This I Believe

This I believe: that we are never too old. We are never too old to laugh until we cry. We are never too old to completely give our heart to something or someone. We are never too old to change our mind about life philosophies, careers, politics, or religion. We are never too old to have a best friend and to share with that person our biggest secrets, our biggest fears, or our biggest dreams. We are never too old for a birthday party or a kiss from our mom or a holiday car from our Grandma.

While in medical school, I spent a year living and working with very sick children. Throughout that year, I witnessed life in a different way. I listened as Jefferson described his experience of being hurt and disfigured from his burn scars, when Tracy confided about how scared she was after her bone lengthening surgery, and while Esly bragged about his heroic courage as he gave blood for tests. I was there when Yobisa lost her battle with leukemia and mourned her death along side the other kids. And I cherished how they always– no matter what– managed to cause trouble and be rambunctious. It made me appreciate how I could play make believe with a five-year-old, how I could talk directly and honestly with a teenager, and how with babies I could still give and receive unconditional love.

During that year, I saw kids overcome very adult problems and I, as an adult, was able to act like a kid again. Curiosity, adventure, and wonder filled our days, even as we dealt with death, fear, and abandonment.

That experience– and this belief– is why I decided to become a pediatrician. I do what I do because caring for kids allows me to protect and nurture my own inner child and it makes me incredibly happy.

We do not all have to be pediatricians to stay young. Every day we are given opportunities to see the world as children do. There is no denying that, as we get older, life tends to become more sober. Death becomes real. A family needs to be provided for. Work can slide in to monotony. It is no accident that most adults forget what it feels like to be a kid.

Is it as simple as making a decision? Can we commit ourselves to staying young and do so purely through an act of will? I would like to think that we can. I would like to think that we have the power to determine our own attitude. There are times when we need to focus on work, or a loved one dies, or we cannot get along with our significant other, or nothing seems to excite us. But I believe even then we can dodge the falling leaves while walking to our car. We can give someone a second chance. We can share a too-big smile. We can pause every time we think “I’m too old for that” and maybe, just maybe, do it anyway.

Like I said, never too old, even for dress up and school plays.

This post was inspired from the “This I believe” project. Find out more information here.

Red Flags

The ancient roads of Ollantaytambo were paved with Incan stones. Towering doorways opened in to courtyards the size of one square block, the interior divided in to households. Gardens full of fruit, flowers, and sheep hid behind the walls, protected by the cacti and glass shards that decorated and stood guard from above. Protruding from the Incan-carved stones, set over the cobblestones and saquías, were long wooden poles with red bags at the end. The red flags indicated “chicha de jorra” for sale. These flags can be elusive, but today they were everywhere, criss-crossing the narrow passageways. I approached the one closest our house and stepped past the haggard wooden door.

The portal

Once inside, the magic and beauty of the Incan walls were lost. There was no vegetation in this courtyard. Mud, blackness, and falling brick structures greeted me. A man was seated in front of what was presumably the entrance to his small room. He waved me on to the next door, the opening an impenetrable black, especially in contrast to the bright mountain sun. I stepped through this portal as well, unsure what lay beyond.

Here I found a woman, sitting on a stool, next to a giant cauldron that was as wide as it was tall. The woman mirrored the shape of the cauldron, her presence rolling outward; her large, red, traditional dress was responsible for her shape more than an ample belly. Food was not that plentiful. She wore a white blouse and the tan top hat typical of the mountains. The room was maybe ten feet by twenty feet, with an old wooden table opposite the cauldron and two young children, a girl of perhaps ten and a boy of seven, talking with whom I presume to be their grandmother. They all quieted and turned to look at me when I passed through the doorway. I spoke to the grandmother.

“¿Se vende chicha de jorra?” Do you sell <fermented corn drink>?

“Sí, joven.” Yes, young man.

“Deseo una botella, por favor.” I would like a bottle, please.

“¿Tiene botella?” Do you have a bottle?

“Sí. Aquí está.” Yes. Here it is.

I passed my empty two liter bottle of water to the young girl.

“En este caben cuatro jaras.” Four pitchers will fit in this.

“¿Y cuanto se cobra?” And how much will that cost.

“Dos soles.” Seventy-five cents.

Surprised, I pulled my ten Soles bill from my pocket.

“Tiene diez” the little boy whispered to his grandmother. She stopped filling the little pitcher she was dipping in the cauldron and looked at me.

“Dos soles no más, joven. ¿No tiene sencillo?” It’s only 75 cents. Don’t you have any smaller change?

“Um, un momentito y me cambio en la tienda. Lo dejo aquí.” Uh, one second and I will change it at the store.

When I returned with the coins, she was squeezing the bottle, sending foam out in little pulses in order that she may fill the container with as much fermented corn drink as possible. The two liter bottle was filled to the brim as the young boy looked on, learning the tricks of the trade. I stood and watched, a little awkwardly, wondering if I could ask a question or if I had already invaded enough. I remained silent, watching, taking in the dark room and unfamiliar happenings.

The abuelita finished and passed me the bottle. I, in turn, handed over the two Soles, said thank you, and stepped outside, back into the sunlight. The courtyard was mostly rock and dirt with some puddles from the rain the night before. I tip-toed around them. The man was still seated in front of his door, a bicycle pump at his side but no sign of anything else. Ducking my head, I returned to the Incan roadway and left the portal behind. The man, the woman, the darkness, the cauldron, the red flag disappeared around the corner.

The stone corridors set in a grid where the Red Flags would fly.

Capoeira

It is difficult for me to talk about capoeira. Difficult not only because it resists definition, but also because it is hard to put in to words what it has come to mean to me. In short, capoeira can be described as a “dance fight.” I do not necessarily like this image, but it is easy to work with. A Brazilian martial art form with strong roots in the African slave tradition, capoeira is, above all, an expression of life born from oppression. That fact, in and of itself, captures my heart and imagination. Like many martial arts, capoeira is more than just a fitness regimen. It encompasses a way of life that includes creativity, play, respect, discipline, survival, and pride. Brazilian Portuguese and the sounds of the batería (berimbau, atabaque, pandeiro, agogô) are essential. Similar to the undaunted resistance and fight hidden in the beauty of the dance, all of this lies just below the surface of something that appears so effortless, but which is impossibly difficult.

Capoeira, as I describe my experience, is like one of those people who you meet, and after a week it feels like you have been friends for ten years. Sometimes I get self-conscious when people ask and I say I have only been training for one year. That does not seem long enough to justify my obsession with it, my trip to Brasil specifically to visit my teacher’s hometown of Goio-erê, Paraná, and also to Salvador, Bahia, the birthplace of capoeira. Trying to communicate how important my fellow capoeiristas are to me as friends, even though I have really only been able to train with them and do not even know some of their real names, makes me feel silly. It is no less true and sincere, though.

Grande helping teach a class in Goio-ere at a community center.

Capoeira came at a point in my life when I had a big hole inside me. My principal community had left New Orleans, continuing on with the adventure of life, leaving me behind in a city which still held my heart, but which also felt dramatically different. Arte Reviver (NOLA Capoeira Brazilian Cultural Arts Center) became a place where I felt like I belonged, where I felt like I could be myself, where I could find kindred spirits. When I was there, I could escape the medical school bubble and academic stress. It was not easy making time to train, but I am a firm believer that we all make time for the things that are important to us. I made time for capoeira.

The more time I spent playing and learning, the more hooked I became. The fitness was a bonus. For me, the most engaging parts were stretching my mind to learn songs in Brazilian Portuguese (an absolutely beautiful, musical language), having a creative outlet in playing the instrument called the berimbau, and discovering that the history and tradition were rooted in the honorable fight against oppression, which fit right in with my social justice tendencies. My travels during my fourth year of medical school took me away from New Orleans and Arte Reviver more than I would have liked, but I never stopped thinking about capoeira. Each time I would return, I slid back in like I had never left– still as awkward and gringo as ever, but trying, and loving every minute of it.

Class in Bandeirantes.

My trip to Goio-erê only heightened these feelings. While briefly stepping in to the life of Professor Gafanhoto and Graduada Guerreira, I was privileged to see the vision that Arte Reviver can bring to kids who otherwise have little to imagine outside of poorly paying agricultural labor. Confronted by the pressures of gang violence and drug addiction, capoeira encourages community, play, and creativity. Every instructional class we held was at a community center, for everyone to see and take part. The joy and pride painted across these kids’ faces lifted my heart. I felt like I was living on borrowed time, having no business being there except for the gift of the capoiera family.

Class taught by Graduada Guerreira.

As I think about continuing capoeira in Denver when I start my residency, I realize that Arte Reviver may have spoiled me. Leaders like Mestrando Cocada, Graduada Rosa, Professor Gafanhoto, Graduada Guerreira, and Grande are rare. I have benefited so much from their mentorship, to such an extent that, when asked to talk about an important mentor in my life during my interviews for pediatric residency, I did not talk about baseball coaches or teachers or church leaders or even my parents; I talked about Mestrando Cocada and the things I have seen and learned from him in the short but meaningful time I have known him. All of these teachers’ humility and dedication blow me away. Their tenderness yet discipline with the kids strike a perfect balance. To see someone with so much potential physical power be so gentle with children really captures the respect and intention of capoeira: investing in our world’s most precious resource. These teachers live and breathe this stuff. It is not a hobby. Rather, they devotedly believe in it, in the good it can do for the community, in the good it can do for an individual. That dedication inspires me to be the best I can be, too.

Professor Gafanhoto said that the first time he walked the streets of Salvador (the birthplace of capoeira) this past year, it was like he had been there before. That is how I feel about capoeira– an old friend. The demands of my life may take me away for a while physically, but the beat of the atabaque, the twang of the berimbau, and the sense of belonging will live in my heart forever.

Professor Gafanhoto tuning the berimbaus in preparation for the roda.

*** The Capoeira Brazilian Arts Center (NOLA capoeira, Arte Reviver) is participating in GiveNOLA day on May 5th. It is one day only. Please consider donating (using this website) to help support projects in New Orleans and Brasil which inspire our children and even adults like me. The City of New Orleans will match a portion of the proceeds collected on May 5th given at this website. Please email if you have any questions. (gjkenneda@gmail.com) Thank you.

Race Snapshots

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The humid night is barely any cooler than the day. The sky feels low, somehow. The street is lined with balconies and signs hanging underneath. No breeze to swing them. The windows glow with light, as do the embers of a few grills on the sidewalk, offering brisket and sausage. The people stream by, shouldering past each other on the sidewalk. Cars foolishly creep down the narrow street as people dart in between, following the music. The sound pours from the buildings, rolling down the front steps, cascading through the windows, drawing the crowds in. Blues and jazz bloom from old gnarled hands and wrinkled cheeks. The new generation plucks the bass. Scratchy throats croon at the microphone. Lazy swipes caress washboards. The people push to the bar then slide back to the stage with drink in hand. They exchange glances and sway with the music. This night the kaleidoscope sees polo shirts, checkered button downs, sunglasses hanging down the back, Sperry’s scraping the floor. I am there, too. All our white faces, paying to be entertained by the black men playing the music. We part as one of the performers moves through the throng between sets, tip jar in hand, the lone stain.

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The sky is blue. The grass is green. The free shirts are yellow. I am part of the MLK brigade– a day on (of service), not a day off. I am in Central City beautifying a neighborhood park. The baseball field called my name. Edging the base paths, turning up the dirt around home plate, repairing the fencing along the dugouts and in the outfield. My hands are raw from working with the shovel, my yellow shirt is dark with sweat, and my hair-challenged head is almost certainly burnt. I straighten up, stretch out my back, and lean against my shovel. Looking around, I think of the man whom we are honoring today. As my thoughts drift through time and thought, I think of my part in all this. Who have I touched? Who have I changed? How am I part of the solution? The faces of important people in my life surface, crossroads in my youth come back in to focus. This is hard. There aren’t many. Thinking about my inner circle of family and friends, I realize I can count on one hand my black friends. Surpassing segregation, in all its structural fortifications, is going to be hard.

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The spokes in my wheels blur as I ride my blue bike along Simon Bolivar, past Washington Park, through the heart of Central City. On my way to the hospital, this is my favorite part of the commute. Bright shotgun houses stack up along the road. The neutral ground separates the traffic. Street art tells stories on the walls of the old public pool. But I just pass through. I am perceived as bold to willingly go through Central City. I like that, being thought of as bold. Yes, this neighborhood is the source of many of the staggering statistics on violence, but they are people, too. It is not a blighted land. It should not be whispered about and tip-toed around. I wave to those on the porches, I nod to the men working under the hoods. I smile at the children waiting for the school bus. But I do not stay. Is that enough?

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Graduation. Four years of medical school and I get to watch the class I entered with walk across the stage. Yes, a pang of envy turns within me, but more than that, I am filled with pride. My classmates rise, hoods donned, diplomas in hand, and descend as physicians. I watch as three African-Americans accept their hard earned degree. All are women. In a city over fifty percent black and at an institution which prides itself on diversity and community involvement, there are three African-American women becoming medical doctors in a class of 185. Is it my place to be proud of them, particularly them? When the ceremony ends I exit and move between the mingling groups of families and friends. I am looking for Denise and Carol. My study family. Two of my closest friends. With them I no longer feel out of place. Together we pose for a picture, Denise, Carol, Gregg. Honduras, Taiwan, USA. The diversity of my study family was not intentional, but some accidents are rooted in purpose.

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I am never happier than when family or friends from two different worlds meet. My twin brother Scott and now sister-in-law Lisa are out by the pool. The grill is smoking and being tended to loosely. Conversation bubbles between the groups. Everyone is relieved to take a break from medical school and relax. Denise from Honduras, Emma from Honduras, Carol a local but parents from Taiwan, Jerry from Zimbabwe, Jason’s parents from the Philippines, Charles from China, Phil from Germany, Du from Vietnam, Lan from China. I don’t think of this image until later, when my brother mentions my multi-cultural friends and when events are such that my thoughts wander frequently to race, but it makes me happy. It’s a start- this sharing and mixing.

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My parents are telling a story about a kid. This kid was likely in the wrong place at the wrong time. Probably falsely accused, he was nonetheless taken in and met with much skepticism. Young, there were suspicions of drug involvement, violence, and theft. Frustrated and embarrassed by the injustice of the situation, I sympathized with him. Why do people do this? As I listened to more of the story– the context, the neighborhood, the stereotypical clothing– I tried to find a reason why the police would wrongly accuse. Nothing I had heard quite made sense. Suddenly, I realized I am waiting to hear if he is black or not.

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Back on the baseball field at Kirkwood High school. Kirkwood is a West County suburb school that buses in some inner city kids. It has a neighborhood called Meachem Park that I never saw growing up. It is where the majority of the African-Americans live. Four black players are on the baseball team. Well, one is half. Two twins are significantly whiter than the darkest, because being black is a spectrum. The darkest would always frustrate me because he was so “paranoid” about “it’s because I’m black.” I always thought he was blowing it out of proportion. He was way too defensive. There is no way that is a problem at our school. Mothers of black kids say and teach the same things as mothers of white kids. Social interactions, housing applications, drug penalties are all the same not matter what the skin color. Right? “It’s because I’m black” rings more true to me, now.

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On rounds at Tulane Hospital. The hallways are a weird white and brown that make me think of wood panelling from the sixties. Nurses busily attend to patients in their Tulane green scrubs. Pagers alarm, wheels chairs or IV stands roll by, binders spring open and closed. I start my presentation on the patient I saw that afternoon in the ER. My history of present illness starts with age and gender and race…the story continues, detailing the length and severity of the event that brought him in, any other co-morbidities, allergies, home medications, social situation. We make our plan, visit the patient, and move on to the next room. It is from the outside looking in that I am able to question the importance of commenting on the patient’s race. What image am I painting? Yes, certain illness are more prevalent and have a different natural history according to certain population groups. But am I the expert identifier? Do I ask the patient how he self-identifies? Is that really pertinent to this illness? I wonder.

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The retelling makes me cringe, though I was not present. Thank God I was not present. A weekend night. One of my roommates drunkenly draws the parallel between the name of a medical student applicant we are hosting and feces. This roommate is white. The applicant is black. He dresses well, speaks well, and is evidently not black enough. He is more fake black, according to another presumably drunk roommate, himself a dark black, which in some minds may make it acceptable for him to say that. One could argue context, or that it was all a joke. None of this is acceptable to me. My own roommates and close friends. I don’t know what to say. I am sorry.

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Church on Sunday. Blessed Sacrament St. Joan of Arc. An Uptown church with a downhome message. A predominantly black congregation, I sit in front of the choir next to my New Orleans mother, Lula. Tyrone conducts, the drummer and keyboard player rock their shaved heads and sunglasses, the base player adds a toothpick sticking out from between his lips. Father Chuck presides and directs this celebration as only he can. This spring day the community is recognizing its graduates. Students from pre-K, kindergarten, and five middle schoolers. Seven high schoolers are all going to college. College students, a pharmacy doctorate, two PhD recipients, and an orthopedic surgery resident also stand up to be recognized. Am impressive group. An accomplishment not taken for granted. They are examples to everyone. They are the pride of the church family. They are breaking the stereotype.

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“Hi, my name is _____.” “Cool, I’m Gregg.” “Where are you from?” “St. Louis” “Oh. It’s crazy what’s happening there, isn’t it?” “Yeah, it’s crazy.” “I can’t believe how ridiculous those protestors are being. They try to make everything about race.” Ferguson has made global news. Civil unrest mixes peaceful protest aimed at constructive dialogue with disorganized and purposeless violence and destruction. The media’s power and responsibility is never greater than during these times. The conversation about race and police discrimination is everywhere. At least, it appears that way. Much of the conversation is actually diverted to the events and behaviors which occurred after the fact, not to the event or the historical forces that led to the fact. I wish I could be back home in solidarity. I wish people would not make assumptions about how this white upper class male feels about the issue. “No, it’s not ridiculous. It’s about time.”

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I See Her

I see her standing there, phenomenally.
A goddess, a seamstress, full of
Courage and pride and grit and strength
All the while tender, soft, glowing.
The women in my life showing
How to be, phenomenally, she.

I see my mother in the icon of commitment
Telling me I am never alone.
My grandmothers in voice and mind and spirit.
Sister seeking to save both sides, herself and the world around.
A family that has this man humbled and ground.

I see the black shimmering skin accentuate the bright fabric
Carrying the weight of the world: a child.
She mostly comes alone, her feet give testimony and her smile joy.
But there is pain and grief that is heard
Which, too, makes her resilient, hard.

I see the mamitas envelope in loving embrace
The children lost on the margins.
These short leathered women in dress and dance
Pinch my legs and rule the home
Giving life where before was fear alone.

I see the families sit down to eat, fatherless but at home
In a community of safety and security
Fleeing the violence and discrimination too often unchallenged.
Here they hold on, bitter or grateful to accept help from them.
Delivered- with their food- is admiration from him.

I see the hair pulled back or let down or cut short.
The professional, the teacher, the laborer, the server, the volunteer.
An aura robes the woman gleaming of spirit sadly unseen.
Do not walk by or over or through
For she belongs as much as- if not more than- you.

I see the curves that give strength to the form,
Which embody ferocity and creativity, artful fight.
The movement and presence command attention once denied.
Heroines here to change in abada, apelido, and Portuguese,
Lives to be changed, a neighborhood embraced.

I see my world enhanced
By that to which I cannot add
For I am he.
But she is she.
Phenomenally.

I see.
I am changed.
I will follow and carry them on.

In honor of International Day of Women, 8 March 2015. Thank you to the women in my family, to the mothers I worked with in Malawi, to the mamitas who changed my life in Peru, to those at the Karen House I never knew how to talk to, to my brilliant colleagues, and to capoeiristas. You are an inspiration and you can change the world.

My Favorites

It has been about nine months since I left Peru. That seems a little unbelievable to me. Last year at this time I had wrapped up my first few months in the town of Chaclacayo just east of Lima, had had invigorating adventures in Colombia, and was preparing for another three months amidst the routine yet unpredictable days at Hogar San Francisco de Asis. How does so much happen in a year? How humbling it is to think about where I was and who I was on this day one year ago, two years ago, three years ago.

My interviews for my upcoming pediatric residency have given me ample opportunity to talk about that unforgettable experience which moved me to appreciate the unconventional beauty in life. Whenever I try to talk about it, all my emotions and thoughts get bottled up and often spew out in completely unconnected memories. It is hard, but I love that roller coaster. I spit and sputter and then smile, resigned to the fact that I cannot put it in to words. That is why I appreciate so much when someone sits down and actually wants to hear, when someone has the tact to ask follow up questions to make sense of my responses. Side-step my incoherency and pull out my enthusiasm.

When I am by myself, the memories have a way of sneaking up on me. Without warning they will overwhelm me; for a moment they fill my chest with love and longing. It happens with a smell, a glance, a sound– some trigger that snatches me from where I am, leaves me floating in my memory, and then drops me where I started, feeling a loss that can’t be filled and a love that will never fade. It is rude because it unexpected and makes me hurt, but I cherish those interruptions. I cling to those trips back in time.

I am not always supposed to have favorites. Yet I do. I have a favorite ice cream flavor, a favorite color, a favorite book and movie. I have favorite campers, favorite friends, and favorite foods. And of course I have favorite patients and favorite kids. But you don’t get to know all those. What you do get to share are my favorite memories of the Hogar, which correspond to my favorite parts of the day, and which can make a case– to some degree– that the journey is sweetest at the beginning and the end.

***

Every day starts with a morning kiss. Sometimes, the bleary eyes lift from the slouched position on the couches. We touch cheeks. Usually, though, I awkwardly bend over and slip in the kiss before falling. I sneak around, interrupting sleep, conversation, or teasing. If it is a good day, they are excited to see me. If the cheek proves elusive, I touch the scratchy tops of knitted caps, or I brush the smooth plastic or textured surface of a burn mask. Mi bella, mi sonrisa, mi princesa, mi rapunzel, mi amorcita, mi blanca nieves, mi pulgita, mi amiguita, … Each is beautiful. Each deserves acknowledgement. Each is starting another day of childhood possibilities that I get to share.

For the boys, a handshake. No kisses between us. I circle around the couches, tip-toe through games of jacks, and pause youtube videos. No nick names for them. We are practicing being men, in the morning, falling in to machismo, thinking about responsibility, hard-work, and strength. We are equals. Comfortable. Real. Eyes say more than words. The handshake holds so much.

Sometimes I venture upstairs. As soon as I reach the top, my legs get stuck. Esly and Eloy and Valentina and Kiara attach themselves. Chants of “Ogo” try to be silenced, to no avail, since I egg them on from behind. Percy waddles by. The baby nurses spare me a quick kiss as they scramble to ready those who are Lima-bound. It is chaos and no order is to be found. Little tornados swirl and swirl. Until the doctor descends and parts the sea and even I scramble to the dining room.

Then the night. The blessed night. The noise is muted by the darkness as children trudge up the stairs. They finally exhaust themselves like I never thought they would. Homework put away, TV turned off, they climb in to the bunk beds, they snuggle next to their friends, they slip in to their pajamas. I make my rounds.

To Jefferson, his eyes open in sleep, I whisper sweet dreams. To Esli and Eloy, inseparable even in their dreams, I say good night. Bruno and Segundo whisper-yell “boo!” to scare me in the dark, without success. Brayan’s braces I strap on just like he likes them, or maybe he stops my hand and waits for the cute girl volunteers to do it. The papa gallo is retrieved for Bresni. Percy gets his last meal through his gastric tube without stirring.

The ladies I give privacy. Their room is their sanctuary. From the doorway I see their shadows and silhouettes bouncing in to bed. My “sleep with the angels” tucks them in. They reply with “sleep with your princess”. “You all are my princesses.” I linger there. They are my treasure.

Victor wriggles in to his corset. Adolescent faces are aglow from phones playing music. Blind hands, finger-less grips, left-hand switches, sleep-heavy awkward arms. Dr. Tony usually chases me from this room. I cause too much noise and activity. Oops.

The revving-up in the morning. The calm after the storm. That’s my time. Each day begun and ended with little balls of love. It doesn’t matter what happens in between. Those two times are the memories that jerk me back thousands of miles to home, to el Hogar. They are my favorites. I will never let them go.

Music Moves the Soul

from December 2013

It is funny how the powers-that-be stitch together life. Things appear haphazardly thrown together. Minor incidents come back to demonstrate profound significance, while decisions that were stressed over for hours or days prove unimportant. It is funny how we come to find ourselves in the location we are and the people we are with (or lack thereof). Life is so random.

These thoughts flitted quickly through his mind even though their subject suggested that they should carry more weight and therefore move more slowly through his consciousness. He was a little lost there– in his mind– as the loud music in the small rehearsal room completely deafened him and he thought about how utterly different and perfect this night in Medellin was when compared with the serenity and perfection of last night. Then he shook himself, looked around, and laughed at himself. He actually did think those things. He almost wished he was not the person that would think about those things. But he was. So he took a bigger swig of the aguardiente, passed it on to the next person, and took it in.

***

The day was wet and more than a little chilly in Salento, the clouds releasing their charge instead of just gently drifting between the tall stalks of the wax palm trees. The sun was hidden, the trails between the rows of plants were muddy, and the coffee steamed and filled the small space between the wooden walls in the cabin with warmth. Even though it was a day to lay in bed, he could not do that. He was never very good at that. With the light came opportunity, adventure, possibility– and that was not to be missed.

But even such optimism can meet its match. Three hours after ambitiously heading out armed with raincoat and rubber boots, he returned without having seen the sought after waterfall, with pruned hands, with aching feet, and with a deep need for something warm. He took a shower, made some popcorn on the stove, and was about to go eat dinner when the group entered the lower cabin.

***

Medellin is a destination. It features the epicenter of Colombia’s fashion industry, public transport gondolas that serve the shanty-towns climbing up the surrounding mountains, the delicious banjea paisa, a breath-taking Christmas-light show which lines the river, and night-life that is a perfect exhibition of beautiful people who are born with swaying hips. It intimidated him. He felt lost and alone amidst the crowds, in front of the women, eating alone, walking the streets– and it was not the peaceful smallness found in the mountains. But Medellin buzzed. And he wanted to follow that. He just needed Alejandro.

He had met Alejandro two years before while hiking to Machu Picchu. They had only spent five days together, but he had been clutching for any friend-tendrils during his three weeks of traveling alone in Colombia, and Alejandro was gold. With only two days to see Medellin before returning home for Christmas, he agreed to meet Alejandro in Las Castillas, a neighborhood full of young college students and the energy and creativity that come with them. They were going to a small recording studio to hear a rehearsal by some of Alejandro’s friends. They played angry punk rock.

***

They were five: two couples and a woman, all musicians. One of the guys had long hair in a braid and was wearing the same green Peruvian alpaca sweater that the gringo had on. His flaquita was a cute petite girl with soft eyes. The other couple was more hippy, with feathers decorating their hair and an aura of spirituality that was unmistakable. The lone woman was sensuousness personified, a light dress falling over curves with a face that was striking in its ordinariness. They arrived in a zen excitement, muted by the weather but buoyed by their communion in this space. The gringo was completely unbalanced, the damply predictable day suddenly glowing with embers of potential. He could feel the beauty growing.

They invited him to stay but he insisted that he had to get something to eat– but that he would return. He slipped out of the door as they stacked wood in the fireplace and carefully laid out their guitars, flute, drum, harmonica, and shaker.

***

The ringing in his ears did not go away for the rest of the night. Three hours of screaming, jumping, and passing sugar liquor in a space the size of most bedrooms had left him “experience-saturated”. The transition to cool air, a ceiling of stars, and the front porch of one of the musician’s house was perfect. The aguardiente continued and it was becoming more and more difficult to keep up the Spanish, especially since the conversations were tending toward the more cerebral. These college kids who before were yelling explicit lyrics until they could no longer speak also talked existentially about existence in Medellin and the youth movement.

The gringo could not take it in fast enough. The conversations, the music, the lives were so exotic; not sexy, they were uncomfortable, for him, which is what he wanted. Eventually, though, the cup starts to spill over. As the sky began to lighten with the morning, the paisanos helped him find a cab. With his forehead leaning against the cold window, he watched the lights fly by. Alejandro, far from the Sacred Valley, nicknamed el mono with his long blond hair, a smile and laugh as ready as his kindness, a punk rocker.

***

How can one describe the way music fills the air and affirms one’s existence? Its thickness is full of meaning, raw or refined. It moves people. It changes them. This is what was happening when he reunited with the musicians. They were friends who escaped for a weekend to relax and make music– and he happened to be there, sharing in the fellowship. Folk, contemporary, fusion. Sometimes ideas were shared in the silence between the songs: music as therapy for the soul and the mind, conscientious music, reality and truth, medicine and miracles. They were celebrating the birthday of the voluptuous woman and they were celebrating something unspeakable that existed between all of them.

The gringo, for his part, mostly just sat in a chair, slightly on the outside, closing his eyes at times, watching the movements, the expressions, the familiarity. They acknowledged him and he was part of it, somehow, but together they were reading notes that he could not quite see. He could feel them, though, and knew it was right.

At the end of the night they invited him to join them and participate in the medicinal music. He stood between two of them and closed his eyes. They raised long, wide pipes which stretched two meters, aimed at his chest and back. The deep vibrations from those instruments penetrated him through. He closed his eyes and let his body move as it wanted. The instruments traced over his head, down in to his gut, back to his heart. He was held there in between, suspended in the notes, transcended by the night, infinite.

Gondolas rising above Medellin.

The wax palms of Salento.

Christmas in Medellin.

Alejandro.

I unfortunately never got a picture of the musicians, but I recorded one of the songs and am working on putting it on youtube to share.

Stories from the People

The people make the difference. Even after having traveled to beautiful places like the Galapagos Islands, Machu Picchu, the Kenai Fjords, and the San Juan Mountains, I believe that is true. People make life richer, fuller, deeper, and are what stick with me with and change me. I have had a lot of time to reflect on this as I travel for residency interviews, crash with old friends, think about my next step in life, lament who I have to say good bye to here in New Orleans, and anticipate all the fantastic people I have yet to meet. I am saddened and excited at the same time.

The view from my porch looking down the Madison Valley onto Ennis Lake.

I wanted to share, therefore, a couple experiences with my patients in Ennis, Montana, that made those four weeks in July a time I will never forget. I think doctors and teachers always have the best stories because you never what who will walk in to your clinic or what will come out of a five-year-old’s mouth. My highlights are little snapshots, the things that make me shake my head and smile to myself. Keep in mind that Ennis’ population is only 850, so the role of the physician is very intimate. He checks in on his patients in the town store, at the gas station, and walking between fishing holes. His principal job, rather than making people healthy, is making sure they can get back to hunting, fishing, and ranching. Priorities.

The names are changed to protect privacy.

I remember Carl, a man in his 60s who hadn’t been to the doctor in two years. Fortunately, there aren’t many places to hide in a town the size of Ennis, and after running in to Dr. Marks on the street, he was guilt-tripped sufficiently to make a visit to the clinic the following week. I sat and talked about his shortness of breath, how the inhaler was working, his alcohol consumption, and what on earth brought me up to Montana from New Orleans. I was able to spend as much time as I wanted with Charles, and I took advantage of it, hearing about how the town had changed, where the latest hunting and fishing hot spots were, and what I had to experience before I left. As he headed out the door, I remember thinking about how lucky I was to be able to share experiences with Charles and how much I had to learn from conversations like those, not about medicine, but about life. I absolutely did not expect the two pounds of elk meat that he dropped off at the clinic for me the next day. I, the southerner, was instructed to enjoy the fruits of Montana, and I did, enjoying delicious elk tenderloin for the first time that I grilled on my birthday and which melted in my mouth.

Another man, we’ll call him Jeremy, arrived with tattoos on his arms, black leather vest, a face weathered by wind and sun, and a history of orthopedic surgeries from motorcycle accidents that he was more than happy to share. Before I had asked more than two questions his shirt was off and he was showing off one scar after another. I laughed, said I was impressed, and tried to redirect the conversation to the purpose of the visit. That was when he pulled out his phone, half serious and half smirking, and told me he didn’t really know how to say this, but that I should just take a look at the picture. In it were two naked people, a man and a woman, the woman doing a headstand on the man’s erect penis, and the advertisement Viagra over the top. He gave me that– well, what do you think?– look. Jeremy, I told him, I am not sure we can produce miracles, but we should be able to help you out.

Despite the above story, the clinic was a family medicine clinic, and we did see kids from time to time. There was one five-year-old child that I remember seeing who had uncontrollable diarrhea. Now, the direness of this situation was probably debatable, but for that kid, this was obviously pretty serious stuff. The dad was more reasonable, though, and I knew I could give him the facts and he’d understand. After getting the history and all the lovely details, I told them that diarrhea really wasn’t serious, that it was probably a viral infection, and it will pass soon. The dad said it had already been going on for a day, though. How long should we expect? When do we come back? Honestly, I said, I wouldn’t do anything until he has been having diarrhea for a week. That’s when the dad laughed at me. A week? he scoffed. It wasn’t mean or incredulous. It was a– do you have any idea what it is like to have a kid at home with diarrhea for a week?– kind of laugh. It was a– you probably said the right textbook answer but when you have your own kids you’ll understand– kind of laugh. Riiiiight.

Another little boy came in for a more serious reason. He had been extra tired lately with random aches and pains in his bones and tons of bruises from seemingly little bumps and scrapes. We checked his throat, listened to his heart and lungs, and felt a large spleen and liver in his belly. I walked out of the room with a bad feeling in my stomach, and the serious face on Dr. Blake confirmed what I thought– the little guy probably had leukemia. It was a Monday and not a great way to start the week for us, though a worse way to start a years-long journey of chemotherapy for that family. Fortunately, leukemia is a childhood cancer that has a very successful cure rate. Still, it is never fun to have to share that news. We did not have the laboratory resources to definitely give the diagnosis, so we tried to tell the family what we knew without being too ominous or too hopefully, a very difficult line to walk. It made me appreciate the wide variety of demands that a family doctor is faced with.

A week after Fourth of July we had a young man come in who looked like he was straight out of a National Parks brochure. And he might have been. Being only 70 miles from Yellowstone, we got a lot of patients who were either tourists or forest service workers. This guy was the latter. His complaint, though, was far from a twisted ankle or jammed finger that I might have expected. He had been celebrating the nation’s birthday with friends at one of the many cabins in the park and they all decided to climb up on the roof to get a better view of the fireworks. Obviously. But this guy had to one-up everybody, and jumped from the roof to a tree so that he could get even higher. Turns out he was a little too ambitious about his jumping ability– and coordination at that point in the evening– and crashed to the ground, straddling and breaking branches during his descent, ultimately ending up with no broken bones but a rather impressive cut on his scrotum. Because they were all tough mountain men they put some duck tape on it and kept celebrating. After a week, though, he thought it was best to have it checked out, and we were able to clean the area up a bit and put some better bandages on it. He escaped without any stitches.

The Grand Canyon of Yellowstone.

Another of the many responsibilities of Dr. Marks was to visit the nursing home in Ennis, named the Manor. Twice a week he would go over and flirt with the young 80 year old women, talk rough with spry 80 year old men, and make sure things were going well. Occasionally, the patients would walk across the street to visit us, pushing the walkers across the pavement and relishing their time outside and unsupervised for the 100 feet between their door and ours. One man, Andrew, came to check in with us. He used to ride some type of motorcycle that I did not recognize but was clearly supposed to be impressed by. He told me about where he got his cowboy hat and how to tell an authentic one from a cheap. And at the end of the visit, Dr. Marks wanted me to make sure I asked him about his worm problem. I was thinking maybe he had some GI issues, so I asked, even though he hadn’t been complaining of any diarrhea. “Oh,” he said, “they aren’t worms, they’re nematodes.” He held his arms up and examined them closely, then looked at me and said they were pretty much under control. “They’re on your arms?” I asked. “Yeah,” he said, “they poke their heads out every once in a while, but usually they stay just under the skin. Don’t worry, Dr. Marks is taking care of it.” I told him I was happy to hear it and showed him back to the waiting area. I gave Dr. Marks a look as I passed his office. Doctors have weird senses of humor sometimes.

Fish hooks that have been removed from patients in the clinic.

When I signed up to go to Montana, I wasn’t sure what type of stuff I’d see. They called it a “wilderness medicine” rotation. Would I see people poisoned by berries and mushrooms? Would I see falls from cliffs? Snake bites? People gored by deer or mauled by bears? Actually, it really wasn’t any of that. There were some fish hooks that had to get removed from ears and hands, but most of the stuff I saw was normal. My one claim to fame, though, was the chain saw laceration I sewed up. I don’t think I would see that in Louisiana. It was about 10 inches across the inside part of the knee. The cut was surprisingly clean– those blades are crazy sharp. I’ll let you judge my handiwork.

My final patient is one who exemplifies the joy and challenges of family medicine. When I first saw her in clinic, I said hi with my best southern charm and reached to shake her hand. She dodged and sternly told me to wash my hands since she had no idea who or what I had touched that day. And she instructed me to never call her “miss” and instead use her first name, for God’s sake. Thus began my four week relationship with Ms. Crawford. She was in her 50s but looked a little worse for the wear. Ms. Crawford had recently burned through a marriage and was doing her best to fight alcoholism. I will pardon any gruffness on our initial encounter for the incredible courage I know it takes to challenge addiction. Ms. Crawford’s liver function tests were not great, her nutrition could definitely be improved, and her cough made me cringe. However, she did not grace us with her presence every week so that we could follow her labs. Whether she would admit it or not, she came for support as she confronted the most important struggle of her life. I grew to love her abrasive attitude and recognized that it was exactly that which was pushing her to try and reclaim her life. I left Ms. Crawford rooting for her and appreciating how important the physician is in rural communities.

As I said before, the mountains were beautiful, but the people are what I will never forget about Montana. It almost made me want to be a family physician. Almost.

Thumbs Up

The fact that she felt compelled to make sure that he wasn’t going to kidnap us should have made me uncomfortable. But it didn’t. I was on sitting in the back, on the floor, of an old Astrovan with a tiny dog named Mr. Whiskers in my lap and two complete strangers in the front seat. I was stranded in the middle of nowhere Montana. But I wasn’t uncomfortable. I was just speechless. I couldn’t believe that all this was really happening. But it was. Thank God it was.

The story starts in Ennis, Montana, close to Yellowstone National Park, where I was doing a family medicine rotation through my school. It was a rural wilderness elective and I was making the most of my time in the mountains. That weekend I had planned to meet up with a good college buddy named Gabe, who is a physical therapist near Glacier Naitonal Park about 6 hours north of me. I had to borrow a car (driving my own car from Louisiana was not an option) which was a 2002 Subaru hatchback that creaked and worked hard but got the job done. Gabe and I planned to summit Holland Peak in the Swan-Seeley Mountain range and I was getting ready to drive 4 hours to meet him.

The adventure– because everything that happens in Montana is an adventure– started at the gas station. I did something I thought I would never do: I drove off with the gas dispenser still in my car. Fortunately, the gas station did not explode and the German tourists in the car next to me got to try and tell me what happened in broken English and frantic German. Don’t worry, I had no trouble figuring it out. I put the gas dispenser back, screwed on the cap to my car, and tried again, this time with success.

I felt good. I had my backpack in the back, I was meeting up with a great friend, and I was listening to “On the Road” by Jack Keroac, perfect for my wanderings out west. About two hours in to the drive though– between one gorgeous valley in the middle of nowhere and another– my car started making a little more noise than usual and my steering wheel started jumping back and forth. I know nothing about cars, so this worried me a little bit, but since I usually subscribe to the idea of pushing through problems and hoping it all works out for the best, I kept going. But the noise and shaking didn’t go away and I finally pulled over to the side of the highway to take a look.

I checked the tires: no flat. I checked underneath the car: nothing dragging. And that’s about where I end in terms of knowing what to check on a car. I got back in and went slower– sure that would help. Nope. Still the noise and still the shaking. I decided to pull off the highway at the next town– which don’t come very often. Fortunately, Deer Lodge arrived about 5 miles later and I exited at a gas station. I lifted up the hood and didn’t find anything dead or exploded. I took a very slow lap around the parking lot to more noise and shakes and decided I couldn’t risk it. Meeting up with Gabe was looking unlikely.
I called him and started explaining the bad news. My borrowed car was not acting right and since it was 7pm on a Friday night no mechanic shops were open. I was going to have to find a place to stay and figure things out in the morning. As I was talking and looking angrily and confusedly at my front left wheel, a man walked by, looked at me, looked at my wheel, whispered that he works on cars, made a face, and walked away. I immediately hung up on Gabe and flagged the man down, pleading for him to take pity on a helpless traveler ignorant about anything with an engine.

I quickly described what was happening and he was convinced I had a flat. He squatted next to my car and told me to reverse slowly. We’d find the flat, put a little fix-a-flat in there, and I’d be back on the road in no time. This was way better news than I was expecting so I did as I was told. But there were no smooth spots on the tire and no bulges that would indicate a weakness in the tire wall. I got out and looked blankly as he sat on his haunches next to my wheel. Then he cocked his head, looked at the back wheel, and looked at me. How many lug-nuts are you supposed to have? he asked. I scrambled to come up with what a lug nut was (somehow I figured out it is what holds your wheel on to your car) and also looked first at the front wheel and then at the back. There were five lug nuts on the back wheel. There were two on the front. Three had very clearly broken off and I will never know how my car did not flip over as I was doing 70mph for at least 5 miles. Oops.

The mystery man was undaunted, though. He had no place to be and offered to track down some studs and lug nuts and switch it out for half the cost of an autobody shop– allowing me to get back on the road that night. I’ll be honest, I’ve been conned before with my car in New Orleans so I didn’t exactly jump at the idea, but what other choice did I have? He said it’d cost $100 at the shop, so I offered $50, and we shook on it. That was it. Obviously, it couldn’t be that simple.
Robert (I had by that time discovered his name) came out of casino attached to the gas station (classy) and said all the auto parts shops were closed but he got the number of a junk yard just outside of town. The tricky part would be finding it. While he was on the phone trying to get directions, a young woman a couple cars down yelled at us from her window saying she knew where it was and would take us there. What?! As random and ridiculous as that was, I refrained from asking questions and took her up on the offer. Robert, though, insisted on taking his van since all his tools were in there to work on the car. Thus, Briana (my random angel) and I got in to the old van and were introduced to Mr. Whiskers. Brianna was assured we would not be kidnapped and we were on our way.

This story is most assuredly quite bizarre and I think all three of us in the car knew it. Robert, a skinny and tatooed chain smoker who looked the picture of a mechanic, was uncomfortably yet comically hitting on Briana in the front seat. Briana, who clearly stated she was married– in fact, her father in law was the owner of the junk yard– was having none of it gave lip right back to Robert, matching him jab for jab. Though both were clearly doing something extremely nice for a stranger (me), I was afraid they would offend each other and start fighting before they got the chance to help me. I tried to steer the conversation away from confrontation and drunk fantasies.

Turns out Robert was from Oregon and had been traveling to North Dakota (to maybe save some kind of animal?) when he saw a sorry couple on the side of the road and pulled over to ask if they needed help. The couple took Robert to the old mechanic shop where they were sleeping on two old recliner chairs along with about 30 cats and litter up to their ankles. I’m not exactly sure what Robert did, but somehow he helped them. Evidently I am not the only random person Robert has taken pity on. As Briana and I wondered what kind of crazy person we were in the car with, he told us that life is all about stories and he’s got plenty of them. He’s even thought about writing a book: Thumbs Up. Brilliant.

We pull up to the junk yard and the hornery owner, Monty, sticks his head in the window and tells us to go down one of the aisles. He’s got a mullet and handle-bar mustache with an old cap on and a stained and torn flannel shirt. He didn’t even say hi to his daughter in law. Robert was incredulous but Briana said that’s how he’s been the entire 10 years she’s known him. A real charmer.

Of course, Robert decides it’s his duty to start running his mouth off to this guy too, in defense of Briana, and he starts cursing and pushing Monty’s buttons. Monty bristles immediately and starts railing on Robert, telling him the sun is going down and the mosquitoes will be so thick we’ll be eating them and is he actually a mechanic because it doesn’t look like he knows anything about cars. I just wanted everybody to stop fighting so they would keep helping me. Robert is an angel and a devil at the same time.

After about 30 minutes of insults, finding tools, losing lugnuts, threats of packing up early, and trying to trade a hammer for a shirt, Robert somehow managed to make Monty smile and we got the car parts we came for. We backed out of the narrow ailse in the football field piled with trucks, derby cars, and any other piece of machinery you can imagine and headed back to the gas station.

We jacked up my car and got to work pulling off the tire and the brake pads. Briana brought some beer and dropped off some towels for Robert and Mr. Whiskers (on the ride we discovered that Robert had been using grease covered towels for himself and Mr. Whiskers for who knows how long). She then wished us luck and said good bye.

Robert with his Astrovan and trunk full of tools

I pulled Robert’s van around and turned on the headlights as darkness fell. A drunk man from the radio station rolled by on his bicycle and asked if we needed any help. Nope. Things looked to be going pretty smoothly. Until Robert realized that one of the nuts required a rachet size that he didn’t have. He looked at me solemnly from the ground and told me my mission was to find a 15mm rachet. My first thought was that that was bogus, but I knew I couldn’t give up at this point.

I jogged back to the gas station and walked in to the casino next door. There were about 15 slot machines with the sorry crowd you would expect sitting at them. I cleared my throat and made an announcement: I’m working on my car and don’t have the right size rachet. Does anyone have an extra rachet set in their truck? Sad eyes looked at me and shook their heads in silence. Then the bar tender reached behind his back, undid his apron, placed it on the counter, walked around front, and told me he just happened to put an extra rachet set in his trunk this morning. God bless him.

Armed with my 15mm rachet, I jogged back to Robert and we got to work wiggling the studs and lugnuts in the place. It wasn’t easy. The Duck Dynasty flashlight kept going out. Some beer was needed for lubrication. Lots of sweet talking and coaxing was necessary to help ease the brake pads on. Finally, though, the wheel was reattached. I took a test run around the parking lot, Robert tightened the screws again, and I was good to go. I gave Robert $50 and a little tip, we shook hands, and I hit the road.

I had no idea what to do or say to thank all these random people that decided to help me. It was incredible. I was stuck in the middle of nowhere with a broken car and no hope. Four people, these exact four people, had to find it in their own heart or crazy brain to help me. And they did. Each one chose to go out of his or her way to help a total stranger.

I drove for two more hours that night before arriving at the campsite to meet Gabe around 1:15 in the morning. The whole trip in the dark on the lonely road I kept thinking about how even when traveling by myself I wasn’t alone. I had been listening to the book “On the Road” which celebrates hitch-hiking and free spirits and starting over in a new place with nothing but your own two hands. I had been lamenting the fact that hitch-hiking across the country and meeting fellow travelers was no longer possible. Turns out I had my own “On the Road” experience that night, and discovered that in Montana, help is never far away. We may not be hitch-hiking, but we meet strangers every day that can change our lives. They may not be who we expect and we may not immediately hit it off, but we are all in this crazy world together. If I’m lucky Robert will honor me with a chapter in his book if he ever gets around to writing it. I’d be honored.

It Makes You Humble

“Doc” Ron Losee

 

Doc Losee: Hello! I don’t know you.

Gregg Kennedy: Hi Doc Losee! I was here last week.

DL: Come in, come in. You were here last week? I don’t remember. So what! Jesus I’m glad you’re here.

GK: Have you had the trains going?

DL: WHAT?!

GK: Have you been running the trains here in the living room?

DL: You like model trains? These are Lionels.

GK: Yeah, they remind me of my Grandpa. He had a set he would put up every Christmas. I would put on my overalls and conductor hat and load the tiny milk bottles or miniature barrels and run the laden cars through the tunnels.

DL: Good. Hmmm. Yes. … You want some booze? Come here come here. This way. You can have whatever you like. Gin, whiskey. Take what you want.

GK: Naw, I need to eat dinner. I’m good.

DL: Dinner! No no no. I don’t like to drink alone. Get yourself some booze. Here. What do you want? Take a bottle. I don’t care. Whatever you like.

GK: Well, that whiskey…Hennesey? I’ll try that.

DL: Hennesey. Ha! Good. Here here. Let me get you a good glass. I don’t think we have any ice.

GK: That’s ok.

DL: I am so GOD DAMN glad you’re here. So GOD DAMN happy.

GK: Hahaha, me too Doc Losee.

DL: Here, let’s go to the porch. Get yourself a seat. That one. That’s a good one. Good good.

GK: This is beautiful. Woooow. The view of the Madison Range, the river running below. Man.

DL: Best place on Earth. So what! … Now listen here. You can go wherever you what to go and do whatever you want to do. Anywhere! Doesn’t matter. Ok?

GK: Ok.

DL: Now wait a minute. You’re a medical student.

GK: Yep.

DL: At Tulane.

GK: Yep.

DL: Nothing wrong with that. Nothing wrong with that.

GK: Nope. I love it there.

DL: It’s a great school. Now wait a minute, wait a minute. What do you want to do?

GK: I’m interested in pediatrics.

DL: Pediatrics! That’s great. Pediatrics. Why pediatrics? You like kids.

GK: Yeah, I like kids. They have this energy, this infectious life, a way of bouncing back from everything.

DL: Now wait a minute, wait a minute. Let me think. I like that. Energy. Infectious life. Yeah, I can see that. … Where do you want to go?

GK: I’m not sure yet. I’m kind of thinking about Denver.

DL: Denver. Denver General?

GK: Well, it would be the Children’s Hospital.

DL: Oh. Denver’s a good place. I trained at Denver General Hospital.

GK: Did you like it?

DL: I was there for residency. After the war. It was a big place. Right there downtown. Olive and I took the streetcar there. Not much to look at. I liked Montreal better.

GK: Montreal? What did you do there?

DL: Orthopedics. You know, I was a pretty good surgeon. I liked orthopedics. It made sense to me. I was too simple minded for general practice– too hard.

GK: Hahaha. You know, orthopods still have that reputation.

DL: Well, that’s how it is. I wasn’t smart enough for general practice. Orthopedics was simpler for me. So what!

GK: Yeah, I heard you developed one of the first ACL repairs. The Losee procedure.

DL: The Losee procedure. Ha! I figured out the trick knee, you know. The pivot shift. They took me to France to talk about it. France! <gibberish in French>

GK: You speak French?

DL: <French french french>

GK: Where in France did you go?

DL: Bordeaux. It’s in the south. Beautiful beautiful. … And the Swedes. They came all the way to Ennis, Montana to let me talk to them about it. Ennis, Montana! You can do whatever you want to do wherever you want to do it.

GK: How did you end up in Ennis?

DL: It’s the best place on Earth. Look at it! Nothing better. Yes. I went west in my Jeep– an old Army model, have you seen it? Me and Olive. We went west and found Ennis. Let me tell you. Live where you want to live.

GK: Yeah. I like that.

DL: Now wait a minute, wait a minute. You’re a medical student.

GK: Yep.

DL: Well. What’s your name?

GK: Gregg Kennedy.

DL: Dr. Kennedy. Let me be the first to call you doctor.

GK: Whoa, whoa, whoa. I’m not a doctor yet. I have one more year.

DL: No. No. You’re a doctor. You’re in school, aren’t you? You’re a doctor. Dr. Kennedy. I’m the first one to call you doctor, aren’t I?

GK: Yes. You are.

DL: Well you’re going to be a damn good doctor. A damn good one. It’s the best thing in the world. I am so GOD DAMN glad I was a doctor. Jesus I’m glad I was a doctor. Nothing better. You like being a doctor?

GK: I think so. So far.

DL: Now wait a minute. Wait a minute. You sound skeptical.

GK: No no no. I am glad. I can’t imagine doing anything else.

DL: Why did you decide to be a doctor? You always knew.

GK: Nooo. I actually decided late. When I was 21.

DL: Why?

GK: Well, I knew I liked people– hearing their stories, meeting new people, learning about their lives and thus learning about myself. But it wasn’t until I took an anatomy course my junior year that I realized how beautiful the human body is, how everything works perfectly yet how much mystery there still is. I knew I would never get bored studying it

DL: Now wait a minute. Let me think. I like that. Ha! That’s great. You’ll never get bored. I agree. … The human body. It’s complicated. That’s why I liked orthopedics. You know I was a surgeon? I went to Montreal and trained in Canada. Never be afraid to change your mind. Do what you want to do. You can always change your mind. You know, I went to Yale. So what! I tell everyone. It’s the boys in Nebraska and Kansas who get the best training. I’m right, you know.

GK: Kansas and Nebraska, huh?

DL: Kansas and Nebraska. The boys in Kansas and Nebraska are trained better. I’m right. At least I think I’m right.

GK: I think you’re right. Have you ever heard of the big fish in the little pond theory?

DL: Now wait a minute. Wait a minute. Let me think. The big fish in the little pond.

GK: Yeah. The big fish in the little pond or the little fish in the big pond.

DL: Hmmm. Now wait a minute. I don’t know about that. Let me think. Oh, my mind doesn’t work like it used to. You might be right.

GK: Sure! The Nebraska and Kansas boys are the big fish in the little pond.

DL: Ok ok. You might be right. You probably are. I just can’t think anymore. …. Wait a minute. You’re at Tulane. One more year to go? You want to do pediatrics.

GK: Yep.

DL: Nothing wrong with that. Why pediatrics?

GK: Uh, well. The kids keep me young and I have a profound respect for mothers.

DL: That’s good. … I am so GOD DAMN happy you’re here. You know that? … Do you know Hervormde Kerk?

GK: No.

DL: Ah so what! It’s the Dutch Reform church. What does that mean. It doesn’t mean anything. It’s not important. Upper Red Hook. That’s where I grew up. I learned at the age of twelve the golden rule: do unto others. That’s where I first learned an appreciation for the privilege of life. That’s doctoring. It’s the best way I can show my appreciation for the privilege of living. And I am so glad I was a doctor. SO glad! It’s the best profession in the world. … You know what my God is? Love. That’s all there is. The rest is just bullshit. Sorry.

GK: No no. That’s ok.

DL: What’s your God?

GK: Well, that’s tough.

DL: No it isn’t. There’s one: love. I think I’m right about that. Love. The golden rule. You know what I call the Virgin Mary?

GK: No.

DL: Mrs. Joseph Christ. Ha! I just can’t stand being lied to. If you lie to me everything else goes out the window. Honesty. Impecable honesty. That’s what we need. Love and impecable honesty. There’s nothing else. The only noble pursuits. My first God is love. Love one another. Do unto others.

GK: I can’t argue with that.

DL: I think I’m right. … GOD DAMN I am so happy you’re here. Are you happy?

GK: Yes sir!

DL: Do you want some more booze?

GK: No no. I’m good.

DL: …. Now wait a minute. You have one more year left. You’re at Tulane. You’re going to be a pediatrician.

GK: Yep.

DL: Why did you want to be a doctor?

GK: Wonder and awe.

DL: Now wait a minute. Wonder and awe. Let me think. That’s kind of vague. I don’t know about that. Hmm. I’m not smart enough for that.

GK: Hahaha. No, I just think that when I hear other people’s stories I can learn more about myself. I think the human body is something that I can study for the rest of my life and never get bored.

DL: Huh huh. Ok. Yes. I agree with that.

GK: It is beautiful here. Do you like to fish?

DL: No no. Do you? You can fish right here. Right now. You want to fish?

GK: No no no no no. You ever hike up in those mountains?

DL: Hike in the mountains? No no.

GK: No?!

DL: Well, yes. Maybe. I don’t know. I don’t think so.

GK: Well, you have a beautiful view here. Sphinx mountain. The Madison Range. The west fork of the Madison River. Wow.

DL: Mmmhmmm. Yes. Live where you want to live. That’s what I did. Where do you want to go?

GK: I’m not sure yet. Probably Denver if I can.

DL: Denver. In pediatrics? You have one more year?

GK: Yep yep!

DL: Nothing wrong with that. Are you glad you’re a doctor?

GK: So glad.

DL: Nothing better. Now tell me more about yourself. I want to hear about you. That was so GOD DAMN nice of you to come out to see me. So awfully nice.

GK: I grew up in St. Louis. I have a twin brother. He’s a neuroscientist that plays with monkeys and makes prosthetics controlled by brain waves.

DL: Ha! Plays with monkeys. That’s great.

GK: Yeah. I have a sister and a younger brother, too.

DL: Great! What do they do.

GK: My sister just got back from Africa and is in Indianapolis studying nursing and my little brother is in college still and is studying abroad in Germany.

DL: Wow! That’s great. Are you married? That’s none of my business.

GK: Hahaha. No Doc. Unattached. I can go anywhere and do whatever I want to do. My twin has that covered. He’s married and is expecting a little girl. I’m off the hook.

DL: Well that’s ok. You’ll find someone. Or you won’t. It doesn’t matter. … I’m so glad you’re here.

GK: Thanks Doc. I’m glad I’m here too.

DL: Now did you get a copy of my book?

GK: Already read it.

DL: You did? Well it’s not any good. But it’s honest.

GK: That’s all we can ask for.

DL: Impecable honesty. That’s what I believe in. And love. The golden rule: do unto others.

GK: I like that. … Well, Doc, I think I have to go.

DL: You’re leaving?

GK: Yeah, I need to get some food.

DL: Well, there’s food in the kitchen. Help yourself. I don’t know what we have.

GK: No no no no. I have food at my house waiting for me.

DL: At your house? Oh. Ok.

GK: But thanks for letting me come by and chatting with me. Walk me to the door?

DL: Of course, of course. Go slow. It was awfully nice of you to come out and see me. Awfully nice.

GK: I had a good time.

DL: Dr. Kennedy. I’m the first to call you doctor.

GK: You are.

DL: Well it’s the best thing that will ever happen to you.

GK: Thanks Dr. Losee.

DL: I am so happy you came by.

GK: Me too. Don’t worry, I’ll be back to see you again.

DL: Ok. Drive safe. And remember, go where you want to go and do what you want to do.

GK: Got it.

DL: And you can always change your mind. Don’t be afraid to do that.

GK: Yes sir. Thanks again, Doc.

DL: You bet. Any time. My house is your house.

GK: Of course.

DL: So nice. So nice. Ha! Awfully nice of him to come out. Awfully nice.

When I asked Doc to take a picture with me, instead of saying “cheese”, he said “BULLLLL” and we finished together “SHIT!”

 

 

Dr. Ron Losee was the first doctor to serve the town of Ennis, Montana. He arrived in 1949 fresh out of residency, taking his jeep from New York and going west with his wife and daughter. He practiced family medicine until the mid 1970s and has numerous stories of delivering babies, serving the ranchers, staying up all night, and loving life which he humorously and honestly documents in his book “DOC”. At the age of 37 he went back to residency to train in orthopedics and was one of the first to diagnose and treat the “trick knee”: the knee that would give out due to a torn ACL (it was previously taught that the MCL was the most important knee ligament and there was no treatment for the trick knee). In the 1970s he switched to orthopedics full time and wrote a pioneering paper on the diagnosis and repair of the torn ACL. He made several presentations both in the states and abroad as athletes and others traveled to small town Montana to see the knee specialist. It is difficult to over emphasize the importance of this man in the community. He can be ornery and opinionated in his old age but his sacrifice is a testament to how much he cared about his patients and to a type of doctoring that we will probably never see again. It was a privilege for me to get to visit him several times during my stay in Ennis. I wish I could have spent more time with him. I will echo what he learned from one of his heroes in medicine and has passed along in his book about life, medicine, and the people you meet along the way: it makes you humble, it makes you humble.