Wednesday, March 23, 2011

The Struggle

March 8, 2011

At the moment, I am sitting beside a Starbuck's kiosk at London Heathrow airport, sipping an inappropriately named Grande coffee, whiling away a 5 hour layover, enroute from Sacramento to Cape Town, South Africa. We will arrive there at 0855 tomorrow morning, get picked up by good friends Mya and Etienne and start our 2 week holiday. I am going to CT to ride the Argus Cycle Tour bike race, a 110 KM road race climbing 3800 feet and circling Table Mountain, the largest geographic outcropping in Cape Town. Nearly 40,000 riders participate in the race. I did this race 2 years ago, did well, and am going back this year to try and win my age division. Training at home for the race has been difficult what with work and fairly lousy northern California weather. We need the rain and I welcome it, but, it does make serious training difficult. When my teeth are chattering and gritty from sand thrown up from the road, I tell myself, "this is where champions are made"; that, or I am simply nuts.

About work: It is obvious to the casual reader and follower of this less than oft- contributed-to-blog that there has been no entry for 4 months. After my sabbatical ended last year, I returned to work November 8 and my schedule since has been hectic and stressful. I have been unable to sit at the computer and write. Between falling reimbursements and evermore unrealistic patient expectations my satisfaction level has ebbed. The aforementioned is provided as backdrop and not as a whining complaint. It is to set the stage of a patient interaction I had recently that serves to remind me of why I am still in practice.

Gene is a 50ish year old gent whom I have been following for many years. He has a syndrome known as Wolff Parkinson White (WPW), (no relation) and has chosen a conservative approach to his ailment, with which he has done well. About a year ago he brought his father to me for a consultation regarding a heart rhythm ailment. We dealt with his dad's problem and everyone was happy. Last week Gene came to the office for his scheduled visit and in his hand was an aluminum tube. "Looks like a fly rod case", says I. "It is" he said and asked me if I still fished. "I do, though haven't had much of a chance lately", I responded. He handed me the case and said, "I'd like you to have this. It was given to me by my fifth grade teacher on his deathbed. He had no heirs and it was one of his prize possessions." "I'd like you to have this" Gene said to me as he handed me the case. I swallowd hard and thanked him as best I could, knowing the sentimental value the rod held for him.

I opened the tube and unwrapped the softly burnished 4 piece Fenwick rod, a 6 weight, 7 1/2 foot beauty snuggled in a plaid blanket with a compartment for each section of the rod. To a fly fisherman and admirer of things old and well-worn, a thing of beauty.

Taking care of patients and their families involves so much more than diagnosing and prescribing. Likewise, the intangible rewards so far exceed any monetary remuneration that my inner struggles with the concept of "retirement" become understandable. To be sure, I do struggle with the inevitable cessation of practice. As I head to Cape Town to race against a bunch of retired, rested and very fit guys, I wish I had trained more and worked less.

The struggle goes on.

Thanks for reading.

Larry Wolff

Saturday, November 13, 2010

Back to Work

Monday the 8th of November was my first day at work in 4 months and 1 week. That's 130 days of not wearing a pager. The time off was valuable in many ways and has provided memories that will last the rest of my life. I had 2 major goals in taking the time off; prepare for the US National and World Championships and, just as important, to see if I could not work. Historically, I have not done well with down time. I probably have some element of ADD. To my surprise, I had no problem whatsoever not working. At no time did I feel antsy about not doing something. I did not feel guilty for not accomplishing something. Trish and I stayed busy with lots of travel and obviously exercising, but still, there were times with nothing to do. I loved it. I read 6 books, had time to connect with friends and spent lots of time with my dad. All in all, a spectacular time off.

My first day back to work was a bit of a shock. I was a little out of sync and inefficient. My first operation, a pacemaker, happened on day 2. It all came back very quickly. I guess after 30 years of doing something it is fairly ingrained. By weeks end I had seen nearly 100 patients and done 6 operative procedures. Friday night after seeing my last patient I had the familiar deep fatigue I had not felt for 130 days but have known far too many times in my career. Despite that, I am happy to be back at work. It is a gift to feel wanted and appreciated and I felt both on my return. I felt it from patients and colleagues, alike.

My training will drop off substantially over the next month but will then pick up. I will start to train for the Argus Cycle Tour, a 110 KM road race in CapeTown, South Africa in early March, 2011. I have high hopes of winning my age group. Hopefully, things at work will stay at a dull roar and allow for quality training.

This may be the last entry in this blog for a while. I don't want to bore people with the mundane happenings of my work life. Looking at the stats section of the blog, I note that the blog has been looked at more than 1500 times. Truly amazing. Someone from Germany read it this week. How does that happen? I don't know anyone in Germany. Anyway, to all of you who have read along, sent good wishes and just been there with me throughout this epic, I am truly appreciative.

Thanks for reading.

Larry Wolff

Friday, November 5, 2010

Heading Home

Driving in Lisbon is notoriously difficult. A week ago, Mike Brodsky, a good friend from internship and residency called me from Lisbon. He had been in Anadia watching my races and then headed south with his son, Merrick, to Lisbon. Shortly after arriving there he was arrested for making an ilegal left turn. The cop spoke no English and he, no Portugese. Ultimately, he was let go. He phoned me to warn me. Armed with that info and that of our guide books advising not to drive in the city, we parked the car at the hotel on our arrival and took cabs for the rest of the week. I could write a short book on Lisbon. Fascinating city with great views and culture. Spent an enchanting morning in the Gulbenkian museum, a wonderful private collection of art. This vies with the Borghese museum in Rome as my all-time favorite.

But what I want to tell you about is returning our car after dropping off family and luggage at the airport. I was alone, fortunately, and had 2 + hours till our flight for London left. The drop off point for the car was no more than 1/2 mile from the airport. Though I had the paper explaining (in English) how to get there, I could not fine the place. Time is running out. I have made the circuit around the departure area in the airport 3 times. I stopped a cabbie in the middle of the street to ask directions and finally a cop who was giving some poor guy a ticket. He explained I needed to go across a bridge and then head back as I was on the wrong side of the highway. So, I finally find the place and am now 45 minutes later than I had arranged. The person to whom I was to give the keys and title to the car (This was officially my car as I had leased it) had already left and gone home. I left the keys and documents with the doorman and asked him how I get back to the airport. I understood his universal shoulder shrug and headed out on foot. Crossing several major throughways I finally made it to the departure area, having sweated through my shirt and sweater. Not a problem. It's only about 24 hours till I get home.

But I've told you about the end without relaying data from the Points Race. The race was Sunday 10/31 at about 2:00 PM. We had gotten to the track early and I felt confident as I had found .25 Euros on the street walking into the velodrome. Maybe confident isn't the right word. I was no longer nervous and was so tired from everything that had gone on before that I decided this was just another race against a bunch of 60 year old guys. I ended up 3rd and got the Bronze medal. It was a good race. Very fast. I could not use my tactic of gaining a lap on everyone as the speed was just under 30 mph for the whole race. No way I could get away. So, I had to sprint for points and was able to eke out 3rd.

Standing on the podium was a thrill. I can't imagine what it would be like to stand there and hear the US national Anthem. Looking out into the crowd of spectators (maybe 40 people) I saw Trish and my Dad and they were beaming. That was really all I needed.

I will be back next year. I learned a huge amount and know what I have to do to win. We'll see what happens.

To all of you who have been reading along and sending your good wishes and Karma I say thank you.

Larry Wolff

Saturday, October 30, 2010


A lot has happened since I last wrote. There really are 2 stories here to tell; the bike racing and the trials of day to day survival here.

I will start with the daily struggle issue. The "villa" ultimately proved too much to handle. On Wednesday night we returned from the track near midnight. The place was ice cold. My father slept with all his clothes on. When I went to the washroom Thursday morning there were a minimum of 30 flies coating the shower curtain, towels and sink. I stripped down to take a shower, but, alas, no water. Someone was taking a shower downstairs. So, no shower. I had not really rested since arriving in Portugal. Between the 2 1/2 hours of driving daily back and forth between the residence and the track and the fact that the villa was uninhabitable I had gotten virtually no rest. I was worried about my father. He does not complain but I knew he was miserable. The situation was untenable.
Speaking of the velodrome, yesterday racing had to be temporarily suspended as they wiped water from multiple area of the track. It was raining and the roof leaks. Badly. Water was dripping into large puddles in the spectator seats and on to the track itself. I got some good pictures of the crew climbing up the banking of the track on ladders trying to wipe it down and dry it. The track is visually beautiful but the thin veneer hides a crumbling infrastructure.

So you get the idea of how difficult it is to concentrate on racing and concentration is key to doing well.

On Wednesday AM we had qualifying heats for the 2 KM pursuit, my main event. There were 11 riders in my category so one rider would ride alone. Of course, that turned out to be me. I was in the first heat with no one to ride against. This can be good if one does not have to pass the other rider, but, may also be bad for I had no one to race against. Anyway, I had a reasonable ride and posted the 3rd fastest time at 2:35.581. I was out of 1st place by 0.4 seconds.

The final rides happened that night some 12 hours after the AM ride. The men with the 2 fastest times rode against each other for gold and silver and I rode against the 4th fastest time for the bronze medal. I lost my race by 0.9 seconds to David Mulica which put me in 4th and out of the medals. As it turned out, both of our times were faster than the gold and silver times ridden that night. So it goes. A word about David Mulica: He rode on the 1972 US Olympic cycling team and competed in the olympics. Today he is an MD in Denver, Colorado practicing with Kaiser. He is a true gentleman and has become a friend. If I had to lose I am glad it was he I lost to.

Thursday night was the scratch race. This is a 20 lap drag race. First one across the line wins. For the first 18 laps I was never worse than 3rd place. I did a lot of work. Way too much trying to break away. With 2 laps to go the field surged ahead and I could not respond. I sat up with half a lap to go and soft pedaled in coming in last. It was OK, I learned alot.

Tomorrow night is the Points race. I must say I do not have the same level of enthusiasm I had a week ago. I am tired and feel a bit defeated. People tell me that one´s first trip to the Worlds is about experience and not to expect too much. I am trying to keep everything in perspective.

Mark Altamirano is a track cyclist living in San Francisco. He is here competing and has been a valuable friend and aide to me. He has helped me warmup and called out my time splits in the pursuit. He does not know how much I appreciate his TLC.

Portugal is a physically beautiful country producing wonderful wines and people. The culture is rich while the country is very poor. I don´t mind leaving my hard earned greenbacks here. Having said that, what I am shelling out for fuel is mind boggling.

Hopefully the next entry will have some humor and more upbeat news.

Thanks for reading.

Larry Wolff

Tuesday, October 26, 2010


We arrived in Lisbon after 2 pleasant flights from San Francisco to London and then on to Lisbon. Once here we picked up a brand new Peugot with just 3 KM on the odometer. We had to get diesel as the tank was empty. I figured I'd fill it up so started with 20 Euros. That of course bought me about 15 liters which brought the gauge up about 1/4. Holy mackeral. I did the math: Fuel costs 1.20 Euros/litre which is about $7.20 /gallon. That was surprise #1.. Surprise # 2 was the distance our "villa" is from the velodrome. Over 100 KM, taking about 1 1/4 hour each way. I guess that would be OK if our "villa" had heat and toilet paper, which, of course, it does not. My father said we are camping out. I told him at least we have indoor plumbing but he relayed that he needed a stick to get the TP to go down. It's a long story of how we ended up here at the villa, but that's for a later time.

Surprise #3... A cup of coffee here is about one tablespoon full. It's tasty and strong, but not enough.

The track is the most beuatiful I have ever seen. Silky smooth and nuclear fast.

Today we had our 500 meter time trial. This is not my event but I am pleased with my performance. My goals were to not hurt my back and to get a PR. My start was straight and without my usual wobble. The first turn was fine. The second saw me moving up track out of the sprinter's lane. Twice I nearly lost control of the bike. In the end, my time was 40.485 seconds, good enough for 11th place (of 19) and 0.7 seconds faster than my best time to date. The race was won by fellow countryman Reid Schwarz in a blistering 36.97 seconds. He has spent the last 7 years with a starting coach helping him perfect his start. In this race, the start really is key. Team-mate Mark Rodamaker took the silver

Tomorrow is my big event; the 2 KM individual pursuit. I am as trained as I can be, so we'll see what happens. There are some really fast guys here. I am happy to be here rubbing elbows with these elite athletes and especially glad to have my dad here to help keep things humorous.

Thanks for reading.

Larry Wolff

Friday, October 22, 2010


It's 4:00 PM and we are sitting in the British Airways lounge awaiting boarding of our flight to London then to Lisbon. The car was packed getting here. I alone have 5 bags, not including my carry on. I strapped both my road bike and track bike (both boxed) to the top of the car driving from Sacramento to San Francisco. Ten years ago I took a 2 week trip to Africa and took only a carry on. This bike racing makes for lots of schlepping.

So far everything has gone smoothly. Lots to "worry about" still. Will the bikes and gear make it in one piece? Will the rental car be large enough for all our stuff? How far is our residence from the track? Will there be enough time to warm up etc., etc., etc. And then, how will I feel with jet travel, different food and, the harshest of all hardships, a different pillow.

I want to win in Portugal. After all, that is the stated reason for a 4 month sabbatical from work and all the financial hit that entails,; not to mention , hundreds of hours training. As I sip (gulp) my Merlot (it's free) my concerns seem to be melting away. They will be gone 15 minutes after I take a Lunesta (sleeper) on the plane.

Hopefully I will have internet connection in Portugal. I may have to find a Starbucks to get on line.

To those of you reading this and wishing me good luck, a giant Thank You. I will try and make you all proud.

Larry Wolff

Wednesday, October 13, 2010

Such a Fan

With the fog rolling in, covering the field at El Camino High School in South San Francisco on a cold night in early November, 1967, the bleachers were filling with student-body, family and friends anxious for the football showdown between the El Camino Colts and my team, the Westmoor Rams. This was a big deal; our very first night game and a league game which had consequence on the final league standings.

As the starting right defensive end I had a clear shot at the quarterback as he dropped back to pass, deep in his own territory. I lowered my shoulder into him forcing a fumble which we recovered. The stands erupted with a roar that cut through the blanket of heavy, wet air. Only one voice was clear and distinct and heard above all others. That was the German-accented voice of my father yelling "LARRY!!!". It made me smile then as it still does today.

The significance of that play and that night is best appreciated in the context of what transpired the preceeding 3 years. As a freshman, sophomore and junior in high school I was a second string bench warmer despite playing my heart out and getting the tar knocked out of me daily at practice. Those years I saw little to no playing time on game day. Despite that, my father did not miss a single game. Ever. He even came to some of our practices. He knew how painful it was for me to do so much work and not be able to play. He remained and remains supportive. Always.

So we fast forward 43 years as we prepare to leave for Portugal and the Master's World Track Cycling Championship. My dad and his wife are accompanying Trish and me to Portugal and he will be in the stands as I race and I can already hear him yelling.

Such a fan.

Thanks for reading.

Larry Wolff