Doing Nothing

There's a Buddhist parable that kind of promotes the whole concept of my trip to China to date, and it kind of goes like this.

Young trees in the forest spread their roots in search of water, and spread their branches in search of sunlight, all so that they can grow straight and tall and majestic as they get older. But alas, for the young trees, as they grow up straight and strong, they become the object of desire of wood cutters, who are looking for straight tree trunks for which to make lumber that they can sell to home builders and furniture makers. The young trees, who spend their entire lives, trying to attain that goal of straightness and perfection, inevitably end up in the lumbar yard.

Whereas the big old oak, who's gnarly tree branches, and grotesque trunk, does nothing, nothing but exist, not making himself known, not advertising his presence in the forest. All he does, is sit and grow. And as such, he grows stronger and stronger, and grander and grander, for the woodcutters find his looks and his condition undesirable for their needs. And because of that, the old oak just gets older and bigger and stronger, doing nothing, just existing.

The meaning of the Buddhist story, is that by doing nothing, one grows old. Well, I'm taking that to heart this trip.

It's been one hell of a trip so far. I've experienced a lot, I've learned a lot, I've gotten stronger, and I've done absolutely nothing.

I guess maybe a brief history of my health is in order. It all started, back in December, quite ironically, upon my return from my last trip to Shaolin.

I fly Business Class when I go overseas; I am far too large to sit in an economy seat for more than two or three hours. My legs just don't fit all that well. And because I get pretty bad migraines, I usually dose up on some medication which helps me avoid those. Problem is, they tend to make you pretty sleepy, which, for a thirty hour trip back from Thailand, I guess is not such a bad idea. But, as you've undoubtedbly heard, flying long distances in cramped quarters, and being relatively immobile, has its hazards, one being, blood clots in the legs.

It is very uncommon, but not unheard of, for people to develop serious blood clots in their legs while sitting motionless in an aircraft seat. The veins depend upon muscle contractions to help propel the blood out of the extremities and up to the heart. Sitting motionless for a prolonged period of time predisposes the poorly flowing blood to occasionally clot, and remain lodged in the leg. A common complaint people have, when they have these things, is leg pain, particularly in the calf, and leg swelling. If the traveller is smart, he'll take some aspirin for a day or two before his travel, so that the blood is "thinned", and the platelets are less likely to form clots. This is what I do, every time, religiously.

And a hard, tense, painful calf is what I had when I got home, last December. I really didn't think much of it, as we traversed through the Christmas holidays, into the month of January. The calf pain was starting to go away by then, but, it was replaced with something much more ominous, and much more frightening. Chest pain.

Oh, all sorts of things go through the mind of a physician when he's confronted with an illness that he doesn't understand. Even more goes through his mind when he's the one with the illness. Especially I, who specialized in intensive care medicine and anesthesiology, both high risk fields in medicine, both which present you with the absolute worst that pathology textbooks can throw at patients. I've seen, almost all of it. And when you're walking the dog, and you start to feel some chest discomfort, multitudes of diagnosis start swirling through your head. And all of them tend to be the bad ones. The bartender with chest pain thinks muscle strain; the physician with chest pain thinks rapidly debilitating viral cardiomyopathy. Or worse.

I slowed down on my anti-migraine medication, and started building up on the Coca Cola, a soft drink which helps me with my headaches. And the chest discomfort just kept appearing more and more often. Getting more and more uncomfortable. And I didn't know why. It was all very confusing to me, as, just two months previously, I had been in Shaolin, working out four to six hours a day, walking up and down the hell I call the Chinese Stairmaster, hiking, lifting weights, exercising. Never had a bit of chest pain. Why it was erupting now, just didn't make sense. In the back of my mind, I knew it couldn't be heart disease. In the back of my mind, I wondered if I was right. It gnawed at me, constantly.

It all came to a climax one night in early January, when I was eating a rather large meal with some friends in Las Vegas. All of a sudden, completely without warning, came the onset of chest discomfort with trouble breathing. I knew it couldn't have been my heart, I was far too healthy for that. But the spectre of a pulmonary embolus (a blood clot that breaks off of the inside of the leg vein and travels up to the heart, causing chest pain, shortness of breath, and commonly, death) loomed above me. That was all I could think of. A god damn pulmonary embolus. A long time nurse friend of mine had a simple nasal surgery the week before, and subsequently died at home, from a damn pulmonary embolus. I thought back on all the people in my career that I had taken care of, some young and healthy, who had suddenly died of pulmonary emboli, and there was nothing that I could do. Fear struck my heart like it never had before, and I made the decision to not even wait for an ambulance, and just drive myself to the almost nearest hospital.

I drove past Nevada's University Medical Center, because, I had taught there for many years, and, in my opinion, the residents at that institution were the absolute bottom of the barrel. Instead, I kept driving to a private hospital, went into the emergency room, identified myself as a physician, and was promptly taken care of.

The concern was a pulmonary embolus, that was the highest thing on the list. I underwent all sorts of studies for my heart, and my lungs, and spent the evening in the Geriatric Ward, (as there were no beds available anywhere else), something which my friends, who, at the time, thought I might die, still don't let me live down. I spent about 24 hours in the hospital, and as the tests kept coming back negative, I decided to check myself out. Staying in a hospital is anathema to me now; the fluorescent lights trigger all sorts of migraines, and the lack of sleep one gets there just makes the whole situation worse. I decided that if I was going to die, I'd rather die at home. With the dogs. Besides, Mindy was getting pissed at all this nonsense, me not being home and what.

I never really got better, back then. In fact, I started drinking more Cokes to help my ailing head, and, I noticed, that I was getting more and more chest pain. The following week, after doing some more studies that my doctor friends were unable to diagnose my condition with, I ended up in yet another doctor's office, again, seriously short of breath. I was subsequently sent to the nearest hospital, after consultation with yet another specialist friend, and I was extensively tested and CAT scanned. Nobody could figure out why I was having such difficulty.

It was one of those flukes of nature, a complete haphazard mistake, a suggestion that I had just "thought off" at the right time. As I was being CAT scanned, I told one of the techs, who knew I was a physician, to scan my abdomen also, just in case I had something that we hadn'[t suspected, like, a stomach tumor, or, a hiatal hernia. He gave me a large glass of disgusting barium to drink (which is supposed to "highlight" the esophagus during the CT), after which, I noticed that I was completely pain free. And, breathing normally. The tech had made the diagnosis, without even knowing what it was. But I knew.

Barium not only acts as an xray contrast agent, but also works as kind of an antacid. It buffers the acid in the stomach and esophagus just by it's sheer coating action and chemical properties. It was clear to me, I had severe esophagitis from reflux. And, ironically, my drinking all that Coca Cola had just made the whole situation worse. A new treatment plan, some diet changes, and I was better.

For, a short time. For, right after that, I came down with a community acquired bronchopneumonia, which was particularly severe in the Las Vegas area, and, which I probably had picked up in the damn hospital. Lots of people had become hospitalized with it, and now, I had it. Some successful home treatment over the next few weeks, and all I was left with, was a twitchy set of lungs. For some reason, the pneumonia was severe enough to cause long lasting bronchospastic effects in people, upwards of six weeks after treatment. I had it, but I dealt with it. The twitchiness and cough were easily lived with. They didn't contribute to any hospital visits. At least, not by themselves.

And then, the rains came. And after the winter rains came, the warm winter sun came. And, after a few days of warm winter sun, the desert flowers of the Mojave bloomed. Shit bloomed everywhere. Yes, February and March, both months that I'm usually in Shaolin during, I might add, dealing with dysentery and pneumonia at times, were my worst allergy months. I missed them the past few years; I was there in Vegas right in the middle of it now. And, with twitchy, bronchospastic lungs, a result of that damn pneumonia that I had acquired.

I ended up back in the ER with shortness of breath, with some minor EKG changes symbolic of heart strain (from the difficulty breathing). But, after a night in the filtered air of the Emergency Room, I was starting to feel better. All my tests were coming back negative, even though my lungs sounded like shit, and an audible wheeze could be heard every time I exhaled. The three hundred pound ER receptionist thought me to be the absolute twinkle in her eye, and she, over the evening, made no hesitation in letting me know that. Ultimately, offers to "walk me to my car", and "take care of me" caused me to tell the ER doc, who, by the way, thought the whole breathing nightmare idiotically to "be in my mind", that I had to go home. Hell, I thought, if I was going to have this kind of trouble and die, I'd rather do it at home. Not like the poor unfortunate fifty year old Chinese man in the bed next to me, who was in cardiac arrest. I offered to help, but, was turned down. I guess it just doesn't look good when patients start taking care of patients, lol. I left, still with some trouble breathing, still with no answers to my problem, still with this horrendously large woman waddling down the hall after me. It's not always easy being a physician; it's hell being a patient.

The breathing just got worse and worse; I started medicating myself with this and that, just to make it all that much easier. But, nobody could figure out what my problem was; my heart had undergone very extensive testing, as had my lungs and leg veins, and nothing showed up, except for the fact that I had noisy breathing, and that I was having trouble catching my breath. The tests had revealed that my cardiovascular system was in superb condition for my age. The answer that had eluded all these specialists came to me, again, quite by mistake, quite by a fluke of nature, quite by accident.

It rained. And I was able to breathe. And that's when it occurred to me, that it was the damn pollen in the air that was causing my irritated lungs to become bronchospastic. The rain washes the pollen out of the air to the ground, making it "cleaner". The rain, however, also waters all the damn plants in the desert and in the Las Vegas valley, that like to grow this time of year, and, after a few more days of inevitable sun, they pollinate viciously once again.

I informed all of my physicians of my discovery, got on the right medication, and made plans to get the hell out of Vegas, preferably before the next pollen onslaught. I made plans to return to what has been called my second home; got the necessary visas to China in one afternoon, the flight the next, and I made my arrangements to return to Shaolin. Whether I was going to be able to train or not was not even an issue; getting better, and getting healthy, was. This was not the first time that I grabbed the veritable tiger by the balls, took a risk, and went to Shaolin to heal.

Well, so far, I haven't made it. But, that's ok. I'm trying to be an oak, not some young studly sapling looking to get cut up into furniture wood.

The first flight out of Vegas was sheer hell; well, ok, it's hard to call anything hell, because, and trust me on this, it can always, always be worse. Be thankful for what you've got, and make the best of it. (I've taken care of some truly unfortunate souls during my career, and it all makes me realize, that the most important thing that anyone can have on this earth, is his health). The Mojave pollen grabbed hold of me, sitting on the tarmac of Las Vegas airport, and, for a moment, thoughts of having severe trouble breathing while in a plane way over the fucking Pacific, far from any sort of health care, started running through my mind. Damn, what a stupid fucking idea this was, I had thought. Panic started to try to overwhelm me, as thoughts of rushing to the closing airplane door swarmed through my mind. The pollen was just not going to let me go, and it was going to finish me off in the small compartment of an airplane, 35000 feet up, far from any hospital, far from any medical assistance. I thought about it, calmed myself down, and stayed on the plane. I was not going to let fear overwhelm me. A little medication made it a little better, but, still having trouble in San Francisco airport, I questioned the whole idea of going to China while in the middle of a crisis. I, as you can guess, went.

It wasn't a great flight, but, over the following twelve hours, my lungs settled down, and I succesfully made it to Beijing, without needing that "call for medical assistance" on the plane. Hell, I thought back to the many, many times that I had flown America West, and how every time, I had to come to the assistance of some poor unfortunate with emphysema who couldn't breathe. At that time, America West used to shut off the fresh air inflow to the plane, and just recycle the air that was onboard, all in an apparent effort to save money. They saved money, I went to the assistance of stricken passengers. After a while, I got to know some of the stewards and stewardesses; unfortunately, it was only the stewards who always made the extra effort to "get to know me". I started to wonder whether all that newly found and terribly unwanted attention was worth the "going to the aid" of stricken passengers. For my flight over to Beijing, I wondered if I was going to need that aid myself. It was an unsettling discomfort.

Ironically, it was me, short of breath, who went to the aid of a stricken passenger on that plane from Tokyo to Beijing. Some kid had passed out; he was already surrounded by a Chinese doctor who didn't seem to know much English, and who was suggesting a therapy of black tea, and a nurse who kept blaming his fainting on the Allegra pill that he had taken. A brief, ten second exam, and I knew he was dehydrated. Easy fix; shortly thereafter he was up and about, and I was surrounded by stewardesses, thanking me profusely. I guess it's pretty scary for these people, having to deal with the unknown, in a small trapped space, far from the availability of health care. It was scary for me, wondering if I was going to need to be the recipient of such care. I eventually arrived at the Beijing International airport, still a little short of breath, and was greeted by my long term friend, Yong.

Ji Feng Ji Cao

An old Chinese idiom which basically means, The force of the wind tests the strength of the grass. The story originates from the Western Han Dynasty (206BC - 24 AD), during which, a Wang Mang, nephew of the queen, took over power. He was quite the unpleasant fellow, who, through his negative ruling practices, turned the populace against him. A member of the royal family, Liu Xiu, found himself the leader of the peasant uprisings, and, as such, started to war against the forces of Wang Mang. A man called Wang Ba led some of his friends to Liu Xiu's army, and offered their assistance. The battles eventually settled in Henan province, and through the wars, all of Wang Ba's friends had fled, leaving only Wang Ba at Liu Xiu's side. Liu Xiu noticed Wang Ba's strength during the constant adversity, and stated "Ji Feng Ji Cao", or, "This is really a case of the strong wind indicating the strength of the grass". The saying has become a eulogy for those who remain strong, firm, and steadfast, unshakeable in the face of any adversity or danger.

Dealing with the frightening aspects of these health issues has certainly not made me Ji Feng Ji Cao, not by any means, but, I am a hell of a lot like that old oak. My first week in Beijing was spent visiting many friends, and, more important, doing nothing. Doing nothing but hanging in the room, taking medications, sleeping far too much, and "getting better", far from the infuriating pollen of the Mojave desert. My life has revolved around lots of sleep, no training, some walks, some visits to Traditional Chinese Medical doctors (for the hell of it, and for the experience. What an experience...), and juggling two Chinese girlfriends around so that they don't run into each other. Getting better was easy, much like the oak that does nothing and sleeps; juggling two women around the same city, both of whom for some ungodly reason, have missed me, and for another completely uncomprehendable reason, are both in Beijing at the same time, in my opinion, makes me, indubitably, Ji Feng Ji Cao.

The saga continues....