I'LL SEE YOUR CARDINAL AND RAISE YOU 30 OTHER LOGOS!

Nicholas' favorite activity is drawing, and the stay at home order has definitely increased his output. After seening Cate's drawing of the St. Louis Cardinals logo, he thought he would go one step further and draw all the baseball cap logos for the MLB teams. Wow, just wow!

My office walls will look like wallpaper when these kids are done with this quarantine! I am so lucky to have such artists in residence!

SPRINGTIME IS FOR THE BIRDS

The onset of spring often coincides with the return of our bird friends from parts south to northern latitudes like Michigan. Despite the COVID outbreak, the birds seem no worse for the wear, and it has been fun to spot different species in our backyard.

Just last week, I saw many red-breasted robins and - even more strikingly - a beautiful cardinal. Immediately,  I thought of the the St. Louis Cardinals baseball team and their beautiful cardinal logo. 

Though Nicholas is the most avid artist in our family, Cate has some pretty mad drawing skills, too. Therefore, I challenged her to draw the Cardinals logo after we pulled a picture of it up on the computer.

Cate was hesitant at first, but she agreed to give it a shot. She would not let me look at her drawing until it was done, and she kept shooing me away when I entered the office where she was drawing and coloring it. Finally, she said I could come in, and she showed me her creation.

It was a masterpiece! Though I am not a big fan of baseball, this little birdy will be making his way to my office. Cate for the win again!

BEST 10 BUCKS I EVER SPENT

Spending quality time with the kids seems harder and harder these days give the global COVID pandemic, stress of work, and the fact that we all seem to be retiring to our screens more often. As I have become mindful of this, I am trying to be more proactive about carving out interrupted time together, which bring me to this afternoon.

I recently bought a new pair of running shoes. Ordinarily, I would have tried these out at the gym in order to avoid dirtying them in case they did now work out, but that is not an option in the COVID era with my gym shuttered. Therefore, I took my chances and ran outside.

The first few times I ran in the shoes, they felt fine. However, on the third or fourth run - I cannot remember for sure - my feet began to hurt. I decided that I no longer wanted the shoes, but unfortunately the soles had dirt and sand in many of the treads. Undeterred, I decided that I would try to clean the soles and sought out the assistance of a little hard-worker I know!

I am not into free child labor, so I offered Cate $10 to help me. This was far less than the $150 price tag of the shoes, so I considered it a steal. Cate - the professional that she is - filled up two small containers, one with clean water and the other with soapy water. She also got an old toothbrush and a paint brush while I found a straight head screwdriver.

I picked out the dirt first with the screwdriver, and then Cate began to scrub the soles. She did an amazing job, but there were still a few discolored areas in the white part of the sole. That is when Cate had the idea to use white out to paint those areas. I almost cried at her deviousness - I mean ingenuity - and because of how seriously she had taken this job. Needless to say, the shoes look as good as new and clean enough to eat off of! We will be sending them back for a refund tomorrow!

I hope Cate remembers the hour we spent on this project fondly one day - or at least does not view it as underpayment! For me, spending this time with her was pure joy!

LOVE AND LIFE IN THE TIME OF COVID

The COVID-19 crisis burst onto the scene over three months ago in early 2020, and yet we are no closer to its resolution. The most dumbfounding aspect of this crisis is the unwillingness of people in positions of power to head the warning signs from other countries and to prepare the United States adequately.

The United States prides itself on being number one in many things. Now, we can also claim the mantle of the country with the most COVID-19 cases, and we are predicted to soon have the most COVID-19 deaths. How is it that medical facilities in the richest country on earth now look like overrun, makeshift medical units in third-world countries?

As a medical provider, it is hard not to feel anxious or beaten-down, especially when the federal government refuses to take critical steps that could minimize deaths in patients and healthcare providers alike. When I took my oath and became a doctor, I knew that I was placing the interests of others before myself, and I gladly still accept that responsibility. However, in a crisis like today's, I also expect others to accept their responsibilities. Our individualism in this country is accelerating death and suffering right now, and it is only by putting others before our unalienable rights - to live exactly as we wish - that we will end this crisis.

These sentiments truly hit home when I went for a run the other day and approached a set of railroad tracks. I saw a train approaching in the distance. Normally, I would have waited for the train to pass. However, something was different that day. The stakes of dodging a train and running across the tracks seemed lower in the age of COVID-19.

I quickly sprinted across the tracks with just a few seconds to spare before the train crossed the same path. I made it across this time knowing that I might not be so lucky if I were foolish enough to try that again. However, I also knew that I could live the most cautious life possible only to be struck down by breathing the same air as someone infected with this virus. How absurd that one might lose one's life through such an utterly simple and human activity as respiring.

When I got home from my run, I found my kids - who had been sleeping - downstairs. I told them about the foolish thing I did crossing the train tracks. I did so because I wanted them to know that our choices matter more than ever in these times and that there is no room for irresponsibility or nihilism. If I had died crossing those tracks, they would not have known what had happened to me, and they would not have understood my irresponsible actions.

If I die fighting this virus, at least they will know that I died because I put others like them first. It is true that this is not exactly what I signed up for when I graduated from medical school, but this is a responsibility that I am willing to accept.

I leave you with a quote from President Franklin D. Roosevelt, "Courage is not the absence of fear, but rather the assessment that something else is more important than fear."

Be well.

OLD FRIENDS

In recent weeks, I have received several letters or holiday cards in the mail from former patients from Oregon. There are no words to describe the joy that those letters have brought to me because those words reminded me just how close we had become - more like friends than doctor and patient.

There was the update from one of the few patients with metastatic prostate cancer that I may have cured. He was excited about a new grandchild and a book he was hoping to get published. There was the card from the wife of a dear patient who passed away last summer prior to my departure. She wanted to check in to see how I was doing and to say that she looked forward to supporting our research. Then, there was one of my longtime patients who is the biggest Oregon Ducks fan whom I have ever met. He called into my oncology clinic here in Michigan just to let me know that he missed me and hoped that I was doing well.

Men, women, young, old, all white. However, these are men and women with whom I have a visceral connection. We lived through some of the most intense moments of their lives and shared many memories, smiles, and hugs. I miss them just as I miss my old life.

Before we moved, I ran into a friend at Grant Park. I told him that I was sad to leave my friends in Portland. Without missing a beat, he said, "Don't look at it that way. You will always have us here in Portland. You will just have a chance to make some new friends, too!"

I hope his wish comes true and that I find an equally supportive and caring network of friends in Michigan. It takes time, so I am just taking one day at a time. In the meantime, I will be sure to continue to check in with my old friends "back home," including those families whom I came to love through work.

THE 3 Rs

Frank Bruni from the New York Times had a very nice piece today about Joe Biden. In it, he talks about how Joe Biden may not be electric on the debate stage, but that his simple message in Iowa seems to be resounding with many voters.

Bruni talk about how this election for the Democrats comes down to the three Rs: revolution, rejuvenation, or restoration. The left wing of the party - represented by Bernie Sanders and Elizabeth Warren - represents big structural change, or a revolution. Pete Buttigieg represents rejuvenation and replacing the elderly wing of the party with a younger face. Joe Biden - and to some extent Amy Klobuchar - represent a return to normalcy and decency and moderation in our politics akin to the Obama era.

No one theory of governance is correct. However, I find myself strongly drawn to the theme of restoration. I would trade in a heartbeat to return to Nov 7, 2016, the day before Trump won the White House. Then, American seemed more hopeful, more kind, and more unified, I realize that I clearly misperceived the national mood and that many others did not believe their leaders or their lives were on track. They voted to blow everything up, and that is exactly what has happened to this country.

Do I believe we need a Marshall Plan for the United States? Absolutely. However, in order to revitalize our country, one has to to first win an election, and I believe that means building a coalition - rather than being uncompromising and demanding purity tests.

We will see what the voters decide, but if a candidate cannot inspire me - a lifelong Democrat - how do we expect them to inspire someone who voted for Trump in 2016 or who has never voted at all?

WHY I AM AN ONCOLOGIST

This weekend, I was deeply saddened to hear news about three individuals close to us whose lives were affected by cancer. The father-in-law of a dear, old friend had experienced a recurrence of his cancer and was now on hospice; the mother of one of Nicholas' friends had been diagnosed with a large ovarian tumor; and one of Cate's good friends had just undergone surgery to remove a brain tumor. To say that I was stunned would be an understatement, but my feelings pale in comparison to what those families are feeling tonight.

Caring for patients with cancer has been a central part of my life for the past 17 years. Therefore, it feels very strange to not have seen a patient in clinic since we moved in July. Thankfully, I am set to start clinic again in January, and I will resume patient care hungry to meet new families and to try and make a difference in their lives.

When I heard the news from our friends of their cancer stories, I felt a sense of duty to reach out and to try to help in any way I could. Being an oncologist to me means providing comfort, information, and solace while one is prescribing treatment and even more so when treatment is no longer effective or safe. This is the only way I know how to practice medicine, and it is what I wish for every cancer patient, even if they are not my own.

Just like a friend or a loved one, it is a privilege to get to know patients and to try to win their trust. Often this does not come easily because patients often feel poorly or have had bad experiences with the medical system. Our job is to right those wrongs and to help patients and families achieve small victories that allow them to forget about their cancer - at least for a little while. In short, it is our job to try to help give patients back what the cancer has taken away.

I will remember this weekend for a long time. It is a reminder that life is until further notice and that there is no greater cause than being there for the ones one loves. These are lessons that I will take to my grave, and I can only hope that the doctor who comes to be my caretaker learns that lesson along the way.