Sunday, June 24, 2012

Thoughts on Gardening

This morning, like last weekend, I spent much of my time gardening.  Unfortunately, the effort has been somewhat sporadic this year since I was busy with other things when I should have been planting.  But, it looks like the plants are doing well for the most part.

Today, we had a harvest of young radishes.  Our first for the season.  The kids began to understand the effort as they tasted the first results. To come are tomatoes, peppers, peas, carrots, eggplants, cucumbers, summer squash, melons, a variety of greens and a plethora of herbs.  I do most of my gardening in either raised beds with landscape cloth under them or pots since the gophers have taken over my yard, and I can't seem to get rid of them, though I won't poison them.  The poison would be in the soil.  Instead, I would like the owl and the hawks to handle the problem.  Once I was working in the garden, dividing iris, when I heard a thump a few feet away.  I turned to see one of the hawks who live here flying off with a gopher.  I was happy that he was so comfortable with me that he flew in so close.

Relaxing after the work is done under an umbrella with a glass of iced tea and taking in the scents, hearing the birds and seeing the butterflies and dragonflies takes me back to a simpler time.  It reminds me of my mother's garden.  I was a child then, and like my children today, was more concerned with playing than with working.  But I do remember the harvests from the garden.  The strawberries, the cucumbers, the tomatoes, the corn.  Everything seemed so much more intensely flavored then.  And it still does, fresh from the garden.  And I can control the use of chemicals on my food, by not using them.  Instead, I have learned about companion planting, using other plants to confuse pests.  I think we did that in the old days too, though I was much less aware of it then.  My mother rarely used any pesticides either.

Gardening also reminds me of the time we visited relatives in Poland.  Several relatives had small farms yet worked in factories during the week.  So we helped on the farm while staying with them.  It was the peak of summer and time to harvest the wheat.  The nearby collective farm where one of the cousins lived had a combine, but for the small private farms of about 2 hectares (a bit less than 5 acres), it was not possible to own or even rent a combine for the harvest.  So the harvesting of wheat was done with scythes.  I remember spending a few evenings swinging the scythe to help with the harvest.  It was certainly heavy work but it made for a good sleep. 

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And that brings me to the picture above.  The scene reminds me of my time harvesting wheat with a scythe. Pieter Bruegel, a Flemish painter who lived 1525-1569, painted many such farm scenes. The wheat was harvested with scythes. Unlike then, when only men would swing the scythe, I did as a teen. My visit to the family in Poland took me back to that time.  It showed me how little had changed for a peasant farmer.

But even the gathering and bundling of the wheat, usually done by women, was heavy work.  In fact, I liked swinging the scythe better because I was upright, rather than bent over picking up the wheat.  That seemed to me to be the harder work.

Jean-Francois Millet composed "The Gleaners" to depict the lowest rung of rural society, those who picked up what was left after the harvest.  In the original, the woman at the lower right was in the painting, working along with the other two.  The photo at left is from the Muzeum Narodowe W Krakowie, the People's Museum of Krakow.  It was posted on Facebook this week and is certainly an interesting take on Millet's classic work.  Even the gleaner needs to take a break.  Unfortunately, for many of the poor who had to glean what was left over, life was very hard with few breaks. 

Earlier in the week, I heard an interview with Raj Patel, author of Stuffed and Starved: The Hidden Battle for the World Food System (  He discussed how small farmers are literally being driven to suicide and millions are starving while 1 billion are overweight.  The mal-distribution of food is not a thing of the past, but of the present.  Global agribusiness is helping to create this imbalance.  I have yet to read the book but it is certainly on my list.

So, I'm back full circle.  To the need for small scale farming with local distribution and home gardens, not just for healthier food, but for a healthier world. 

Monday, June 18, 2012

Fear of Surgery, Surgical Intuition and Premonitions

Today we discussed a patient who has had a bad outcome.  He seemed to be doing well before a routine surgery, and only hints of the problems to come immediately after.  Everyone on the surgical team agreed the surgery was appropriate and indicated for the problem at hand.  Everyone agreed at the conference today.  But, before the surgery the patient was resistant until his family talked him into it, then he wanted to proceed, and asked that it be done.

Many times I have had patients initially afraid of surgery then change their minds and ask to proceed.  Most of the time things go well, but sometimes not.  It seems reasonable to be a bit afraid to undergo surgery.  I know I was afraid before my knee surgery, but it went well.  I wasn't actually as afraid of the surgery as of the anesthesia.  I was afraid of losing control.  So some preoperative anxiety is probably normal.  Anesthesiologists often premedicate the patient with an anxiolytic (a drug to block anxiety) before they even come to the operating room.

But what of the patient who is so afraid that he is prepared to sign out against medical advice.   What does that mean when things do go bad?  Did the patient have some sort of premonition?  I have seen it often enough that I sometimes wonder.  One place where I worked had the informal policy that a patient who cancels three times needs to see another surgeon before being rescheduled.  I have tended to follow that policy with my own patients since.

Likewise, I have sometimes had a bad feeling before surgery when I am the surgeon.  It doesn't happen often, but when there is a problem, I think afterward about my feelings.  Was I ignoring something that I should have paid attention to?  Or am I simply overthinking the problem?  Remembering my own anxiety in the situation of a less than perfect outcome?  Are premonitions something real?  Something we should pay attention to?  Is intuition just a subconscious processing of an observation that can't easily be described?

When I think of the topic of premonitions, I remember the series of dreams I had for months before my mother's death.  She was not ill, though had some chronic conditions.  And she was well enough to travel and walk for hours on cobblestones.  Hardly, someone I would have thought on the verge of death.  Yet, I had dreams for months before her death of trying to resuscitate a family member.  The dreams stopped immediately after her death.  It was as though I was rehearsing resuscitation techniques in my sleep for when I needed them to try to save my mother.  More of the details are published at:

Yet, as I think about this topic, I am left with more questions than answers.  Premonitions certainly seem real to me at times, yet I cannot come up with a scientific explanation.  The closest I can come is to say that I simply cannot put my observations into words, so get intuitive feelings about something.  Yet this doesn't apply in my mother's case, since she had been living on a different continent for eight months and I did not see her until about a week before her death.  So what kind of subtle observations could have prompted my dreams to begin two months before her death.  Yet, that is when they did.

So what do I do when I feel such a sense about surgery as the surgeon, or when a patient expresses more than the typical anxiety?  I listen.  I recheck everything to see if I am missing something.  I don't rush to the operating room.  But, if I can't find a reason not to proceed, I usually do if I think the procedure is indicated and the patient agrees.  And, most of the time everything is fine.

Saturday, June 16, 2012

Father's Day

My father has been dead for nearly two years.  He lead a long and productive life, dying at age 96, just a year short of the 97 years achieved by both of his parents.  Every day when I drive the kids to school, I pass by where he used to live.  The kids and I remember the frequent visits.  They often comment that they want to go back to see him, but I have to remind them that he died.  The finality of death is hard for children with much to look forward to.   It is interesting that they have commented that they feel that he was their "daddy" as well, since he was so close to them.

The photo to the right is a perhaps a graduation picture.   It is certainly from the right era.  Below is a photo taken in the last year of his life.


The kids have often asked about my mother as well, who didn't live to meet them, though many pictures of her hang on the walls of our home.  My daughter feels a bond, saying that she thinks she looks like her, in that both have round faces and dark hair.  In a similar way, I felt a bond to my mother's mother who I never met.  Her younger sister even commented on meeting me how much I reminded her of her sister, even to the point of mannerisms.

But, back to my father.  He was a scientist who was committed to truth.  In his younger years he was quite an outdoorsman, though he would not hunt or fish.  Rather he was an explorer who took only photos.  He walked everywhere, and in the summer encouraged me and my cousins to hike and camp.  He also loved to swim.

The photo to the left is when he was hiking at Ash Cave.  The photo to the below is from a trip my parents took to Cuba before I was born.  I was fortunate to recently find the pictures.
 Later, he caught the travel bug, which he transmitted to me.  In my teens, I was fortunate to accompany my parents on many interesting journeys.  I recall four trips to Europe and one to Japan with my parents while in my teens and twenties.  We often went off the beaten path.  These trips were some of my favorite memories of him.

It is always hard to lose someone we care about.  He is certainly remembered.

Thoughts on writing while working

Writing can take a lot of time, but work is great for people watching.  Since I have worked as a neurosurgeon in public hospitals, I have observed a lot of people whose lives are very different than mine.

My observations of the homeless I care for has been extremely helpful in writing about the period of homelessness in my novel's main character's life. (Yes, my first novel, though not the first I started on.)  Observing both patients and staff has given me insight into personalities, and some of the stories I have heard from patients would be fodder for great stories.  It is indeed hard to believe what people do every day.

And, being in a largely male profession, I have had the opportunity to observe men up close.  One colleague who read a few pages of a draft commented that he was surprised how much I understood of the male mind.  Another commented that he could feel the character's beard growing.  Likewise, seeing people from other cultures has given me insight into how to write about a given culture.

The downside of working is the time commitment, which means that I don't write every day.  I wish I could, but I'm often just too tired after the kids are asleep.  But, I observe, I read or just reflect on writing everyday.  I have also noticed that I have learned a tremendous amount about my subject on facebook by becoming involved in groups on the topic about which I am writing my novel.  Time limitation is the main reason that my blog posts are so sporadic. 

Perhaps writing classes have been the most distracting when they are off topic and too directed.  Yet, I know that learning craft also has a role, so have tolerated the absence from my novel, knowing that I will come back more skilled and will be able to revise my work with new eyes.   And some of the directed assignments may grow into stories someday.

So, in a sense, I'm constantly working on my writing, even when I'm doing other things.