GET BUSY DYING, OR GET BUSY LIVING

On the plane ride to Texas, I read - no devoured would be a more fitting description - Christopher Hitchens' posthumous memoir entitled Mortality. I found it somewhat uncanny that I read his book on December 15, 2012 - the exact one year anniversary of Hichens' death. May he rest in peace wherever he is.

In this book, Hitchens chronicles his struggle with metastatic esophageal cancer. His book is one of the most touching and moving descriptions of cancer that I have ever read, and I highly recommend it to you. By the end of an afternoon, you will have finished it, and you will be better off for having done so.

In case you are not familiar with Mr. Hitchens, he is a celebrated atheist and political and cultural critic. He famously decried belief in religion or God. He was a bold, boisterous thinker and speaker, and he made many enemies in his life. Not surprisingly, most of these enemies were on the right side of the political spectrum.

Hitchens' quick wit was matched by his taste for drink, smoke, and the fairer sex. He, himself, describes his hedonistic life in these terms: "In one way, I suppose I have been in 'denial' for some time, knowingly burning the candle at both ends and finding it often gives a lovely light." Poetic.

It is the juxtaposition of Hitchens' liveliness and the shear brutality of his cancer and cancer treatment that makes Mortality so compelling. For a man who does not believe in God or heaven, what drives one to fight for one's life? Simply put, it is love of life and all the people on this earth that make one's life worth living. In that sense, Hitchens is no different from any other cancer patient, but one can feel how much this life, the only life he believes matters or exists, means to him. 

I always respect my patients' right to fight for whatever they believe and to believe in whatever helps them get through the day. However, as a non-believer, I found myself strangely drawn to Hitchens and his approach to cancer - clinical, practical yet hopeful, but never sacrosanct or pitiable. Bad things happen to all people. Life is not fair. No one beyond ourselves can be blamed.

Hitchens writes evocatively of living dyingly with cancer. It is a reminder for us all who are well to live livingly, to enjoy every breath, every sip, every taste, and every moment. 

I quote another philosopher - the country singer Tim McGraw- when I attempt to inspire my patients who are in remission and those who are dying,  alike. I use the most simple yet powerful aphorism I have ever heard. 

Simply put, live like you were dying!

TOP CLASS

It is no secret that Nicholas is a soccer fan. However, it is also clear that he is becoming quite a soccer aficionado.

Today, I went to the pitch at my niece's school with her, Nicholas, and my dad. Nicholas was confident, poised, and deliberate. He looked and played like a mini version of his hero Xavi Hernandez, Barca's midfield maestro and possibly the best to ever play that position.

Nicholas' love of playing soccer is only matched by his love of studying it - watching highlights, reading magazines, looking at the "table," or standings, and constantly discussing the game with me. He loves that soccer is a global game, and he loves learning about the geography and history of the teams.

His knowledge is encyclopedic, and his tastes have become more refined. One recent morning he said, "Dad, I am getting tired of U.S. Major League Soccer. It is just not top class." He is 7 mind you.

With that in mind, after we played at my niece's school, we watched the highlights of the Club World Cup.  The final match pitted the Champions of Europe - Chelsea from England -  and the Champions of South America - Corinthians from Brazil. Chelsea lost the match 1-0. The lone goal was scored by Paolo Guerrero.

Afterwards, Nicholas said he was glad that Corinthians had won because they were from Peru, which is one of his favorite countries. I corrected him saying that Corinthians were from Brazil. He protested saying that one of the players was holding a Peruvian flag after the match. I said he must have been mistaken and changed the subject to avoid a fight.  We moved on, and this dispute never came up again.

However, before I began to write this piece, I read an article about the match. Guerrero, it turns out, is a Peruvian. I stand corrected about the flag.

Top class. Nicholas is top class indeed.

HEAVEN IS A PLACE ON EARTH... IN BARCELONA

I do not believe in God, but tonight I witnessed a piece of heaven on earth – an FC Barcelona match at the Camp Nou in Barcelona. I was seated in a prime viewing spot seven rows back from the players’ box at midfield, and no I will not be sharing how much the ticket cost!

The Camp Nou is the largest sports stadium in Europe, and it may well be the largest sports stadium in the world with a capacity of 100,000.  The stadium needs to be this big because countless hoards turn up for every home game to watch Messi and company work their magic. Tonight, was no different, and I witnessed the best sporting event – make that the best public event – of my semi-long life. 

First, the crowd was filled with people of all ages, races, and even genders.  Second, it was a decidedly family affair. A sweet little two-year old Catalan boy was perched on his mom’s lap next to me.  On my other side sat an older Catalan couple.  They seemed quite reserved… that is until the first goal.  After Messi put in the back of the net, the man turned to me and shouted, “Messi!”  I shook my head yes, and we smiled.  After Messi’s second goal, we high-fived, and I had made a new friend.

Despite the fact that we did not speak the same language, we clearly appreciated the masterpiece that was written by the Barca players on the pitch. The whole crowd appreciated that the players were not merely playing for them. These players were performing for the crowd, who witnessed football at its highest level. 

Ten of Barca’s starting eleven players came up through their youth academy, and so the club and the fans are almost like their family. One could feel sense the effusive pride with which these men played, and their love for the game was palpable and contagious.

However, I was struck most by the ease with which the Barca players played the game.  Nothing was forced. Everything was natural and well executed.  There was levity. There was skill. After the opposition Real Zaragoza tied the game, there was determination and Barca quickly regained the lead and did not look back.

Tonight was truly a night to remember.  I sent Nicholas live text updates during the game as he watched  home on TV.  I am sad Nicholas, Cate, and Kathleen could not be there tonight. Had they been with me, they would have witnessed something strange and unfamiliar in me – happiness and pure joy unlike anything in recent memory.

I will be back to the Camp Nou, and next time I will bring them along. Something as sweet as this time was meant to be shared, and I cannot think of anyone else with whom I would rather go to Heaven.

Visca Barca! 

P.S. Do not worry!  Once I get home, I will update this post and add pictures and videos!

THEN AND NOW IN BARCELONA

Tonight, I write from Barcelona. I was last here 14 years ago at the end of medical school in 1998.  Over the years, Barcelona has remained one of my favorite cities. Therefore, when the opportunity to present at an international meeting came up, I leaped at the chance. 

Much is the same in Barcelona- great food, great museums, friendly people, and beautiful women. However, as I wandered around town, I noticed a different mood in the city than the one I witnessed last time. There was a palpable sense of less hope, more dread, and more frustration. 

I witnessed all of these emotions yesterday as I walked the city on the day of the national work stoppage. People were striking due to austerity and the global economic downturn, and Spain has been particularly hard hit with employment around 25%.

I had thought that this was simply a transport strike, but I quickly realized the strike was more widespread when every destination I visited was shuttered.

Few people were mulling around in the morning, but they seemed more purposeful, more busy, and more serious than I remembered from my last visit.  Later, I noticed that crowds were gathering, and so were the police.  On the main drag called La Rambla, political signs adorned the lampposts. Some spoke of Catalan independence while others spoke of socialism without secession. The undercurrent of tension was to be found everywhere.

As I headed back to the hotel on foot, I noticed that the crowds had become considerably bigger and louder.  They were amassing in the city center in the Placa Cataluña.  There, I heard several loud explosions. Initially, I took them for gunfire or a bomb, but they turned out to be some form of firework.  Quickly, I headed in the opposite direction to my hotel.  I stayed in the remainder of the day and could not fathom how different this city that I love was on that day compared to my last visit.

It is true that it was a special day – a general strike. However, the city and the people of Barcelona were measurably different from 1998. It turns out that I, too, am different 14 years later. 

My last trip was all about pleasure and sight seeing at the end of four long years of medical school. This time, I am presenting at an international medical conference.  I have two kids and a wife whom I love, and I think about their future and the state of the world I will be leaving them all the time.  On this trip, I am less interested in partying and more interested in understanding and experiencing the Catalan culture and its people. 

There is no doubt that the Catalan people have been frustrated for hundreds of years.  However, during my last visit I had a simplistic, romantic ideal of the place.  That is no more.

In many ways, Barcelona feels more real and less ethereal.  That does not mean Barcelona is any less special to me. If anything, I am drawn more to this city – its emotions, its will, and its people… not to mention its Football Club. 

Now, Barcelona and its people just feel more grown up, more self-possessed, more introspective, but still hopeful… kind of like me. 

I have never seen a reflection of myself in a city until this trip, but Barcelona is not just any city.  

Visca Barcelona!

FORWARD!

Tonight was a great night! Tonight was an historic night! Tonight we re-elected Barack Obama as the 44th President of the United States.

This was a long campaign. This was a bitter campaign. However, this campaign also marked a clear line in the sand for American elections and the American electorate. Women won everywhere. Women carried the day everywhere. Minorities made their voices heard. Obama won them 80%-20%. The young overwhelmingly supported the President, too. In essence, the future of this country won while the demographics that have ruled this country for so long - the white, the old, and the males - lost, and they lost big.

It is hard not to feel that President Obama and the Democratic Party are on the right side of history and that they have grasped this moment.  What matters now is what they will do with that momentum.  Will they compromise, or will they project a positive vision for the country and try to bring their Republican opponents along? I hope that we will see a little of both.

Most importantly, what will the country make of tonight's Democratic victory?  Will the people raise their voices and rightfully demand that their leaders work for them?  I hope so because we have so much work to do. We must move forward on jobs, the economy, the debt, ending wars, and rebuilding this country.  Are we up for it? Are we as big as our politics?

The answer must be yes if we are to win the future and leave our kids a better country than we were given.  I am in awe of this victory, and I will soak it up.

However, I realize that the climb will be long. Obstacles, some surmountable and some insurmountable, will stand in our way. Those who would rather gum up the works rather than reform our political stalemate will persevere.

Despite this, I am more confident than ever that we are up to the task. Why? Any nation that can commit itself to electing an African-American named Barack Hussein Obama not once but twice is serious about progress. For these reasons, I am hopeful today. I am proud today. I hope you are, too, because today we are all Americans first. Today, we traveled a little farther up the mountaintop. We must keep moving forward!

HAPPY BIRTHDAY CATE REESE!

Cate turned four yesterday. Yes, I know it is hard to believe that time has passed so quickly since 2008, the year of her birth. 

We had a party for her at a local community center with some of her friends from school.  Our big girl said she did not want any presents. Rather, she said she wanted to do a book exchange where all the kids would get a new book to read.  We played games in the gym, ate bagels, and had cake with ice cream.

I was struck by how normal and at-ease Cate was and how she treated everyone with respect and care.  Again, hard to believe this was only her fourth birthday.

Today, we went to her school for a celebration.  I rushed from my morning meeting to get there and was met by Kathleen.  We sat in chairs behind Cate, who sat in a circle on the floor in front of us.  A poster with pictures of Cate from her four years was on the wall, and we told short stories about her.  Each of the children came up to Cate and wished her happy birthday. Then, each child went to wash up prior to lunch.  Very Montessori.

We stayed for lunch, and witnessed Cate get her lunch, set it up on a plate, and use her silver wear.  It is not to say she has not done this at home. However, she usually requests someone to help her or requests that someone make their lap available. I protest often, but I will miss having that little one so interested in our help.

We read stories tonight - Scooby Doo. She was Scooby, and I was Shaggy. We snuggled up, and she even let me give her a few smooches, which she usually fights.  It was a fun and relaxing night.

I look forward to many more birthdays with Cate, and I look forward to watching her continue to grow up.  She will have a major impact on this world one day. How do I know this? Because she has already made quite an impression on me!

Here's to Catherine "Cate" Reese Alumkal!

WATCH OUT!

Lately, Cate has been more into music and singing.  This is probably because of influences at school and because of Nicholas' love for music. I hope you enjoy her performance below.



I guess we need to sign someone else up for music lessons. It's a good thing we have an extra ukulele now that Nicholas has graduated to mandolin!