Re-Building the Cuckoo’s Nest

One thing I learned working on the jail ward at LA County Hospital: do not attack a police officer with a weapon (or even your fists). They and their cohorts will ALWAYS respond with overwhelming, unrelenting force. They are armed, organized. determined to and legally allowed to defend themselves. Most of the young men admitted to that jail ward either didn’t know, had forgotten, or chose to ignore that obvious truth.

This unfortunate truth on occasion causes grave harm to young men with mal-functioning brains (“mental illness”). The solution is not to disarm police, but to return to a system where such individuals can more easily be kept apart from the rest of society, for everyone’s safety. Closing mental hospitals in the 60s and 70s after the introduction of effective anti-psychotic medications was a BIG mistake, in retrospect.

Mental Hospital, Insane Asylum, Booby Hatch, Funny Farm – whatever the moniker, they were an accepted part of life as I was growing up. My mother, during her pursuit of a doctorate in clinical psychology, worked for years in the ‘60s at the Rollman Psychiatric Institute in Cincinnati. The summer after my college freshman year (1967), I worked as an intern on the men’s inpatient psychiatric ward at Cincinnati General Hospital. Ken Kesey wrote “One Flew Over the Cuckoo’s Nest” in 1962; the movie version appeared in 1975.

Such places were dehumanizing warehouses. Initially developed in the nineteenth century, they served to isolate those whose brains malfunctioned from the rest of society. Inmates were kept safe from their inability navigate the simplest tasks. Other people were kept safe from the afflicted’s lack of social grace. By hiding them away often behind locked doors, they had less opportunity to act on whatever random uncontrolled anger or fantasy prowled through their consciousness.

Two current dilemmas stem from the unwillingness of society to lock away people who are unable to manage the chaos which erupts in a disordered brain. A small percentage, after gaining access to deadly weapons, strike out, sometimes killing others. A larger number, but still small compared to the population of “mentally ill”, are unable to construct a stable life. They appear in tents along city backroads, disrupting the feeling of civility in crowded cities.

I don’t know if locking away those who can’t or won’t take the drugs which might help them, or those who have lost the support that family, a job, or a social network might provide is the, or even an answer. I suspect we need to try something to bring them back into our world.

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Give Me A Head With Hair

“Gimme a head with hair, Long, beautiful hair”

March  18, 2020…For a week, it had been one “WTF?!?” moment after another. Sports leagues shut down. Colorado abruptly closed its ski areas. The French stopped eating in restaurants, even on the sidewalk. Schools closed, universities sent students home. Microsoft and Amazon shuttered offices. Public health physicians advised everyone to stay home, except for “essential” services: life-and-death doctor visits, grocery and medicine shopping. We heard it might be a year or more before a vaccine protecting against the “novel coronavirus” would be available.

I had finished my skiing for the season, time for the barber to trim my hair, now that I no longer needed it to stay warm on the slopes. Back to swimming and sweating while preparing for another triathlon season, I valued shorter locks for the comfort and ease provided.

            “Think I’ll stop off for a haircut after the pool tomorrow morning,” I told Cheryl.

            “Wait, is it safe to go in the water, to the Y? They’re saying stay away from gyms and everything,” she noted. “And barber shops – are they ‘essential’?”

            “I’m not worried – won’t the chlorine kill any virus? I mean, you’re underwater, more than 6 feet away from anyone. I think I’ll be OK.”

            That night, our governor, who had declared a state of emergency less than three weeks earlier, issued orders for all those “non-essential” businesses to close up shop. No Y, no gym, no barber.

            Sitting in front of the computer, digesting the news, I called Cheryl over, and asked her if she would cut my hair now, just for the emergency. She stared back at me, a beguiling smirk warding off any further pursuit of something she’d been refusing since 1975.

            “You can let it grow a little, can’t you?” She tousled my hair, mussing my careful comb job.

            I grumbled, trying to make the two inches up top look presentable again. From nowhere, inspiration hit. “That’s it. I’m not going to get a haircut until I’m vaccinated,” I announced.

            “Good. I like it long. All these years, short for surgery, then for triathlon – you look better now.” She reached out for another flick at my head, which I quickly dodged.

            Inspired, I added, “Or I may die with a pony-tail!”

            She cocked her head, imagining me with hair flowing down my back. “Just like Willie Nelson,” she mused.

*******

Class pictures from Kindergarten through third grade show me with very short hair, sometimes long enough to lie flat, sometimes bristly short. My father had grown up having his hair cut in his family’s ranch-house kitchen in eastern Montana during the ‘20s and ‘30s. A couple of years at the Naval Academy accustomed him to the 90-second plebe cut featured at Annapolis. An upside-down economy during World War II and a wife willing to help save money by learning barbering skills solidified his belief that haircuts looked best when done at home.

            At first, my mother tried to corral me into keeping still long enough to let her cut my hair. But mothering is hard enough without worrying whether you’re going to snip off your son’s ear. My father went out and bought a new hair care set, including scissors with a little curved finger rest, two types of combs, scissors with teeth for getting those recalcitrant cowlicky hairs out of the way, and, most important, an electric clipper, and took over the job.

            By the time I was four, I’d learned that my parents did not have total control over all my thoughts and deeds, so I began rebelling when I got the chance. Saturday mornings, every month or two, in the kitchen with a vinyl drape around my neck, I’d squirm, fidget, and complain enough that my father, to avoid smacking me up-side the head, began five years of buzz-cuts for me with those clippers. Just like in the Navy, a minute and a half, and we’re done. It took more time to sweep the floor afterwards.

            With short hair, I sometimes marveled at the brush cut then popular among American males of all ages. In its most elegant incarnation, the “flat-top”, the hair stood straight up, creating the appearance of an even, not rounded, surface. Popular among army sergeants and football linebackers, it evoked aggressive virility, a snarl in place of a hat. Even Elvis Presley, once drafted into the army in 1958, lost his forehead curl and joined the crew-cut set. I never had the courage to join their ranks, afraid I might not have the swagger necessary in my walk. Our President then, Dwight Eisenhower, was bald, and it seemed that flowing locks seen in 19th century tin-types would become a relic of our past, swept away by desire for a clean, sleek, modern head of hair.

            Luckily, John F. Kennedy become President in 1961, and the Beatles led an English Invasion into American music. The mop-top slowly, inexorably adorned the covers of magazines at grocery story check-out lines and sofas next to talk-show hosts. Once again, I yearned to be a part of the tonsorial trend. But my father’s haircuts, and my budding avocation as a competitive swimmer stunted that desire. Yearbook photos show me with a little flop across my forehead, but naked ears and exposed shirt collars. My one nod to flaunting my hair came with that chlorine sheen from hours in the pool, bleached gold from summer days in a lifeguard chair.

            Fall, 1970, I moved permanently to the West Coast, Southern California version. Flower power was in full bloom, and my father was two thousand miles away. My hair, fertilized by the LA sun, revealed a curl as it grew, over my forehead, across my ears, down my neck. Infrequently, I chanced a visit to an actual barber, daring to look a little more like the locals, many of whom were sporting pony tails or radiant spheres of wiry growths, emulating Afros. I found a girl with long hair of her own, and after falling in love and moving in together, hoped she would take over the task of shearing my unruly locks.

            She tried it a couple of times, and then said, “No. Never again. Not me. I won’t do that anymore. You should go to a good barber, your hair is so beautiful,” Cheryl insisted. Since I wanted to keep this woman close to me for the rest of my life, I acquiesced, at least to having her as my barber. Photos from that era show me on occasion with a head band, ears hidden, the collar of my white doctor’s coat tickled by wavy brown strands. Cheryl seemed pleased, both with avoiding haircuts in the kitchen, and having a boyfriend with a lot of thick, alluring hair. 

Under her influence, wispy hairs on my chin and upper lip began curling and darkening into a fuzzy goatee and a moustache mimicking my bushy eyebrows.

My father, meanwhile had retired and begun to cut his hair himself after my mother suffered a stroke and couldn’t wield scissors anymore. His greying hair began to creep over his ears and down his neck.

*******

            I graduated for the fourth, and last, time, in 1978, from residency, and prepared to enter the Real World. We moved from LA to Utah. After a winter skiing every day in the local Wasatch mountains, I undertook a search for a real job. As a Doctor. I did not have the self-confidence to present myself looking like a rock star when meeting the older physicians who would judge and employ me, so I went back to the well-trimmed look of a TV news presenter. My neck re-appeared, exposed to the searing summer sun, and began to itch. We married in August, and I moved to the pacific Northwest.

            “You’re so young! How can you be a doctor already?” I heard more than once from patients in my office. Keeping my hair above my ears provided a shot of confidence that I wasn’t a fraud, a callow youth without skills, knowledge or experience, undeserving of respect or trust. The arrival of first one, then another child reinforced my inner need to appear more mature. Even if I didn’t always feel like a parent, I could at least look the part.

            Soon, the other physicians in my 1000-member medical group began to look to me to help lead and guide our fortunes. I met with CEOs and politicians, journalists both print and video, traveling across the country to represent our group as health care reform and competition buffeted our lives. This, along with kids and patients, conspired to reinforce my monthly visits to the barber. Cheryl’s golden locks retreated into a bob as our third baby entered our home. Our hippie days faded, forgotten under the weight of Responsibility.

            By 1990, I’d advanced to the top leadership position in the health care organization I served. Seeing patients once or twice a month became a hobby, not a profession. Grey hairs appeared first on my face, then temples, a sign of my medical wisdom. Seven years at the top of the heap turned my head from golden brown, to deep brunette, now salted with signs of age.

*******

            If I couldn’t, or wouldn’t, let the hair on my head erupt past my ears or start curling above my suit collar, at least I kept the fuzz on my face. Neatly trimmed like their cousins on my scalp, the wiry growth around my mouth and along my cheeks served as a link to my fading counter-cultural past. It also hid a weak, receding chin. In 1997, I retired from the executive office, and sought a clean break from the past 15 years. Our family loaded up a Class C RV, drove to Plymouth, MA, and spent the summer slowly traveling west, 50 to 100 miles a day. I bicycled the whole way, joined much of the time by Cheryl on her own bike, and less often by Shaine or Annie with me on our tandem while Cody, newly 16, drove.

            By the time we reached Indiana, and a stop with Cheryl’s parents in their home towns, I felt I could safely shed the beard and see what my face looked like after 25 years under wraps. While I was at it, I also trimmed my hair to a ¼ inch stubble, knowing I had 2 months for it to grow back before I had to face patients again. Once back home, I began commuting on my bike several times a week, and took up triathlon racing. The constant swimming, the daily mashing of my hair from a bike helmet or a surgical bonnet, the sweating from running all made the short look practical. I bought a hair trimmer, and every few weeks set it at 3/8” or ½”, enjoying the feathery feeling of hairs falling on my shoulders, down my back, tickling my feet.

            Spending much of my free time with other cyclists, swimmers, and runners, I felt comfortable blending in amongst the other members of my tribe, starting at the top. Serious triathletes all sported military-grade haircuts. Several times I felt doubts about the look. One year, the winning professional racer at Ironman Coeur d’Alene came across the line in 90 degree heat trailing a foot-long braided pony tail under his running visor. I envied his statement, but feared standing out in our insular world. As I kept trying to qualify for the legendary Hawaii Ironman, in the summer of 2005, I decided letting my hair grow until I did would be supremely motivational. Two months later, I managed the feat, and promptly visited a barber for the first time in years. I kept going back every two months, until SARS-CoV-2  invaded the human race.

*******

            “Look at us…we’ve gone feral!” Cheryl said.

In September, we had embarked on our “Apocalypse 2020 tour.” We left on a cloudless Indian Summer day, heading south to the Oregon coast. Fires had flared up in the Tacoma suburbs the day before, fueled by a treacherous Chinook wind. We cleared the smoke by the time we hit Olympia, and cruised across the Columbia. An hour later, visibility dropped to 100 yards as we entered outflow from the fire zone which had suddenly erupted in the Coast Range to our east. Meandering through Oregon, California, and Nevada, we kept trying to out run the smoke, and found relief in Colorado’s high country.

            Up at 10,000 feet, we rested on the porch of a trekking hut on the trail between Ashcroft and Crested Butte. In the smudged window pane, our reflections revealed wild hair, mine below my ears, curling at the ends, Cheryl had missed her hair cuts for six months now, with bangs fluttering over her eyes.

“I think we look pretty good,” I replied.

She nodded, and asked, “So, are you going to get a haircut when you get vaccinated, like you said?”

Operation Warp Speed had taken off, and testing looked promising.

“They say the shots should be ready by the end of the year?” she ventured.

“I don’t know, I think I look kind of good. Remember, I said, ‘until I get vaccinated, or I might die with a pony tail’.” When I had said that six months earlier, I’d meant it as a comment on how long the vaccination development process usually took. It had been 40 years since we’d first heard of AIDS, and still no vaccine on the horizon.

“I like it,” Cheryl said. “You should let it grow, see what happens.”

And so I did.

Now four years later, my hair drapes across my shoulders, reaching to the base of my scapulae. Unfurled, it can be a warming blanket around my neck on colder days. In a pony tail, the wavy curls spread out below the rubber band encircling them. On either side, long strands of white erupt from each temple, fading into grey and brown.

Friends and family don’t notice my luxurious locks. Amongst the public, though, I present range of possibilities. It’s hard to categorize me on first glance. Am I an ex-hippie, nostalgic for the days of tuning in, turning on, and dropping out? Or maybe I’m a sensitive creative type, a sculptor or poet? What about a retired professor, ready with an erudite well-enunciated observation on life’s grand problems? Possibly a WWE pro wrestler, or more likely, a fan. I could be a motorcycle aficionado, roaring down the back roads on my Harley, pony tail flying out from under a helmet festooned with skull and crossbones. I imagine myself a right-wing fanatic, ranting about “fiat currencies and implanted microchips”. I contain multitudes.

I also notice other people’s hair now, the various types, lengths, and styles. There is straight hair, each strand the same, all flowing and flapping together. Wavy locks, or tightly coiled. Wiry natural ‘fros. Ironed, processed, permed…it seems no one is satisfied with their hair. If it’s straight, folks try to curl it, maybe turn it into Shirley Temple ringlets. If it’s wavy, then straighten it. If it’s oily, dry it out; dry, given it a sheen with gel. Keep it short for ease of care, or let it grow, untouched, into Rasta mats. My own hair, I’ve discovered, starts out straight, then soon begins to coil, not tightly, but enough to give it a textured wave. I find myself envying those whose hair falls straight, or those tighter coils, or thicker, longer strands. At such moments I realize my hair is perfect. It shows who I am, in all my breadth and complexity.

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It’s Just Like Swimming a Lap

Thirteen years ago today, I swam for the first time after my near fatal bike accident on Sept 18, 2010. All my life, I’ve been swimming. I don’t remember learning how, nor do I have any memories of water fear. In elementary school, my sister and I always spent the first day of summer at the Golf Manor pool. Every hour, we got out of the water and sat along the edge, kicking madly while lifeguards strolled behind us, pouring chlorine granules over our feet. Lord knows what the dust we inhaled was doing to our alveoli. Then when it was deemed safe again (no litmus paper testing yet), we’d jump back in and splash around, getting joyfully sunburnt.

When I was nine, we drove across the country to California. In Pasadena, we stayed with my father’s long-time friend, Stan Mikulka. In addition to Marineland and Disneyland, we spent afternoons in Stan’s pool, frolicking around with his kids who were about our age. 8mm movies from the time show me breast stroking around, smiling as I chased his brood.

A year later, our family joined the Indian Hill Club, a member of the local Private Pool Swim League. My father promised me a transistor radio if I joined the swim team. I discovered some competency swimming breast stroke, and adopted swimming as my sport after winning a clutch of red (2nd place) and white (3rd) ribbons. Starting freshman year of high school, I joined the team, and followed suit in college, again always a bridesmaid, never the winner in the swim meets. But I gained confidence, strength, and camaraderie, and kept swimming in my life after graduation.

Once I moved to Venice with Cheryl, we went to the local high school pool whenever we could, and kept the regimen up after moving to the Pacific Northwest. It became a constant we did together, our thing. When I turned 50, and took up triathlon, that confidence served me well, as most amateur triathletes were even worse swimmers than I am.

I never gave my ability to swim a second thought, or even a first one. I was always able to jump in a pool any tine I wanted, and start swimming better than most people struggling through the water. All those laps from age 11 to 20 had cemented the motor memory and built an unconscious feel for the water.

The bike accident put me in the ICU for 12 days, during which time I lost 15 pounds. An injury to my spinal cord reduced the strength in my arms and shoulders. I had to wear a neck brace for 6 weeks, and spent over a month with a feeding tube in my stomach because I couldn’t swallow safely. Once freed from the brace and tube, I accompanied Cheryl to the pool one Sunday. Instead of the lap pool, I gingerly entered the heated recreation pool, which features two 25 yard lanes.

I stood waist-deep in the 90F water, leaning on the edge for support. Cheryl smiled encouragingly from the deck.

“Well, here I go,” I mumbled, and dropped beneath the surface, pushing off the wall as I’d done countless times before. I pulled against the water, tried pushing it back behind me, and felt…nothing. No power, no grip, no kinesthetic feedback telling me I had moved myself forward. I let me feet drop, and walked slowly to the other end, wondering if, once I got there, I’d be able to make it back.

After resting at the wall – the simple act of walking through water had exhausted me – I pushed off once more. The push gained me about a yard of forward motion. That, plus my own body length, left me 22 yards to go, an impossible distance. The other end was beyond the horizon of my ability. I swam a slow motion breast stroke, instead of the crawl I’d tried before. This produced some forward progress, mainly from my frog kick.

Usually, I could reach the other end in 10 strokes. As I passed 15, and found myself still five yards from the end, I dropped my feet once more. I slouched to the deck, and draped my arms over the concrete coping, my chest beginning to heave in concert with the tears welling in my eyes. I looked up at Cheryl, her smile jubilant.

“You did it!” she encouraged.

I tried to find a complementary feeling of satisfaction, but only saw a dark chasm where my swimming prowess once had been.

*******

A radical prostatectomy for cancer is notorious for its impact on genito-urinary functions. Without that gland, and other plumbing bits removed, urine drips, flows, or even gushes easily from the bladder. The nerves which stimulate erection are shocked into somnolence. Months, if not years, of rehabilitation can sometimes help, but a return to normal function is not guaranteed.

I armed myself with exercises and tools to re-awaken my equipment. Improving bladder function took about 3 months, with constant forward progress to reward my efforts.

Sex was another matter. I learned that separate nerve pathways control erection and ejaculation/orgasm. I also learned that men with a severed spinal cord can still make sperm, and ejaculate them during sex, despite being unable to create much less sustain an erection.

I began working on both processes. Within several weeks of the surgery, I successfully induced orgasm and the feeling of ejaculation with manual stimulation. This produced not only the usual pleasure, but also a meta-pleasure, that I was not totally broken, that I could enjoy some semblance of a sex life. The trick would be integrating it into my relationship with Cheryl. 

Breaking it down, I hoped to reawaken my ability to become erect, penetrate, and produce an orgasm. Up until my surgery, I had taken this all for granted, the anatomic, circulatory, hormonal, emotional, and neurological components involved. But as with swimming, I had always been able to perform, so never gave the details, much less the possible loss, any thought. Now I would have to break down that process, rebuild the components, and eventually put them together.

This also resembled what I had done with swimming, thirteen years before. I had to regain strength in my limbs. I had to figure out a way to grip the water having lost the use of several muscles in my right hand and forearm. (My right little finger would flop around while I pulled the hand through water; the angle of that hand would not stay perpendicular to the direction of my forward motion.) I literally retaught myself how to swim using my new body. Over the next year, I was successful enough to return to Ironman Arizona and once again win my age group. But I lost about 10% of my speed in the process – my times for swimming meters became the same as my time for swimming the equivalent number of yards had been.

It’s taken years for my brain and sense of self to adjust, but I no longer think about whether, or how I swim. I simply jump in and do it, a bit differently than before.

********

            I have gathered many tools and resources to help me on this journey. First among them is the love and tolerance of Cheryl. She has said two things which have sustained me. First, when deciding on treatment, she stated, “What I care about most is your survival.” Our new sex life would be what it would be, and she knew we would come to that the way we have approached everything – together. And, she acknowledged she did have an interest in the return, in some form, of that sex life: “It’s my penis, too!” Next, I found research studies and other resources which detailed specific ways to perform the required rehabilitation. Viagra, a vacuum erection device, Kegel’s exercises, a vibratory sex toy have all been essential. Finally, seeking out other men who have gone or are going through the same recovery journey has provided an emotional ecosystem in which to attempt and persist in my rehab.

********

            Over the last seven months, I have worked on re-building my sex life, usually alone, at times with Cheryl. Viagra daily for the first six months helped retain the neurochemical function in my penis. Five to ten minutes most days with the Vacurect pulled blood into the vessels essential for engorgement and erection so they did not atrophy. Stimulating orgasm in my flaccid penis helped the re-growing nerves regain their function. And playing in bed with Cheryl kept our tenderness towards each other alive. We used the drugs, the pump, the toy, and while penetration was possible, I could not link in the orgasm. It was too much like work, too artificial, not the playful fun it once had been.

            At my six month check-up with the surgeon, we discussed this a bit. I told him I still had not “put it all together”. We talked a bit about using penile injections to reliably produce an erection, to get us over the hump, so to speak. I said, no, I want to wait nine months after the surgery for that. I wanted to try and reconstitute what had once been unconscious, so natural, naturally.

            On Saturday, 30 weeks after the surgery, I popped a Viagra and 90 minutes later, we went to bed. No toys this time, just our skin and our hands and our love. An explosion shot from my inner thighs up through my face and head. I cried out in joy, as happy as I’d ever been.

         Fourteen months after the accident which almost ended my life, I was back in Arizona for that Ironman triathlon. I have a photograph of me crossing the line in Tempe, finishing that comeback Ironman victory. An ecstatic smile fills my face, my arms pointing skyward. I found what I had been looking for, and knew the future would once again reward me.

Posted in Injuries and Recovery, Prostate | Comments Off on It’s Just Like Swimming a Lap

Acupuncture…Hype or Hope

In today’s Washington Post: https://www.washingtonpost.com/wellness/2023/07/24/does-acupuncture-work-chronic-pain/

My comment…

The brain, with it’s 600,000,000,000,000 (six hundred trillion) synapses and mysterious spinal cord, is much more capable and complex than what our minds, which only use *some* of those synapses, can comprehend. I’m willing to keep an open mind. As a first-line treatment for anything, especially where we have known cures (like infections or fractures), well, that’s a probably not the best idea. But for those who’ve failed other treatments, acupuncture seems a low cost possibility. If it doesn’t work, little lost.

There are several commenters here who seem determined to debunk acupuncture. I wonder what is motivating their persistence?

Me, I’ve never tried it. I am a (retired) MD,  and tried to practice evidence-based medicine. I do not think acupuncturists are snake-oil salesmen or quacks. I know someone right now in a five-year training program. As well as learning meridians and points, they spend a lot of time on “western” anatomy and physiology. 

A lot of “alternative” health care practitioners provide value to their patients by simply spending more time with them, and taking their concerns seriously. That alone has a significant therapeutic effect which has been documented. Who doesn’t want a doctor with a good bedside manner?

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Brothers-of-Another-Mother

Seattle Congressional Representative Jayapal was quoted in the Times:

“I want you to know that we have been fighting to make it clear that Israel is a racist state, that the Palestinian people deserve self-determination and autonomy, that the dream of a two-state solution is slipping away from us, that it does not even feel possible,” Jayapal said to protesters. 

The comment was met with backlash from other representatives and some members of the public. Jayapal released a statement to “clarify” the comment, but did not apologize outright. 

“I do not believe the idea of Israel as a nation is racist,” she wrote. “I do, however, believe that Netanyahu’s extreme right-wing government has engaged in discriminatory and outright racist policies and that there are extreme racists driving that policy within the leadership of the current government.

My response: Aren’t “Jews” and “Palestinians” both brothers-of-another-mother, trying to occupy the same corner of the planet for the last three millennia? I doubt anyone alive today will see a solution, two-state or otherwise, to this age-old dilemma. That said, Jayapal all people should know the risk of painting anyone with the tainted brush of a charged word like rascist. Gasoline on the fire. Congressional representatives should always remember their words will be viewed as representing those who voted for them. What say you, fellow Seattle Democrats? 

Posted in Politics and Economics, Uncategorized | Comments Off on Brothers-of-Another-Mother

On The Road Again

Reporting in on my experience returning to cycling after a radical robot-assisted laparoscopic prostatectomy (RALP).

Prior to surgery 14 weeks ago, cycling was one of my passions as a 74 y/o. I’d done it all – mountain biking, multi-day trips, including across the USA, down the west coast, through mountains of BC, OR, WA, tandem riding with my wife and kids, commuting 20 miles round trip, and twenty + years of triathlons, including 35 Ironman races. So potentially losing it was probably as big a deal to me as penile dysfunction.

All the surgeons I consulted (3) said “no cycling for at least 3 months” after the RALP. The risk: the urethra needs to be sewn back together, and the perineum (between the scrotum and the anus) is where that repair is. It needs time to heal to prevent scarring up and causing problems.

For the past twenty years, all of my bike seats have had center cut-outs, useful to prevent numbness and infertility. The perineum has minimal pressure on it while riding as a result. The weight is carried on the “sit bones”, the ischial tuberosities. Still, I was leery of getting back on, worried about pain. I started with 15 minutes indoors, on a bike trainer. Next day, 45 minutes, then one hour 15 minutes outside, and then a 45 minute ride indoors, working harder. After this first week, I felt ready to go out riding with my weekly group, who tackle the mountains here in Washington. First ride: two hours biking on the road up up Mt. Rainier. Still no pain (except on those sit bones.) I was gruesomely tired, but did not have any soreness in my legs or pelvis.

I’m now starting my third week back, going a little harder each ride. Second road bike ride in the mountains was 2 hours 40 minutes, aiming for a bit more each week.

I’m a retired surgeon myself, and I knew better than to second guess the guy who was re-arranging my innards. I tried not to think about riding during the hiatus. Luckily, being a triathlete, I could still swim and run, so exercise was not a problem. My message to any serious cyclists who find this post: not cycling for 3 months is a significant side effect of the RALP. But given the proper equipment – a saddle which puts no pressure on the perineum – you should be able to get back out on the road. So far, I’m able to ride in the drops for minutes at a time, and on the trainer as well. I have yet to try my new pelvis off-road, which might be a bit more demanding, I want to get most of my fitness back before then. Right now, I’d say I’m at 65-70% of my pre-surgery level.

Posted in Injuries and Recovery, Riding a Bike | Comments Off on On The Road Again

Take Me Out To The Ball Game

The crowd erupted, a full-throated cheer echoing off the steel columns supporting the upper deck above us. I turned to my father, asking, “Why’s everybody excited?”

He pointed down at the field. “Kluszewski’s coming out,” he said.

Seven years old, in my first season playing knothole baseball, my father had taken me to my first major league game at Crosley Field, home of the Reds in Cincinnati. While I understood the rudiments of the game – nine men with gloves spread out over the impossibly green field, awaiting a swing from someone at home base with a bat – I was more interested in the ancillary activities which accompanied the actual play.

A floppy net hung above the fans behind home. Every time a batter hit a ball directly backwards, it shot up the net, slowly reached an apex, and then gathered steam as it rolled back down, to be caught by a young man in a sleeveless Reds uniform with no number on the back. As this happened, the crowd would hum in unison, a rising pitch as the ball rose up the net, then a reversal in tone as it fell back down, followed by a satisfying “pop” sound of ten thousand lips smacking when the ball boy caught it.

Men in white paper hats and floppy linen coats roamed the aisles carrying trays on straps over one shoulder. “Gitch yer beer here! BEER HERE!” they hollered, followed by the brand, “Hudie [Hudepohl], ice-cold Hudie!” A fan would raise his hand, the vendor would stop, lift a dark brown bottle from the tray, pop off the cap with a little opener he kept cradled in one palm, drop the cap in the tray, grandly pour the brew into a paper cup with a swooping up and down arc, spilling a bit of foam into the tray and beer onto the concrete steps. Then he’d hand the cup (no top) to the first person on the aisle, from who it would pass, one person at a time, to the thirsty fan, who sent a fifty cent piece (or sometimes a dollar bill!) back down the aisle. The vendor would pop the coin into a small set of metal tubes on his belt, push a clicker dispensing a quarter (or three) out, and pass the change back down the aisle. All three trips back-and-forth were intently followed by all eyes in that section, making sure the beer got to where it was intended, the money as well. You can imagine the complexity if more than one beer was purchased at a time.

While I couldn’t buy beer, I could get some peanuts. The men selling those cried, “Peanuts! Roasted peanuts!” Although I loved the taste of warm peanuts, and the joy of cracking open a shell, then licking the nut from within, grabbing a taste of salt as I did, my real reason for the purchase was to see how the vendor would toss it over to me. Overhand, underhand, a hook shot, behind-the-back – they had all the moves. And never missed their target. And, I got to participate in the ritual coin exchange as an endpoint, not just a conduit. The sound and feel of newly crushed shells beneath my feet meant the game was moving along, probably past the fifth inning by now.

Crosley Field was built in the early days of the twentieth century, before urban renewal tore down tenements and sweat shops which allowed a stadium to be any size or shape wanted. The Reds park had to fit within the confines of its awkward city block, defined by the street grid already there. Which made for an asymmetrical outfield wall, and fences closer in than most other parks. In addition, the underlying topography rose slightly from the infield to the outfield. The designers gave up on the re-grade, and simply built a slight slope towards the left field wall, starting about two-thirds of the way from the second-third base line. That left field wall extending out to center abutted directly on a street, with a three story factory on the other side. Weekend days, the roof would fill with fans who climbed the fire escape to watch for free. Over in right field, there was enough room for the about 20 rows of plank benches, the “bleachers”. In honor of Crosley Field’s distinction as the first host of night-time baseball in 1937, the area was called the “Moon Deck.” Day games, a tarp with “Sun” covered the first word. The bleacher stands featured rows which got progressively longer as they descended towards the field, creating a triangular space beyond the wall in right-center field, a no-man’s land occupied by the groundskeeper’s equipment. A vertical white line rose from that junction to the top of the center wall, with the admonishment, “BATTED BALL HITTING WALL ON FLY TO RIGHT OF WHITE LINE • HOME RUN”.

The Reds that year were filled with home run hitters, to better take advantage of the cozy fences, 322 feet down left, 384 to center, and 366 to right. They hit 221  homers in 1956, a major league record at the time. Their outfield of Wally Post (36), Gus Bell (29), and Frank Robinson (38) was particularly productive. Behind the plate, Ed Bailey hit 28. The double-play duo of Johnny Temple and Roy McMillan hit 5 between them. Robinson, age 20, was in his first major league season, and the first Black player for the Reds. He won Rookie-of-the-year for his home-run total, 120 runs scored, and 20+ bases stolen.

From 1953-55, the Reds’ first baseman, Ted Kluszewski, hit 136 home runs, a prodigious, almost Ruthian total. He kept that up in 1956, hitting 35, while batting .302 and driving in 102 runs in 138 games.

But he was not just a slugger. Kluszewski became the first and only player in Major League history to hit 35 or more homers in four seasons in which he had fewer strikeouts than homers.  Only three other major leaguers achieved the feat even twice: Lou Gehrig, Joe DiMaggio and Johnny Mize, all Hall of Fame members. He had a lifetime average of .300, and is still the all-time Reds’ leader in slugging percentage (0.692), OPS (1.049), and home runs per at bat (11.4).

Near the end of the 1956 season, he began having “back issues”. He took several weeks off to try and heal his “slipped disc”, finally returning to a pinch-hit role in September. It was that return may father and I witnessed.

“Big Klu” was 6’2”, 225 pounds, but looked much bigger, due to his massive arms and hips. He tore the sleeves off red flannel shirt worn underneath the jersey, exposing those biceps and allowing him a freer swing. When the Reds famously shifted to sleeveless jersey, hoping to accommodate his desires, he simply tore the sleeves off at the shoulders. It was that sight which greeted us in Crosley Field that day, Big Klu kneeling in the on-deck circle, leaning on his 38-ounce Louisville slugger, face tilted towards the slanting sun, waiting his turn to impress the fans one more time.

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King: A Life by Jonathon Eig

The Reverend Dr. Martin Luther King, Jr was born on January 15, 1929, in Atlanta, Georgia. That day is now celebrated as a national holiday in the United States of America.  Should you wonder why it’s worth commemorating a single individual in this unique way, Jonathon Eig’s book, King A Life, is a good place to start. While certainly not the first, nor the longest biography of King, Eig has kept his focus consistently on his singular subject in a way that highlights the man in all his complexity. His story of course encompasses and reflects much in America’s own during the middle of the 20th century, as well as stretching before and after his time among us. Other figures, especially the Presidents Kennedy and Johnson, as well as civil rights leaders such as Roy Wilkins, A. Philip Randolph, and Bayard Rustin, appear in the book solely as they interact with King.

Exhaustively researched and masterfully written, King benefits from Eig’s deep immersion into the massive volumes of data now available. Two examples: all of King’s sermons and other writing are online through the Stanford Library. And summaries of FBI wiretaps of phone conversations and other surveillance are now public record (transcripts will be released in 2027.)  In addition, Eig takes full advantage of the many books already written on King’s life, as well as contemporaneous media sources and private letters and interviews from close associates of King.

What emerges is our most complete picture yet of who King was, his inner thoughts, angels, and demons. At the center, the innermost core and fundamental motivation of his life is as a preacher, in service to others. The son of the pastor of the Ebenezer Baptist church in Atlanta, King from an early age consciously chose to become a Reverend. Whenever he encountered doubt, or trouble in his life, he returned to the knowledge that he felt called by God to preach and serve. Specifically, to help improve the soul of America by empowering its Black population to announce their grievances and, without violence, remove those restraints which kept them from fully engaging in the promise of America as a community where everyone can work to improve themselves.

The decades-long effort to enact laws eliminating discrimination in all aspect of communal life, including voting, is of course central to the work of Dr. King. But this book is not a detailed account of that struggle. Rather, King’s thoughts and efforts in support of that difficult and on-going process are what concern Eig. Likewise, King’s early opposition to the war in Vietnam, which fractured his carefully groomed relationship with an initially supportive President Lyndon Johnson, is treated as a natural response to King’s insistence on solving problems without resort to violence.

I was privileged to attend a small service led by Dr. King in the chapel at my small college in Connecticut several months before his death. There were maybe 40 people in attendance, faculty and students. I came away with two impressions of the man from that short exposure. First, it was clear he was, indeed, the Reverend Dr. Martin Luther King, Jr, a preacher at the very essence of his being, immersed in the bible, its teachings, and picture of God as encouraging love above all else from people. And second, he clearly had an uncommon presence, a charisma which demanded attention, support, and a willingness to follow. Those two threads are woven through every page of Eig’s biography, and account for why he is the only American with his own national holiday. We still have much to learn from Martin Luther King, Jr.

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State of the (Sexual) Union

Sex educators recommend couples have short, periodic discussions of the status of their sexual relationship. In a NYTimes review of a book describing how to do that, I posted the following comment:

Having good lines of communication may seem superfluous when things are going well in a long-standing sexual relationship between a mutually monogamous couple. But life changes occur, and when they do, those habits of frank and open discussion may well be the difference between life and death for that relationship. Case in point…my wife and I, together 48 years, recently went through surgery for my prostate cancer. This results in, at best, a 1-2 year period when the nerves controlling key aspects of a man’s sexual functioning are disrupted and must re-grow. Worst case, it’s permanent. This “side” effect was a major factor we discussed prior to deciding on treatment, and requires on-going frankness as we are now 3 months into the journey.

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Our Two-State Solution

George Will defends the dissenters in this week’s 7-2 Supreme court decision which supports Indian tribes’ rights to determine where their children may go when in need of a new home.

https://www.washingtonpost.com/opinions/2023/06/16/supreme-court-blunder-indian-child-welfare-act/?utm_campaign=wp_post_most&utm_medium=email&utm_source=newsletter&wpisrc=nl_most&carta-url=https%3A%2F%2Fs2.washingtonpost.com%2Fcar-ln-tr%2F3a54cd8%2F648dd79543aca4433fa200c9%2F596a51b5ade4e20ee370ca9b%2F22%2F55%2F648dd79543aca4433fa200c9

Here’s what I have to say to him:

Mr. Will appears to believe that the original inhabitants of this continent should be forced to follow the foundational principles of those who arrived after (“Rights inhere in individuals, not groups.”) Thankfully, after four centuries of subjugation, our government is beginning to acknowledge that those original nations should be granted an equivalent right to to live by their own “foundational privileges”, even if we find them foreign or contradictory to ours.

He should return to his comfortable retirement den and examine this proposition. While doing so, he should ask why he felt it necessary to include inflammatory language in his argument (“sacrificial playthings of race-mongers”, comparing tribes to Nazis).

It seems that 7 of the 9 Justices are able to deal with this conundrum, and allow the tribes to build and nurture an ethos which is unique to them, and not beholden to one we might wish to impose on them. Possibly gritting their teeth while doing so, but doing so nonetheless.

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