That’s Why They Play The Game

I peruse the Mayo Clinic Connect Prostate Cancer Support Group Daily. One gentleman there is frustrated that his doctor won’t tell him what is going to happen to him, now that they have a path report showing margins no clear, some Gleason score 5 cells, and an intial post-op PSA of <0.05. Here’s what I said in response:

My path report showed 4+3 with no mention of Gleason 5 cells. Lymph nodes were negative. There was an area where the margins were not clear. But, the surgeon said he felt the tissue was “sticky” (whatever that means) there, and he took a little extra tissue from the sidewall in that same area where the prostate had been removed. All of that extra prostatic tissue was negative. I also had seminal vessel invasion. My 6 week, 3 & 6 month PSA were all less than 0.02 (I’m having my 9 month PSA next week.)

I did a little research and found several studies which predicted a lifetime risk of biochemical recurrence of 10-15% in my particular situation. The problem with such predictions is, for any individual, the end result is either 0 or 100%. And there is no way to know in advance which of those buckets you will fall into. As they say in betting circles, “That’s why they play the game!” Most doctors know better than to say, “This is what will happen to you.” Rather, they prefer to say, “here is what we will do to follow you”. It’s usually an algorithm which, in our case, starts with the PSA. Since there are endless permutations of how the PSA might evolve, again, a doctor will not tell you the full course of what might happen if your PSA starts to rise. There are so many “it depends” branching possibilities that it ends up being both confusing and scary.

So we are left not knowing what the future will hold for us as individuals. In that uncertainty, we need a physician who understands our fear and concern, and can provide assurance, that, no matter what the course ends up being, there is a plausible route through the diagnostic path to a treatment plan. It sounds like you are not yet getting that from your doctor, and that can be frustrating.

For me, I have a low-level anxiety that, someday my PSA might start rising. I also have a confidence that my medical team (I’m with Kaiser) has a lot of experience with many prostate cancer patients, and will provide whatever future evaluation indicates I need.

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Girlfriend Is Better – II

            Kathleen McNeil had luxurious, long, wavy black hair, usually free or in a ponytail. I found it irresistible. I would slowly, reverently stroke it, which she found soothing. At least, she let me continue.

            I had been moved from the third to the fourth grade in part because I had become visibly bored and unproductive in school. My grades dropped, I didn’t care about doing the work which was so simple, even a child could succeed. Fourth grade was more challenging, and my performance perked up. But I still suffered episodes of boredom, gazing out the windows across the asphalt playground in front of school to the cars rolling past on Montgomery Pike. Through the oak trees, past the repurposed swim set which served as a parking lot for bicycles, to the Presbyterian church and cemetery on the other side.

            Then Kathie would shift in her seat, dark hair flowing side to side as she adjusted her position while Miss Leeds took us through that days Social Studies lesson. My social studies including grasping Kathie’s ebony locks, feeling their smoothness, admiring the lazy coils descending from her neck. I’d stroke, she’d lean back, and we both could concentrate again.

            One day stands out forever. On a field trip – to where I can’t recall – we shared a seat on the school bus transporting us. An extended opportunity to melt in her eyes left me mesmerized by her gaze. Her eyebrows, as dark and full as the hair above, presided over a face often gripped by a serious, knowing aspect. On the way back to school, she gave me an extended precis of the movie she had recently seen, “South Pacific”. Nellie Forbush and her French plantation paramour, Emile DeBeque. I see know their connection was a bit too mature for an eleven-year old. Rather, I heard a lot about Bloody Mary and her daughter, Liat. Kathie seemed particularly entranced by Liat’s infatuation with Cable, the brainy lieutenant who challenged existing restrictions to spend more and more time with the exotic Polynesian beauty.

            Kathie suggested she wanted to see the movie again, but I was too dense to pick up on the opportunity. Instead, I planned a Christmas  party as a boy-girl affair, convening at my house, then walking up to the Pike to the Monte Vista theater to see “Lil Abner”. After all, it also was a musical, and based on a cartoon to boot. I intended to walk side-by-side with Kathie, sit next to her in the darkened auditorium, and…well, I didn’t know what that was all about, but it was something boys and girls did together.

            On the way back home, Kathie walked with her best friend, Shelby Cooper. I dragged behind, listening in as they giggled about Sadie Hawkins day and traded guesses as to which boy each girl in the crowd would ask to their imaginary dance. When Shelby asked Kathie for her choice, she hesitated, turning around to find me, and silently smiled.

            I discovered among my father’s record albums, a curated collection of classical music , “modern” jazz, and the odd set of show tunes, a colorful sleeve picturing Mary Martin and Ezio Pinza on the cover. This was a double album, which folded open like a book, and many more photos appeared inside. I devoured the ones of Liat and Cable, sure that Kathie saw us in their fated affair. “Bali Hai” and “You’ve Got to be Carefully Taught” especially resonated, evoking that forbidden island and its potential girlfriend. The romance of their story stayed with me far longer than Kathie did.

            I visited her house, in upscale Amberly Village a mile north of mine, once in our sixth-grade year. Her room smelled of freshly washed linen, and we sat before a wooden doll house, sharing a fantasy through the family who lived in it, little plastic people with bendable arms and legs, clothed in tiny cotton pants and dresses.

Sixth-grade marked the end of elementary school. Next up: Junior High. In our city, there were two choices. One could go to the local junior high, Schroeder, a mile away from Pleasant Ridge, the elementary, for 7th, 8th, and 9thgrades, then on to the local high school, Woodward. But, those who scored in the top fifth of the grade school class on tests we took had the option to travel seven miles into the city on Montgomery, taking the #4 bus to Walnut Hills, a college prep institution, for 7th through 12th. There was no question where I would go, the option was never given to me by my parents.

When I talked with Shelby and Kathie about the choices, I was shocked to discover that, while Shelby had opted for Walnut Hills, Kathie would be staying close to home at Schroeder. She explained that, as an only child, her parents did not want her traveling so far away. I thought that a bit strange, and tried to talk her out of it – I did not want to lose my Girlfriend! Looking back, I realize there may have been other reasons: maybe she didn’t meet the qualifying standard for Walnut Hills. Or maybe, her parents didn’t trust the neighborhood. Walnut Hills was the center of the Black “ghetto” at that time, and had a reputation among those living in the rarefied suburban fringe where the McNeil’s had their acreage as not the safest place to visit.

No matter, I was devastated. Especially when I read, years later, on a visit home from college, that Kathleen McNeil had been crowned “Miss Cincinnati” and would represent our city in the Miss Ohio contest, hoping to be selected to compete in Atlantic City. Her talent was listed as “violin.”

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Girlfriend Is Better – I

            My first girlfriend had dark, curly hair, barely reaching her shoulders. Five years old, she sported black Shirley Temple-esque wavy ringlets. In my memories, she wears a white button-up shirt with rounded collar, and a plaid dress. A few freckles grace her cherubic face, almost sparkling when she smiles. I remember her as fun-loving. We met in Kindergarten, Christine Harris and I, and there our interactions remained. I had an older sister, seven, and knew there was something different about having a girlfriend, compared to simply knowing another similar-aged human who happened to be a girl. Mysterious sensations flowed through me when I saw Christine, talked with her, or thought about her. Now, seventy years later, I still can’t name them, but know they were the first stirrings of an undeniable urge to couple. I do know I must have told my family and other friends about her special status, receiving beams of approval all round. I’m pretty sure she acknowledged our special connection, yet still played hard-to-get. Setting a template for future growth, no doubt.

            In first grade, my new girlfriend had straight brown hair, parted on the left, surrounding an unblemished face which rarely smiled. Her clothes are darker, more severe in my memories. Lynn Johnson may have been a brainy kid, or possibly just quiet. But alluring nonetheless. As with Christine, I remember no conversations, no hint that our relationship was anything other than a naming of a connection we knew we should be having. I remember neither one coming to my house, nor I to hers.

            Parallel to these memories are others of grade school. Having taught myself to read at age four, I had a leg up when reading circle came up during the school day. I could breeze through the “Dick and Jane” books we read out loud, never stumbling as the other kids did when confronted with odd spellings or unfamiliar words. Until, mid-way through first grade, we read a book about Indians in the southwest, and I saw, for the first time, a word I didn’t know. I tried a phonetic reading, and was crushed when the teacher corrected my “tur-kwa-zee” for “turquoise”. The humiliation was complete, but short-lived, as the other kids constantly came to me for help with all manner of classwork. I began to realize I carried a curse, of knowing things others didn’t, of learning them faster than most others could.

            But it didn’t stop me from moving on in the second grade, to my next girlfriend, Denise Bright. Denise was a boisterous lass, a bit assertive, possessive, and forward in her actions. She picked me out as hers, and we shared a few play dates at each other’s homes. Another girl in the class, Leona, inspired a fit of jealousy in me. Leona left our class mid-way through the year, being advanced into the third grade. Why not me? I thought.  Until then, I had felt myself to be the smartest one in the room, and it was a shock to my self-confidence to see someone equally adept at the game of learning. I felt no attraction to her, finding her eyes and cheeks out of proportion to her jawline, or something equally absurd. She was tallish and gangly, certainly not coordinated, unlike the more outgoing and physically competitive Denise.

            Moving into the third grade I carried Denise along with me in my heart. By that time, I had decided I was supposed to have a new girlfriend every year. But I pined for her, despite her being in another classroom half the day. My curious, searching mind began to get me in trouble. Another boy, Ivan, equally loquacious and clever as Leona and me, convinced me to engage in some prank I’ve now forgotten. We had to spend the afternoon in the school office, getting a disciplinary lecture from the assistant principal. Later that week, at the evening dance class my parents hauled me to, I found myself trying to waltz with a girl, inches taller than I. I was barely able to reach my right arm half-way around her waist. Not only did she insist on leading our steps she also began to regale me with her opinion about my recent visit to the office. She wanted to know whether we were paddled, and expressed her opinion, not on the severity of the punishment, but rather, the relative qualities of myself and Ivan. Seems she liked me much better than him. I suspect this was a nascent draw towards the “bad boy”, and she wanted the better-looking, more popular (in her mind) one. Sarah Jane Marsh had blond, wavy hair which bounced when we cha-cha’d. She wore a light pastel dress with a frilly hem, yellow or blue (or was it green?) in my memory. We danced the night away, and I had my new, third-grade girlfriend. I doubted it would last long, though, as she seemed most interested in gossip, not the “deep-dish thinking” my aunt accused me of.

            Soon, Sarah Jane and I were torn apart when the school moved me, like Leona, into the next grade. Fourth through sixth grade classes featured actual desks, old wooden affairs with metal scroll work on the side and a shelf underneath for books. The top lifted up so one could place their pencils, erasers, paper, whatever inside, private, out of sight. The desks themselves were probably thirty years old (meaning from the ‘20s) and had not been painted or varnished in all that time. They were scratched and worn, their dark brown wood polished smooth by decades of young greasy hands. Near the top, on the side, a round receptacle reminded us that long ago, students had inkwells into which they dipped the nibs of their pens.

            I don’t know when I first met Kathy, but do know that a quirk of the alphabet placed me behind her in the fifth and sixth grades, and despite the yawning difference in our ages (she of course was a year older), I adopted her as my next girlfriend. By this time, I had learned the nuances of speaking to and entertaining others, and she did not reject this. My approach began with her hair.

            Kathleen McNeil had luxurious, long, wavy black hair, usually free or in a ponytail. I found it irresistible. I would slowly, reverently stroke it, which she found soothing. At least, she let me continue.

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North Woods

A young couple cavorts through forest and meadow as spring erupts around them. Each has escaped England, and then together eloped from the Bay Colony, beyond barely civilized Springfield. So this must be mid-seventeenth century, in the Berkshires of Massacheusetts. At the end of this introductory tale, the man plants a stone, saying, “Here.”

Thus begins North Woods, a novel by Stanford psychiatrist Daniel Mason. That stone becomes a house, which accretes additions and occupants over the following four hundred years. The story is told in strict chronological order, but that is the only constraint Mason places on his craft. A first-person account of the woman’s abduction by Indians, scrawled in the margins of a family bible is followed by two pages of transition narrative, only to revert to a prolonged mini-memoir by Charles Osgood, who builds an apple empire and spawns twin daughters, Mary and Alice.

Their story, one of love and betrayal, is told in traditional third-person, albeit using words and phrasing which might have been common during their lives. They engage not only in maintaining and expanding the house and orchard, but also making music, playing and singing their own compositions. Beginning at the one-third point, Mason displays his gift for verse, a multi-stanza epic about a mountain lion (“catamount”) who uses the house as an abattoir. The next chapter is a one-sentence proverb, explicated by a three-page long footnote.

And so it goes. People appear, are sketched briefly, and move on or die. New owners, new centuries, new wings on the house. A painter, seeking refuge from the commercial demands of his agent in Boston, tries to convince his wife to remain in the wooded retreat. In the process, he discovers his love for his best male friend, with whom he traveled in Europe. A writer not unlike Walt Whitman. Almost two hundred years later, a scholar of that writer inherits the house, and achingly (to the reader) fails to discover the connection.

The songs of the Osgood twins are interspersed among the stories, to comment from the past on events of the present. Their own baroque ending is a recurring theme throughout the book.
The joy lies in both style and structure. The characters have convoluted connections over time and space. Mason exposes them with care, as if seen through a filigreed curtain. He dabbles in magical realism to link the occupants of the house, one character’s presumed hallucinations seeming to arise from ghosts which haunt the land.

Each sentence is a jewel, words chosen wisely, at times sparingly, at others, with a grace which astonishes. He is skilled when describing nature, the woods around the house, the trees which rise and fall, the stream which attracts and kills.

North Woods is filled with miniatures, polished and presented not as a coherent narrative, but as individual epigrams lining the walls of the Yellow House. Rushing through this novel is not recommended. Rather, sip it a chapter (there are 25) at a siting, and return when ready for another. The house will be there, waiting.

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I Can See Clearly Now

My paternal grandfather, Al, died when I was in the third grade. Born and raised in Miles City, Montana, he’d been through many incarnations in his 76 years. Deputy Sheriff in Custer County, banker in Omaha, steel worker in Seattle, retired in Hayward, California. I remember him as a gruff, barrel-chested man who helped my father remodel our dank, concrete floored basement.

Together, they laid vinyl tile over the floor, making the design of a checkerboard and a shuffleboard court for indoor gaming. A stone fireplace filled half of one wall, just below ground-level windows. On either side of the masonry, my father placed a framework of two-by-fours, over which he nailed knotty pine planks. Grandpa Al’s job was to stuff fiberglass insulation into the cavities behind the siding and between the studs.

He wheezed a lot while he was doing this. A smoker all his life, my dad said Grandpa had emphysema, which slowed him down a bit. Slow enough that, a few months later, my father flew out to the Bay area to visit him in the hospital. Two weeks after that, he made a return trip for the funeral, bringing back several mementos for my sister and I. Mine was Grandpa Al’s Hamilton watch, gold-plated, with a rectangular face and Roman numerals. I proudly slipped the metal stretch band around my wrist and wore it to school, now independent of the wall clocks.

Soon after, bored in class while the teacher wrote sentences to copy on the blackboard, I pulled the Hamilton off, and began to fiddle with it. After winding the stem to keep it active, I pulled the case back over my hand, and discovered the cover was loose. Giving the edges a couple of mild tugs, I popped out the crystal. The glistening reflections coming off the concave inner surface intrigued me. I held it up to my eye, and looked through it at the words she’d written.

I could actually see them! Up to now, I had been listening to her as she read them out for us, memorizing them so I could reproduce them in my cramped, sloppy handwriting on the lined exercise sheet. Being able to see the sentences saved time and I finished way before my classmates, owing to my lack of care in trying to write neatly. While the rest of the class struggled with their long-hand, I continued looking through the small glass cover at objects around the room. A globe came into sharp relief; the alphabet, in capital and small black blocks above the blackboard, were now dark and clear, not fuzzy suggestions of letters.

“Albert, what are you doing!” I looked up to find the teacher hovering at my desk. “Let me see that. What is it?”

I tried to explain about my grandfather, his watch, the loose crystal, and the sudden clarity of my vision..

“Give it to me. You can pick it up after class.”

The year before, I had not missed one day of school. A model student, I rarely had disciplinary encounters with the dreaded Assistant Principal, who was reputed to have drilled holes in his paddling board for greater impact. When I went up to retrieve the magic Hamilton, the teacher told me, “I’m going to have to report this to the Principal’s office, Albert.”

But no visit ensued. Several days later, my mother announced I was not going in that day. Instead, we went downtown, to the Carew Tower, where a white-coated man with thinning grey hair combed over his shining scalp smiled as he reached out to shake my hand. “Can you show me that watch crystal, son?” he asked.

I excavated it from the case, and handed it over.

Lifting his wire-rim glasses to his forehead, he turned it over between his thumb and foreinger, humming a bit while he investigated its mysteries. “So, this helps you see writing on the blackboard?”

I nodded, still unsure whether this was some fearful extension of the Principal’s office. Frightening objects popped into view: a black leather chair facing a heavy set of metallic circles suspended from the ceiling, jars filled with clear liquid holding little wands with round lenses on the end. I couldn’t imagine what torture they might have in mind for me.

“Can you sit up there for me?” I climbed onto the squeaky leather seat and raised my hands up to the arm rests.

“What’s the first letter you can read on that chart?” he said, pointing vaguely at the wall.

“What chart?” I said.

The man sighed, and swung the metallic circles over my face. “Look through those holes there, please.” He clicked several levers, and pieces of glass fell into each hole, in front of my eyes.

“Now?” he asked.

“Wow!” I said. That’s an ‘E’!”

********

After that, another dimension opened for me in school. Sporting a pair of glasses in a blue translucent frame, I found the tasks much easier to accomplish. So easy that I got bored, and my grades plummeted. A “D” in handwriting – why bother trying to make it neat anymore, I can see what I wrote just fine now! A “C” in Social Studies, another in Art. Several months later, while I was home “sick”, my parents announced, “When you go back next week, you’ll be in the 4th grade.” I think third grade was tired of me.

And that spring, returning to the “Knothole League”, I found that getting a hit was more than (literal) blind luck. Before, my wild swings at the blurry baseball rarely succeeded. Now, I had a fighting chance. As long as I  my glasses didn’t break.

My eyes kept deteriorating, so every year I needed another exam, and another trip to the Wenstrup Brothers optical shop for new lenses, sometimes even frames. By the ninth grade, I discovered wonderful games I could play by taking off my glasses. Driving at night, oncoming headlights became, not bright flares, but stellate discs, multiple bright spikes radiating from a central core. At a distance, one spike, much longer than the rest, would start out pointing east. As a car came closer, the line would rotate, picking up speed until it pointed due north as the car passed by. Cool!

At the annual Christmas pageant, while everyone else listened to the choir warbling through carols, I would take off my glasses and contemplate the tree on stage. What had been many flickering pinpoint dots of light wrapped around the fir branches, now became a phantasmagoric scene of overlapping blurs, red, green, white, and blue. Blinking my eyes, they’d starts to dance and smear into one another. Very cool!

In 1960, I joined a summer swim team, at age 11. We practiced Monday through Friday, June through August. Swimming laps for over an hour in chlorinated water left our eyes blood shot and blurry. In addition, I could see no better underwater than above, so I risked banging into the wall. I began to count my strokes so I would know when it was coming up.

I was never a good swimmer; I collected a shoebox full of red (2nd place) and white (3rd) ribbons from dual meets which featured four to six competitors in each event. Larger events, the end-of-the-season championships, left me watching the finals from the stands.

But I was surrounded by outstanding swimmers. I swam with collegiate champions, NCAA winners, and Olympic gold medalists. Through them, I lived vicariously, as they suffered through year-round two-a-days, miles and miles each week which turned their hair bleached green, their eyes a web of tiny veins from constant chlorine irritation.

In 1969, those who had qualified for the USA national championships in Louisville returned with not only the usual swag of tee-shirts and caps, but strange, dangly objects like translucent versions of the eggs Silly-Putty came in, cut apart with the two halves held together by rubber straps. The first swim goggles, ubiquitous today.

The elite swimmers could now practice even more without the eye irritation which had plagued them. And goggles gave me a new world under water. For those of us with severe myopia, some prismatic combination of the refractive properties of plastic and H20 produces a miraculous correction. Everything becomes visible, at distances of 50 meters or more. I could finally see where I was going when I swam!

The habit of counting strokes had become ingrained, second nature by that point. To this day, I count each and every arm entry. I know how many it takes to go 25 yards, 25 meters, 50 meters, all the way up to (wait for it) 2000 meters. It happens automatically in the background of my consciousness. I can sing songs, plan trips, even do arithmetic while swimming, and not lose count. One of my many useless skills of which I am quite proud.

The same time swim goggles appeared, I fell in love with skiing. My sister had waitressed in Sun Valley over Christmas break, and the next year, my father, an inveterate sportsman, dragged the whole family out to visit her and learn how to ski. He got hooked, and six months later, purchased acreage in the new resort of Snowmass-at-Aspen. I’ve spent the last 54 winters there, learning where each tree, gully and drop-off lurk.

Our first winter skiing at Snowmass, I learned how falling snow could cloud our vision while schussing down hill. Ski goggles existed, and worked well to keep wind from making eyes tear up and the sun from blinding them. But their single pane construction and lack of ventilation meant internal fogging during a snow storm. Not only did they fog up, but the cramped space behind the goggle lens crimped my glasses, to the point I was better off skiing with nothing at all.

About the same time as Speedo developed modern swim goggles, Bob Smith, a Sun Valley orthodontist, revolutionized ski eyewear. First, he made the goggles bigger, to accommodate glasses. Second, he used foam across the top, letting air flow in while keeping snowflakes out. Third, he added a second lens. Double pane construction altered the temperature differential between the outside and inside, reducing the chance of fog. This was a miracle. I now could see as well during a snowstorm as on a bright sunny day.

Hooked on powder skiing, I spent the winter after my medical residency skiing every day in America’s Mecca for deep snow, the Champagne Powder of Utah’s Little Cottonwood canyon. By that time, some goggles had internal fans, even better at clearing out moisture.

Smith couldn’t eliminate all disruptions to visibility.  Powder flying back at me – “face shots” – became an occupational hazard that winter. I learned that, just like swimming, perfect vision is not mandatory for an accomplished skier. On a slope where I know every turn, when the snow covers all obstacles, and is so deep I reach a terminal speed, it is possible to let my legs do the driving.

********

For medical school, we were told to buy a microscope. With my thrifty father, raised in eastern Montana during the Great Depression, I headed downtown to a store specializing in lab equipment. He steered me to the “Used” section, where I found a monocular scope, two-thirds off. Planning to become a psychiatrist, I suspected I would have little interest in spending time staring at slides of organ slices stained purple.

Arriving on campus, most of my classmates brought with them shiny new binocular scopes, which to me are four times as hard to see through as my single lens scope. Not only do I have to dial the scope up and down, but also move the two eyepieces the correct distance apart, as well as adjust the focal length of each, while fiddling once again with the depth of field. I learn that my two eyes are sufficiently disparate in their acuity that I am unable to get all the adjustments to line up sufficient to eliminate a persistent sense of double exposure. And wearing  glasses makes it even worse. (I have the same problem with binoculars.)

But I discover during these frustrating forays into the world of illuminating tiny, unseen vistas that, with my naked eye, I see best close-up. Anything between three and seven inches becomes enlarged, sharply focused. Removing tiny screws from a watch back, excavating splinters no one else can see, and reading the finest print, illegible to most – these are my superpowers. As the years go by, and presbyopia worsens for us all, I have not lost this skill.

I am fearful that one day, I’ll visit the optometrist, and she’ll tell me I need cataract surgery, that my worn and cloudy lenses must be replaced. If that happens I will lose the the one advantage I gain with severe myopia.

********

My struggles with vision include managing the multiple devices I accumulate to help me see. A partial inventory starts with three pairs of glasses which now contain outdated corrections, and which I should throw away. But I labored too long finding just the right frame, to say nothing of the money spent procuring them, to toss them in the garbage. So now they sit, dust-covered and stained from sweat, in the bottom bathroom drawer.

Then there is the multitude of “sunglasses” which I am continually buying and sometimes throwing away. The problem started when I returned to cycling, and needed protection from the wind as well as sunlight. Bike commuting through the city, danger might come from the rear, from cars behind as well as all around me. So I purchased tiny mirrors to place on the left lens, which required  shades with the correct curvature to allow me to spy on whomever might be sneaking up behind me. They also came in handy in triathlons, in which referees roam the course on silent motorcycles looking for racers who are too close the athlete in front (drafting is not allowed.)

Living in the not-always-sunny Pacific Northwest, I need lenses to better see when biking in fog, rain, clouds, deep forest, or at night: clear, yellow, brown, reflective. Then there is the dilemma when hunched-over in the “aero” position (“time-trial”). Normal frames block the view forward, so glasses without an upper element to the frame are mandatory. This problem was “solved” a few years back when snap on visors were introduced to aero helmets.

I grew tired of changing lenses each time I went outside, so I invested in “transition” sunglasses, which start out clear and darken when exposed to the sun’s radiation. I have two with a lower bifocal section (these I use for cycling and running), and two without (for driving when I wear contacts with one near vision lens), all the same brand and style. I have one pair of standard dark lenses with a bifocal section.

And skiing – visibility is even more critical (despite my earlier protestations to the contrary) than when biking. So ski goggles must come with at least three interchangeable lenses: yellow, and rose for differing low-light conditions, and several shades of dark for the intense or angled sun on clear days in the spring or dead of winter.

By now, I’ve lost count of the various “glasses” I have just for the sports I do. The rest of the time, I rely on (sigh) four more. I own two classic pairs, one with transition lenses, and one without. There are contacts, a different one for each eye, one “near”, one “far”, and another set for seeing well beyond five feet (but not close up). In the latter case, I have three  reading glasses. One is shaded blue-grey, to reduce computer screen glare. Another regular pair, +2.75. And the third, my favorite, has a progressive bifocal correction – the lower down I look, the closer I can see.

So adding them all up: four pair transition sunglasses; one bifocal sun; five standard sun; two helmet visors; two ski goggles; four swim goggles; three different sets of contacts; two standard glasses; three readers. Twenty four different ways to view at the world, and those are just the ones I routinely use. Every time I open a drawer, there’s a chance I might find a buried set of something from another epoch of my life.

********

Even with two dozen or so aids for my eyes, I still have little confidence that I can recognize and discern what I’m looking at (except for those three to seven inches right in front of me.) I often joke, “Vision is highly over-rated.” If it were all that important, why do we have eyelids? Any time we want, we can shut out the light of the world, return to our thoughts and other senses.

Take hearing, for example. We don’t have shutters for our ears; we are continually bombarded with oscillating air pressure, converted to physical vibrations of ear drum and three little bones, then to nerve impulses and finally, interpreted by our brain as “sound”. Unlike sight, it’s always there, ready to intrude.

In addition to my close-up vision super power, my hearing is also quite acute. I’m always having to tell other people what was said, on TV or in real life. It’s as if, in those years before my vision was corrected, the visual cortex in my brain gave part of its space to auditory reception and interpretation. While not as potent as a blind person’s hearing, I do find myself relying on my ears as much as my eyes.

When cycling in a group, I get a little irritated when someone behind calls out, “Car back!” Yeah, I know, I think. Been hearing that for 20 seconds now.

I often wonder what my life would have been like, had I lived 200 centuries ago. Would I have been picked off early by a pack of wolves I never saw, or would I have saved my clan, hearing them sneaking up on our camp before anyone else?

I close my eyes, and see myself sitting by a fire as the sun sets behind the bushes, wrapped in a musty wolf skin. I tilt my head back, eyes closed, and shake the thinning grey hair off my ears. Children and grandchildren surround me, waiting for the word.

“It’s quiet tonight. Go sleep in peace, I’ll keep my ears open for you.”

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Trust, But Verify…And, Why Unions?

No question each of us should learn all he can about his body. It’s all we have, and without it working well, life is shorter and messier. Some guys pay more attention to their cars or computers than their body.

********

Sheesh, lighten up, folks.

A lot of comments disparaging unions and the workers who want them. Especially about lower wage workers who haven’t settled down yet.

Seems to me people in these kinds of jobs feel powerless to control their work life — when they come in, what they’re told to do, etc. Yeah, that’s the way of the world down there at the bottom of the pyramid. So maybe pushing for a union gives one a sense of purpose and control, along with a feeling of belonging.

There’s power in numbers, when people organize. Maybe that’s what y’all are afraid of, why you want to deny the strikers any sense of agency in their lives.

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I Can See Clearly Now – IV

For medical school, we were told to buy a microscope. With my thrifty father, raised in eastern Montana during the Great Depression, I headed downtown to a store specializing in lab equipment. He steers me to the “Used” section, where I find a monocular scope for one-third the price of new. Planning to become a psychiatrist, I suspect I will have little interest in spending time staring at slides of organ slices stained purple.

Once I get to school I discover that most of my classmates have brought with them shiny new binocular scopes, which to me are four times as hard to adjust as my single lens scope. Not only do I have to dial the lens up and down, but also move the two eyepieces the correct distance from each other, as well as separately adjust the focal length of each, while fiddling once again with the depth of field. I learn that my two eyes are sufficiently disparate in their acuity that I am unable to get all the adjustments to line up sufficient to eliminate a persistence sense of two, not one images. And wearing my glasses makes it even worse. (I have the same problem with binoculars.)

But I do discover during these frustrating forays into the world of illuminating tiny, unseen vistas that, without my glasses, my vision is keenest closest to my eyes. Anything between three and seven inches becomes enlarged, sharply focused. Removing tiny screws from watch back, excavating splinters no one else can see, and reading the finest print, illegible to most – these are my superpowers. As the years go by, and presbyopia worsen for us all, I have not lost this skill.

I am fearful that one day, I’ll visit the optometrist, and she’ll tell me I need cataract surgery, that my worn and cloudy lenses must be replaced. If that happens I will lose the one bright spot in my struggles with severe myopia.

The struggles include managing the multiple devices I accumulate to help me see. A partial inventory starts with the three pairs of glasses which now contain increasingly outdated corrections, and which I should throw away. But I spent labored too long over finding just the right frame, to say nothing of the money spent procuring them, to simply toss them in the garbage. So now they sit, dust-covered and stained from sweat, in the bottom bathroom drawer.

Then there is the multitude of “sunglasses” which I am continually discovering and sometimes throwing away. The problem started when I returned to cycling, and need protection from the wind as well as sunlight. Bike commuting through the city, I needed to be aware of cars behind as well as all around me. So I purchased tiny mirrors to place on the left lens, which required discovering shades with the correct curvature to allow me to spy on whomever might be sneaking up behind me. They also came in handy in triathlon races, in which referees roam the course on silent motorcycles looking for races who are riding too close the athlete in front (drafting is not allowed.)

Living in the not-always-sunny Pacific Northwest, I needed various shades of lenses to better see when biking in fog, rain, clouds, deep forest, or at night: clear, yellow, brown, reflective. Then there is the problem of riding in a hunched-over “aero” position (“time-trial) when racing triathlon. Normal frames block the view forward, so glasses without an upper element to the frame are mandatory. This problem was “solved” a few years back when snap on visors were introduced to aero helmets.

I grew tired of changing lenses each time I went outside, so I invested in “transition” sunglasses, which start out clear and darken when exposed to the sun’s radiation. I have two with a lower bifocal section (these I use for cycling and running outside), and two without (these for driving when I wear contacts with one near vision lens), all the same brand and style. I have one pair of non-transition dark lenses with a bifocal section.

And skiing – visibility is even more critical (despite my earlier protestations to the contrary) than when biking. So ski goggles must come with at least three interchangeable lenses: yellow, and rose for differing low-light conditions, and several shades of dark for the intense or angled sun on clear days in the spring or dead of winter.

By now, I’ve lost count of the various “glasses” I have just for the sports I do. The rest of the time, I rely on (sigh) four more types of glasses. I own the two classic pairs of, one with transition lenses (darken in the sun), and one without. There are contact lenses, both for near vision (a different one for each eye, one “near”, one “far”), and a set for seeing well beyond five feet, but not close up. In the latter case, I have three additional types of reading glasses. One which is oddly shaded, supposedly to reduce computer screen glare. Another standard set, correction +2.75. And the third, my favorite, are readers with progressive bifocal correction – the lower I look through them, the closer I can see.

So adding them all up: four pair transition sunglasses; one bifocal sun; five standard sun; two helmet visors; two ski goggles; four swim goggles; three different sets of contacts; two standard glasses; three readers. Twenty four different ways to look at the world, and those are just the ones I routinely use. Every time I open a drawer, there’s a chance I might find a buried set of something from another epoch of my life.

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I Can See Clearly Now – III

In 1960, I joined a summer swim team, at age 11. We practiced Monday through Friday, June through August. Swimming laps for over an hour in chlorinated water left our eyes red and blurry when we got out. In addition, I could see no better underwater than above, so I was continually surprised when I would arrive at the wall to turn around. I began to count my strokes so I would know when the wall was coming up. I was never a very good swimmer; I collected a shoebox full of red (2nd place) and white (3rd) ribbons from dual meets which usually featured four to six swimmers in each event. Larger meets, the end-of-the-season championships, left me watching the finals from the stands.

But I was surrounded by outstanding swimmers. I swam with collegiate champions, NCAA winners, and Olympic gold medalists. Through them, I lived vicariously, as they suffered through year-round two-a-days, miles and miles each week which turned their hair a bleached gold/green, and their eyes a constant blood-shot red. In 1969, those who had qualified for the USA national championships in Louisville returned with not only the usual swag of tee-shirts and caps, but strange, dangly objects which looked like translucent versions of the eggs Silly-Putty came in, cut apart with the two halves held together by large rubber straps. These were the very first swim goggles, which are ubiquitous today.

For the elite swimmers, this enabled them to practice even longer without the eye irritation which had plagued them. And goggles gave me a new world under water. For those of us with severe myopia, some prismatic combination of the refractive properties of plastic looking through H20 produces a miraculous correction. Everything becomes visible, at distances of 50 meters or more. I could finally see where I was going when I swam!

Unfortunately, the habit of counting strokes had become ingrained, second nature by that point. To this day, I count each and every time an arm enters the water. I know how many it takes to go 25 yards, 25 meters, 50 meters, all the way up to (wait for it) 2000 meters. It happens automatically in the background of my consciousness. I can sing songs, plan trips, even do arithmetic while swimming, and not lose count. One of my utterly useless skills of which I am quite proud.

The same year swim goggles appeared, I fell in love with skiing. My sister had waitressed in Sun Valley over Christmas break one year, and the next, my father, an inveterate sportsman, decided to drag us out to visit her and learn how to ski. He immediately got hooked, and six months later, purchased acreage in the new resort of Snowmass-at-Aspen. I’ve spent the last 54 winters there, learning where each tree, gully and drop-off hide.

Our first Christmas there, I quickly learned how falling snow could cloud our vision while schussing down hill. Ski goggles existed, and worked well to keep wind from making eyes tear up and the sun reflecting off the snow from blinding them. But the single pane construction and lack of ventilation meant internal fogging when clear vision was needed most – during a snow storm. Wearing glasses, as I did, made things doubly worse. Not only did they fog up as well, but the cramped space behind the goggle lens crimped my glasses, to the point I was better off skiing with nothing at all.

About the same time as Speedo developed modern swim goggles, Bob Smith, a Sun Valley orthodontist, revolutionized ski eyewear. First, he made the goggles bigger, to accommodate glasses. Second, he used foam across the top, to allow some airflow without letting snowflakes in, Third, he added a second lens. Double pane construction altered the temperature differential between the outside and inside, reducing the chance of fog. This was a miracle. I now could see as well during a snowstorm as on a bright sunny day.

I became hooked on powder skiing, eventually spending the winter after my medical residency skiing every day in America’s Mecca for deep snow in the Champagne Powder of Utah’s Little Cottonwood canyon. By that time, some goggles had internal fans, even better for reducing fog.

The goggles couldn’t eliminate all disruptions to visibility. Fog, deep snow flying back at me – “face shots” – became an occupational hazard that winter. I learned that, just like swimming, perfect vision is not mandatory for an accomplished skier. On a slope where I know every turn, when the snow covers all obstacles, and is so deep I reach a terminal speed, it is possible to let my legs do the driving.

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I Can See Clearly Now – II

The year before, I had not missed one day of school. A model student, I rarely had disciplinary encounter with the dreaded Assistant Principal, who was reputed to have drilled holes in his paddling board. When I went up to retrieve my crystal after class, the teacher told me, “I’m going to have to report this to the Principal’s office, Albert.”

But no visit ensued. Several days later, my mother announced I was not going to school that day. Instead, we went downtown, to the Carew Tower, where a white-coated man with thinning grey hair combed over his shining scalp smiled as he reached out to shake my hand. “Can you show me that watch crystal, Albert?” he asked.

I quickly excavated it from the case, and handed it over.

Lifting his wire-rim glasses to his forehead, he turned it over several times, humming a bit while he investigated it’s mysteries. “So, this helps you see writing on the blackboard?”

I nodded, still unsure whether this was some fearful extension of the Principal’s office. The room was filled with frightening objects: a black leather chair facing a heavy set of metallic circles suspended from the ceiling, jars filled with clear liquid holding little wands with round lenses on the end. I couldn’t imagine what torture they might have in mind for me.

“Can you sit in that chair for me?” I dutifully climbed up and raised my hands up to the arm rests.

“What’s the first letter you can read on that chart?” he said, pointing vaguely in front of me.

“What chart?” I said.

The man sighed, and swung the metallic circles in front of my face. “Look through those holes there, please.” He clicked several levers, and pieces of glass fell into each hole, right in front of my eyes.”

“Now?” he asked.

“Wow!” I said. That’s an ‘E’!”

********

After that, another dimension opened for me in school. Sporting a pair of glasses in a blue translucent frame, I found the tasks each day much easier to accomplish. So easy that I got bored, and my grades plummeted. A “D” in handwriting – why bother trying to make it neat anymore, I can see what I wrote just fine now! A “C” in Social Studies, another in Art. Several months later, while I was home “sick”, my parents announced, “When you go back to school next week, you’ll be in the 4th grade.”

And that spring, returning to the “Knothole League” baseball games, I found that getting a hit was more than (literal) blind luck. Before, my wild swings at the blurry baseball rarely succeeded. Now, I had a fighting chance. As long as I kept my glasses from breaking.

My eyes kept deteriorating, and every year, I needed another exam, and another trip to the Wenstrup Brothers optical shop for a new set of lenses. Sometimes, even a new set of frames, as my face grew with the rest of me. By the time I got in the ninth grade, I discovered the wonderful games I could play simply by taking off my glasses. In the car at night, oncoming headlights became, not blurs, by stellate discs, multiple bright spikes radiating from a central core. At a distance, one bright spike, much longer than the rest would start out pointing east. As a car came closer, the bright line would slowly rotate until it pointed due north as the car passed by. Cool!At the annual Christmas pageant, while everyone else listened to the choir warbling through carols, I would take off my glasses and contemplate the tree on stage. What had been many flickering pinpoint dots of light wrapped around the green fir branches, now became a phantasmagoric scene of overlapping blurs, red, green, white, and blue. Blinking my eyes, they’d starts to dance and smear into one another. Very cool!

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I Can See Clearly Now – I

My paternal grandfather, Al, died when I was in the third grade. Born and raised in Miles City, Montana, he’d been through many incarnations in his 76 years. Deputy Sheriff in Custer County, banker in Omaha, steel worker in Seattle, retired in Hayward, California. I remember him mostly as a gruff, barrel-chested man who helped my father remodel our dank, concrete floored basement.

Together, they laid vinyl tile over the concrete, making the design of a checkerboard and a shuffleboard court for indoor gaming. A stone fireplace filled half of one outside wall, just below ground-level windows. On either side of the masonry, my father placed a framework of two-by-fours, over which he nailed knotty pine siding. Grandpa Al’s job was to stuff fiberglass insulation into the cavities behind the siding and between the studs.

He wheezed a lot while he was doing this. A smoker all his life, my dad said he had emphysema, which slowed him down a bit. Slow enough that, a few months later, my father flew out to the Bay area to visit Grandpa in the hospital. Two weeks after that, he made a return visit for the funeral, bringing back with him several mementos for my sister and I. Mine was Grandpa Al’s Hamilton watch, gold-plated, with a rectangular face and Roman numerals. I proudly slipped the metal stretch band around my wrist and wore it to school, now independent of the wall clocks.

A few days later, bored in class while the teacher wrote sentences to copy on the blackboard, I slipped the watch off, and began to fiddle with it. After winding the stem to keep it active, I pulled the case back over my hand, and discovered the crystal was loose. Giving the edges a couple of mild tugs, I popped out the crystal. Looking carefully at it, the glistening reflections coming off the concave inner surface intrigued me. I held it up to my eye, and looked through it at the words written on the blackboard.

I could actually read them! Up to now, I had been listening to her as she read them out for us, memorizing them so I could reproduce them in my cramped, sloppy handwriting on the lined exercise sheet. Being able to see the sentences saved time and I finished way before my classmates, owing mostly to my lack of care in trying to write neatly. In the idle time while the rest of the class struggled with the long-hand, I continued looking through the crystal at objects around the room. The globe came into sharp relief; the alphabet, in capital and small black blocks above the blackboard, were now dark and clear, no longer fuzzy suggestions of letters.

“Albert, what are you doing!” I looked up to find the teacher hovering at my desk. “Let me see that. What is it?”

I tried to explain about my grandfather, his watch, the loose crystal, and the sudden clarity of my vision..“Give it to me. You can pick it up after class.”

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