Feline Fortitude

Fully supporting the New Year resolution, Minerva reads to Kathy from "How To Quit....."

Tokyo Vignettes

...Or, What Do You Do When You Realize It's Holiday and Everything Is Closed?

You could visit Tokyo Tower, but don't go up to the top...


You could get some interesting coffee from a vending machine:

(Reminded me of a Sylvester Stallone movie)

Or, you could find an English Pub and have pub food, with beer, cider, or coke.

(Deuce and Sandy, take note.)



So even if the Edo and Sumo Museums are closed, you can still have fun in Tokyo.

Tales from the Crypts: Uninvited Holiday Guests

Has anyone ever shown up at your place for the holidays, unexpected and not really wanted? Did you graciously succumb to the holiday spirit and invite them in, along with whatever baggage (human or otherwise) they brought with them? Or did you do the Ebenezer thing and gruffly shoo them away from your doorstep? Perhaps in a moment of weakness you did invite them in, only to later suffer the pain of getting them to leave.


We had very welcome arrivals in our house this holiday season. Our twenty-something bright, attractive, smart, and witty daughter/stepdaughter not only graced us with her own presence, but she also brought our two family cats. Five months have passed since we were last together, so we were delighted to see all three of them arrive.


Little did we know that she also carried some very unwanted and definitely not invited guests. She as well was oblivious in the beginning to the ultimate pain that she would suffer in getting rid of these nefarious interlopers.

Mr. Strept O. Coccus and his paramour Ms. E-B Virus had found the perfectly susceptible holiday party hostess: a young, hard-working and dedicated graduate student who had severely challenged her immune system for weeks as she finished a demanding semester and got herself and two cats ready for trans-Pacific travel (including stressful interactions with the U.S. Army and the Government of Japan); followed by a 14 hour flight over as many time zones. As soon as golden girl settled into our home and recovered from her jet lag these clandestine culprits quietly invaded her tonsillar crypts and promptly set about reproducing at will. As they and each successive generation of offspring multiplied themselves, soon the young lady's entire oropharynx (tonsils, adenoids, arytenoids, and all the soft tissue in between) were jammed with raucously partying microorganisms.


Seldom herself the life of any party, this unwilling hostess found the pain of this microreverie nearly unbearable. Courageously she fought off the discomfort through Christmas Eve and midnight Mass, but by the next day the celebration had spread throughout her soft palate and into her cervical lymph nodes. With the pain came fever, chills, malaise, and generalized body aches. These germ guys can seriously party. She was left no choice but to take to bed for extended periods of time, forcing cancellation of a trip north and putting her return flight to the USA in some jeopardy.


Enter the hero! After three days of suffering it was time to call in the antimicrobial strike force, led by Sgt. Clin D. Mycin. This fearless fighter of micro-terrorists swiftly and efficiently went to work. First the force eradicated the younger germs just as they began to reproduce themselves, then Sgt. Mycin took on the older troublemakers. None would be spared. Total eradication! 


Within 48 hours, order was restored, swelling and inflammation were curtailed, and pain was alleviated. Her strength and energy returned. Happily restored to good health, our heroic young lady returned safely to the east coast of America, ready to dive headlong into yet another demanding semester to be followed by yet another trans-Pacific trip for her brother's high school graduation. Only next time there will be no cats to transport. And she will be better rested and more resistent. Really.

Reflections on "St. Elsewhere"

This Emergency Department scene from the early 1980's TV show, "St. Elsewhere" recalls similar scenes from the Phoenix hospital, where I practiced emergency medicine at the time. Although we had no one of the stature of Denzel Washington or Ed Begley, Jr., we experienced similar dramas and challenges as the ones depicted in that iconic TV drama. Back then I had neither the time nor interest to watch more than a partial episode. I was a full-time emergency physician and chose to spend my leisure time in non-work related activities. Did teachers watch "Room 222"? Did law enforcement officers watch the plethora of police shows on TV at the time?


Nowadays my family and I often watch TV series on DVD because we appreciate the closed captions and lack of commercials. About two years ago we got into classic TV drama series with "Picket Fences". Now "St. Elsewhere" fills our viewing time.  In the process, our teenage and twenty-something offspring seem to enjoy  glimpses of life in the "old days," which I find entertaining as well.


"Did you ever do that, Dad?" 


"Actually, yes." The TV show realistically portrays both the science and art of medicine at the time...including now obsolete practices like intracardiac adrenaline.


 "No way could someone be in labor and not even know she was pregnant! Right, Dad?" Well, yes they can. Happened twice in my practice. Both full-term. Truth can be stranger than fiction.


Watching "St. Elsewhere" over twenty years later brings back a flood of memories, poignantly so because quite a few years have passed since I worked a regular shift in the emergency department. Few places on earth put you so close to real life drama, to personal tragedy and triumph. I still remember some of the patients I saw and treated. My heart still aches recalling the times I had to tell a family that their loved one had passed. "We did all we could" sounds even more trite now that it did then. But I also recall the thrill of feeling a faint pulse where seconds ago there was none, the welcome whisper of a scant breath bringing new oxygen to an almost dying body, the return of a blood pressure as bleeding was stopped, and the joy of telling an anxious family that all would be okay.


As a young narcissistic emergency physician I was hooked on the adrenalin rushes of those challenges and triumphs. A good shift was marked by the numbers of major trauma and cardiac patients seen and resuscitated. (How I pitied my internal medicine colleagues who must deal with chronic, unexciting maladies day after day after day.) But as the years went on I experienced more tragedy than triumph. The dramas of the human condition played out in the ED often reflect the one-to-one statistical correlation of life to death. The only variable is when and how one will die. When that final moment occurred on my shift, I was never empowered to change destiny. In death or in life, I was simply the instrument of a higher power's plan.


Once I recognized and accepted that reality, I matured both as a physician and human being. Success was no longer measured by blood pressures and respirations, but by the degree of compassion and empathy given to fellow humans in times of life crisis. That was when I became not just a physician, but a real doctor, and where I found the true meaning of my honorable profession...rooted as it is in the Latin word meaning "to teach" and reflected in the tenets of the Oath of Hippocrates.


The young resident physicians portrayed in "St. Elsewhere" are not yet real doctors, although some are further along than others. Their fictional mentors, Drs. Auschlander and Westphall, do understand that their professional value is fully vested not in themselves but in service to their patients. Their vital role in the drama is to instill those values in the young physicians who follow them. Some will get it, and their careers will mature. Others will not, just as Chief of Surgery Dr. Mark Craig still doesn't understand it, and never will. Here too fiction reflects reality, and little has changed from the 1980's to today. 


I ardently pray that today's Auschlanders and Westphalls, whoever and wherever they are, will prevail.

I Saw Kathy Kissing Peko-Chan...

Christmas eve day Kathy (who is an excellent driver!) drove the four of us to Kamakura with promises of the world's tastiest waffles at one of the many fantastic little restaurants in our favorite Japanese town. She adroitly motored across the Miura Peninsula, along Zushi Beach, and into Kamakura. After a short narrated tour of the main drag, she turned left onto a very narrow street - beckoned by one of those ubiquitous semi-official men waving large wands that resemble light sabers. Another helpful Japanese gent very professionally guided her into a primo parking spot from where we alighted just steps from the main drag.


Unfortunately the famous waffle restaurant was closed, so we lunched in the Fujiya restaurant, home of  Peko-chan. This cute young lady is not only a long-time favorite character in Japan, she is also Kathy's alter ego (well, one of them). We especially love her around the holiday season. She was in front of the store, all decked out in Christmas red, so who could resist a loving buss on the cheek...even if it did make her head bobble a bit (Peko's, not Kathy's). I always enjoy bringing Kathy to Peko places because her unabashed cuteness (Peko's AND Kathy's) always fills us with joy .


The remainder of the day we meandered the little shopping street, munched on freshly baked rice crackers, bought Kate a really cool hat, petted a CC look-alike cutout cat, and noted the "White House" complete with Texas Flag. 

On our return trip to Yokosuka, Kathy once again demonstrated both her driving and navigational perspicacity by first finding the Yoko-Yoko expressway, then cleverly leaving it at the Zushi exit to avoid a traffic jam, thence winding through very long tunnels and unfamiliar roads right back to the CFAY main gate. 


We all avow that Kathy-san certainly earned and deserves her very special Peko-chan holiday gifts this year. Peko would be proud as punch. We certainly are.

Guest Post, by CC and Minerva

CC: See, Minerva, I told you they didn't abandon us! We are one intact family again.


Minerva: Well, except for James, who got us into this six years ago. Plus, I don't think the blond one is going to stick around. She's allergic to us, you know. Plus, she has a life.


CC: There you go again, Minerva. Always the cynic. We wouldn't be here now if not for her. She's my new hero.


Minerva: Yea? What makes you think they're not going to ship us off to some other foster-home as soon as we get used to this one?


CC: Minerva, they did not bring us all the way here just to send us somewhere else. Besides, they're nicer than they used to be. That big guy hasn't even called us "mangy" yet. And the tall one doesn't  move from his computer when we run under his bed. He likes us in his room! Furthermore, we haven't been here a week and they've already cleaned the litter box. 


Minerva: Big woop. They don't leave food down all the time like they used to. So now you have to wake the big guy up at 4 a.m. every day to feed us. But at least he gets up, eventually. What are we going to do when he's not around? Huh? I suggest a big dinner, because you won't know when or if you'll get breakfast.


CC: Well, be an optimist for once. You look 100 times better with the weight you've lost since that redhead put us on a diet. You're quicker on your feet too.


Minerva: Yeah, that redhead was a real hoot. Guess we showed her, huh? Now that next lady, the other blond one, she was really nice and she actually understands cats. I could have stayed there. But,... I guess this is better.


CC: Of course it's better. This is our home. What, you want it to always be like that high class cat resort where we first stayed? That was vacation. This is real. This is our life. This is as good as it gets. And, you know what, Sister? It's pretty darned good.


Minerva: Yes, it really is. Even I will admit that. 


Hey, look, she's heading to the bedroom. You know what that means! Reading time! My favorite part of any day! Okay, so it really is good to be home at last! 

Both: Happy Holidays, Everyone! Wherever you are.

Do Cats Get Jet Lag?

Hard to tell, since cats mostly sleep during the day anyway. This is where I found them when I got home from work today. That is my desk chair that they have thoughtfully warmed for me to plant my backside after walking home in the brisk winter chill. (Well, chilly for here in Japan. I imagine the 39 degree wind chill would be golfing weather in Michigan.)

It is nice to have the cats around the house after a five month separation. They wasted no time in making themselves right at home by immediately resuming their positions as heads of the household and quickly whipping their human servants into place. They spared no effort in getting Kathy to resume her role as designated reader. After all, they do have a lot of literary catching up to do.

As for the heroic transporter of said cats, I haven't seen much of her since she walked through the portal at Narita Airport. She seems to be on a different schedule from the rest of us. But that is very understandable given not only the 14-hour time zone difference, but also the frenzy of activity leading up to her long trip across the wide ocean. We do expect that she will eventually be awake during actual daylight hours...probably just in time to suffer through it all over again after her return trip to the States at the end of the month. Would not count on her to be the life of any New Years Eve parties this particular year.

"The Degree of Neurosis...

...depends on how one responds to ambiguous situations." When faced with difficult challenges, my mother often paraphrased that line from a Saul Bellow novel. She never actually articulated - at least not to me - which responses would be more or less neurotic making. That was left for me to discover as I grew into adulthood.


I've generally witnessed two somewhat dichotomous approaches to resolving ambiguous situations. I personally favor the problem-solving approach, namely that through analysis and creativity - and perhaps some luck - we can clear up ambiguity through the light of reason, novel ideas, and perseverance. This approach often leads to unfamiliar recesses of thought, so it can require considerable risk-taking, and it is sometimes very hard; but ultimately worth both the risk and the effort.


This is an effects-based process: First describe the desired outcome ("Begin with the end in mind" a la Covey), then figure out a path or process to that outcome. Next describe obstacles to that path, and determine how to eliminate or mitigate them. Finally, consider the downrange consequences of actually achieving the outcome through that particular process. If the consequences appear to be too dire, work out how to mitigate those. Throughout the process, dare to think "outside the box" (trite though that expression has become). As a last resort, when all novel choices fail the test, choose an alternative outcome or look for a different process. Ironically, the ambiguity is never completely erased and one is often critically aware of the risk involved in charting a new path. So this approach does tend to keep one right on the edge of the personal comfort zone, sometimes right on the border of neurosis. But that is where true creativity and innovation reside. If I find myself feeling too comfortable about a proposed course of action, I wonder what about it I'm missing. 


The antithesis to that analytic and creative approach is practiced by the (seemingly) myriads of people who strive to resolve ambiguity by throwing a cloak of rules on top of it. For the most adroit proponents of this latter approach, life has no ambiguity at all, and therefore no risk. One simply needs to find and apply the right rule. They are seldom at the edge of their comfort zones because the rules that govern their decisions create comfort. Original thought? Out of the box ideas? Novel processes? No need for any of that. Outcome? Don't bother with that. Only the process matters. As long as I have my rules, I am comfortable and life is smooth. Neurosis? Wouldn't know one if it hit me in the head. We often find practitioners of this approach in positions of quasi-authority, where their decisions - or refusal to make any - can wreak neurotic making effects on others. We often call these people "bureaucrats", an unfortunate association since many people who work in bureaucratic organizations are very imaginative and not at all driven by rules for their own sake. Perhaps "autocrat" is a more pertinent moniker. Rules are, of course, important and necessary...as means to achieving a good desired outcome. But when an imaginative thinker and rules-enslaved autocrat clash over an ambiguous situation, the result is often very unpleasant, especially for the creative one.


A recent case in point for our family was the process of moving our two cats to Japan from D.C. We left them behind last summer when we moved because the airline rules clearly state that they will not accept animals when the weather is hot. Not a bad rule in itself, but the downrange consequence of our compliance was to foist the ambiguous burden of cat care and feline transport to several surrogates. Most affected was Number One Stepdaughter, whose life is already quite full both personally and academically, and who never saw the "future mover of cats" memo tacked behind her bedroom door when she was growing up. 


No problem, right? Simply interpret and reinterpret multiple poorly written documents summarizing rules of two different countries, the U.S. Army, and the airline; and deal in an unfamiliar environment with well-meaning but not forward leaning individuals for whom rules are comfort, and who could not imagine stepping even a toe outside the box. Doing so over 6,000 miles distance and 14 hours time difference from the real cat owners/parental comforters simply adds relish to the challenge. Neurotic making potential? Major Generals could decompensate over less.


Fortunately, the analytic/creative process succeeded in finding the simplest of solutions, plus we had a patronus in our local U.S. Army veterinarian. He helped us correctly interpret the  rules-laden documents and then guided his U.S. counterparts to the proper  solution...consistent with the rules, no less. So, while some of our nerves may have been seriously tweaked over the last several weeks (and assuming the desired outcome actually occurs as expected), we are happy to report that our degree of neurosis remains constant. All things are relative, of course.

Kannonzaki Revisited, Part 3

Once completing this flat stretch along the bay I'm back on Route 16, heading slightly inland and climbing  some rolling hilly terrain that steepens toward the top. It's less than a mile climb, with a fairly rapid descent on the other side (Note to self: That rapid descent will be a steep climb on the return leg). Then the road winds gradually down into an almost idyllic little marina that looks and feels like a quiet fishing village. Boats and launches predominate along the water, and again one sees little fishing establishments and people wearing rubber boots and carrying fishing gear.

Another gradual incline runs past the Yokosuka Art Museum on the right and comes to the Kannonzaki Keikyu Hotel and SPASSO Spa on the left. Very inviting. An alternative to taking the road past the Keikyu Hotel is to turn down a short street to the water and thence along a boardwalk (real boards this time) that eventually joins back up to Route 16 near the lighthouse. Expecting a chillier breeze as the overcast deepened, today I took the high road. I soon crested the small hill and came upon the welcome sight of the Kannonzaki Lighthouse parking lot, just where I had left it back in the summer of 2008.

Descending the hill toward the parking lot I was delighted to see the Jizo statue at the entrance is still there, and that someone is still taking care to properly clothe it. These simple, almost primitive statues are often seen in cemeteries around Japan, where they represent children who have died. Jizo is said to be the protector of children, women, and travelers. I surmise that this one is close to the lighthouse for the latter purpose. It was carefully decked out in a full length white faux cloak and plastic outer raincoat. A child-size knit hat and scarf completed the ensemble. Jizo looked warmer than I was.

A quick trip across the lighthouse parking lot to the bathroom and water fountain, and I was ready for the return run to the base and home. The rain began just as I started back, and it stayed with me all the way home. I realized I had totally blown the clothing decision at the start of this run. However, the breeze was mostly a quartering tail wind, so I didn't feel too cold or wet until I got closer to the base.

The rain increased all the way home, so I was a wet, cold, and tired runner by the time I took off my shoes in our foyer. All in all it was a great run, where I got to visit many fondly remembered sites along the way, and to be out and about in Japan is always rewarding.

I will continue to head in that direction for my biweekly long runs, expanding the distance every two weeks.  It's a great way to experience the local area and takes some of the monotony out of those time-consuming training runs.

Kannonzaki Revisited, Part 2

After my refreshing stop in the neighborhood park, I continue my run along a thriving commercial area that includes a baseball batting range and three Wal-Mart/Target/Lowes look-alikes: Homes, Livin, and Ave. The going here is a bit congested with a constant flow of Japanese frequenting these shopping complexes by foot, bicycle, or automobile. Cars are the least threatening because the driveways are controlled by Japanese sentries with their lighted batons that resemble light sabres. Aware of my approach, they resolutely stop the traffic when I'm still a good 20 yards away. I always smile and say, "Arigato", and they always smile and bow politely.


Shortly after the enclave of home shopping malls I pass a large commercial fish market and then an inlet featuring several small fishing enterprises. Japanese folks in rubber boots and coveralls hustle about with tackle and gear. In the summertime there might be seaweed drying in the sun, soon to become nori. Logically perhaps, I good looking sushi restaurant appears just ahead.


About a half mile after the fish market I turn around an apartment complex and leave the road for the boardwalk (okay, cement walk) that runs next to Tokyo Bay for about a mile. To my right is Maborikaigan, a residential neighborhood where quite a few American naval officer families live. This whole area is built on landfill, and it is one of the more picturesque places I've ever run. On a nice day, people sunbathe on the rocks, but even on a cool, overcast day like today a few people are fishing from the edge, taking photos, or just out for a stroll or run. The bay is a panorama of water in motion, small islands on the horizon, and a plethora of ships and boats of all sizes and shapes. In spite of its beauty, this stretch along the water can challenge a runner, because it is unprotected from the climate, and leaves one vulnerable to whatever wind or weather whips off the bay. Today it was a crosswind, so even though it was cool it was not as annoying as the cold winter winds that blow directly in your face and cut your motivation in half. Enjoying the crispness of the breeze washing over me from left to right, I  did wonder what I would find here on my way back.

Kannonzaki Revisited

The Tokyo Marathon is less than three months away, so it is time to get down to serious training. That means a long run every two weeks, increasing the distance by 2 miles from the previous long run. If all goes according to plan (which it never does) I'll complete runs of 20, 22, and 24 miles before taking on the 26.2 mile marathon on February 28. This weekend I needed to do a 14 miler, so I revisited one of my favorite courses from our prior tour here. The run from Yokosuka Base to Kannonzaki Lighthouse is not only a good run, it's also a neat cross-sampling of the country and culture.


One challenge of running long distances this time of year is deciding what to wear. It is not a fashion thing…Lord knows I'm never to be confused for one of those guys on the cover of Runners World magazine. The trick is dressing right for the weather, which can be variable and unpredictable. The standard gouge is to dress for the end of the run, meaning that if you are comfortable for chillier conditions at the start, you will likely overheat as the body and ambient temperatures warm up. Well, today's prediction was for intermittent rain showers later in the afternoon, with a northerly breeze to make the 54 degree high feel more like something in the forties.


I added some long running pants and light jacket to my shorts and long-sleeved shirt and headed out the door. The out and back distance from the Base to Kannonzaki is roughly eleven miles, so I planned to do three miles around the base first. I had barely gotten started when the sun came out and the breeze lightened up. After two miles I was already hot, so I circled back home, shed the jacket and long pants, and resumed my path to the gate. By the time I egressed from the base it was overcast again.



Running left from the gate one first passes the Kanagawa University of Human Services, which houses schools of dentistry and nursing. Typical of any Saturday, students were coming and going from classes. School at any level in Japan seems to be six days a week.



 
Mikasa Park sits just beyond the Kanagawa University. This park features the Battleship Mikasa that was the Flagship of Admiral Togo Heihachiro during the Russo-Japanese War in 1904 – 1905. This park is a favorite gathering place of the local Yokosuka citizens, complete with fountain and bandshell, and is also frequented by Americans from the nearby base.

After Mikasa Park the run heads out onto the ubiquitous Route 16, which seems to be everywhere in Japan. One first passes a very large parking lot that is a staging area for newly manufactured automobiles to be loaded onto ships to countries where the driving configuration is opposite Japan's. Strangely, this huge lot that could accommodate several football or soccer fields was completely empty today. A sign of the economic times?



Continuing along Route 16 a family park nestles between the road and the bay. On a nice day many people are there, playing basketball, riding bikes, or just enjoying family time. When I that park the weather was turning more overcast and chilly, so little was happening. It's one of my favorite sites along this run because it sports a very nice public restroom and a water fountain where I can refill my water bottle. I always stop here.

To be Continued....