which made a sound like hail striking a tin roof, and a cloud of thick, black smoke enveloped me. Once the dust settled, I doused the black squares with lighter fluid and struck a match. Whooosh!! The cicadas made a rattling noise as the flames from the grill punched a tire-sized hole in the ozone layer and the temperature of Earth’s atmosphere rose by a couple of degrees. This maneuver almost cost me my eyebrows on several occasions. My Dad nodded in approval as he arrived with a thick porterhouse steak on a plate and surveyed the glowing coals. His barbeque tools shined in the midday sun as we began to cook.

“Bill, could you push down on the grill a little more?” For my Dad, grilling was both a science and an art. The circular grill was mounted on a central axle, which made it extremely unstable unless there was a perfect balance of food on all parts. I can only assume that the manufacturers of this product never actually tried to grill on it. To make matters worse, my Dad only used one half of the grill, which meant that I had to constantly counterbalance the other side with a long fork to prevent all the food from sliding off. Besides the fact that the fork was never long enough to completely protect me from the searing temperatures, this was no easy task for a couple of other reasons.

First of all, my Dad was constantly adjusting the distance from the coals to the steak using an equation known only to him and Albert Einstein. The muscles in my hands had not yet developed such precise control at that age, but I tried to oblige as he alternated between, “a little higher” and “a little lower”. Secondly, my Dad felt that it was necessary to repeatedly stab the meat until all the juice ran out onto the coals. This meant that I had to constantly anticipate his downward stabs to keep the system in harmony. If I was off by a millisecond, I could potentially launch the meat off the grill and send it to its final resting place in the azalea bushes. When the grilling was finally done, my Dad would point out once again all the physical attributes of a perfectly grilled steak. Inside the house, I iced my medium-well done fingers, wiped the black dust off my face and placed some Ben Gay on my aching shoulder before sitting down at the table to eat.

1995

After five hours, we were finished with the case. Mr. Kingsford was in the recovery room and his wife was relieved that the surgery went well. It was 10 o’clock at night and my Chief Resident and I both collapsed with exhaustion in the locker room. “So Bill, are you hungry?” “Yeah, I’m starving - Where do you want to go?” My Chief thought for a moment. “Hey, there’s a barbeque place right down the street!” My eyes widened and my jaw dropped open. After a few seconds, he said, “Maybe we should just go Chinese.”

What's That Smell?

2009-10-18T15:30:00.000-05:00

I sat in the terminal at Miami International Airport with a cooler tucked under my arm. These were the days before taking off shoes and offensive magnetic wand searches, and I was able to carry the suspicious box through security without the slightest hesitation. The safety officer must have been sound asleep, because the contents of the box would be easy to recognize on X-ray. I looked around nervously as the announcement sounded overhead, “Now boarding all rows to New York.” I grabbed the cooler, making sure that the lid was secure, and headed up the jetway.

The stewardess greeted me with an inviting smile, and I decided to engage her in some small talk. She was tall and pretty with long, blonde hair that was pulled back tightly into a bun. Her well-pressed, navy blue uniform couldn’t hide her shapely figure and her gold nametag said, “Tricia”. “So, Tricia, are we getting any food on this flight?” “Don’t worry, I’ll take good care of you”, she replied and I smiled back. The weight of the cooler was making my shoulder ache, and I worried for a moment that she might want to know what was inside, so I politely excused myself and found my seat.

I immediately felt better once I stowed the cooler in the overhead compartment. I wiped the sweat from my forehead and sat down next to a middle-aged woman who was reading the newspaper. I was a senior in college, but this was only the second airplane flight I had ever taken. My father was not a big fan of flying, so whenever my family took a trip, we would travel by train, boat or car. But I decided to spend my spring break in Key West, so I flew down to Miami and drove down US 1 to the Keys. It was an unbelievably fun trip, but now I was ready to go back to school. And I was traveling with special cargo.

The plane took off and made a gentle bank turn up the coast. The water was a beautiful shade of aqua, and the view of Miami was equally as amazing. Suddenly, the plane jolted and dark smoke began billowing forward from the rear of the aircraft. I turned to the woman next to me and asked, “What’s that smell?” “I believe that one of the engines is burning”, she calmly stated without looking up from her newspaper. I felt the sweat building up on my palms, and when I looked out the window, I saw fuel spraying out from every engine. “They do that to make the plane lighter for emergency landings”, the woman continued. She put her newspaper down and smiled reassuringly, “I’m a pilot’s wife. Don’t worry. It’s not a big deal.”

The plane suddenly made an awkward bank turn back towards the airport. I wasn’t sure if we’d make it back to the airport or have to land on the water, but I was relieved when I saw the ground below me. I closed my eyes and recited every prayer I ever knew. The plane shifted from side to side and bounced down on the runway with enough force to make me rise out of my seat as the lap belt dug into my thighs. Several passengers screamed as black smoke continued to fill the cabin. When the plane came to a stop, we all made our way towards the side doors and slid down the evacuation ramp onto the tarmac.

What followed was a 4 hour layover in Miami. I learned that one of the engines had caught fire, but even more amazing was the fact that we would be getting back on the same plane! I calmed my nerves with a couple of Margaritas in the lounge. When I finally boarded the plane again, the plane was overheated from sitting on the runway for so long. I heard a couple of people behind me complaining that there was still a bad smell in the cabin. Suddenly, I realized that the bad smell was not coming from the vents. It was coming from MY COOLER!

During the flight, more and more people began complaining about the putrid smell in the airplane. I asked Tricia for a blanket, but she gave me a quizzical look because the temperature in the cabin was probably close to 80 degrees. She brought the blanket, but the smell in the area was obviously putting a severe strain on her beautiful smile. I quickly opened the overhead bin and stuffed the blanket around the cooler to mask the odor, but it didn’t help much. All around the plane, passengers were fanning themselves and looking at the people next to them, saying, “I didn’t do it!” When I arrived at JFK, I found a deserted section of the terminal and dumped the contents of the cooler out into the garbage. What a crime.

I drove back to my parents’ house on Long Island. They were naturally concerned about my horrifying experience on the plane. “You see, that’s why I don’t fly”, my father announced triumphantly. I told them about all the good times I had in Key West with my friends. We rented mopeds, hung out on the beach and even went deep sea fishing right off the coast of Cuba. We caught a lot of Mahi Mahi and brought it back to the hotel where we mixed up a beer batter and had a huge fish fry. In fact, we couldn’t even finish all the fish we caught. “So where is all the fish you were going to bring back for us?” my parents inquired. I hesitated and looked down. “Well ... that’s a whole other story.”

Colors

2009-09-21T21:58:00.001-05:00

My sneakers squeaked as I hurried down the hospital’s hallway. A fresh coat of wax had just been applied and I could see my distorted reflection in the shiny, off-white tiles. For a minute, I thought that I looked good in my green scrubs and long, white jacket. I must have walked down that same corridor at least twenty times that day and I knew all the pictures on the wall by heart. The flowers and seascapes in the prints were all faded and I figured that the original painters would be sad to see what had happened to all the vibrant colors they had chosen for their artwork. It made me a little sad too. I passed by the nurses’ station on that floor, waving and smiling at the ladies behind the desk. They were busy writing in their patients’ charts and measuring medications as the sound of heart monitors droned in the background. I stopped by a window near the elevator. The sun was beginning to set and I spotted an architecturally beautiful church nestled in the distant hills. I had seen it many times before. It looked so inviting to me and I often contemplated running there to seek refuge, but then the elevator came and I went inside.

It was my first year of general surgery and I was on night call at one of the hospitals outside of NYC. I was both exhausted and lonely all at the same time. I missed my bed and the softness of my girlfriend’s skin. My days were spent scrubbing into as many surgeries as possible. In between, I would run around the floors performing consults and taking care of the many needs of our floor patients. Yes, it was pretty much like Grey’s Anatomy, but without the sex and commercials. In any given hour, I would unclog a feeding tube, change an abdominal wound dressing, insert an intravenous catheter into someone’s internal jugular vein, deliver blood samples to the lab and write orders for a battery of x-rays and medications.

I tried to be as efficient as possible, but it seemed that every place I had to go was at the opposite end of the Medical Center. To make matters worse, the hospital was a Level 1 Trauma Center, which meant that it accepted the worst accidents. Just when I was getting caught up on my “scut” (that stood for some common, unpleasant task), I might be called to the ER to handle a multivehicle accident with half a dozen casualties. Suddenly, I’d be up to my elbows in blood trying to put a chest tube in and re-inflate a collapsed lung. There were days when I barely had time to change gloves before the next trauma rolled in, and all the while I would be thinking about how behind I was getting on my other work and how my prospects of sleeping that night were dwindling.

During the evening, the hospital transformed from a chaotic madhouse into a quiet, eerie place. The lights became dimmer and all the pain and suffering that was taking place behind each curtain and door took on a more silent character. That night, I was so tired from a sleepless night before that I felt bugs crawling under my skin. My hair was oily and I wasn’t sure when I had last brushed my teeth. I suddenly realized that the gnawing feeling in my stomach was hunger, so I found my favorite vending machine and made a selection. I made sure to vary my diet, so I chose something from a different row than before. I was just about to sneak off to the call room for a nap, when I heard the announcement from overhead, “Surgical Resident to the Medical ICU, STAT!”

I listened to it for a second, and then looked around me. A calm voice inside my head broke the confusion. “Yes, that’s you.” I looked down at my candy bar, stuffed it in my pocket and ran to the MICU which was, yes, at the other end of the medical center. When I arrived there, one room full of light and bustling activity stood out amongst all the others. A nurse ran out of the room and looked at me. She was out of breath as she adjusted her glasses, checked her watch and screamed back into the room, “He’s here!” Walking towards the room, I felt like Alice floating down the hole into Wonderland, but I had no idea where this rabbit was leading me.

I walked into the room and stared at the unconscious man on the bed in front of me. The anesthesiologist was at the head of the bed trying to put a tube down his windpipe to help him breathe. “I can’t get it in, he’s too swollen. He needs a trach!” Somehow, I found myself right beside the bed. My white jacket had been taken from me and in its place was a surgical gown. It all happened in a matter of seconds. Betadine, a skin cleanser, was placed in my right hand and a scalpel was placed in my left. A tracheotomy is a surgical procedure to place a tube through the skin into the windpipe an inch below the voicebox. I had learned about it, and even saw a few done, but I had never done one myself. I knew that if I succeeded, he might live, but if I failed, he would surely die.

My eyes remained fixed on the patient in front of me. I coated his neck in betadine and felt for the location of the incision. I brought the scalpel closer to my patient, but just as the edge of the blade indented his skin, the anesthesiologist screamed, “I got it, the tube is in!” I looked over and saw that air was entering the man’s lungs from a tube in his mouth, called an endotracheal tube. The scalpel made a clanking noise as I dropped in back onto the instrument stand next to me. Part of me was relieved that he was going to be OK, but another part of me was disappointed that this pivotal moment was swept out from under me. “Thanks for coming”, the anesthesiologist said with a smile and patted me on the back. Walking back to my call room, I felt empty and confused. The adrenaline was still pumping through my veins. Consuming the rest of my half-eaten candy bar was my only consolation.

That was one of the toughest rotations of my two years in General Surgery. Before heading home the following morning, I actually had the opportunity to perform an emergent tracheotomy in the ER with my Senior Resident leading me through it. These days, as an ENT, I get to perform these procedures rather frequently, but I always think about the one that got away that night. Walking through the hospital’s parking lot, the sun was shining and I enjoyed the feeling of warmth on my face. The faded paintings in my mind were now replaced by a vibrant, blue sky and the sweet, warm breeze coming off the hills. For now, I was free, but I knew that my escape would be short-lived. As I drove out of town, I passed the church that I saw the night before. The doors in the front were opened wide, as if they were saying, “I’m here when you need me”.

Olé Part III – The End of the Rainbow

2009-08-23T19:16:00.007-05:00

7/25/09
10:30 AM, Veracruz, Mexico

Today is my last day in Mexico. I went for an early morning walk on the beach to snap some last minute pictures, then showered and had breakfast at the hotel. I managed to stuff all my souvenirs into my bags and brought them to the Convention Center. I have one more lecture to go, so I have to go and prepare for this now. I’m looking forward to coming home, but I am also sad to leave this magical place. I am convinced that I experienced almost everything that Veracruz had to offer, but I feel like I took only one spoonful of a huge ice cream sundae. At home, I used to think of Mexico in terms of margaritas and men with large guitars, but now I see that there is so much more to this land. The people here are bound together by their common history and by the love they share for their country. I’m proud to have been a part of it for a few days, and I’m looking forward to returning here very soon.

EPILOGUE

7/26/09
9:30 AM, Mexico City, Mexico

OK, when I said that I didn’t want to leave Mexico, I didn’t mean that literally. In fact, I was supposed to be boogie boarding in Ocean City, MD with my family at this moment, but I’m not. No, I’m sitting in the airport in Mexico City where, about 17 hours ago, I was doing my imitation of O.J. Simpson (the commercial, not the … other thing).

I arrived at the airport in Veracruz yesterday with lots of time to spare. I had the same driver who originally brought me to the hotel, and we greeted each other like long lost friends. On the first leg of the flight, they naturally served peanuts, but this time I figured out how to use my plastic cup like a gas mask. It worked pretty well! The flight to Mexico City was delayed by 15 minutes and landed in Terminal 1 at 4:15 PM instead of 4:00 PM. My connecting flight to JFK was slated to take off at 4:55 PM from Terminal 2. Here’s how it all went down:

4:18 PM - Ran down the gangway. Found the first person I could find in a uniform and asked him how to get to Terminal 2. He told me I needed to take the air train and he told me to go outside and look for Puerta 5 (gate 5) I found myself in the main part of Terminal 1, but I saw were lettered gates.

4:22 PM - My pace quickened. I assaulted a porter and asked him where the air train was. He pointed up, and for a moment I thought he was signaling that it might help to say a prayer. He sensed my confusion and redirected his finger towards a nearby escalator. I thanked him and charged up the escalator. I was wondering how my checked bag was doing in all of this.

4:30 PM - I found the air train and the electronic sign above the entrance told me that it would arrive in 7 minutes. This is not what I wanted to see. I sat down and began to wallow in my growing despair, when I suddenly heard a tapping sound on the metal roof of the train terminal. The tapping grew louder and more frequent until it became an incessant banging that shook the whole structure. I looked out the window and saw golf ball sized hail coming down in sheets. This was my chance, my glimmer of hope! After all, how could a plane take off in this? My heart sank, however, when I looked out the window again and saw a plane taking off.

4:42 PM - The train to Terminal 2 took another 5 minutes. I was practically in a full sprint towards my gate, hurdling over groups of crying children and sidestepping souvenir stands. I actually thought that I had a chance, but then I turned a corner and was horrified to see a Security Checkpoint! I threw my carry-on bags through the conveyer belt and ran through the metal detector with such speed that even a suit of armor wouldn’t have set it off. I asked the Security Guard to call my plane to tell it not to leave, but I don’t think he understood me.

4:50 PM - Almost there. I was a little disoriented finding my gate number, so I asked an information clerk for the directions. I also pleaded with her to call the gate and tell them I was almost there, but she just told me to hurry up. Did she think I was flushed and sweating because I just waltzed out of the sauna?

4:56 PM - I arrived at my gate. I saw that the door was closed, but I walked casually towards it thinking that everything would just work out fine. The clerk at the desk stopped me and said, “Señor, the plane has already left.” Her lips seemed to move in slow motion and that sentence reverberated several times in the hollow void that used to be my brain. I stared at her in disbelief and my breathing became deep and labored. I managed to get out the words, “You have to tell it to wait. I need to get to New York.” “No, Señor, the doors have already closed.” My mind began swirling with ideas like riding alongside the taxiing plane on the luggage truck and grabbing the axle of the landing wheel in order to gain entry into the plane’s belly. I saw that in a movie once and it looked pretty easy, but then I snapped back to reality. “OK, when is the next plane to New York?” “Not until tomorrow, Señor.” My heart sank deeper into despair. My family was waiting for me back home to start our beach vacation, and here I was, all alone and trapped!

What proceeded for the next 2 hours was the most interesting Spanish language emersion experience of my life. I learned more in those 2 hours than I did in 3 years of Spanish class (Sorry, Señor Rivera). I must have spoken to every employee of that airport twice. I traveled on the air train twice more and passed through a half dozen security checkpoints. In fact, metal was starting to stick to me. I finally found my luggage, which thankfully missed the flight to New York as well. Unfortunately, it was sitting on the tarmac during that bad storm and was a bit on the moist side.

The airline was great in taking care of everything. They put me up free of charge in a nice hotel with meals included and changed my ticket to a flight leaving today at 11 AM. If all goes well, I should be boarding in about an hour. I’ll let you know how things turn out …

7/26/09
7:00 PM, New York, NY

I did it! I’m finally back in NYC! I made it onto the plane successfully after 3 separate security checks and sat next to two young boys from Mexico City. They were cousins who were traveling alone on their way to camp in Connecticut and spoke beautiful English. One of them played video games incessantly and the other had some difficulty controlling his gas, but they were both very friendly. It’s amazing how children feel so free to start conversations and use different languages, but somehow fears of embarrassment and rejection develop as we become adults. Naturally, peanuts were served. I think I’m actually starting to like the smell.

As soon as my plane touched down at JFK, the rain began pouring down so hard that I actually thought they were washing the plane. I immediately made my first cell phone call in 5 days to Cynthia at 4:52 PM to let her know that I was on my way home. After collecting my soggy, souvenir-laden luggage, I had one final obstacle to overcome.

I approached a heavy-set African American woman at the U.S. Customs desk. She looked me up and down and seemed to be able to smell fear in the air. She had a look on her face that told me that she knew I stole a library book in the fourth grade. “Do you have anything to declare?” Trying to soften her expression, I replied, “Besides the fact that I’m really glad to be home?” Not only did her expression not change, but she continued to stare at me and I thought I heard a soft growl. I looked down in shame and gave her a humble, “no”.

Sensing that she had me on the ropes, she asked me, “So why were you in Mexico, business or pleasure?” This was a dilemma for me. Technically, I was on a pleasurable business trip. My mind began to race. What do people who are in the “pleasure” business say to a question like that? I answered “business”, which apparently pleased her enough to show me a slight smile. I swallowed hard as she asked a rapid follow-up question, “What kind of business?” For a split second I thought about giving it all up and answering, “Drug trafficking”, then I came to my senses and said, “Medicine”. Suddenly, I realized that I just did the very thing I was trying not to do. I closed my eyes in regret and opened them to see her smiling the smile of a cat who knew that the mouse was trapped. I knew the next question. “What KIND of medicine?” I thought for a moment, and suddenly a smile broke out on my face because I knew that there was only one answer to that question. Confidently, I replied, “The BEST medicine”.

Driving back to the Upper East Side in a yellow cab, the events of the past several days danced through my mind. The river, the sweet shrimp and the music all seemed so far away now. The sound of hail hitting the roof of the cab brought me back to reality as we crossed the Triboro Bridge. This reminded me of the hail in Mexico City which almost saved me the day before. The FDR drive was a river and the cab moved at the exact same speed as the current. Across the East River, I saw a beautiful rainbow which extended down to the ground. As the cab turned onto 78th Street, the tears welled up in my eyes. My wife and kids were waiting outside, jumping up and down holding a “Welcome Home, Daddy” sign. This is what I have been searching for all along. This was the pot of gold at the end of the rainbow. I’m finally home.

Olé Part II – Billy and the Bull

2009-08-16T19:22:00.020-05:00

7/23/09
7:00 AM, Veracruz, Mexico

I woke up to a beautiful sunrise. My hotel room had a full view of the Gulf of Mexico. The sky was golden and several oil tankers loomed ominously out in the distance.

The hotel was right on the beach, a luxurious building that stood in stark contrast to the less affluent areas around it. The sand was not white or powdery, but dark, with the consistency of loosely packed dirt. I was nervous about putting a towel down on it, but it was great for running. The temperature was already 80° F, but lots of people were out walking on the beach. The waves were small and broke about 100 feet out due to a large sand bar. As I ran, I saw a large tusk of an elephant washed up with flies on it, about 3 ft in length, and wondered how it got there. Saw a Chihuahua peeing into the hollowed-out half of a coconut. Now that was a well-trained dog!

I saw Jorge, one of my hosts, also running on the beach and we stopped to chat. We made plans to go out for a bite to eat after my lectures were over at 1 PM. I read on the internet that Veracruz produced the best coffee in the world, and I will be searching for that perfect cup today. I met some of my American colleagues at the hotel’s breakfast buffet. I was able to communicate with the waiter totally in Spanish and he was comfortable with it. A blackbird perched outside the window, looking towards an island out in the distance. I ate a variety of meats, queso blanco (white cheese) and papaya. The coffee was pretty good, but I’m going to keep looking for that holy grail of caffeine. I almost burned myself shaving this morning. I have to remember that “C” on the faucet stands for caliente (hot), not cold. Right now, I’m getting anxious about giving my lectures today.

7/24/09
1:00 AM, Veracruz, Mexico

I’m so tired. All I want to do is fall asleep, but I want to write this all down before it slips away from me. I’ve been eating and drinking for almost the entire day. My lectures went well. I cracked a couple of jokes in Spanish that were not that funny, but the audience laughed politely anyway. I spoke slowly at the first one, because it was being translated. It sounded so strange to me, and at the end of the lecture, the translator came up to me and said, “For the next one, could you please speak a little slower?”

After the lectures, I met Jorge and his friend Antonio. We changed back at the hotel and went driving with another friend at the wheel. The first stop was a convenience store to buy beer for us and soda for the driver. Apparently, there is no such thing as an open container law here, because the three of us finished a six pack while on the way to the next destination.

We drove out of Veracruz to Boca del Rio (mouth of the river), where we stopped at a local restaurant, which was on the bank of the river. I bought a pearl necklace from a man for 100 pesos (about 9 dollars) after he proved to me it wasn’t plastic by putting a flame underneath it.

Jorge was conversing with the owner and he motioned for me to come out back. The four of us boarded a small boat with an outboard motor and watched as a small boy, about 10 or 11 years old, dove to the bottom of the murky water. After a long, tense 30 seconds, he burst out of the water with a couple of handfuls of large shrimp. I mean, I can’t even get my 10 year old daughter to pick up her own clothes!

They brought the shrimp to the kitchen, boiled them and brought them back out to the boat on a plate with green lemons and salsa picante (spicy sauce) on the side. One thing I learned here is that lemons are green and limes are yellow. Go figure.

To drink, they brought out a tray of toritos, literally translated as “little bulls” because of how strong they are. They were originally created for workers to help them make it through a hard day in the field. My friends told me that when someone asks you a tough question, they are throwing you a torito. It’s made from fermented sugar cane, not refined enough to be rum, and blended with honey, lemon and sometimes another fruit. I had two on the boat made with guanabana, a gelatinous white fruit. As we motored down the river, I pulled the head off of one of the shrimps, peeled and ate it, throwing the uneaten parts overboard. This process repeated many times. It was the sweetest, softest shrimp I had ever tasted.

I was on my second torito as we passed a house on the river called, Casa del Diablo (the house of the devil) because of several ghost sightings in the abandoned dwelling. The air was hot and sticky. The sunlight danced over the water like diamonds, and I reached out my hand, thinking that I could catch a few. I think I could be happy living a pure, simpler life. Our boat trip lasted about a half hour. On the trip, Jorge opened up to me about getting divorced after 13 years of marriage. He had 3 grown children, but was now remarried to a woman named Patty, who had younger children. Antonio had 5 children around the teenage years and could not understand Jorge’s desire not to have any more children.

After the first restaurant, we drove to a bar for, you guessed it, more toritos. The bar seemed to be a cave cut out of a large rock. This time, I had a coconut and mango which were much more potent than the first two I had. With each torito, my Spanish got a little better, while Jorge and Antonio’s Spanish got a little worse until it finally became one beautiful, perfectly fluent language. We shared common interests and family situations. There was mutual respect as well. Antonio spoke only Spanish to me in the beginning, but as he became more comfortable with me, he decided to practice his English, which I could understand very well.

In the next restaurant we stopped in, we feasted on spicy shrimp soup with lobster claws, local fish and fried fish eggs wrapped up in a tortilla with salsa and vegetables. The waitress asked me what I would like to drink, and when I ordered water, she and my guests had a similar look of dismay on their faces. I quickly changed my order to cerveza (beer) and everything continued normally.

At this point, I was so tired and buzzed from the food and alcohol that, at least in my head, the line between English and Spanish became very blurry. I made it back to the hotel at 6:30 PM, slept for one hour and opened my eyes at 7:20 PM. I had to be in the lobby by 7:30 PM to board a bus taking us to the reception for visiting professors. I watched a traditional dancing show near El Centro, the center of the old town of Veracruz, and was called onto the stage to receive a certificate from the Congress along with several bottles of alcohol and local coffee. The reception was held in the central courtyard of a beautiful, old museum that used to be a hospital. It was a night full of good music, good food and good conversation. I drank paloma (dove), a white drink made of tequila and grapefruit extract. Not bad. With dinner, I had red wine and, yes, another glass of tequila to finish off the night. I hope my liver survives this trip. I’m going to bed.

2:00 AM, Veracruz, Mexico

A storm rolled in from the Gulf along with lots of wind, rain, thunder and lightening. One bolt shook my room. It must have struck the building, but I’m still here. I wish I had Cynthia next to me.

8:00 AM, Veracruz, Mexico

The storm lasted all night, and sleep was intermittent. I went running this morning. The rain knocked the temperature back about 5 degrees, but did nothing for the humidity. The dirt on the beach was even springier, but had lots of debris washed ashore. I ran even further today, all the way to a jetty of large rocks. I saw some grey crabs on the rocks, about 6 inches across. They didn’t look particularly aggressive, but I didn’t get too close. Out in the distance was Isla de Sacrificios (Island of Sacrifices), the island I spotted yesterday morning at breakfast. I’m going to try to find out today why it is named that.

On the way back, I saw a man rowing in the ocean with his son sitting at the front. He was rowing with a long oar that had a fork-like device on the other end, presumably for catching fish. To me, this represents the entire meaning of life – do good things in the world and then teach your children how to do the same. I hope I can accomplish that in my life. I’m meeting Jorge in an hour and going to breakfast. I told him about my coffee quest, and I’m excited about the possibility that I might soon be sipping the best cup of coffee in the world.

7:00 PM, Veracruz, Mexico

I’ve been to the top of the mountain and I saw the other side! I had my caffeinated epiphany today at last. Breakfast is forever ruined for me and I refuse to walk into another Starbucks again. Jorge and I drove to downtown Veracruz and stopped at the Gran Café de la Parroquia, or La Parroquia (parish) for short. It is named for the church that it used to be next to before the café was moved to its present location in 1976. We waited about a half hour until a table opened up, and dove to occupy it, as their was no waiting list. The waiter who took our order told us that he has worked there for 52 years. The first thing we ordered was café lechero, or coffee with milk. It came as a couple of shots of espresso in a large glass. To call over the “milk guy”, I was instructed to bang my spoon on the inside of my glass until he came, a maneuver referred to as “tinkling”. For me, that’s usually what I have to do AFTER the coffee. So I tinkled, but was afraid someone was going to make me give a speech or random couples were going to begin kissing.

When he came, he poured the steaming milk from about 2 feet in the air, transforming the espresso from a black puddle into a bubbling, sea of mocha colored waves and white, swirling foam. The milk he used was freshly milked from a cow without pasteurization or homogenization, and thus it contained stringy and gelatinous elements that I didn’t even mind. It was moderately sweet by itself, but I added a small amount of sugar. I wrapped the hot glass in a napkin and brought it slowly to my lips. As soon as I took my first swallow, I felt my whole body go numb. I closed my eyes and all the rough edges in my life suddenly smoothed out. I felt the pride, beauty and sweat of 500 years of Mexican heritage enter every cell of my body and I could do nothing but bow my head in respect and quietly mutter, “Olé”. Needless to say, that was one slammin’ cup of joe!

Next, I ordered huevos tirados, or eggs with frijoles (beans). Jorge, still amused by my reaction to the coffee, ordered gorda (a pastry made from frijoles) and picada (a tortilla with cheese and hot sauce). On the side we had fresh breads and bomba, a baked pastry with a slightly gooey, sweet center and a thick, crumbly cheese crust covering the outside. OK, let’s just call it a Danish. Dipping that in the coffee further intensified the magical transformation that was going on inside my body.

The café was crowded, but not unruly. People walked around selling newspapers and shining shoes. Jarochos (Ha-ro-chos), something like a Mariachi band, played for different sections of the café and a beautiful woman wearing a traditional Spanish dress came around with a hat for tips.

After we finished paying, we headed out to the marketplace for little shopping. Music played from every doorway, alternating between modern music with a heavy beat to soft, traditional folksongs. Many women, some with their children beside them, sat outside the stores selling items that they had obviously made themselves, but I did not encounter one person begging for money. There was a military presence, many with assault rifles by their sides. In fact, the night before, we were warned not to wander in the town because of the “dangers”.

Jorge showed me all the historical sites in the downtown area, which is where he spent a great deal of his childhood. I asked him to tell me the story behind the Island of Sacrifices. His face became very serious as he explained that when the Spanish settled Veracruz, they discovered that the indigenous people there had used that island for regular human sacrifices to appease their Gods. The island is reputed to be haunted by the spirits of all those who lost their lives there. I guess I won’t be going over there any time soon.

I made it back to the hotel with minutes to spare before I had to go over to the Convention Center and give my next lecture. It went OK, but it’s strange telling a joke through a translator, only to have the audience laugh 30 seconds later. I’m starting to realize that I’m really going to miss this place. I decided to relax for the afternoon and spent four hours baking in the sun, feasting on quesadillas and margaritas by the pool. The pool was a winding, sprawling network of smaller pools linked by waterfalls and hot tubs. I didn’t want to leave.

I showered, rested and went down in the lobby to meet Sergio, who was assembling a group of people for a farewell dinner. I also saw Jorge in the lobby and finally had the chance to meet Patty, who was very pretty and charming. I excused myself and proceeded with Sergio and friends to a local seafood restaurant nearby. I had ceviche, spicy crab soup and flan for dessert. Several Dos Equis washed it all down. A group of us then went out to a bar and had a round of drinks called toros (bulls). These were different from the rustic toritos I had the day before. This concoction consisted of tequila, whisky, brandy, rum, beer and honey. It tasted a bit like a Long Island ice tea.

Next week, read about the final leg of my trip, and find out why it’s not as easy to leave Mexico as it sounds!

Olé - The Extranjero

2009-08-09T18:49:00.006-05:00

Prologue

A couple of months ago, I was invited to speak as a guest Professor at the 59th annual meeting of the Mexican Society of Otorhinolaryngology (Ear, Nose and Throat), Head and Neck Surgery. The meeting was supposed to take place in the spring, but because of the swine flu outbreak, it was rescheduled for the end of July. I was asked to give five lectures on a variety of ENT and allergy topics over a four day period. The meeting was to take place in Veracruz, a city in Mexico on the Gulf Coast which I had no idea even existed before this invitation. I accepted the honor, but was filled with a mix of emotions. On one hand, I was excited to explore new places, but on the other hand, I was nervous about leaving my family and traveling alone outside the country. I kept a detailed journal of my adventures while I was in Mexico and I took a lot of pictures. It was an exciting journey, and I think you’ll be surprised at how it ends. As you read each of the three parts, you’ll surely taste the sting of tequila on your tongue and hear the sweet folksongs as they float past you on the warm, afternoon breeze.

7/22/09
7:00 PM, Veracruz, Mexico

I woke up at 5:30 this morning, got ready and caught a cab to JFK. It’s always sad to say goodbye to Cynthia and the kids. As soon as I got on the line for AeroMexico, I felt like I was in another country. There were about a dozen people before me in a line which wasn’t moving at all. I suddenly became aware that I looked different from everyone else, and a few people around me probably thought I was in the wrong line. After about 15 minutes, the entire line cleared out, and I realized that there was only one family in front of me. The plane took off uneventfully and I drifted off to sleep. Suddenly, I awoke to the flight attendant saying, “Pan francais?” I was still in a daze, and thought for a moment that I died and was reincarnated as French bread. She then continued, a bit annoyed that I was making her struggle through English. “Would you like French toast or omelet?” I asked for the French toast and my next door neighbor got the eggs. I was so shocked that I received real food that I quickly gobbled it down before someone noticed and took it away.

I didn’t make much conversation with the guy next to me, and he didn’t really say much to me either. He was probably afraid that I would assault him with the English language, but I was actually looking forward to using my Spanish, which I think I’m pretty good at. I use a lot of Spanish in my office with patients, but if you’re not suffering from an earache or a sinus infection, a conversation with me in that language might be a bit tedious. Suddenly, my heart quickened as the guy two seats down leaned over and asked me to borrow a pen. Unfortunately, he spoke fast and used the word for pen that I wasn’t familiar with, so we had to convert to charades. Señor Rivera, my Spanish teacher from Junior High School, would have been so ashamed of me.

I’m having the exact opposite problem that I had when I went to Germany last year. When I was in Germany, everyone spoke to me in German because of my appearance, and they wouldn’t give me a break, even when I answered them in English. I have a small, working knowledge of German. I learned most of it from my Grandmother, who spoke fluent English, but would only converse with me in German once her Alzheimer’s disease got worse. Unfortunately, you can only say “turn on the light” and “what’s your name?” so many times before you have to move on to another topic.

I really wanted to impress the guy next to me, so I planned on asking him how his eggs were. However, I realized just as the words were about to leave my mouth that the phrase, “Como estan sus huevos?” can also be interpreted as, “How are your balls?” I knew that mine were feeling a bit cramped, but I really wasn’t interested in how his were doing, so I stayed quiet. Silence dominated the rest of the flight, until a person with an extremely productive cough woke up and began expectorating one of his lungs. I voted for pushing him out with a parachute, but I think they just took him to the ICU right from the airplane. I almost needed an ICU myself when they passed out roasted peanuts as the snack. Some of you may remember that I am severely allergic to peanuts. I managed to hold my breath for a record-setting 30 minutes until the smell cleared, but once the oxygen finally returned to my brain, I still felt horrible.

We flew into Mexico City, which looked like Brooklyn from the air. When I landed, I had to fill out a questionnaire asking if I had any symptoms such as cough, fever, runny nose, body aches, etc. I imagined all the horrible things that could happen to me in a Mexican hospital, so I quickly ran a line down the “no” column. I went through customs, where I always feel guilty even though I have nothing to hide. I was now officially an extranjero (foreigner). My connecting flight was a tiny, cramped jet which served peanuts again. I guess they were trying to finish me off. I got off the airplane in Veracruz, still clutching my Epipen, and surveyed my surroundings. The glare of the noon sun reflected off the tarmac, and the air was heavy and still. The heated exhaust from the plane’s engines made it difficult to breath, but as I walked farther away from the plane, the air quality didn’t improve. I trudged into the air-conditioned terminal and was relieved to see a young man smiling and holding a sign with my last name on it.

On the way to the hotel, I spoke to Alex, my driver, in Spanish. He must have been about 18 years old and seemed to understand everything I was saying. He told me that he dreamed about going to NYC to come and see the Yankees play, but had not been able to get a travel visa. I met some of my hosts at the hotel and we went out to eat at a place which overlooked the Gulf of Mexico. I ate rice, plantains and some of the best shrimp I ever had while enjoying a beautiful view of the water. They asked me if I wanted something to drink, and before I could answer, the waiter placed a beer and a glass full of tequila in front of me.

As I sipped tequila, my new friends told me a bit about the history of Veracruz. It was actually the first city settled by the Spanish back in the 1500’s and for a while, the city was larger than the country’s capital, Mexico City. The city was founded in 1519 on the Friday before Easter Sunday, which is known as Good Friday or the day of the True Cross (Vera Cruz). Over the past several centuries, Veracruz has not only been an important commerce port on the Gulf of Mexico, but is also an agriculturally blessed region with a rich culture and tourism base. The song “La Bamba” was written about Veracruz as well. You’ll have to take me out for a beer to hear the true story behind the song.

7/23/09
1:30 AM, Veracruz, Mexico

After lunch, I went back to my room, showered and slept off some of the tequila. I took a bus to the opening ceremonies at the Convention Center, and the Governor from this part of Mexico was there. I was immediately escorted to the front row. There was a color guard procession, which was followed by a chorus of blaring trumpets that almost sent me under my seat. Suddenly a group of photographers kneeled in front of me and the other American doctors I was sitting next to. I tried to duck out of their way until they motioned to me that I was the subject of the photos. Every time I laughed or applauded, the cameras swung from the Governor back to me as another round of flashes fired. I felt just like Paris Hilton and preyed that there was nothing stuck in my teeth. I was really not used to this kind of attention, but it felt nice.

After the ceremony, there was a show. There was a band and dancers called “jarochos” doing something similar to the “River Dance”. The theme was old world meeting new world. The music was intense. The rhythms were distinctly Indian, but the costumes and music were classic Spanish. During the reception which followed, tapas were served along with tamarind margaritas coated with flakes of chili pepper and salt around the rim. Every time I put down an empty glass, it was mysteriously refilled. I never actually saw it happen. It was like some little Mexican margarita fairy was flying around the place. I lost track of how many I actually drank, but I eventually boarded a van going back to the hotel at around 1 AM. Despite the current humming noise inside my head, I am determined to get up early and go running. My first lectures are also tomorrow if I can survive that long.

Independence Day

2009-07-20T23:04:00.002-05:00

I sat at my desk, drumming my pencil on the test paper in front of me. I looked up at the clock, which told me that I had 15 minutes left until noon recess. I looked back down at my paper and checked my answers once again. The test was on the American Revolution, a subject which we seemed to cover endlessly in the fourth grade. I knew the information so well, that I was practically on a first name basis with most of the Founding Fathers. When my teacher announced that those who were done could leave, I sprang out of my seat and launched the paper towards her desk so carelessly that it almost landed on the floor. My teacher cleared her throat and I knew that the sound was intended for me. “Billy, you forgot the date”, she said in a hushed tone and slid the paper towards me. I scribbled, “April 22, 1978” at the top and raced out of the room.

Walking down the hallway towards the cafeteria, I was filled with excitement and nerves. My friend, Bruce, came up behind me and I almost jumped out of my skin. “Ready to go?” he asked and I nodded. In retrospect, I was agreeing to abandon the life that I knew before and open a brand knew chapter from which there would be no return. As we passed the library, my feet were beginning to feel like cement. Bruce and I entered the cafeteria, but instead of taking a seat at our assigned table, we tossed out our brown bags containing wilted bologna sandwiches and carrot sticks and headed out the cafeteria door into the short, dark passageway that led to the playground.

“Where do you think you guys are going?” a voice boomed from the darkness. A mop blocked our path as Frank, the janitor, stepped into the light. He had a muscular build and a military haircut. Despite some loose skin, thick glasses and a stomach which hung over his belt, he was still a figure to be feared in his dark, green jumpsuit. Bruce thought quickly and blurted out, “We left something on the playground.” I though our plan was surely doomed, but a smile suddenly broke out on Frank’s face as he returned the mop to its bucket and began to laugh, “Yeah, right!” Without looking back, we burst open the outer door and the light of the midday sun made us squint. It felt strange to be alone on the playground, but we weren’t in the clear yet. We stayed close to the fence so that the staff in the Principal’s office would not see us. Passing the monkey bars and the swing set with all of the broken swings, we made it to the corner of the playground and out onto the sidewalk.

As we walked down the street, my nervous, short steps turned into a relaxed stride, even a cool swagger. I realized for the first time in my life that nobody, except Bruce, knew where I was. I was truly UNSUPERVISED! This experience alone would have been enough to last me many years into the future, but we continued further down the street to the pizza place. Dano’s was a classic establishment that produced some of the best Italian food that I have ever tasted. My family had ordered pizza from them many times, and as we entered the shop, I panicked for a moment thinking that someone in there might recognize me. I looked down as I ordered a plain slice and a coke from the man behind the counter. He was sweating as the heat radiated out from the ovens behind him.

With every bite of pizza, I was enjoying the sweet taste of freedom. I was ready for my independence and I knew exactly how the Founding Fathers must have felt at that crucial moment. I searched my pockets and realized that I only had another $1.25 to fund my revolution. One quarter went to playing the video game in the corner, which would actually shake when the racing car crashed. With the last dollar, I bought Italian ices and we enjoyed them thoroughly as we headed back to school.

Recess was just coming to a close as I joined my class lining up on the playground. I was dying to share the secret of what I had done with the others, but I kept it to myself. I didn’t say a word, fearing that the cherry red coloration of my tongue would give me away. What I had committed that day was nothing short of high treason. But there was no escaping the fact that I had been liberated and there was no turning back. It was a brand knew world and I was a brand new person, ready to take on all the challenges that were in front of me ... as long as my parents didn’t find out.
______________________________________

This story describes one of my earliest adventures as an independent creature roaming this planet. From these humble beginnings, my thirst for excitement has never fully been quenched. This week, I will be heading south of the border. For those of you with your minds in the gutter, I am referring to Mexico. I can already see the bewildered facial expressions on the unsuspecting locals as I unleash my own brand of Spanglish on them. Of course, I will be writing down every single detail of this journey for the sole purpose of your amusement. Keep an eye on “The Best Medicine” and see if a white boy from the Upper East Side with a weak stomach and delicate skin can survive the hot deserts and tropical rain forests of Mexico, not to mention the tequila.

Oink!

2009-06-28T22:24:00.001-05:00

Walking through my High School lobby was one of the most stressful activities of sophomore year. I never knew where to look, so I usually just looked down at the floor. By graduation, I think I memorized the location of every crack and piece of gum all the way from Hall B to the cafeteria. It felt like everyone was staring at me, but I knew that it was all in my head along with all the other crazy thoughts: “Why did I pick these clothes today? ... Are these pimples ever going away? ... I think I’m getting fatter by the second!” I quickly glanced to the right and saw a table of football players all standing around in their team jackets. They were smiling and laughing as if they didn’t have a care in the world, and I wished I could be more like them. On the other side of the lobby, Dawn and Michelle were sitting by the window applying lip gloss. They were arguably the hottest girls in the class. The sun illuminated their feathered-back hair, and I wondered if I’d ever get to say anything to them besides, “Excuse me”. I was so relieved to finally make it through the lobby. I approached a large, metal blue door with crooked, painted yellow letters that read, “WKWZ”, and pulled it open with all my strength. It squeaked shut as I disappeared into the dark hallway and was finally free.

There was barely enough light to see, but I knew exactly where I was going. I let out a deep breath and descended down about 50 concrete stairs. With each step, my heart rate slowed, my breathing became easier and I think my skin actually started clearing. The air was cool and my steps echoed in the darkness. As I got to the bottom, the sound of Elvis Costello’s music and the smell of cigarette smoke welcomed me immediately. I pushed the door of the radio station open and Agnes’ face brightened as soon as I walked in. She was a woman in her 50’s who was more like a really cool aunt than a secretary. She pushed a cigarette into the coffee cup in front of her on the desk and lit another. “Important day, Billy, nervous?” “I’ll be fine”, I replied with a smile, and headed towards the back of the station. On the way, I ran into Judd, a junior who was generally regarded as a class comedian. He worked as a DJ and an engineer at the station. He also knew my older sister, who worked at the radio station and convinced me to join when I first came to High School. “So the little Reisacher wants to be a newscaster just like his sister?” he said with a devilish grin. I laughed silently at the joke and continued on to the Associated Press machine.

The AP machine looked something like a military weapon used by the Germans in World War II. It was a hulking mass of grey metal which made the sound of repeating artillery as it belched out reams of thick, tan paper with the latest news typed like telegraph messages. I ripped off some “copy” and arranged a 15 minute newscast that included international, national, state and local news along with sports, weather and a 30 second public service announcement. This was going to be my audition for the news department. I wanted desperately to go on the air. I walked into the studio, arranged my papers on the desk in front of me and placed the headphones on my head. I swung the microphone in front of me and tilted it into the perfect position. I looked up into the engineering booth and saw Judd smiling at me through the glass. He fiddled with some controls and slowly tilted his finger towards me. The red light in the studio began to glow.

My voice was strong and I felt really good about the newscast. I kept telling myself to slow down, pronounce every syllable and avoid saying, “umm”. I made it through international news and was covering some U.S. stories when a heard a strange sound in my headphones. I paused, thinking it was feedback, but then the noise repeated. It could only be described as the mating call of a chimpanzee, although I’m not really an expert on this topic. I decided to move on to local news, but when I said “news”, the sound, “moooo!” played instead. In horror, I paused once again and looked up. Although I couldn’t hear any sound from behind the glass, Judd was obviously laughing his head off. He caught himself from falling backwards on his chair and sat up, putting on a serious face that didn’t convince me. I made it all the way to sports, but then the sound effects returned just as I was giving the scores for women’s field hockey. “Oink, oink, oink!” I practically felt the porky breath of a trough-full of muddy swines right in my ear. Amidst the cacophony of squeals and grunts, I tried to choke back the laughter. Trying not to lose bladder control, I cleared my throat, turned the volume knob on my headphones down and finished the newscast.

Although it may sound unbelievable, I was accepted into the news department and went into regular rotation on the air. I covered evening news and eventually became the News Director of the station. I also hosted a weekly health show called, “No Preservatives”, probably one of the earliest signs of my interest in medicine. Throughout my high school years, the radio station was a place where I could go and just be myself. Everybody who worked there was a little different or strange in their own way, but down in that basement, we accepted each other and had a blast both on and off the air. Judd went on to do pretty well for himself. On that day, I didn’t find his joke very amusing, but as I watched his movies, “Knocked Up” and “The 40-Year-Old Virgin”, I’ve come to appreciate the humor of Judd Apatow. Thanks, my friend, wherever you are.

The Music

2009-05-31T19:17:00.000-05:00

For as far back as I can remember, the music has always been there. It’s like a movie soundtrack inside my head that never stops playing. I’m not exactly sure why it’s there, but all these notes and rhythms weave their way into my dreams and keep me company while I’m in the operating room, eating lunch or playing with the kids. Sometimes the music is low and in the background, while other times it becomes louder and more melodic. Occasionally, I hear words as well. Over time, I learned that the only way to control the music in my head was to somehow play it. It’s not surprising that I decided to take up a musical instrument.

I started with the clarinet in the 4th grade, but eventually grew frustrated with playing single notes and marching up and down Main Street, so I turned to the piano. On the piano’s keyboard, I could play any combination of notes to produce all the complex and colorful sounds that I needed. All throughout high school, I studied the sheet music for classical and popular songs and taught myself how to play them. But my mind would always wander and I would end up changing the music in some crazy way. Eventually, I just started writing my own songs, and that process has continued to this very day. Creating music and lyrics at the piano can be a deeply frustrating task. The chords and melodies both haunt me and heal me at the same time. But in College, I discovered that this skill had another very important function ...

The year was 1987. I was a sophomore in College. A couple of my friends had just joined a fraternity, so I dropped by one of their parties to see the house. The fraternity house was a 100 year old stone structure with large, sweeping spaces that made it seem more like a castle. After getting the royal tour and meeting all the brothers, I poured myself a beer from the keg and headed out to the dance floor. “The One I Love”, by R.E.M., was blaring from the speakers. The windows were open and the cool breeze from outside became laced with the smell of perfume, sweat and musty wood. I saw a girl that I knew from class who I really wanted to dance with. She smiled and waved at me, but she was dancing with one of the brothers. Feeling a little sorry for myself, I retreated to the next room, refilled my beer and started thinking about the midterm I should have been studying for. That’s when I saw it in the corner of the room.

It was covered with a heavy canvas and seemed to be as lonely as I was feeling at that moment. I uncovered it, pulled out the bench, sat down and lifted up the lid. I pressed down on one of the worn, ivory keys and the action was smooth. I had to strain to hear, but the tones were deep and rich. Both of my hands settled in and I began to play a ballad that I had been working on. I could barely hear it above the party noise, but I knew my fingers were doing the right thing. All of a sudden, the girl from before came over and smiled. “What are you playing?” I smiled back and tried to answer her while continuing to play, “It doesn’t have a name yet!” I’m not sure if she heard me, but she sat down next to me and said, “I love it!” Captivated by her pretty face and confused by what was unfolding, I began to lose my focus. My hands were now playing something completely foreign to me, but she did not seem to notice at all. All of a sudden, another girl came over and leaned on the piano, then another, and another.

Soon, I had a crowd of women all standing around the piano. By this time, I had no idea whatsoever what I was playing. I couldn’t hear anything, but neither could they. They kept drinking and requesting different songs. Some tunes I knew, but most of them I had no idea how to play. So I kept on playing the same improvisational nonsense and they kept on laughing and giving me complements. I stared at one girl in disbelief when she actually began singing along with my random, never-ending song. A couple of girls stuffed dollar bills into a glass on the piano, and that is when I knew that I had officially entered “The Twilight Zone”. My fingers were starting to cramp up, but every time I stopped, the girls would protest and encourage me to play on. The fraternity brothers were standing by the side with a mixture of anger and disbelief on their faces. I gave them a sheepish smile and shrugged my shoulders as I launched into the next verse of ... well, whatever you call it.

You might be surprised at this, but I walked home all alone that night. It seemed that when I finally stopped playing, the spell was broken. Most of the women whom I had entertained earlier had either staggered on to the next party or had passed out on one of the couches in the fraternity house. In the following year, I went to many parties at that house, and it became something of a legend that, late into the night, I would sit down at the piano and serenade anyone who needed their spirits lifted. As I passed over the bridge leading back to my dorm, I heard the rush of water from the gorge below. This soon gave way to the silence of the night. I paused for a moment, confused by this silence. Then the music in my head began once again. I smiled and continued my walk home.

Summergirl

2009-05-10T23:09:00.001-05:00

I drove down the dirt road that took me to the rear entrance of the camp. The worn tires of my ’71 Chevy Nova crackled as they rolled over gravel in the staff parking lot and came to a stop with a cloud of dust. I grabbed the backpack on the front seat, my orange juice and half-eaten cream cheese bagel and headed inside to the lifeguard station. The morning sun was low in the sky. There was moisture on the grass, but the air was hot and dry. Inside, the Lieutenant was checking his clipboard, but he stopped to look up at me. “Late night?” he asked. I smiled and nodded as I shoved my clothes into the locker. He returned the smile and added, “You got beginners today”. Standing by my locker, I covered my nose with zinc oxide and took one more bite of my bagel. The sunscreen on my shoulders began to burn, which reminded me that I didn’t put enough on the day before. I hid my bloodshot eyes behind dark sunglasses, grabbed my whistle and headed out to the pool deck.

When I was in school I worked during each of my summers. Besides a very brief stint as a supermarket cashier and one as a painter’s apprentice in the Hamptons, I spent all my summers since high school as a lifeguard and swim instructor on Long Island. This was the summer after my first year of medical school and the last of my “free” summers. I had endured Gross Anatomy, but nothing I learned in that class could help me as I approached my class of 6 and 7 year-olds. About a dozen of them huddled together for safety, clutching their towels like they were life-preservers. I gave them a big smile and dove into the pool. Emerging from the peace and quiet of my underwater sanctuary, I blew the water out of my whistle and said, “OK, who’s coming in with me?”

I was working with each of them on their back float, supporting them under the water with one hand and encouraging them to arch their backs. Then, something caught my attention across the pool. Out of the hazy, morning sun, she appeared. Her wavy, brown hair with reddish highlights bounced as she moved. On her wrists, she wore multiple, hand-made bracelets. She smiled and laughed with the freedom of a warm breeze and her face glowed with the radiance of the sun. I was immediately intrigued by this Summergirl, but a splash of water and the sting of a small hand smacking by sunburned chest broke me out of the moment. “How was that, Mister?” “Good, Jimmy”, I encouraged. “Let’s try it again.” I looked up once again, but she was no longer there.

That was a summer I will never forget. During the day, I would walk around the camp and find Summergirl making friendship bracelets or eating lunch with her group. I’d catch her eye and smile, pretending that the encounter was just an accident. My heart would always beat faster when she returned the smile. Those were magical, innocent times, when my entire paycheck would go towards rides and funnel cakes at St. Rocco’s. There seemed to be a different party every night with friends from work or high school. The cool air was always filled with music and felt good against my warm, tanned skin. We would dance for hours while sipping from large cups filled with Coke and Malibu Rum. I feasted on frozen yogurt and scrambled eggs from the diner at midnight. Days off were usually spent at the beach and my hair was as blonde as ever. I spend a lot of time with Summergirl. She was so full of life and energy, and I just wanted to be a part of that. We talked and laughed and flirted with each other. Life was so simple and easy for us then, and I convinced myself that those days could last forever.

But soon, the days began to grow shorter and Labor Day was quickly approaching. I was starting to prepare for the tough school year ahead of me. I kept looking for Summergirl, but it was becoming harder to find her. One night, as I was standing at the waterline overlooking the Harbor, I felt a hand on my shoulder. I turned quickly and she was there. I was so excited to see Summergirl once again. Our eyes met instantly, but for the first time, I saw a trace of sadness in her smile. I held her in my arms and kissed her soft lips, but just like the sand, she slipped through my hands and faded away right in front of my eyes. Deep down, I knew that this was the price I had to pay for getting so close to an angel.

These days, summer is kind of like winter, only hotter. Now, my paycheck goes to Con Edison and Time Warner Cable instead of the ring-toss guy at the carnival. My days of contemplating life’s mysteries at the diner have now been replaced with begging my kids to eat their chicken fingers. Are the best years of my life really behind me? I’ll admit that sometimes I want to go back to those days, but in the end I realize that in order to get where I want to be, I have to move forwards. I think that the best time in anyone’s life is the present because this is where all the opportunities exist. This is the only point in time when you can actually make a change in who you are and what you do. Unfortunately, it’s impossible to appreciate the magic of your life until time edits out the painful parts and leaves you with a soft, warm memory of it.

When that summer of innocence finally came to an end, so did my relationship with Summergirl. I never saw her again, but I’ll always carry a part of her inside of me. There are moments when I hear her laughter as I’m walking down the street or riding the subway, but when I turn, there is nobody there. Sometimes, when I’m alone, I feel that she is still watching over me, just like she did almost 20 years ago. She is timeless in my mind, a free spirit that goes wherever the wind takes her. Wherever you are, Summergirl, I want to thank you for being a part of my life, and I hope you always remain happy and free.

The Rocket

2009-04-26T18:51:00.000-05:00

There it stood, maybe 100 feet tall or more. Its metal cage arched gracefully towards the sky and I had to shield my eyes and squint just to get a look at the top. The year was 1973 and, like many other 5 year olds, my goal for the summer was to make it to the top of the Rocket. It was the centerpiece of the playground at the Community Pool that I went to on Long Island. Looking back, there was not a single safety requirement that this monster would satisfy today, but at the time safety was the farthest thing from my mind. For those lucky enough to make it to the top, the rewards were bragging rights and a view that was beyond compare. From the top, you were higher than the lifeguard stands, the highest diving board and even many of the tall pines that surrounded the picnic area.

My palms were sweaty, so I wiped them off on the sides of my blue bathing suit with the white whales all over it. I kept my hands by my sides as I marched through the sand that lead up to the rocket’s entrance. The larger sand particles and stones filled my sandals, but I disregarded the pain and remained focused on my mission. The sun beat down mercilessly as I approached the ladder that lead into the Rocket. There was no plastic coating or rubber mats anywhere to be found, only steel and the strength of my own conviction. I grabbed the ladder, but the searing heat of the metal sent me flying backwards. It was as if the Rocket was saying, “Did you think I was going to make it that easy?”

After a trip to the water fountain to cool down my second degree burns, I made another attempt. First, I licked my hands. Then I scampered up the ladder and through the porthole that lead to the first level. For the first time in my life, I was on the inside of the bars looking out. The smaller children on the playground were looking at me with admiration in their eyes, and for the first time I felt like I fit into the social order. I was assuming my rightful place in society and nobody was going to get in my way. I had three more levels to go until I reached the top. I grabbed the next ladder, but the combination of fear and burning flesh made a tight grip impossible.

The Rocket levels were small, only accommodating three or four children comfortably around a central pole. The levels were accessed through small portholes that could only fit one child at a time. A few times, I successfully shimmied up the ladder, only to be knocked back down by a larger kid coming down from the top. Stories existed of kids who were near the top and got knocked all the way back to the sand. The Rocket was an unforgiving beast. As I reached the level below the top, I felt the natural sway of the Rocket, which was exaggerated by older kids grabbing the bars and shaking back and forth. I looked up the final porthole and saw the sun beaming through it. I caught a glimpse of steering wheel.

I was literally on top of the world. I grabbed the metal steering wheel and the steel levers next to it that did absolutely nothing except produce a sick, squeaking sound. I looked out over the world which now appeared very different to me. For that moment on, the world would be all mine. Life seemed limitless and I felt invincible. Even to this day, I always keep a small part of that feeling with me, and I call upon it whenever it is needed. Sometimes it’s during surgery or when I have to get up and speak to an audience, or sometimes it’s when I’m all alone and unsure of what to do next. It’s been many years since the Rocket was taken down, but I will never forget the lesson that it taught me that day. The strength is inside all of us, and if we only face our fears, anyone can touch the sky.

________________________________________

Come see Dr. Reisacher perform his standup routine. He will be at The Comic Strip, 2nd Avenue, between 81st and 82nd street on Thursday, April 30th from 5:30-7:30. Tickets are $30, 2 drink minimum. Proceeds will benefit the enrichment programs of P.S. 158. Hope to see you there!

Bull's Eye!

2009-04-06T22:21:00.001-05:00

I squirmed nervously on my seat while my eyes remained frozen on the floor. The metal of the chair squeaked with every twitch of my muscles. Across the table, Detective Harris pounded his cigarette into the ashtray and, with a sigh, blew a cloud of smoke in my direction. He had a square chin, which he was rubbing thoughtfully, and his rough voice cut the silence like a chainsaw. “This is the point where I’m supposed to put you in handcuffs and formally charge you.” I looked up at him, but did not make eye contact. He answered my unspoken question. “Second degree assault and battery.”

After a few moments, he continued. “What year are you, son?”

“I’m a Freshman.” My voice cracked so badly I wasn’t sure he understood me.

“What are your plans after you graduate from college?”

“I want to go to Medical School.”

“Well, do you realize that something like this on your record could seriously jeopardize your chances of doing that?”

I remained silent. His rhetorical question rang inside my head and I tasted the acid in the back of my throat. How could things have come to this? My mind drifted back to the same time last night when I was safe in my dorm room, studying for my Economics midterm ...

______________________________

Pete burst into my room as I was sitting at my desk. “Hey, Bill, what are you doing?”

“I’m trying to figure out what the hell a negatively sloping demand curve is”, I replied.

“Oh, that’s a bummer.” He took a sip from his Diet Coke. “Come down to the lounge when you get a chance. I’ve got something to show you.”

I tried to concentrate, but it was no use. The graphs on the page began to swirl and the heat from my desk lamp was causing beads of perspiration to emerge on my forehead. My skin began to crawl and I realized the iced tea I had been drinking over the past hour finally filled my bladder. It felt good to get up and walk around. On my way to the bathroom at the end of the hall, I passed by the lounge. Pete and Mike were sitting on the couch, examining something that I had never seen before.

“What’s that?” I inquired.

Proudly, Pete held it up and exclaimed, “It’s a Funnellator!”

He proceeded to demonstrate the device to me and Mike. Basically, it was a huge slingshot made out of canvas and surgical rubber tubing. Two men, called stanchions, would each hold one end of the tubing, while the wingadoro would pull the canvas pouch and its contents backwards before letting it rip.

“Let’s give it a try!”, Mike said as he jumped to his feet. “I’ve got some balloons.” We all got caught up in the excitement and began filling up our arsenal in the bathroom. I finally had a chance to pee.

Our target was the dorm across the way. We ran down to the other end of the hall and took our positions. Mike and I were the stanchions, while Pete was the wingadoro. The first few attempts were clumsy, but soon we could nail the side of the building with surgical precision. The water balloon struck the bricks and burst into a shower for the unsuspecting students on the path below, who believed that it came from our rival dorm. We were having a wonderful time, laughing and reloading, when all of a sudden the unthinkable occurred.

Pete pulled back on a balloon that was under-filled. It took an unexpectedly low trajectory and struck the window of the dorm directly across from us and broke the window. The sound of glass shattering echoed in the courtyard below as we looked on in horror. Through the broken glass we saw a male student holding his arm. He had been standing next to the window and a piece of glass had cut his arm and there was blood running down towards his hand. Instinctively, we raced from the window and stashed the Funnellator under Pete’s bed. I sat back down at my desk, but was overwhelmed with feelings of remorse and fear.

This is the point in the story where things turn from bad to worse. Apparently, the floor where we launched our assault was inhabited by several members of the football team who conducted a quick investigation and concluded that the missile came from our floor. An angry mob assembled across the courtyard, armed with bats and letterman jackets instead of torches and pitchforks, and promptly marched towards our dorm. One of our dorm windows was broken as they stormed up to our floor. It was a standoff. They were thirsty for revenge and we all hid behind a thin veil of innocence.

The conflict was about to escalate when the Campus Police arrived, alerted by the reports of glass breaking. With clubs out and hands on their revolvers, they separated the two groups and took a full report from each. They assembled all the students on our floor into the lounge and issued an ultimatum. “Whoever is responsible for this, you know who you are. And we’re not going to give up until we find out. Someone was injured, so the town police had to be notified. If you don’t turn yourselves in to them by 5 PM tomorrow, the entire dorm is going to suffer because of you.” Pete, Mike and I exchanged glances. We knew what we had to do.

______________________________

“Is he OK?”

Detective Harris pulled another cigarette out of the wrinkled pack in his shirt pocket, lit it and took a long, slow drag that he did not expel until he responded to me. “He’ll be fine, but it took a few stitches. You should be grateful – he agreed not to press charges.”

I was. “So can I go?”

“Not yet, kid. It’s out of our hands now, but you’ll have to face J-R.”

“J-R?”

“Judicial Review. It’s judge and jury all in one. They’ll decide your punishment. Go on, get out of here.”

______________________________

The three of us went separately to Judicial Review. In retrospect, we didn’t suffer nearly enough for our carelessness. I was sentenced to work as a cook for a semester, flipping burgers and preparing food for a variety of campus functions. This skill served me well when I moved off campus the following year and cooking remains a passion for me to this day. I earned a B in Economics and never took another class in that department again. As for the three of us, we did not exactly retire the Funnellator. The following year, we entered the slingshot event at a fraternity competition, requiring us to launch water balloons into the football stadium portholes from the 50 yard line. Needless to say, we took first place. Proving that violence only leads to more violence, our prize was a dartboard.

Orgasmic

2009-03-15T16:27:00.001-05:00

The other day a woman came into my office complaining of a burning sensation in the back of her throat. After examining her, I informed her that she was most likely suffering from acid reflux. I then went on to explain that the treatment for this condition was medication along with dietary changes. “Dietary changes?” she exclaimed, “My diet is just fine. Everything I eat is orgasmic!” After fighting back the urge to invite myself over for dinner, I went on to explain that eating organic foods is not a guarantee against developing illness and disease. This encounter made me realize two things: First of all, many people have unrealistic expectations about the benefits of organic foods and, secondly, some of us have no idea what organic actually means.

The dictionary is always a good place to start, so that is where I began my search. (Translation for the younger generation - the “dictionary” is a thick, heavy version of Google with lots of paper pages that you can actually turn.) The first definition of “organic” that this book offered was “a chemical compound that contains carbon.” I’ll have to admit, that does describe most of the food that I prepare, but I don’t think this is what they mean. The second definition was, “related to an organ.” That didn’t seem to apply here. I don’t remember the last time I saw a pancreas on the shelf of my local organic food store, or hearing cathedral music at the checkout counter, for that matter. I knew that I struck gold with the last definition, “grown without the use of chemicals or pesticides.”

The USDA states that organic food is grown by farmers who use renewable resources and emphasize the conservation of soil and water. Over 70% of organic food produced in the U.S. is fruits and vegetables. They are produced without conventional pesticides, synthetic fertilizers, bioengineering or ionizing radiation. Organic meat, poultry, eggs and dairy products come from animals that are not given antibiotics or growth hormones. To meet organic standards, farms are certified by Government-approved inspectors. To be labeled “organic”, at least 95% of the requirements must be met, but if all the requirements are met, the food may be stamped, “100% organic.” Organic foods do not have to be labeled as such, and many non-organic foods are labeled as “all-natural” or “hormone-free” to enhance their marketability. In general, organic foods are more expensive than their non-organic counterparts.

I don’t think anyone will disagree with the statement that our bodies are flooded with chemicals. They enter our bodies through the air we breathe, the food and water we eat and drink, and the creams, soaps and cosmetics we place on our skin every day. All of these chemicals are either broken down by our body or stored in our cells, and this not only consumes a tremendous amount of our energy, but may also lead to cell damage and certain diseases. Organically produced foods help us a great deal in this battle, but they also help promote good farming practices and environmental conservation. The danger comes when we accept an “organic” diet as a substitute for striking a balance in our lives. We all need a balanced, varied diet. Just whip the good, the bad and the ugly into a medium-sized shake and enjoy! Get out there and move your body safely in any way possible, try to love someone or something and, please, don’t forget to laugh! And if you’re still a bit confused by all this, don’t worry, because you’re not alone. I’m still wondering if I’d rather eat the pesticides or the pests!

Be Free!

2009-02-08T23:33:00.000-05:00

Along the steep and curvy road towards the medical profession, many obstacles stood in my way. Some were speed bumps, some were hills and some were deep canyons that I had to race towards at top speed and hurdle myself blindly into the air, hoping that I landed safely on the other side. For me, Genetics was one of those canyons. It was a pre-med requirement in college and what many referred to as a “cut-throat” class. At first I thought that meant that if I failed the class, I would essentially be cutting my own throat by ruining my chances of getting into medical school. But by the end, I was pretty sure it meant that any other students in the class would gladly cut my throat if it improved their chances of doing well in the class. Either way, it was not a subject that I was going to enjoy, so I just wanted to survive it.

I entered the lecture hall on the morning of the first day of class. This large room was constructed almost entirely of wood and approximately 500 folded theater-type seats lined up like soldiers preparing for battle. The musty air was soaked with the odor of chalk dust and the audible tension in the voices of the students who were beginning to file in. I took a seat towards the front and smiled at the girl sitting next to me. “Don’t you just love Genetics?” she said with an inappropriately large smile on her face that caused mine to quickly fade. “Love is kind of a ... strong word”, I replied as I covered my neck and sat back in my seat. The Professor began speaking as the lights dimmed. He was a thin man in his 50’s who looked like he hadn’t smiled since Nixon was in office. His face almost cracked as he spoke, “This afternoon, you will begin your fruit fly experiment in lab. It counts for half your grade. Midterms are in 6 weeks. Shall we begin?” Suddenly, he smiled.

My footsteps echoed in the empty hallway as I approached Genetics Lab. I looked in one of the classrooms along the way and saw a group of students sitting around a table staring at a green, foam block in the center trying to figure out how to arrange the colorful flowers piled up along the side. I longed to join them, but forced my feet to continue all the way to the double doors at the end of the hall. A pungent odor stung my nostrils the moment I opened the door. I saw the girl from the lecture, but managed to avoid getting sucked into the gravitational pull of her smile and took a seat at an empty lab bench. I stared at the jar of fruit flies in front of me as the instructor explained how we would be raising generations of flies over the next 2 months and recording traits such as patterns on their wings and eye color in each fly. The final goal was to tell which chromosome the gene for each trait was on and where it was located on the chromosome. This is referred to as gene mapping. Smiling girl was beaming brighter than ever.

I had to work very hard over those 2 months, partly because the information was challenging for me, but mostly because I was afraid of bugs. I managed to overcome both of these shortcomings, but events took a dramatic turn for the worse one Saturday morning. The experiment was drawing to a close and I was on my forth or fifth generation of flies. To count them, I had to place ether over the jar until they fell asleep, then dump them out and examine them one by one under the microscope. I frequently wondered how this was going to help me as a doctor, but one day several years later as a surgical intern, I was picking small pieces of glass from a broken beer bottle out of the scalp of a drunken man and finally understood.

The only other person in the lab that morning with me was smiling girl, who I finally learned would only smile when people who handed down grades were in the room. From the look on her face, she was as hung-over as I was. When I arrived at the lab, I started consuming large amounts of water to help dull my throbbing headache, and soon my bladder was throbbing as well. I had just spread my anesthetized flies out on the counting sheet. I quickly weighed my options and dashed down the hallway to the bathroom. I barely made it in time, and I had to brace myself in the stall for fear of being thrown backwards by the force of the stream.

I immediately knew something was wrong when I returned to the lab and saw smiling girl smiling again. I went over to my desk and a wave of nausea washed over me. Where my generation of about two hundred flies once lay sleeping, now only a couple of drunken flies remained, staggering towards the edge of the desk. My entire experiment was soon hovering silently in the air around me, darting to and fro as I comically tried to grab them in my fists. Soon, I was swatting at them with my textbook. I was determined to take them either dead or alive. They, however, had other things in mind as they promptly headed towards the window I had foolishly opened when I first arrived. In desperation, I began searching the lab for any dead creatures that had wings.

Somehow, I managed to squeak a passing grade out of Genetics. I excelled on the written exams, but my fruit fly experiment left the Professor scratching his head. Clearly, I could not map my flies’ traits to the correct chromosome, nor could I even tell how many chromosomes the poor creatures had. In fact, some of the faculty thought that I actually discovered a brand new species. But in the end, only I and smiling girl knew the truth about what happened that morning. And to this very day, every time I see a fruit fly, I wonder what color eyes it has and if it might be a descendent of my lost generation.

When You Gotta Go ...

2009-01-01T22:16:00.002-05:00

Do you remember what you were thinking when the ball dropped last night? “Who am I going to kiss?” “Which party should I go to next?” “How much more champagne can I possibly consume without passing out?” “Where, exactly, are my children?” Before midnight, I spent some time trying to plan how I would become a better person this year. Unfortunately, this reflective moment was interrupted by the sounds of my stomach trying to digest the overpriced, overindulgent PreFix dinner I had just enjoyed with my wife. I accepted some cabernet from my father-in-law, but my assumption that more wine would help settle my stomach proved to be overly optimistic. After glancing up at the TV, I put my thoughts on pause, grabbed a bottle of champagne from the refrigerator and began unscrewing the cage.

Happy New Year!

Working on my third glass of champagne, my thoughts shifted to how I was going to get back to the person I was an hour ago. With that many bubbles on board, the lyrics to “Auld Lang Syne” actually started making sense to me. Sitting on the couch of my in-law’s apartment, I began making resolutions uncontrollably as the emotions of hope, fear, love, joy and regret all blended up inside my head like a huge cerebral smoothie. At that very moment, a neighbor of my in-laws sat down next to me. She was in her 50’s, tan-skinned, holding a half-filled glass of champagne as she proceeded to tell me a story about, well, when you gotta go ...

“I was walking around Times Square this afternoon before the barricades went up. I hadn’t been there in probably 30 years. But I was so cold that I had to go to the bathroom. So I went into a local bar to warm up and use the bathroom. I usually don’t drink more than wine, but while I was there, I sat at the bar and asked the bartender to give me the strongest drink he had. He poured me a shot of whiskey, and after two more of those, I headed back outside. As I was looking up at the big tree, I suddenly realized that I had to go even worse than before! I crossed my legs and concentrated as hard as I could until the feeling passed. I managed to make it to 5th Avenue where I found myself in front of Saks Fifth Avenue, so I went inside. Luckily for me, there was a bathroom right by the entrance, so I used it. But while I was there, I felt bad for using their bathroom, so I decided to do some shopping. I found a nice, fur wrap which I bought before heading home. I only made it half way home before the urge to go came back again. I looked around for a bathroom, but the only place I saw was a pizza shop. They were nice enough to let me use their bathroom. I wasn’t really hungry, but when I came out I ordered a pizza. I brought the pizza home, opened up a bottle of champagne and here I am.”

She smiled, sat back and took a sip from her champagne as the story still rang in my head. I looked down at my champagne glass and realized that I had to answer the call of my own bladder. I thanked her and excused myself. On the way to the bathroom, I thought about how nice it was to leave my world for a while and spend a few moments in someone else’s. She came to me at the perfect moment, just when I was becoming lost in my own head. I decided that I would focus on two resolutions this year: The first is to pay more attention to the feelings of others around me, and the second is to always bring an empty bottle with me on long trips in the cold weather.

Pass the Syrup

2008-11-28T22:21:00.001-05:00

I woke up this morning, still feeling the effects of several helpings of turkey and a few too many margaritas during yesterday’s Thanksgiving celebration. I shuffled to the living room to find my boys lounging on the couch watching a cartoon they had seen so many times that even I knew how it ended. I smiled at them and they smiled at me. Not a word needed to be said, because we all had the same thing on our minds. They jumped off the couch and raced me to the kitchen. I dragged out the griddle pan and the boys began putting the flour, sugar, baking powder, salt, milk, chocolate chips and vanilla extract into a stainless steel bowl. They knew exactly how much of each ingredient to use, because I have spent every weekend over the last two years training them how to make the perfect pancakes.

A half hour later, with only minimal amounts of flour on their faces and pajamas, my sons and I brought our steamy little creations to the table, where my wife and daughter were eagerly awaiting them. As usual, a fight ensued about who could have the syrup first. All attention was focused on a jug of 100% pure maple syrup. I watched it go back and forth like a tennis ball during the U.S. Open until it was finally my turn. I opened the cap and the odor permeated my nose and lifted my spirits. As I watched the dark amber elixir cascade down my stack, I began to think back to the time when this obsession began ...

The year was 1988. I was a sophomore at Cornell University, majoring in Biology in the college of Agriculture and Life Sciences, originally designed to educate farmers in the 19th century. I was premed, so most of my courses were related to biology, chemistry and physics, but I had to take a certain amount of credits in the Agriculture Department. As I looked through the course book, Maple Syrup Production struck my eye. It seemed like an easy four credits, so I signed up. In the class, we learned about how sap flows and how scientists have never been able to reproduce the special sugars in maple syrup that are believed to produce its unique flavor. But the real fun began when it was time for our first laboratory.

Our professor drove the entire class across the Finger Lakes region in a van, pointing out wild turkeys and other forms of wildlife on the way. Soon we arrived at the Arnot Forest, Cornell’s maple research facility. I stepped out of the van and the crisp, February air hit my face as my clean, white Reebok high-tops crunched on the snow beneath me. What could be easier than tasting some syrup and tapping some trees? I was now sure that I had made the perfect course choice, but this conclusion was only short-lived.

Dan, the maple farmer, took me and a couple of the others up the mountain to tap some trees. When we reached a grove of trees, I jumped off the tractor and Dan tossed a heavy canvas harness at me. I wasn’t sure whether to catch it or jump out of its way. “Go ahead, put it on.” I buckled everything as tight as I could, trying to remember the techniques I learned in a book on Houdini I used to read as a boy. “You can never tap a tree in the same place”, Dan explained. “Each year we have to go higher up on the tree.” Dan’s attention moved from my face down to my feet, and his facial expression sank in clear disapproval of the footwear I had chosen for the day. I looked around at all the Timberland boots around me and my face sank as well.

I quickly came to terms with the fact that I was heading up the tree. The rope which was pulling me was meant to assist me in my climbing, but instead my body just scraped its way up the tree as my arms flailed meaninglessly to the sides. If the wood on the tree was polished with colored lines, I would have been fine. The rope stopped with a jerk and I shamelessly hugged the mighty Sugar Maple. Dan scaled the tree in a fraction of the time to hand me my equipment. I was expecting a mallet and a bucket, but instead Dan handed me a hardhat and safety goggles. This was not a good sign.

Suddenly, Dan placed a machine in my hands which was the size of a lawn mower. The rope tensed and made a squeaking sound that told me it would break soon. “Are you sure this is safe?” I asked Dan, but in the middle of my sentence, he pulled the ripcord and the monster roared to life. I could only read Dan’s lips now. He mouthed, “Just screw it straight in”, but in my mind I thought he said, “You’re screwed, stranger.” I felt my cheeks vibrate as the drill bit made contact with the pulp of the tree. Soon, my entire body was vibrating as the bit sank further in and then bounced out. Dan gave me a thumbs-up sign as I hammered the tap into the hole I had just made.

Back in the sugar house, I was starting to regain sensation in my feet and hands, which were frozen and still vibrating. The sap was slowly being boiled down to produce syrup and the steam provided not only warmth, but also that intoxicating aroma I still remember today. Dan poured us each a small paper cup of hot syrup which was so delicious that I waited as long as possible before swallowing it. I felt both proud and humbled as I returned to campus that day, excited about my next visit to the mountain ...

After we cleaned up breakfast, the kids and I decided to go to John Jay Park for some bike riding. Today was a cold, but beautifully sunny day. After showering, I got dressed, put on my Timberland boots and headed out the door.

Boo!

2008-11-01T22:13:00.000-05:00

Last night I was walking down First Avenue with Spiderman and a Special Forces agent by my side. Sure, they were each only about 3 feet tall and occasionally forced me to carry their bags of candy, but it was still an honor I will never forget. Spiderman coughed from under the mask which apparently obscured his view of the curbs, and my Special Forces agent spent the night battling an aggressive enemy wedgie. I encouraged them to go into every store possible to add to their loot, but my pleading repeatedly met with a chorus of “Nah”s. Finally, as we stood outside a Japanese restaurant, I knelt down, put my arms around them and said, “Look boys, the people are not going to come out of the stores and give it to you.” The moment the words escaped my lips, a man from the restaurant leapt onto the sidewalk in full karate apparel with two fistfuls of candy, saying, “Hiya!” Before he could deposit his candy, the bags fell to the sidewalk. The blood drained from the heads of my superheroes and they froze in place. “Maybe I’m wrong”, I thought to myself, as I thanked him and bowed instinctively.

Later that night, as I watched my kids trading candy pieces on the dinner table like it was a high-stakes poker game, I thought about my own Halloweens when I was their age. Some things never change. I remember picking through the pennies and fruit to get to the gum and chocolate. Urban legend said that someone was going around putting razor blades into apples, so my parents sorted through the contents of my plastic pumpkin and made sure that no bombs had been planted in my UNICEF box. To make matters worse, I was allergic to peanuts, so by the time my candy had gone through interrogation, I was lucky to be holding a single box of Good-N-Plenty.

Costumes seem to be much more comfortable these days than when I was a youth. All modern costumes are so full of lycra and padding that my kids have actually fallen asleep in them. When I was young, my parents took me to the drug store and I had to choose between 6 costumes: Batman, Superman, WonderWoman, Lone Ranger, Princess or the Bionic Man. All of them came in a shirt-sized cardboard box with a small, cellophane window that was so shiny that you had to hold it in a certain light just to see what you were getting. When I took it out of the box, I had to warm up the industrial vinyl costume for at least an hour before it would fully unfold. It was one-size-fits-nobody and never looked good with my Buster Brown shoes. I did enjoy the contact high I obtained from the pungent odor coming from the outfit, just like I enjoyed the smell from the wet, purple ink on papers I received in school (younger generations, ask your parents about that reference).

Once I was able to don my chemical-laden outfit, the cherry on the top of this sundae was the mask. It was thin, stiff plastic with a flimsy rubber band in the back which was secured with a single staple. And strangely enough, the mask was always adult-sized. I think the manufacturers went out of their way to make sure that sharp edges on the plastic were not filed down. There are still some areas on my face where facial hair will not grow. To make matters worse, they put tiny holes in the regions of my face where I guess they thought I would be breathing out of, but my nose and mouth had other ideas. The warm condensation on my face would then freeze when I took my mask off and exposed my skin to the cold, October wind. One year, I got so used to breathing my own carbon dioxide that I wore my Batman mask until the following Easter (If you don’t believe me, ask my mother!).

But no matter how things have changed over the last 30 years, the magic of Halloween night never changes. For one night out of the year, you can put on a mask and be somebody else for a while. You can paint your face with white makeup and fake blood and see what it feels like to live in the world of the dead (or nearly dead). Who among us does not want to satisfy that curiosity? There is a special chill and an eerie silence in the air. Suddenly, the wind makes a strange, sad sound as it moves through the trees, as if the ghosts who have been summoned are announcing their arrival. And as you pass by the cemetery on your way home from the Halloween party, you’re going to walk a little bit faster. Your heart will pound its way right up into your throat and your eyes will become as wide as the moon which lights your path home. Your mind convinces you that you didn’t see that spooky figure in between the headstones, but just in case, you’re not going to look over your shoulders.

Flu ... Who Knew?

2008-10-06T22:57:00.002-05:00

Think back. Do you remember sneezing so hard that you thought you might lose your memory? Have you ever felt that your body’s internal temperature was directly linked to the stock market? If you’ve ever been so miserable that you just wanted to dive into a pool of Advil, then you know how terrible the flu can be. But what exactly is the flu?

Flu stands for influenza, a virus that is present at highest levels during the fall and winter, reaching its peak in January. This contagious illness generally lasts under one week and commonly produces fever, sore throat, chills, fatigue, cough, headache and muscle aches. However, more serious cases can lead to high fever, pneumonia, diarrhea and even seizures. Almost a quarter of a million people have to be hospitalized each year for influenza and 36,000 people die from it each year, mostly the elderly. While antibiotics are not effective in treating influenza, vaccination can prevent the illness. You’ve probably seen all the ads on TV or heard about co-workers who have been vaccinated, so I’d like to hit some of the high points in case you have any questions:

Who should be vaccinated?

1. Children from 6 months through 18 years of age
2. Adults 50 years of age or older
3. Women who will be pregnant during the flu season
4. People with long-term health problems, such as heart disease, diabetes or asthma
5. People with weakened immune systems, such as people with HIV/AIDS, long-term steroid treatment or currently undergoing cancer treatments.
6. Nursing home or residents of chronic care facilities
7. People living with or caring for people who are chronically ill or elderly
8. People living in dormitories or working in crowded conditions
9. Anyone who wishes to decrease their chances of becoming ill or spreading the disease to others

Who should not be vaccinated?

1. People with a severe egg allergy
2. Anyone who has had a severe adverse reaction to the flu vaccine
3. Children less than 6 months of age
4. People who are currently ill with a fever (They may be vaccinated when they feel better)

How is the vaccine given?

The vaccine is given as an injection of the killed virus in the arm. Most people require only one injection, but children under 9 years of age or those getting the injection for the first time should have two injections. A live, weakened flu virus vaccine is also available in nasal spray form, but this is only available for non-pregnant people between 2 and 49 years old.

What are the side effects from the vaccine?

Most of the side effects from the flu vaccine are mild and occur soon after receiving it. Soreness at the injection site, low-grade fever or body aches are commonly seen and last only a couple of days. Side effects from the nasal spray include runny nose, headache, sore throat and cough. You cannot get the flu from the vaccine, but there have been rare reports of people who received the nasal spray vaccine transmitting the virus to others. Severe allergic reactions are rare, and if you feel that you have been injured by a flu shot, a claim may be filed for compensation from the National Vaccine Injury Compensation Program. (http://www.hrsa.gov/osp/vicp/)

I hope this clears up some of the confusion. As always, the best advice is to eat properly, exercise regularly and devote enough time to sleep. Oh, and remember to laugh for at least 15 minutes every day. Don’t worry – I’ll help with that.

That's My Home

2008-09-07T23:38:00.001-05:00

I had a little time to kill. I wasn’t expected at dinner until 7 PM and it was only 5 in the afternoon, so I walked around the streets of downtown Denver for a while. To be truthful, I wasn’t really looking forward to dinner. I was in town for the annual meeting of Ear, Nose and Throat specialists and representatives from the drug companies often took us out for decadent steak dinners. The food was always great, but the conversation was always a bit forced until about the third or fourth glass of wine. A few blocks away from my hotel, I saw a green sign with an arrow which said, “World Trade Center Parking”. I was impressed that other cities besides New York had a World Trade Center, but it made me a bit homesick at the same time. My wife, daughter and 6 month old son were back in New York, and this was the first time I was away from them for an entire week. I found myself standing next to the Hard Rock Bookstore and Café, so I took off my sunglasses and traded the bright afternoon sun for the dark, air-conditioned cafe.

I scanned down the row of large coffee table books for something that interested me. I picked out one on the history of the Rolling Stones and flipped through the pages. Then, out of the corner of my eye, I spotted a black and white book on Skyscrapers of New York City. I stared at images of the Empire State Building and the Twin Towers for the next 15 minutes. I looked at my watch and realized that I had to get back to my room and take a shower before finding the restaurant. I bought bottled water at the counter and glanced at the newspaper on the rack. “September 10, 2001” was the date at the top.

Sitting at the table with a half-devoured, medium-rare filet mignon on my plate, I found myself staring at the photos on the wall. The group consisted of two reps and about half a dozen physicians. I swirled the red wine in my oversized glass and tried to seem interested in the conversation. It moved awkwardly from the stock market to football to President Bush to the current healthcare crisis. I laughed on cue. Finally, the topic shifted to terrorism and one of the reps commented that the world is just not as safe as it used to be. I agreed, and on that note, the group disbanded. I tried to shovel in the rest of my New York cheesecake, but was forced to leave some behind.

Lost in thought, I walked back to the hotel. As I got ready for bed, I stared at the gift basket I received from the hotel after my room was not ready the first night I was there. It was filled with nuts (which I am allergic to) and some strange pink grapefruit sucking candies. I didn’t have to get up early the next day, and I had a pretty light meeting schedule. I went to sleep that night thinking that tomorrow would be one of the easiest days for me in a long time.

†

I was awakened by the telephone at around 7:30 AM, a full hour before my alarm was supposed to go off. It was my wife and her voice was telling me to turn on the TV. “The World Trade Center has got a hole in it”, she explained. “They’re on fire. They interrupted Sesame Street.” I stumbled to the TV and didn’t have to turn any channels to find the images that would later become burned into my memory. I watched the flames engulf the buildings as my mind flashed back to all the times I had been there. I visited often as a child because my father worked around the corned on Church St. I took my wife there when we dated. I stayed in the Millennium Hotel after by bachelor party and woke up staring at the blurry Twin Towers. “That’s my home”, is all I could think as tears welled up in my eyes. These tears began to stream down my face and I held my breath when the South Tower collapsed. I ran to the shower, but could not feel the water hit my skin. The water hitting the curtain drowned out my audible sobs. Twenty minutes later, I returned to the TV, and a few moments after that, I saw the antenna of the North Tower tilt and then fall into a cloud of soot. Suddenly, my tears stopped. I wiped my eyes and focused my energy on one thought and one thought only: I have to get back home!

I knew instinctively that all planes would be grounded. I called several car rental agencies and discovered that nothing was available. In desperation, I tried to rent a moving truck, but was informed that no trucks were being rented considering the current situation. Cell towers were flooded with calls. All I could think about was my family. I quickly packed my suitcase, ripped the grapefruit sucking candies out of the basket, and ran out of the room.

Still in a daze, I hurried to the Conference Center and tried to gather a group of friends from New York to make a plan and get home. Some thought that flights would be available the next day. Some were just unsure about what to do. Lectures were cancelled. All of the monitors in the Center were playing the collapse over and over again. Then I heard of a few doctors from New York who had a bus and were meeting at a certain corner downtown, but spaces were limited. I didn’t hesitate in making it over there. A husband and wife were willing to drive there tour bus across the country for $150 per person. I recognized one of the organizers as someone I knew from my training, and he agreed to give me a seat on the bus when it arrived. Many of the doctors who were waiting changed their minds when they found out that the bus did not have a bathroom, and after waiting 2 hours, I was beginning to think about making other plans as well. Then it arrived. I shoved my luggage in the overhead rack, sat down and popped a grapefruit candy in my mouth. Glancing down the city streets, I saw the beautiful, snow-capped mountains in the distance as the bus pulled out of town.

We stopped somewhere for dinner at a family restaurant. I overheard a group of people watching the news in the bar as I ate. They were saying how bad they felt for people who lived in New York. As afternoon turned to evening, the bus fell silent. The sound of President Bush giving his address to the nation played quietly in the background, interrupted by frequent static. My head throbbed and my mind was racing. I looked out the window and saw a bright, quarter moon in the sky. I tilted my head, remembering the time when my daughter pointed out how much it looked like a smile. I had never thought about it that way before. I smiled for the first time since the night before, but I was more homesick than ever. I closed my eyes, but didn’t sleep.

The sun rose on the first day, and my eyes stung from all the tears from the last day. I looked out and saw the St. Louis arch, suddenly wishing that I was better at geography. When enough people on the bus complained that they had to go to the bathroom or were hungry, the drivers stopped at a Cracker Barrel. At each of these restaurants, there was a gift shop by the exit. On the way out of one, I bought a small, pink stuffed poodle for my daughter, and for my son I found a children’s guide book on how to be a good American.

The hours dragged on. I finished the last of the grapefruit candies. Each one started out sweet, but then turned sour in the end. My cell phone signal was inconsistent, but I called my wife whenever I could. I was amazed how long we could drive without seeing a house, or even another person. For most of the time, I didn’t even know where I was. I tried to see the license plates as they whizzed by. We stopped at a gas station, so I got out to stretch my legs and buy something to drink. A young girl with plump, rosy cheeks and a beaming smile was at the counter. “What state is this?” I asked. Her smile faded for a moment, then reappeared as bright as ever. “Why, you’re in Indiana!”

Once again, evening fell and I felt that we were getting close. I began to recognize the meadowlands of New Jersey and then as we turned north. I strained my eyes to see as Lower Manhattan came into view. Over the last 35 hours, I did a good job convincing myself that the Twin Towers were still standing, but now I saw it with my own eyes. “Ground Zero” glowed like a bonfire and a cloud of smoke rose in a straight line up to the sky. My tears suddenly began again, partly out of sorrow and partly out of joy that I would see my family soon.

When I opened my front door, I dropped my bag and fell into my wife’s arms. I couldn’t verbalize all the things that I wanted to say, and she understood that. All of a sudden, my own home seemed like such a strange place. The whole world was different, and tomorrow I would have to begin learning how to live in it. The kids were asleep, but I placed the pink poodle on my daughter’s bed and kissed her goodnight.

Again, why are you here today?

2008-08-07T21:16:00.001-05:00

Welcome to the second installment of the game I like to call, “Why are you here today?” Just to review, this is the first question on a questionnaire that every patient fills out when they come into my office for the first time. While I take every single complaint very seriously, I have to admit that some responses … how shall I say it … are more colorful than others. Here are some that I thought you might enjoy.

The first category includes those individuals who are a bit challenged in the spelling department:

“Clocked right ear”
“HOH”
“Have a lam under the chan”
“Have a bad sore throat, can’t talk long, hard to breeze”
“Growth on thort”

Did you get them all? Well, here are the answers:

Clogged right ear
Hard of hearing (This was an 85 year old woman and one of the original users of text messaging)
I have a lump under my chin
I have a bad sore throat. I can’t speak for very long and it’s hard to breathe.
I have a growth on my throat

The next category goes under the title, “Dazed and Confused”:

“Nose and hear”
“Appointment on my ear”
“He bleed from noise”
“Terrible noise in left hand”
“Loss of hearing in eye because of infection”

And, finally, one of my favorites of all time:

“Allergic breakdown”

I hope these put a smile on your face. I’d like to thank all the patients who unknowingly gave me these little nuggets of joy. You’ll have to believe me that none of the responses were altered in any way, shape or form. After all, I could never make up anything this good!