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

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