“Quiet on the set, please! Now….Action!” Look for your critic’s cap as the tale will soon be spun about attempting to make a movie based on my first, unpublished novel, Dr. Kamikaze. The trailer on the home page was the result of developing a screenplay, hiring a producer-director, and filming it using some local talent and The Flight for Life Trauma Team to throw our bodies around the rocks and trees of Colorado as a training exercise. Promoting the trailer as a tickler to gain support to make the movie, I talked one of the Bottom Brothers into being the star over breakfast in Santa Barbara, got to wear a baseball cap…still have it, too…emblazed with our film company name, Pikes Peak Films, and Dr. Kamikaze on it, and enjoy blowing several thousand dollars. Unfortunately, Hollywood did not come calling. I was smart enough not to mortgage my life on my ego. What is left is a campy trailer and exhilarating memories. As for the novel, it will be resurrected and rewritten as a sequel to Goin’ to Nebraska in the next year. Stay glued to the web-site for upcoming events. 

An excerpt from "Adventures in Medicine" - Coming Fall 2010:

     Don’t listen to Dr. Milt Waldron. I did not kill the Captain. Everyone knows Milt as a semi-retired orthopedist. Milt is also a physician recruiter for Semester at Sea, teller of tale tales, and part-time stand-up comedian. He often plays doctor lounges near you. Known to stretch his stories on occasion, Milt has gone too far this time implicating that I was the accomplice to the Captain’s mistress. This medical adventure needs little embellishment. It’s not giving the story away to say that the actual cause of death was too much “Zorba” in the Greek Captain. 

     In between his own voyages as the SAS Ship’s Physician, Milt often haunted the ER’s picking up the latest tips from the emergency physicians.  At times, he used these visits to recruit ER Doc’s for the Semester at Sea Voyages. From what I can figure out, he has a de facto, rather than official, title for this. His entertaining slide show on his voyages certainly hooks any qualified physician to wish to do it.  Besides, what is more adventurous, exotic, and challenging than being a ship physician cruising around the world with a boat-load of college students and professors?  The only drawback is the time commitment and loss of income.  So, I signed up after I retired from emergency medicine, taking my wife, Mary, and son, Ryan, as a student for the 2005 Summer Voyage. The staff boarded the beautiful MV Explorer in the Bahamas and became oriented to our roles and positions while cruising to Halifax where the students met the ship. We ultimately visited the following ports for five days: Reyjavik, Bergen, St. Petersburg, Gdansk, Antwerp, LeHavre, Dublin, Bilboa. After steaming back across the Atlantic Ocean, the cruise ended two and months later in Ft. Lauderdale. Milt Waldron went along as my “medical assistant,” to enjoy the voyage primarily as an adult student. It was really a ruse to watch over his wife, Betty, the adult social coordinator, his grandson, Dan, and, of course, me. The fact that the SAS CEO was also on board didn’t make any difference according to him, but I knew Milt did not want any screw-ups.

     A month into the cruise I had earned my ship physician’s sea-legs taking care of the usual stuff like sea-sickness on the rough Atlantic crossing and a few unusual diagnoses like Lyme Disease. Milt had made only a few “suggestions” about my running the medical clinic. I spent several hours in an ER in Iceland trying to expedite x-rays and fractured passengers. Norway was spectacular and uneventful, the beer being too expensive to consume excessively. Having rounded Denmark, we were festively sailing in calm and warm Baltic waters toward Russia on July 4th.  Our Greek Master Captain joined in celebrating the American Holiday on the back deck of the ship. The crew had decorated the area with patriotic flourish intermixed with tables laden with momentous spreads of hot dogs, hamburgers, and potato salad.  To the beat of an impromptu, rag-tag band, the gregarious Captain line-danced with the students waving at everyone as the group snaked through the appreciative crowd and the tables piled with food.  Normally known to be a stern, albeit fair taskmaster, looking after his Number-One Lady, the Ship, he revealed his “Zorba” side that afternoon with dance and frolic. Later, many observers thought he appeared rather “gray around the gills” as he excused himself early to go to his cabin.

     As the campus settled into the ship’s amphitheater a few hours later for the evening entertainment, there was an announcement over the PA system, “Code Blue in the Captain’s Quarters…this is not a drill.”  My first reaction was disbelief.  Then, the message was repeated, prompting the SAS Medical Team to head for the exit. Crewmembers escorted us to the Captain’s quarters.  Pre-resuscitation dread mixed with performance anxiety filled me as I descended the ship’s main staircase to the ship’s officers’ quarters. The door of the Master’s suite was already clogged with the crew’s medical team. Like so many other times at codes during my emergency medicine career, the bystanders parted before me without a word, relieved to place the responsibility on me, the old ER Doc. I doubt Milt will ever admit it, but my old buddy, the orthopedist, a glint of terror in his eyes and sweat flowing off his brow, looked like he could have kissed me at that moment as he kneeled on the floor over the cyanotic Captain doing Basic CPR. In the midst of everything, as usual, he had been alerted directly by the crew’s physician, a psychiatrist, and her code blue team. Both physicians gladly deferred to me as I took over the code, obtained the immediate history, and intubated the Captain. He was an unwitnessed arrest, last seen thirty minutes before, found down…fully clothed…by one of the ship’s receptionists, a fetching twenty-seven Latvian lady, who I later learned was his mistress. His pupils were fixed and dilated. His rhythm on the Life-Pak showed asystole. We worked him for twenty minutes anyway, hoping, quite honestly, for a miracle from Neptune. The Captain should only die when he goes down with the ship. Alas, futility brought clearer reasoning. With the command of the situation came the responsibility to make the decision to stop the attempt of resuscitation. As the minutes passed…fleeting for the code team and dragging by the distraught bystanders, I sensed the ambivalent emotions to stop or not boring down on me. My experience told me from the start that we would not be successful. Our hope demanded a valiant effort. When I asked whether anyone objected to stopping the code, no one did. 

     Even with the death of its Master, it’s not surprising that on such an organized society as MV Explorer, there is an immediate shift to practical matters…like what do you do with his body. No, he wasn’t wrapped up in sheets, placed on a board, and slid off into the sea. There were two, never-used, refrigerated, roll-out morgue lockers at the back of the clinic specifically for this purpose. The ship’s electrical engineer was called upon to figure out how to turn on the cooling system since no one had done it before. He conferred with the medical team on what the temperature setting should be for the next three days until we reached our next port, St. Petersburg. We didn’t think we should freeze him. As this was new territory for all of us, we settled for the same temperature as the ship’s food refrigerators. A select group of the grieving crew gently carried the Captain down the two levels to the back of the medical clinic, manipulating his limp body through its cramped, narrow hallway to the “cooler,” pulled out and ready for service. With a few adjustments here and there, he was placed on the cold metal tray. Gazing at him laid out unceremoniously on a slab of steel, everyone’s head drooped a little. Accompanied by a few mournful sighs, we pushed him into the dark cavern, the tray’s roller bearings whirred like a grand filing cabinet. The locker door was snapped shut with a smart click just as you would expect of its Germanic origins. It wasn’t stated, but I think we all got the “Willys,” none of us being familiar with this part of death protocol. At the same time it certainly seemed to bring closure to the episode. It wasn’t. 

     Even with the Captain’s death, shipboard life seemed to be returning back to normal as we approached Russia. We sailed through a calm Baltic Sea, finally experiencing the first warmth and sun of the cruise. Thoughts turned to life more than death. As in all the cities, the MV Explorer docked early in the morning in St. Petersburg to save a day’s worth of port charges.  Routinely, the ship cleared customs within the hour, and the passengers, then, were allowed off the ship. The process seemed slow that morning, but this was Russia after all. Rarely getting off the ship the first days, I hadn’t really considered the problem until I was summoned to the Officer’s Conference Room to meet the local authorities concerning the Captain’s death. “I’ve got nothing to worry about here,” I thought as I headed up the stairs. “I know I didn’t kill the Captain…I just didn’t resuscitate him…and I don’t think there was really any hanky-panky going on…but there was the issue with the young and beautiful Latvian mistress…he was fully clothed, right…and despite his clean medical records, he probably did smoke, drink, and lived life excessively…nah, I got nothin’ to hide.”

     I may have groaned a stunned, “whoa,” under my breath as I entered the conference room.  Seated at the table was the Latvian beauty handwriting her “confession” while an irate, black t-shirted Russian cop loomed over her, his short-cropped hair pulled forward in a malevolent frown. Four similarly attired, nasty inquisitors stood to my left arguing with the Armani dressed, nouveau-riche, port authority representative.  They noted my entrance with a sneer and motioned me to sit down with Milt and crew physician.  Even Milt looked contrite and, for once, without a good one-liner.   I sat down where indicated.  The next two hours consisted of the nasty thugs acknowledging our presence on occasion by asking a question through the nattily dressed interpreter.  “What caused the Captain’s death?…how does one die at age 59 with no record of medical problems on his records?…did the Latvian woman poison him?” Their minds made up.  They rudely turned their backs on us before we could finish the answer. They didn’t discriminate. They were inconsiderate to everyone. At times the scene was so surreal that I chuckled to myself. I was also wondered whether the new Russia still had Gulag’s for the innocent. I felt sorry for our Latvian Receptionist, who took the brunt of the wrath from the Russian cops, ironic that she was living again the abuse of the past Russian occupation. Unable to get a confession and tired of bullying us pansies, they seemed satisfied that we weren’t a group of conspirators. However, they demanded to see his body to make sure that there wasn’t any “funny business.”  The cops kept watch on us as we filed our way down to the morgue…like who’d want to escape into Russia after this.  We rolled the Captain out of the cooler. He looked just as dead. As the cops gruffly gyrated the poor Captain’s body about looking for bullet holes or stab wounds, they grumbled amongst themselves in probably not the nicest Russian. With their stubby whiskered jaws, buzz “do’s,” and muscle bulging t-shirts, they looked more like grave robbers. Unhappy that they didn’t find a crime, they stomped off without any apologies for our time.

     Later that day, the Captain’s Body was ceremoniously carried down the gangplank by his officers for his final journey.  Dressed in their best uniforms, the crew looked on from the deck, many with tears in their eyes.  When I asked one of the officers what kind of Master he had been, he answered that he had been an excellent, well-respected Master, always fair in his judgments as he looked out for his first love, the MV Explorer. My limited observation was the same. I also think that he lived life to the fullest. Possibly, he had too much “Zorba.”  At his funeral his Greek wife sat in the front row on the right, his Dutch wife sat in the front row on the left, and his Latvian mistress sat in the second row.  I don’t know what side.

An excerpt from "Adventures in Medicine" - Coming Fall 2010:

     Mary and I landed in hospice about the same time. Unfortunately, she had developed aplastic anemia, and I had transitioned from emergency to hospice medicine. She was a memorable character for many reasons beginning with our first encounter in the emergency room twenty years ago. As I examined this tiny Asian woman with abdominal pain, she remained animated and talkative despite having what turned out to be a partial bowel obstruction. Her dynamic personality and prior multiple episodes had just allowed her to tolerate it. The first time I examined her, I was impressed by a huge abdominal scar, noting that it sure didn’t look like a surgical incision. I asked her about it, expecting to hear about some botched surgery to resolve her problem. “Oh,” she said, “that’s when Japanese soldier bayonet me when ten year old at Christian girl’s school in Burma during World War II. It tough time. Have problem with belly ever since.” Wow, I thought, how did she survive? As she continued her story, I realized that it had to be her tremendous perseverance and will to survive that transported her from the savagery of Burma to the competitiveness of America after World War II. After the War she had married one of Chenault’s real Flying Tigers, but the marriage…”it got me to America”…hadn’t last, not that it had fazed her as she worked at various businesses to become financially comfortable. Each time I saw her in the emergency room, she tried to get me to invest in one of her schemes, “you doctor, you got money, I take care.” I listened, amazed that she could promote a deal in her condition, and politely declined before admitting her to the hospital to resolve her bowel obstructions.

     Her personality didn’t exactly match the philosophy of the Medicare Hospice Benefit as Mary worked at manipulating the system as best she could. She had to be discharged once for seeking aggressive management, which wasn’t surprising. But then, given her history, I understood her perspective. Even in her last days she often vacillated about whether she wanted to let go. Like the rest of her life, when she made the decision that it was her time, it was a done deal, and she requested a last visit with me. As I entered her apartment, I was greeted by her current rotation…she had arranged the schedule…of friends from her church. At her bedside an Odyssey nurse was tending her with an agency CNA…also, arranged by her and not paid out of her pocket. As expected, Mary lay regally in her bed giving out orders. I reached down to give her a hug as she was too weak to sit up, suggesting to me that maybe this really was the end. On the other hand, her conversation was as animated as ever, making me wonder whether this was really it. She instructed one of her church ladies to bring out the bottle of Champagne from the refrigerator that she had been saving for out last visit. The church lady offered an apology for bringing the Champagne to the bedside as she did not approve. Our nurse declined as she was duty. I took the bottle and uncorked it slowly with the correct seven twists, not spilling a drop. Two fancy glasses appeared, and I poured a couple of short ones, keeping one for myself and handing the other to Mary. I raised my glass extolling her remarkable journey through life and our long friendship. We clicked glasses and sipped our Champagne with devious smiles. I choked a farewell and gave her another hug. Mary thanked me for taking good care of her over the years. I thanked her for being her. No further words were necessary. As if on cue, a church lady showed me to the door. She died the next day as she had planned.

An excerpt from "Adventures in Medicine" - Coming Fall 2010:

     “So, Richard, will you look in on my fellow Hungarian, John, who is in terrible pain from prostate cancer,” my old buddy, Miklos, said with an accent like Bela Legosi.  “I think he needs some hospice.”

      The tone of his voice was more than a request…an offer that I could not refuse.   “Of course,” I replied knowing that I would be dealing with another unique gentleman from the Old World.  After many years of appropriate treatment, John’s  prostatic cancer had metastasized to his back.  However, his pain had been poorly controlled, a result of his cultural reluctance to address it and the minimizing of it to his physician.  John was bedbound and miserable, unable to move without nauseating pain.   His quality of life made him wish for a quick death.  After initial protestations and further encouragement from Miklos, he agreed to accept hospice a few days later, desperate for relief.  With the combination of narcotic, antiemetic, and antinflammatory medication, the hospice team was able to get his symptoms and pain under control with dramatic improvement in a matter of hours.  

     I visited John often over the next nine months.  My time with him and his wife became as much a social as a medical call.  He was able to return to his beloved garden and yard work.  It was impossible to keep him down even as the cancer progressed making him weak and cachetic.  We could control his pain, but we could not slow his ravishing disease.   John was a man of perpetual motion to the end, sometimes to his detriment with the hematomas, abrasions, and finger dislocations from his falls to prove it.  The day before his death, I visited him for the last time.  Barely responsive, too weak to stand  to greet me as he normally did, John, nevertheless, perked up enough to sit with me and his family at the dining room table to toast our friendship with his homemade wine, the fruit grown from his garden and squeezed from his ancient Hungarian Press.  John was even able to take a few bites of Pelachenca, a Hungarian desert crepe, made especially for our last visit.  We bid our final, respectful farewell.   A true gentleman, he always honored my presence, and I will always honor his memory.

     “So, Richard, you did good with my friend, John,” Miklos said after I informed him of John’s death, including, of course, all the details of our last meeting .  It was a rare compliment coming from a man, like John, who had lived a full life mixed with the ravage of war, torture from communists, and fighting for a new life in America.   Yes, I had done “good” with the help of the Odyssey Team.

An excerpt from "Adventures in Medicine" - Coming Fall 2010:

      Judy reminds me of Nancy, my first love. Nancy died twenty years ago of metastatic breast cancer. I learned of her death at my twenty-fifth high school reunion from Murf, my best buddy from my youth. The three of us went from kindergarten to high school together. Lucky him, his house was only two doors down from hers. The first time I saw Nancy was over a drink of water at the four-spigot, playground fountain. As I raised my head from a long drink and looked across the fountain, I gazed on the most beautiful vision of my five year old life. I watched Nancy daintily take her drink. Finished, she lifted her face toward me and gave me a smile that captured me forever. Although Murf, Nancy, and I drifted apart as we progressed through junior and senior high, we saw each other at school almost daily. Murf and Nancy became very popular with their dynamic personalities and looks to match. Transforming from jock to nerd, I receded to the sideline determined to make something of myself…and worthy of Nancy. No matter how unrealistic, thoughts of her often motivated me to make the extra efforts necessary to persevere through college to get into medical school. I finally asked her for a date, our first and only, during a Christmas break. She was home from Boston where she was special-education teacher, and I was a second year med-school stud. My understanding, generous aunt visiting from Santa Barbara slipped me fifty dollars to make the night special at the best restaurant in town. The evening was bliss. We talked until 4 am, never missing a beat. Throughout, I gazed on her as enraptured as ever. As I departed, she gave me a warm hug. She never responded to my letter a few weeks later confessing how I felt about her. Years passed, she married another, and, fortunately, I married my true love. When Murf and I saw her and her husband at reunions…a man, who was “nothin’ much” in our estimation, we would turn toward each other and read the other’s mind , “what did she see in him and not in one of us.” As I listened to Murf’s account of Nancy’s last year, my regard of her husband was even less. He had not allowed her to have possible curative treatment for her breast cancer when first diagnosed based on his selfish beliefs. She had died painfully and miserably of metastatic disease a year later.

      As I make my hospice home visit with Judy, I also gaze upon Nancy, whisked back to the water fountain. Despite the ravages of her metastatic breast cancer, unresponsive to aggressive medical and holistic treatment, Judy looks up at me with a warm smile as I discuss my hope that I can help give her a comfortable death. At times our eyes meet, stunning me, and I lose my medical train of thought, feeling a special connection to someone who I barely know. I hesitate, trying to control the misting in my eyes as she does the same with hers. Her devoted and supportive husband and family watch in silence. I hope they do not mind my intrusion. As I leave her bedside, possibly never to see her again, I only touch her hand as a farewell gesture keeping my professional distance. I fumble my last words, not knowing what to say. I am overwhelmed with sadness for Judy and Nancy, both exceptional women in their forties, so alike, struck down by the same disease. I cannot rectify Nancy’s suffering. My promise to her is that I will alleviate Judy’s.

An excerpt from "Adventures in Medicine" - Coming Fall 2010:

     I thought the mugging had been brutal. The beating had not been physical with bumps and bruises. Worse, it had been an intellectual one, more painful and demoralizing. A disquieting familiarity to a previous episode at the same University made it tougher on my ego. Just like walking down a dark alley or being ill-prepared for Grand Rounds, I should have expected trouble being out of my league when I attended the University of Iowa's Writer Workshop Summer Seminar on the advanced novel.     

     Before, it had happened in my third year of medical school during my second clinical rotation on the orthopedic service. Poorly tutored, I had been selected by my staff professor, a world renowned orthopedic pathologist, to present a complex patient we had seen in the morning clinic to the weekly Grand Rounds that afternoon. The primary goal of these weekly events was educational, and, to be fair, they generally were. However, depending on the level of the malevolence of the department chairman and his henchmen in the long coats, the “rounds” could be more miserable than “grand,” especially in the field of "one-up-man-ship." My medical career nearly ended during first Grand Round presentation. I died on stage attempting to present the orthopedic problem and mumbling inept answers in response from the following inquisition. Embarrassed more for himself than for me, my mentor slumped further in his front row seat with each passing minute as I dug a grave of incompetence. My furtive glances to him brought no support as he detached himself from my awful presentation as well as his poorly conceived plan for the patient. As the rabble clamored for my head, the senior resident in my group took pity on me to get me off the stage by accepting the responsibility of the debacle. The experience forever made me wary of allowing myself to be placed in awkward, unfamiliar situations. Ironically, I did it again thirty-five years later at the same university, only across the river in the foreign land of the humanities.

     The week long seminar's round-table format consisted of two or three critiques per day of twelve, including me, aspiring novelists' first captivating twenty pages of their unpublished work. A published author, a Masters Graduate of the U. of Iowa Writers Workshop, ably lead the discussion of the submissions, which were read by all the participants. Unlike the lone physician, me, the majority of the attendees were well read, insightful in a literary sense, and totally dedicated to their writing. Most of them were English Majors in College. My concerns started at the opening reception when I noticed that this seemed to be a different crowd than any medical conference I attended. It increased when I was asked in what "genre" my novel was. I had no clue. But then, what was I to expect? That was why they were there.  Maybe, and it probably was, I was the one who had the priorities screwed up. It was certainly a different crowd than the usual medical conference where the seriousness of the subject was left in the classroom.  Even there, the interactive intensity of it left no one dozing with their head on the desk. In fairness, everyone worked hard, made those constructive comments, and was tactful in their criticism.  Despite being friendly, they were difficult for me to read in conversations outside the classroom. Their self-absorption in their novels seemed to extend to their normal behavior. What surprised me most were their revelations of themselves in the novels. This was great material in itself.   

     Everyone around the table seemed to be a sensitive and responsible citizen. Their novels often reached for something else. But, then, we learned that the irony of good novel writing was to explore the normal and boring making it complex and interesting. That certainly was the case. The violent and chaotic worlds of forlorn relationships, sociopathic behaviors, and repulsive fantasy seeped out in their stories. Only one budding novelist gave hope to the human condition. Their beloved works seemed incongruous to the people who sat with me in our circle of discussion. Most described worlds with which they had, thankfully, no direct experience, yet provided insight into their personal axes to grind. 

     The oldest participant started out first. He sat there sternly in his John Deere hat and Marine Corp t-shirt while we discussed his novel about a young farm boy in the 60's, who, scorned by pretty girls in high school, runs off to the Marines to become tough and rough. On a two week leave three years later in Chicago, still a virgin, he obsesses on finally getting laid while displaying a frustration for a society that does not recognize his value. In the process the main character demeans women as untrustworthy sexual objects. Next, a bearded and round Classics professor, seated to my side, wrote about an all-knowing seer roaming about ancient Greece making fools of those who thought they were more intelligent than he.  At the start of our breaks, the professor would often start our conversations in reference to medical issues with "of course, I won't insult you by asking you if you read this or that novel." Of course, I hadn't.  Histrionic as hell displaying cleavage and tight pants each day, a displaced Toronto housewife currently living in the dull, safe suburbs of Des Moines Iowa presented a story about the destruction of two stepsisters by drugs and men in a squalid bus station in Toronto. She talked of returning to Toronto with her three children because they didn't have an understanding of the dangers of the undercurrents of society. Gee, and I thought Toronto was a nice city. The most insightful person, fastidious and height-challenged man, wrote of a vicious and cruel Spanish Pirate. The tall, bloodthirsty character towered over his enemies and crew, cut off their fingers, and fed them to the sharks as punishment. With hands as big as dinner plates, he raped woman until his "faucet" went dry. Others wrote of multiple partners, assaults, corporate greed, and a seduction of a priest. 

     When my day of reckoning came, I knew I was in trouble much like the day across the river in the Orthopedic Grand Rounds. My work was not up to the literary standards of the group or the leader. My novel, based on my youth and relationship with my father, had been written with as much inexperience as my knowledge as a third year medical student doing a first rotation on the wards. There were few positive words about my effort. I felt that my soul had been bared to be trampled on to submission by daring to work in the humanities rather than science.  

     After a day of reflection on what had happened, I realized that my literary “mugging” was much like the theme of my novel being that it is often not about you, but about them. Adversity can either build character or destroy it depending on how you let it affect you. On the final day of the workshop, our leader wrapped up his comments with a personal story to make this point. It concerned a successful English writer friend with whom he had attended the Iowa Writer’s Workshop. His name was pronounced Chasee with a hard "e." In a hurry to a book reading in New York, he stopped at a Barnes and Nobles for a copy of his book as he did not have one with him. He asked at the information counter where he could find a copy using his name. The man behind the counter informed him that the name was really pronounced Chasee with an "a." The author without telling him who he was corrected him. In a condescending manner, the man assured Mr. Chasee of the proper pronunciation. After the story, our most informed, condescending, and well-read participant stated, "that's so Barnes and Nobles." It was an amazing lack of her insight into her own conceit.         

     Both these medical and writing experiences taught me hard lessons in the art and craft of the professions. They also taught me more about myself. To excel in either requires a willingness to learn and to accept constructive criticism. Insight into your personal motivation and behavior coupled with knowledge of the subject will also lead to a more satisfactory result. Thus, despite my limitations, I continue to write…maybe not so great in a literary sense, but because I enjoy telling stories.