On Tuesday, we decided to take Dick Hatch, our 89-year-old neighbor, to the Hope Valley to see the fall colors.  We make this trek every year if we're in the States and have only been disappointed a few times, usually in drought years when the leaves dropped without much color change.  We were a bit concerned about this season given the major drought and the nearby fires, but ultimately weren't disappointed.  

We left our place in Pioneer mid-morning and made our way up Highway 88 past the devastation of the recent (and still active) Caldor Fire.  From the entry of the Mormon Emigrant Trail (which will remain closed through next spring) past Kirkwood and Caples Lake, the fire had reached the highway and, over the approach to Carson Spur, had crossed the highway, devastating trees and leaving normally spectacular aspen groves burnt to a crisp. Only blackened trees with no leaves and few branches remain.

​Arriving in the Hope Valley after descending Carson Pass, we were a bit disappointed to see that smoke from fires to the south had invaded the valley.  While the colors were there, it wasn't the best day for photos. 
​ ​

We made our way to Wylder's Sorenson Resort which usually has spectacular color and were a bit disappointed to find that many of the leaves had just dropped.  We hiked the property through the aspen groves and then decided lunch was in order.  Since our favorite spot, Sorenson's Cafe, is closed on Mondays and Tuesdays, we took our chances with the highly recommended Cutthroat Brewery in Markleeville.  Between Sorenson's and Markleeville, we had to drive through more fire devastation, this time from the recent Tamarack Fire.  ​

​After a superb lunch, Dick wanted to show us a few things on the way back.   Our first stop was just off Highway 88/89.  We took a short trail up to Snowshoe Thompson's Cave.  Thompson stopped here on his trips and the smoke from his fires still marks the top of the 'cave'.

For those of you who haven't heard of him, John Albert Thompson was born in Norway and came to the States at age 10.  After moving west and making a small fortune during the Gold Rush,  Thompson volunteered to carry mail from Placerville, California to what is now Genoa, Nevada, a 90-mile trip each way.  This wouldn't have been particularly unusual except for the fact that he did this during the winter when the mountains were impassible.  His claim to fame was what the locals called his 'snowshoes', ten-foot long boards that he attached to his feet.  Skiing was unknown in the West at that time.

Thompson was born near Telemark, Norway and had learned to ski as a child.  For twenty years, until his death at 49 from appendicitis, Thompson made the trek two to four times a month.  There are countless tales of his heroic exploits which I'll leave to you to check out if you're interested.  

Thompson made the trip to Genoa in three days and did the return in two.  It is said he could ski downhill at over 60 miles per hour and could jump over 100 feet.  Ironically, Thompson was never paid for his mail deliveries.

Following our short hike, we continued back into the Hope Valley.  Dick had us pull over at a small parking area just past the 88/89 junction (also known as Pickett's Junction).  This is officially the entrance to the Hope Valley Wildlife Area.  We have stopped there before and walked over to the nearby Carson River to do some fly fishing (actually, this is where Karen caught her first trout on a fly rod several years ago) but had never realized that it was a recognized wildlife area.  

Dick explained that this is where Highway 89 used to leave 88 to traverse Luther Pass to reach Lake Tahoe.  We crossed a bridge over the river and walked about a half-mile until the remnants of the road started to get steep.  

In his younger days, Dick, his wife Carol, and their five kids had been guided up the old 89 and onto the Pony Express trail which he now describes as a challenging trek.  We returned home, vowing to come back to check it out.

Friday morning we awoke to rain - the first real rain of the season.  We checked the weather and decided that since the cold front was passing, we could drive through the few inches of snow at Carson Pass and do the hike.  

We pulled into the lot at 10am and stepped out into blustery 40-degree weather.  We bundled up a bit and started walking.  As we began to climb, the views were spectacular.  No more smoke and the contrast of the aspens against the freshly snow-covered peaks was breathtaking.  

Most of us have heard of the Pony Express.  I didn't realize that the 2000-mile route with 190 stations from St. Joseph, Missouri to San Francisco went through the Carson Valley but we encountered the historical trail marker about a mile up old 89.

We left old 89 and took the single-track trail upward.  About a hundred yards further, it crosses old 89 and then crosses it again about a mile further.  Ultimately they join just before old 89 intersects the new 89 at Luther Pass.  

We stepped into the large meadow at Luther Pass.  Google Maps shows it as a lake and I'm sure I've seen it full of water after wet winters, but this fall, it's a dry meadow surrounded by aspens, pines and spruce.

Beginning our return to the car, we noticed a trail going off to the right.  We followed it for half a mile or so before realizing that it would continue along the ridge until it met the road at Scott's Lake.  We often hike the trails off that road, but hadn't found this one.  It looks like a good one to explore.  Unfortunately, if we had taken it, we would have had a long walk along the highway to get back to the car.  

Instead, we retraced our route and enjoyed the scenery looking down on Hope Valley as we descended.

That night we had dinner with Dick, his daughter, and her husband.  She told us about some of those 'challenging' tours they'd taken as kids, including following the Mormon Emigrant trail and learning about Tragedy Springs and the Maiden's Grave.  It's on our list for next year assuming they reopen those parts of the National Forest after the fire damage.

Our summer started out well with several excellent hikes in the Sierra, but with the fires, we cut back dramatically, and for those hikes we did, the pictures were worthless.  Fortunately, the air has finally cleared, at least for the moment, and the crowds have thinned, so yesterday, we did the much-travelled, but highly praised Woods Lake Loop.

Woods Lake is just past Caples Lake on Highway 88  before you get to the top of Carson Pass.   A short paved road leads you to the trailhead parking area.  As has happened with most of the parking areas around Carson Pass, the US Forest Service has turned management over to a private company.  No more free parking. 

We paid our $8 parking fee, feeling lucky to get one of the few remaining parking spots and made our way to the trailhead.  

Not far along the trail you have a choice.  You can stay to the right and go to Round Top Lake, 2.5 miles away, or turn left and go to Winnemucca Lake also 2.5 miles.  It is a loop, so either way, you'll return to the starting point.  We went right and began to climb.  

There aren't many aspens on this stretch, and we were a bit past peak color, but it was a beautiful hike around massive granite boulders, spruce trees and small creeks.  You gain 1200' in that 2.5 miles, so it is a bit of a workout.  You'll pass an abandoned ancient car chassis and will wonder how it could ever have made it up there, and you'll pass an abandoned mine.  

As the trees get shorter and fewer, you know you're getting close to the top.  And suddenly, you're on a plateau with the spectacularly green Round Top Lake on the right.  You can follow the trail to the right to Fourth of July Lake about a mile and a half away, or turn left to continue on the loop.

After admiring the lake, we continued a short distance along the loop trail to its highest point.    Looking up, you see Round Top Peak (10,381').  It's a thousand feet higher but looks like more.  There is a thin trail leading in that direction but from all accounts, the last part of the ascent is a demanding climb to get to the top of the peak.  We weren't prepared for that yesterday.  

​Instead, we decided to stop for lunch before heading down to Winnemucca Lake.  While eating, we saw several pairs of hikers making their way up from Winnemucca Lake towards Round Top Lake.  Surprisingly, we saw only one other pair on our own way up, suggesting that most people did the loop in the opposite direction, or, more likely didn't do the entire loop.  

The trail down widened substantially and was clearly much more travelled.  We considered stopping at the lake, but there were a surprising number of people at each of the spots we looked at.  We decided to just continue down.  

The rest of the hike is an easy descent - much less steep than our climb up.  It follows a creek down a wide canyon with nice views until you reach the thicker forest near Woods lake.  We didn't pass anyone on the way down.

Overall, this was a nice hike for a fall weekday.  According to Karen's GPS watch, it was just over 5.5 miles.  It took us almost exactly 3 hours including time for lunch and pictures.  We'll likely do it again in the spring (July at this elevation) for what are touted to be magnificent wildflowers.  

It was a beautiful swell from the southern hemisphere and Southern California was seeing double-overhead waves.  My friend Tom and I raced to a secret spot north of Los Angeles where we, along with a few others, caught some of the best waves of our young lives.  We were both 19.  At sunset, Tom went in and I waited for one more.  As expected, it was perfection.  A nice stand-up barrel after takeoff and then a long workable wall that would take me to the beach.

I knew that my wave would meet an outgoing wave from the steep beach and I expected a huge vertical exit.  What I didn't expect was the hyperextension and dramatic compression that would crush two discs (between L5 and S1 and L4 and L5), and would leave me nearly paralyzed on the beach.  Tom carried me to the car and it was six months before I could touch my knees and nearly a year before I was back to surfing.

Over the next forty years, I had intermittent back problems some of which would sideline me for weeks at a time.  I saw doctors and chiropractors and got temporary relief, but invariably would have flare ups a few times a year.  The quality of my surfing was dependent on the condition of my back.  When I had no pain, I surfed well.  Otherwise, I was slow to get up and conservative in my drives down the line and off the lip.  

When there was no surf, I went trail running if my back permitted.  At some point, I developed Achilles tendinitis and saw Jeff Moreno at Precision Physical Therapy.  He put me through some tests, watched me walk, and declared that like most surfers he worked with, I was an 'Extender'.  I had spent most of my life arching my back while paddling, had over-developed back muscles and under-developed core strength.  My posture was bad, I sat and stood incorrectly, and I was a mess.  

Trusting his judgement, I started developing core strength, corrected my posture, and was diligent in not 'extending'.  I later discovered that Kelly Slater had put out a video on core strength for surfing and added those exercises and paddling techniques to those prescribed by Jeff.  

Six months later, my back pain was gone.  Over the next seven years I had zero back pain.  No flare ups.  When my fellow surfers complained about back issues, I talked up core strength.  I was finally done with back pain and back to surfing at full capacity.

The Accident
Like most surfers, I've had my share of accidents: a fin into the thigh when a barrel collapsed on me at Wind'n'Sea in San Diego, stitches from run-ins with boards (not always mine) and encounters with rocks and reefs, and a torn MCL, which I rehabbed (see How I Rehabbed my MCL Tear).   So, I wasn't surprised when I hit the bottom at the Lane ten weeks ago.  Unfortunately, what is normally just a bounce off the bottom was much worse this year because of the portions of the cliff that fell in last winter.  Sharp rocks have accumulated in front of the point.  

I managed to finish the surf session after recovering for ten minutes, but the next day, I could hardly move.  I had hit my sacrum on a rock.  There was significant bruising and my back was twisted.  After a couple of osteopathic treatments (see another post on Why I Believe in Osteopathy) and a great massage with a 'Q-L Release' from Rochelle at Joy of Movement, I was on the mend.  Surfing wasn't a problem and I was dancing, hiking, and playing disc golf. 

I knew I was only at maybe 80% recovered but hey, why limit myself?  Of course I did something stupid and it was game-over.
​

I woke up the next day in extreme pain.  I couldn't walk more than a few feet, couldn't stand, couldn't sit, and couldn't lie down.  Most of the pain was down the front of my thigh, and my knee was hypersensitive.  Over the next week, the pain increased each day.  I tried to sleep standing up but that didn't work.  The doctors gave me anti-inflammatory shots, morphine, and hydrocodone, but nothing stopped the pain.  After another week with continued degradation, my osteopath recommended surgery.  The docs at PAMF scheduled an MRI (the most painful experience of my life - even after a big morphine injection) and the surgeon diagnosed a herniated disc with nerve impingement between L3 and L4.  

Never having had any kind of surgery, the prospect was terrifying, but I knew I couldn't live in that state.  

I met with the surgeon who described the 'minimally invasive' microdiscectomy.  It did require general anesthesia.  He would make a 3 cm incision, shave the bone and the disc and free the nerve.  Aside from recovering from the incision, I should be pain-free immediately after the surgery.  Complications were rare.   In the meantime, the surgeon prescribed Gabapentin to calm the nerve pain.  

Doing the research, it appeared that the only real risk arose if you needed another surgery.  The additional scar tissue could complicate subsequent surgeries.  The one thing that concerned me was that studies showed that after two years, patients who avoided surgery had the same outcome as those who had the surgery.  It looked like aside from the risks of that scarring, the surgery provided a faster way to get pain-free but that alternative treatments could be as effective.

I scheduled the surgery, did all the pre-clearance testing, and two days later - three days before the surgery - I was feeling a bit better.  I still couldn't walk or lie down, but I could sit.  I was able to get a partial night's sleep - my first in weeks - sitting up. ​  As the surgeon explained, this was the result of the Gabapentin.  And that was as good as it got.  At least I could sleep a bit.

The Miracle Machine
Hearing about my impending surgery, a friend who had gone through multiple back surgeries contacted me.  Several months ago, he was about to undergo yet another surgery (he'd been suffering back pain since a car accident when he was a teenager), when someone suggested he contact Dr. Bernstein at Santa Cruz Osteopathic.  After a few weeks of treatments on a spinal decompression machine, he said that he had now gone six months without pain and without medication for the first time in his life (actually, since his accident decades before). 

I did the research and discovered that MDs and DOs had a 90-100% success rate with the decompression machine while chiropractors had success rates between 50% and 60%.  This was attributed to the DOs and MDs being more experienced doctors who could accurately read an MRI and better target the focus of the  machine, as well as the fact that they could better identify patients who wouldn't benefit from the treatment.  They also can prescribe medication like the Gabapentin.  

I spoke with the surgeon and we agreed to postpone the surgery to see if this would work.  

I met with Dr. Richard Bernstein who reviewed my MRI and pointed out my original injury with degradation of my vertebrae from S1 through L4 and the nerve impingement between L3 and L4.  He said I was a good candidate for SpineMed treatment. It would give me the spacing necessary to relieve the nerve pain and would stimulate blood flow to the damaged disc and to the previously degraded vertebrae.  The treatment wasn't covered by insurance and would require 20-25 sessions.  He suggested two 30-minute sessions a day.  

Because I still couldn't lie down without major pain, the first sessions were difficult.  I had a hard time not moving.  I was constantly trying to relieve the pain.   I suspect I reduced the efficacy of the machine because I couldn't lie still.  By the 10th session, I could lie with legs elevated and minimal adjustments.  By the 19th session, I could lie there comfortably, and afterwards, could sit and stand, and walk short distances pain free.  

Dr. Bernstein suggested I continue for a few more sessions - one a day for the next week.  

Two days later, I was walking well.  I also started physical therapy at Precision. I took Precision's Spine Dynamics class, and  continued massage with Rochelle.  For the first time in over two months, I had zero pain.  I tentatively began increasing my walking distance and now, a week after my last treatment on the SpineMed machine, I'm up to 3 miles a day at a rapid pace.  Yesterday, I took my new board  (which I ordered just before my accident), and paddled for 20 minutes - again with no pain.  

My physical therapist is cautioning a slow return to full activity.  I have lots of exercises to do, but she thinks I'll be surfing in two weeks.  In the meantime, I can stand-up paddle, hike, and start dancing again.  I still have some residual hypersensitivity around my knee (about 10% of what it was), but Dr. Bernstein and the physical therapist believe that as the nerve heals, that will disappear.

If you're considering back surgery because of lumbar disc problems, see if you can find a doctor (MD or DO) who has a SpineMed machine.  In Santa Cruz, definitely have a talk with Dr. Bernstein.  

After doing this treatment and a lot more research, I honestly believe that this is a great alternative to surgery for most lumbar problems and that surgery should really be a last resort.

If you liked this blog, please check out my novels.

If, like me, you're not a boater, you probably think the Santa Cruz Harbor Patrol is only purposed with maintaining order in the harbor and helping boaters in distress in and near the harbor itself.  You may have seen Dan Coyro's picture at left of the Harbor Patrol boat towing a capsized boat after the 2011 tsunami that wreaked havoc on our small harbor.  Although I spend a huge amount of time in the ocean, I have to admit, I certainly never gave the Harbor Patrol much thought.  

But then, as I started working on my next novel, currently titled The Swimmer (you can check out the beginning in my Work in Progress section), I knew I needed to do some research on ocean rescues.  My scenario is very dramatic and I thought the chances of my swimmer being rescued were nil but I needed to describe an attempted rescue in the book.

I met briefly with one of the members of the Santa Cruz Fire Department's Marine Rescue Unit, thinking these were the people who would attempt such a rescue.  Over the years, I'd seen them doing physically demanding training exercises at night along West Cliff Drive.  

I was hoping to understand how they'd attempt a rescue of a swimmer trying to commit suicide in Monterey Bay at night, expecting lots of information about their jet skis, search patterns, rescue swimmers, etc.  And while they have all that, apparently, if we're looking at a rescue more than a couple hundred yards offshore, especially at night,  it would be the Harbor Patrol that would pursue the rescue, possibly in coordination with the Coast Guard.  I was told that the Harbor Patrol boat had all sorts of cool high tech equipment including thermal imaging, side sonar, sophisticated radar and more, and that I should contact the Harbormaster to find out how they approached ocean rescues.

I spoke with Latisha Marshall, the Harbormaster, and she gave my contact information to Blake Anderson, the assistant Harbormaster.  Blake would meet with me to explain rescue strategies and show me their rescue boat.  

I sent Blake a link to my scenario and when I arrived, he greeted me and introduced me to Latisha.  Blake was more than prepared to answer my questions.    I laid out my scenario and apologized, saying I understood that the likelihood of saving my swimmer was just about zero.  But Blake interrupted me and said he wasn't so sure.  Over the next thirty minutes he told me about some remarkable rescues.  One was led by Don Kinneman (Senior Deputy Harbormaster) and was later recounted by Santa Cruz's resident ocean science guru, Gary Griggs.  Griggs writes a not-to-be-missed biweekly column for the Santa Cruz Sentinel titled Our Ocean Backyard.  

Griggs describes ocean disasters, impacts of climate change, pollution, and much more.  You can find archives of his articles here.

In the early 70s, Griggs did a study of ocean currents in Monterey Bay.  He dropped floats containing postcards at various points along the coast and followed where they were found.  Ironically, in the summer of 1972, I found one of the floats in the rocks on the south end of Four-Mile Beach.  Grigg's current research would play a significant role the first story.

Amazing Rescues
In one of the rescues, Don Kinneman led the search for two brothers whose Hobie Cat had capsized.  Two very distressed women had entered the Harbor office just before dark.  The first was the wife of one brother and the second was the fiance of the other brother.  The brothers were supposed to have returned hours before.  Don put together a crew and  following the lead of the Coast Guard, searched southeast of the last known position (accounting for drift from the northwest winds).  But after hours of searching they were forced to return to the harbor about midnight.

Frustrated with their lack of success, Don didn't give up.  Having studied Gary Griggs' results on currents in the Monterey Bay, he pulled out charts, and plotted where the currents might have taken the brothers.  Don, and Cary Smith, another Harbor Patrol Officer, went back out and after starting a sweep search in the projected area, found one brother clinging to the side of the overturned boat 10 miles offshore.  He was hypothermic and likely near death so they raced back to shore and then returned to search for the other brother.   A mile further out, on a pitch-black night, they rescued the other brother.  If you think about the vastness of the Monterey Bay and the odds of finding a swimmer 11 miles out, this is truly miraculous - or beyond miracles, perhaps Don Kinneman is a rescue force to be reckoned with!

Gary Griggs gives us a nice footnote to the story that Blake didn't relate.  Don, and Cary were invited to the brother's wedding a few weeks later.  For his first toast, the groom raised his glass to Don and Cary without whose help, the wedding would have never happened.  

As Blake finished this story, which clearly reset my expectations about my swimmer's rescue, Laticia jumped in.  "Why don't you tell Steve about that rescue where you were awarded the Rescue Professional Hero Award?" she suggested.  

Modest Blake reluctantly agreed to tell the story.  

He was on duty one evening and heard what seemed to be static on the radio.  The operator had concluded that it was just static.  Somehow, Blake thought he heard something else.  At first it was 'mile buoy' and then 'water'.  Since no one else heard this, Blake went on instinct.  He found a crew member and they motored out to the mile buoy - just in case his hunch was right.  Not far beyond the buoy, they found an overturned Hobie Cat.  They continued their sweeping search and located the victim another quarter mile away.  Once again, this was another successful rescue in what I thought of as a near impossible situation.

The Harbor Patrol Boat

Moving back to my scenario, I asked Blake to take me through the entire process from the time a 911 call is placed.  He explained how they would be alerted and that once the Fire Department confirmed a rescue was needed, they'd contact the Coast Guard and would begin the search. Blake described the complex process of coordinating the searches (you'll find a dramatized account in my novel).  He then suggested he take me out on the boat.

Today, the Harbor Patrol Rescue Boat is a 21-year-old 28' RIB (Rigid Inflatable Boat) with twin 250 HP Yamaha outboards.  The 'cabin' is tricked out with  two displays which show charts, side-sonar imaging (looking at the bottom up to 40' down), thermal imaging, radar images, and much more.  They have a camera where they can record interactions with boats or rescues.  The boat has a top speed of almost 50 knots (nearly 58 mph), so it can get to distress situations remarkably fast.  The soft sides make it easier to come alongside other boats and to bring victims on board.

The Harbormaster staff includes 4 deputies who are 'offshore certified'.  As Latisha and Blake explained to me, this is a rigorous training and certification program where part of the final exam is done in the boat at night with blacked-out windows.  The candidate must show navigation and rescue skills using only instruments.  

I put on a PFD and Blake led us slowly out of the Harbor.  One screen showed the thermal imaging while the other used the side-sonar to show the bottom of the harbor entrance.  We headed toward the wharf, my eyes jumping back and forth between the thermal imaging and the windows.  A few hundred yards into our trip, I saw a kelp bed ahead of us, just offshore from the Boardwalk.  It looked like any other kelp bed.  But on the thermal image, I spotted 6 white balls moving around.  As we got closer, I could see that this was a family of sea otters - well hidden in the kelp, but visible through thermal imaging.  

On our way out to the mile buoy, we passed some swimming sea lions.  Again, I would never have seen them visually but the thermal imaging clearly saw their heads as they periodically rose above the water. 

Several hundred yards from the buoy, I could see the buoy on the thermal imaging screen.  I was a bit surprised, but Blake explained that the system spotted temperature differences and the buoy was warmer than the ocean.  Several large white objects were moving on the buoy - sea lions.  I realized just how powerful this imaging tool was.  And apparently, the Coast Guard boats and helicopters are similarly equipped.

On our way back to the harbor, Blake talked about other work he and the Harbor Patrol had undertaken.  Over the last few years, they've become instrumental in cliff rescues.  As most of us know, not only do people fall off cliffs into the ocean or get knocked off by unexpected waves, far too many beach walkers fail to pay attention to the tides.  Incoming tides have trapped many on virtually inaccessible cliff faces and in caves.  

While it's the Fire Department's cliff rescue and marine rescue teams that usually perform the actual rescues themselves, they need to locate the victims first.  With high cliffs or high wave conditions, this can be nearly impossible.  But once again, it's the Harbor Patrol and their thermal imaging to the rescue.  They can locate people and help guide the rescue teams to the victims.

Blake also talked about the Harbor Patrol's recent involvement with law enforcement.  I won't go into detail here, but they now do training for police departments, SWAT teams, and Federal agencies.  

As you can see, I was impressed.    Between 2015 and 2018, the Harbor Patrol saved over 217 lives.  I never suspected that the Harbor Patrol was so critical to the safety of our ocean-loving community.  And I wondered why.  Why didn't I know this?  How is it I could have underestimated their contribution?  I hope that this blog and my accounts to surfing buddies and friends will help get the Harbor Patrol more recognition.

The good news is that the Harbor Master recently received a Federal grant that will allow them to replace the aging Harbor Patrol Boat with a new $550,000 craft so that they can be even more effective.  

If you see the Harbor Patrol while surfing, boating, kayaking, stand-up paddling, or during other ocean activities, give them a wave.  And if there's an issue on the ballot that involves funding for the Harbormaster or Harbor Patrol, give it due consideration.  This team might one day save your life or the life of someone you love.
​

This post is intended for those of you contemplating hip replacement or those of you who might be caring for someone who's going to have hip replacement surgery.  I'm hoping to set your expectations for the recovery.

Many of you know the story of My Miraculous Wife - the blog post I did several years ago where Karen made an amazing recovery from major hip problems to actually do the Big Sur 21-mile race.

A few years went by and we were back to our active lifestyle, dancing Salsa and Swing, hiking, surfing, stand-up paddling, kayaking - you get the idea.  

But then, Karen started having hip problems again.  Our dance sessions and hikes got shorter and finally stopped.  Walking was limited and even sitting was painful.  This time, Karen's orthopedist showed us the arthritis in her left hip.  Parts of her hip were bone-on-bone, and the best spacing was less than a millimeter where there should have been four millimeters.  A very painful cortisone shot did nothing to help.  Hip replacement surgery was the only viable option.  

A few of my surfing buddies had recently had hip replacements and were now surfing as well as they did before the surgery.  Other friends had had the procedure and raved about the results.  We were hopeful.

We discussed their surgeries and recoveries with all of the people we knew, then contacted the doctors and asked for patient referrals.  It quickly became clear that the anterior (front) approach had the best recovery times and the fewest complications.  We decided to go with Dr. Nicholas Mast of SFHips in San Francisco.  Although that would require a longer drive, from what we could see, his patients had the best recoveries.  We met with Dr. Mast and his staff and got briefed on pre-op procedures and post-op plans.  We scheduled the surgery for early April in Novato (the earliest available appointment).  

Weirdly, the one physical activity that Karen could still do was downhill skiing.  She couldn't walk well (I had to carry her skis to the slopes), but boy could she ski.  The week of skiing before the surgery helped her get stronger (she had gotten pretty weak in the preceding months), and likely aided her recovery.
​

Overview of the Procedure
Your hip consists of a ball joint at the top of your femur (femoral head) that moves in the hip socket (acetabulum) which is part of your pelvis.  The socket and the femoral head are covered in cartilage which helps lubricate the joint.  

With an arthritic hip like the one in the photo at the top of this blog, the hip joint has deteriorated.  The cartilage has worn away, lubrication is gone, and bone spurs develop.  Movement becomes restricted and painful.

In the anterior approach hip replacement, a 3-4 inch incision is made in the front of the upper thigh.  The thigh muscles are pulled away from the joint and the femoral head is removed.  The hip socket is resurfaced to make it smooth and an acetabular cup is installed along with a lining.  A ridged spike-like prosthesis with a titanium ball on top is inserted into the femur.  Clamps holding muscles are removed and the muscles go back into place.  The thigh is stitched up with dissolvable sutures and a sealed bandage is applied.  

Hip replacement is one of the most successful major surgeries performed today.  Nearly all patients report getting their lives back.  

The Surgery and Time in the Hospital
We spent the night in Novato and made our way to the hospital.  Surgery was scheduled for 10:30am but pre-op began two hours earlier.  We met with Dr. Mast and with the anesthesiologist.  Dr. Mast was personable and reassuring and talked about recovery times of his patients who often were walking over a mile within a week.  He told us about one patient who went to dinner and a movie with his wife the day after surgery.  This was very encouraging!

At 10:30, they wheeled Karen into surgery.  About 11am, Dr. Mast came into the waiting room and spoke with a woman waiting for her husband who was now in recovery.  He said that her husband could go home that afternoon.  Then he turned to me and said that Karen was next. 

Just over thirty minutes later, he was back and said that everything went perfectly.  Karen would be headed to recovery and would probably be there about an hour.  He said that since she wouldn't be out of recovery before noon, she would be staying the night.  That was exactly what we expected.  

Unfortunately, Karen was in recovery two and a half hours and once in her room, she continued to have numbness in her legs, so she wouldn't be getting up to walk yet.  Apparently, people recover from anesthesia differently.  However, once the numbness subsided, Karen did walk - with a walker - but she easily (from my perspective) covered the 150 feet required for discharge.  Pain medication (we had chosen Tramadol) kept her comfortable and surprisingly, not at all loopy and it didn't upset her stomach.  

The next morning, we had a visit from the occupational therapist who showed Karen how to get on and off the toilet, get into and out of the shower, and some clever tricks for getting dressed.  A bit later, the physical therapist came by and invited Karen to walk to the physical therapy room about 500 feet away.  He and many of the nurses commented on how amazing Dr. Mast's results were.  No other surgeons compared.  The physical therapist showed Karen how to get in and out of bed and how to climb stairs using a cane.  We walked back to her room and prepared for discharge.  Basic instructions were:

- No restrictions on movements other than no lunges.
- No baths, swimming, or hot tubs for 4 weeks - showers are okay.
- For the first week, walk five minutes every hour.
- Wear TED stockings (Thrombo-Embolic-Deterrent) stockings to prevent blood clots
- Taper pain medication as appropriate. 
- Take an anti-inflammatory (Celebrex) for 30 days, and aspirin for ten days. 
- Use ice consistently to reduce pain and swelling. 
- Start physical therapy two weeks after surgery.
- Remove the bandage after 4 weeks.  
- No driving until she stops the Tramadol.
- No risky physical activities which could involve falls for 3 months. 
- Follow the instructions for exercises from the PeerWell application.   

Home Care
We made the lengthy drive home, stopping every hour so that Karen could walk for five minutes.  Once home, Karen had no problem climbing the stairs (using the cane and handrail) to the second floor of our house, home to our living room, kitchen, dining room, and bedroom.  

Karen was exhausted, so after dinner she spent the evening in bed, getting up to walk every hour.  The only significant pain she had was in and around her left knee which was hugely swollen.  With the anterior approach, no muscles are cut.  Instead, there is a 4-inch incision in the skin and the muscles and ligaments are pulled away from the hip so that the surgery can proceed.  This places major strain on the knee attachments.  

We set up a mattress in the living room in front of the television so that Karen could watch TV when bored.  

At this point, and for some time to come, I needed to be present to help Karen get into and out of the shower, get dressed, and to supply her with ice packs.  I also provided massage of her thigh, knee, and lower leg multiple times a day.  

Over the next few days, Karen did as the PeerWell application instructed with exercises and meditations.  In addition to a guided recovery, PeerWell tracked her progress and reported back to Dr. Mast's office.  Remembering Dr. Mast's words about the patients with amazingly fast recoveries, Karen increased her walks of five minutes an hour to ten minutes, then to more.  However, it seemed the swelling and pain in her knee increased.  She had expected to stop pain medication (others had done so at this point), but it wasn't possible.  

We called Abigail, one of Dr. Mast's PAs (physician assistants), and she said that for the first week, Karen should really be reclined or lying down fully, except for the five minute walks.  And, she emphasized keeping the walks to five minutes.  As we later discovered, this is what the patients with the best recoveries had done.  Dr Mast is a great surgeon, and as you'll see, Karen's recovery was remarkable, but Dr. Mast may be a bit over-enthusiastic about the pace of recovery for some patients.  ​

For the next few days, Karen remained prone most of the time, doing the five minute walks.  She could sit to eat, but needed to keep her leg elevated without too much bending at the hip.  After day 7, she began increasing her walking time, very much aware not to increase too much too fast.  

Pace of Recovery
On day 9 after surgery, I came down from my office to find Karen grinning from ear to ear.  She asked me to watch and then proceeded to walk the length of our hallway without her walker.  I was very impressed.  She still used the walker to get on and off the toilet that day, but by day 10, the walker was history. And, so was the pain medication.  Karen had begun tapering after a week (the setback from too much walking early on probably delayed that), but by day 10, she was done.  However, we still iced after walks and before bed.  

On day 11, Karen went downstairs for the first time using a cane and we went for a walk outside.  After 10 days cooped up inside, Karen was ecstatic to be out and about.  We walked to the end of the block and back several times that day.  Karen used walking sticks (we'd bought them for hiking some years before).  These are a better than a cane for walking as they allow for a more natural, even gait.

At two weeks, Karen had her first physical therapy appointment.  After testing, the focus was on range of motion.  Karen couldn't put on her TED stocking, socks, or tie her shoes by herself.  The physical therapist gave her exercises and thereafter, Karen just used Peerwell for meditations and progress tracking.   She also made a remarkable discovery - if she pulled the TED stockings over her knee, it greatly reduced knee pain and swelling - we should have done that from the beginning.  Since her surgery was on her left side and since we have a car with an automatic transmission, Karen was able to drive.  She was a bit nervous - an accident or sudden stop might be painful, but she was pleased to have more freedom of movement.

On day 15, Karen stopped using the cane going up stairs.

On day 17, she could walk downstairs with alternating steps.

On day 18, she could walk upstairs with alternating steps.  At this point, we were doing several 20 minute walks a day on flat sidewalks - adding up to over 3 miles.  Karen was cautiously increasing her distance every other day.  

At three weeks, we went for a hike in Ano Nuevo.  The total distance was almost two miles with a massage break at the halfway point.  The uneven surfaces were much more challenging and tiring than walking on flat sidewalks.   She took the next day off to recover.

At four weeks, the bandage came off and we did a wound inspection via video conference with Abigail, Dr. Mast's PA.  Everything looked great.  At this point, the Physical Therapist showed us how to start massaging the scar.  We also started doing tougher hikes with more elevation and Karen started doing short rides on a recumbent stationary bike.  

At five weeks, Karen could tie her shoes but with difficulty.  

6 Weeks and beyond
At 6 weeks, we started doing more significant hikes and Karen tried disc golf - this involves a dramatic twisting of the body with substantial pressure on the hips and a lot of walking.  We also cautiously restarted our Salsa dancing at Salsa by the Sea at the base of the Santa Cruz Wharf.  

At 9 weeks, Karen began doing daily yoga sessions (via videos)  in addition to the physical therapy exercises and  regular treadmill and stationary bike workouts.  Her flexibility increased steadily.  For all intents and purposes, Karen was back to where she was a year before the surgery - actually, better!

12 Weeks - All Clear!
After 12 weeks, Karen started biking.  We're also very confident about some more difficult hikes - falling is no longer a major risk to the prosthesis.  We're dancing regularly at full speed with dramatic moves and fast turns,  and are back to our previous active lifestyle.  Karen continues to work on getting stronger and on increasing her flexibility. 

This past week we played disc golf at Kirkwood Ski Resort.  The course is physically demanding, even if you're in great shape.  We played the entire course complete with significant climbs at altitude, scrambling over rocks and cascading creeks, and making challenging throws on one of the most difficult courses we've played.  Next week, we'll be doing more disc golf there, then cooling off by kayaking and stand-up paddling on nearby Silver Lake.  

It's great to have our old  life back again!

Lessons Learned
First, Karen believes, and I agree, that she waited too long for the surgery.  Constant struggles with pain as our active lifestyle declined could have been avoided with an earlier surgery.

Choose the best surgeon and talk to his/her patients about their experiences and recoveries.  If Karen needs another hip replacement, or if I do, we'll go to Dr. Mast again.  

Don't be in a rush to get off the pain meds.  There's no competition with other patients who may have told you they were done with meds after two days.

Last, and most important, be patient with the recovery.  Go slowly and you'll get there faster.  

I have to admit it.  Even after the testimonies of my friends, I was worried about the hip replacement for Karen.  It's a major surgery!  But with an excellent surgeon, great support staff and physical therapist, and Karen's amazing work ethic and never give up attitude, My Miraculous Wife has done it again!

If you liked this blog, please check out my novels.
​

I have quite a few friends who are doctors.  Most are around my age and they've done quite well for themselves financially.  They have the lifestyles they wanted, and if they work at all, they choose when.  Some have built small empires and have joined what most of us would think of as the truly wealthy.

When I was growing up, becoming a doctor was the ultimate path to success, if you were good enough.  Getting into medical school was challenging, surviving medical school was harder, and according to everyone I know, residency was true hell.  

But if you made it through the gauntlet, you were guaranteed success in every sense of the word: financially, socially, and making the world a better place.  And as I've described before, doctors constitute a significant percentage of angel investors in startups, so even after the contributions in their careers, many continue to pay back for their success.

If you ask doctors of my generation if you should go through medical school and become a physician, they'll give you a resounding yes.  They'll promise that all of the upfront challenges will be more than worth it.  And, they'll point to their own success.

Unfortunately, things have changed.

I've added this blog post to my  Startups category  because I wanted to look at the new challenges of becoming a 'successful' doctor from a business perspective.  Many people entering medicine do so not just as a way to achieve financial independence, but often also from an altruistic desire to help others.  In my mind, you really are a success if you can do both.  

So what's different now? 

Well, you still have to get into medical school - no small feat.  You still have to survive it - I don't think that's changed much either.  And, you still have to make it through residency, working ridiculous hours on very little sleep and endure what seems to be hazing by older residents and attending physicians who propagate the torture because if they suffered, you should too.

So, again, what's different?  

Let's look at how a new physician starts a career.  In general, there are two choices:  1) go to work for a medical group or hospital, or 2) open your own practice.

In the 'old' days, these were two viable choices.  But no more.  In my surveys, the average new physician starts her/his career with at least $250,000 in student loan debt and it can be much more than that if they go into a specialty that requires more education and longer residencies.  Several years ago, Ben Bernanke (former Fed chair) remarked in an interview about student loan debt that his son would exit medical school with over $400,000 in debt.  That was several years ago.  Medical school costs have skyrocketed since. 

Most of these new physicians are in their 30s, sometimes in their late 30s (again if they sought a specialty).  If they married before or during medical school and residency, there's a good chance they divorced.  Medical school and residency are hard on relationships.  Because of this, many physicians wait to marry and they often marry other physicians.  I know several couples who finished their residencies in their mid to late 30s and are now saddled with over $500,000 in combined debt.

But that's okay, right?  They're going to make a fortune.  Well, not so much.  

Starting a practice right out of residency while carrying and trying to service medical school debt has become much more difficult than it used to be.  Sources of financing for these startups are generally unavailable.  And with the debt load, it's virtually impossible for new physicians to come up with startup funds and then generate enough cash flow to live on while they try to bootstrap a practice.  So for the vast majority, this idea of starting your own practice fresh out of residency is no longer a viable choice.  That means you need to get started in with a medical group or hospital.  Not a bad choice, right?  You'll gain experience.  You'll make a good salary.  And many of these groups will help pay for your student loans.

Sounds like a great place for a career or perhaps it could be a jumping off point for starting your own practice.  

The reality is a bit different.  I'll just hit on a few points.  Larger medical organizations are businesses.  Years ago, most businesses provided a second home for their employees.  You could start a career and work towards retirement with health insurance, vacation, and other benefits guaranteed.  If you worked hard, you'd be promoted, you'd earn a good living, and your job would be secure.  That's changed in virtually all of our industries, and the medical industry is no different.  

In many ways, the medical industry is worse.  If you've followed the posts in my Startups category, you know that I have very strong feelings about business models that motivate and reward employees.  If you look around, you'll see that just as mergers and acquisitions have created huge corporations in most industries, there are now fewer and fewer medical/hospital groups as they too become giant enterprises.  In tech, some companies have worked to leverage their size to ensure the best environments for their expensive talent.  They provide flexibility to ensure creativity.  Not so with the medical industry.  Arguably, the talent there (physicians) is even more valuable and more expensive than what we see in tech.  So what does employment look like?

I was shocked to discover that in spite of what appear to be contractual promises to the contrary, most of these groups have moved to a model where a physician's pay is 100% incentive based.   It didn't start out that way.  Medical groups wanted to provide incentives for physicians to spend their time on procedures that produced the most revenue, so they took a portion of the physician's pay and designated it as incentive-based based on Relative Value Units (RVUs).  

RVUs were originally developed as a mechanism to determine the relative value of medical procedures against each other.  This enabled insurance companies, and in particular, Medicare to standardize the definitions of the procedures themselves.  It made sense.  It even made some sense to provide incentives to physicians.  But now, it's gone too far.

Physicians are often now paid based on the number of RVUs they log.  If they go beyond what is expected, they get a bonus.  If they fall below, their compensation is reduced. 

One problem with this approach is that the physician has very little control over which patients are seen or what procedures need to be performed.  Scheduling is out of their hands as is the amount of time they are permitted to spend with a patient.  Add in the disincentive to spend time with a patient that needs more help but whose visit will generate fewer RVUs, and you get a physician who becomes frustrated that s/he can't deliver the necessary care, and patients who don't get the best care possible.

Worse, the number of 'expected' RVUs changes every year.  If the group of physicians does well with their RVUs, the expectation is raised.  After a few years, as the required RVUs  climb, physicians are doomed to miss the targets.  This model guarantees failure.  And that's not just from a financial point of view, it's also a question of the quality of patient care, and of the physician's motivation.  

But it's even worse.  If a physician takes vacation, s/he is not accumulating RVUs and those 'lost' RVUs are impossible to make up.  So, physicians avoid vacations.

And what about the new reporting requirements - physicians are required to fill out Electronic Medical Records (EMRs) documenting each visit, procedure, etc.  Do you think they get paid for that?  Not a chance.  Since they're only paid for RVUs, that work is done on their own time.  

All of the young physicians I know who are working for medical groups are stressed to the extreme.  Those that are making their quotas in RVUs know that it's just a matter of time before they can't do it anymore.  But they're making the big bucks, right?  Well, in the words of an urgent care physician I interviewed, "With the student loans and the current compensation structure, doctors are now blue collar workers."

And you know, there's no way out.  They can't just quit.  The student loan debt hangs over their heads.   Loan forgiveness in bankruptcy isn't generally granted to someone who could earn six figures.  Unfortunately, the only way they can earn it is to work as a physician.  There's no way out.  

If you really don't think it's that bad, take a look at suicide statistics for physicians.  They're more than double those of the general population.  Between the stress caused by lack of control of their work, the stress of trying to repay medical school debts, and the stress of knowing they can't quit,  and the lack of vacation time, it's not like it was for the physicians that came before them. 

Sure.  Some make it.  Some do manage to get their own practices started.  But unfortunately, it's not as easy as it was years ago.  Physicians get no training in how to start a practice.  And with the new reporting requirements, complex coding for insurance, and dealing with insurance companies who deny first, starting a new practice is a herculean task, worse for a new physician.

If you're thinking of embarking on a career as a physician, think twice.  Don't just listen to the physicians of your parents' generation.  Make sure you talk to younger residents and attending physicians.  Then, at least your expectations will be properly set.  
 

  It's finally over.  Or is it really?

When I received my jury notice, I  figured that this time would be like the dozens of others - I call in each day and am told to call the next.  At the end of the week, the recording thanks me for my service and says that I have fulfilled my jury duty obligation and would not be called for the next two years.  

But this time was different.  It started out the same; I called in to see if I had to report the first day and as had happened literally dozens of time before, I was told to call back the next day.  Same thing the following day.  I was sure that this was going to be a repeat.  What was the likelihood that I'd be called in the middle of the week for a DUI trial?  Almost everyone I knew who was actually called to appear was impaneled on a 3-day DUI trial.  Only a couple of people had to serve longer - a week or so on civil suits.  

On my next call, I was told to appear on Thursday.   The fact that I was supposed to show up at 2 pm near the end of the week should have been my first clue that more was going on here.

After driving around the courthouse for 30 minutes in search of parking, I finally found a spot on Water Street.  I walked into the Jury Assembly Room, dripping wet because of the raging storm, with barely 10 minutes to spare.  I filled out the basic questionnaire and took a seat among over 100 people.  A few minutes later, a friendly Sheriff's Deputy led us through security and into the courtroom where we struggled to find seats.  Judge Timothy Volkmann greeted us warmly and encouraged the stragglers (me among them) to sit in the jury box.  He jokingly assured us that sitting in the jury box at this point was nothing to be worried about.  We looked nervously at each other.

Over the course of the next twenty to thirty minutes, Judge Volkmann explained our responsibilities as jurors and how the process worked.   He also made it very clear that no one was getting out of jury duty without a very good reason.   Then he dropped the bombshell.  This was a five week trial and the defendant was charged with raping his 7 year-old daughter.  There were countless audible gasps in the courtroom.  

I'm sure this is disappointing, but I'm not going to go into the details of the case in this blog.   Instead, I want to describe some surprises in the process and how this trial impacted me and the other jurors.  First the surprises:

1) We were given a very long questionnaire to be completed outside the courtroom and returned to the bailiff before leaving the courthouse.  There were a few yes/no questions, but the majority were questions that really got into who you were and what you thought about the justice system, the police, and the idea of innocence until proven guilty.  There were lots of case-specific questions about sexual abuse, your ability to separate lies from truth, and questions about children testifying, children lying - it was all surprising.  It took me nearly two hours to complete the questionnaire.  Court and jury selection would reconvene first thing Monday morning.  

2) On Monday morning, the court requested private interviews with seven of us, me included. Based on my questionnaire responses, both the prosecutor and defense attorneys asked me numerous questions about my previous experience with people who had been sexually abused and about my ability to render a fair decision in spite of this experience.  While they seemed to find my answers satisfactory, I noticed that 3 of the seven were excused. Not long after entering the court as a group, a few dozen potential jurors were excused, some for hardship (a separate form they'd filled out).  

3) Jury selection progressed as you might expect.  They put 12 people in the jury box. The judge asked several questions, then the defense and prosecuting attorneys asked questions. Surprisingly, it wasn't adversarial at this point.  Both attorneys seemed to be looking for impartial jurors, not jurors who would favor their side.  Countless jurors were excused.  At one point, it appeared there were 11 jurors who seemed acceptable to both sides.  They needed one more juror and 4 alternates. They brought me up.  I was selected as the third of the 4 alternates - juror number 15.  Everyone else was excused and thanked for their service.

4) During the course of the trial, winter storms closed roads and caused power outages.  At times jurors couldn't get to court on time.  The judge would either excuse us for the day or delay the start until the jurors could get there.  

5) During the trial, the prosecutor and the defense attorney worked closely together.  Certainly, they had disagreements which were settled in sidebars or through objections, but overall, they spent a lot of time conferring on how to best present evidence.

6) We've all seen the movies where there is direct examination of a witness followed by cross-examination, followed by a possible redirect.  What I didn't know is that the redirect and recross become a re-redirect and re-recross and that there's no limit to the back and forth.  And the biggest surprise: JURORS GET TO ASK QUESTIONS.  

According to Judge Volkmann, in California and many other states, judges have the option to give an instruction permitting jurors to ask questions.  A juror notes the question on a piece of paper, the bailiff delivers it to the clerk who enters it into the record and hands it to the judge.  If he thinks it might have merit, he gives it to the attorneys.  They determine if it has merit and if so, decide who will ask it, sometimes getting clarification from the judge on evidence and legality before posing the question to the witness.  We had over 80 juror questions during this trial.  

7) The police, forensic examiners, and expert witnesses were excellent.  It was clear that these people knew what they were doing and had expertise that you wouldn't think possible, even after watching countless courtroom dramas.  Personally, I couldn't imagine doing their jobs.

So here I was.  After decades of receiving jury duty notices, and only having to show up once, this time I was selected for a criminal trial forecast to last 5 weeks, but which actually took almost 8 weeks.   Since I'm now retired, I thought the timing was perfect.  For years, I had managed to escape jury duty's  impact on my startups so now it was time to pay up.  For the first time in my life, I had the time and flexibility to try to contribute to this most fundamental of our democratic processes.

But, I had no idea how much it would impact my life.  

It was a complicated trial.  Witnesses lied. And they lied about things that didn't seem to matter to the case.  They contradicted each other.  They changed their stories. They recanted previous testimonies with investigators and at the preliminary hearing.  The process was long.  The crime was described in excruciating detail complete with forensic evidence, photographs, and hours and hours of victim and family interviews. The defendant interrogation was grueling.  Most of us were overwhelmed seeing a real life interrogation that went on for 10 hours or more.    And as the trial progressed, it was clear that innocence, guilty, or not guilty (can't be proven beyond a reasonable doubt) was not clear.  There would be no easy decision here.  

But the worst was that none of us could talk about all we were seeing, hearing, and feeling.  As we exited the courtroom for breaks, it was clear that most everyone was deeply shaken by what we had seen and heard.  We couldn't talk to family, friends, counselors - as you might expect - but we couldn't talk to each other either.  It would have been helpful to be able to discuss the contradictions that seem to arise throughout the trial as well as the truly disturbing claims.  

I had nightmares.  I got depressed and angry - short tempered - not like me at all.  I couldn't stop thinking about the trial - about the process, the victim, the defendant, the attorneys, the conflicting evidence.  Unanswered questions haunted me and there was no one I could talk to about them.  During evenings and weekends when we had time for social events, my mind was on the case.  I couldn't stop thinking about it.

Now, after the end of the trial, other jurors tell me they experienced the same or worse.  Like mine, their spouses tried to be patient and understanding, but when you're in a relationship where you share your lives, and talk about what you do each day, going 8 weeks without being able to discuss what occupies your every waking hour and disrupts even your sleeping hours is a strain on any relationship.  

Worse, for me as an alternate juror, while I got to ask questions and participate in the whole trial just like any other juror, I was excluded from deliberations unless someone dropped out.  We did lose one juror during the trial, but the likelihood of losing another during deliberations was virtually non-existent. All the analysis, all the questions - I wouldn't be able to ask them.  I wouldn't be able to give my input in the deliberations.  And now that I know how it turned out.  I get to feel some additional guilt and lose more sleep over the fact that I think I might have helped bring about a different outcome: on the major counts, the jury was hung, 11 to 1.  

Eleven jurors thought the defendant was not guilty.  If you think about it, that's a long way to come from the initial gasps, especially after 6 weeks of intense prosecution evidence including those police reports and interviews, forensic interviews, and testimony by  police and experts.

I admit that I wasn't sure about my conclusions until I finally laid out the entire thing for Karen after the decision came in and I was released from the confidentiality instruction.  But over those hours of explaining every detail to her - my first chance to talk about all the evidence and associated contradictions - it was clear to me that there were just too many holes in the prosecution's case.  Not only was there reasonable doubt, I was convinced that the defendant was innocent - falsely accused of one of the most horrendous crimes.  

And what about that one hold-out juror?  According to the others, that juror admitted there was reasonable doubt (the requirement for a not-guilty verdict as dictated by the judge), but just wouldn't allow a not-guilty verdict.  It must be nice to not have any doubt.

What happens now?  There will likely be another trial.  The defendant, who has spent over 3 years in jail and who has had his life ruined, will likely face the whole process again.  There's a major concern about the charges on which he was found not guilty.  These provided much doubt about the main charges.  They likely won't be admissible in a future trial.  

But I'm glad it's over.  The other jurors are glad it's over.  None are happy.  All have been disturbed by this particular trial.  We all hope to find some way to move on.  

For me, I'm still not sleeping well.  I hope to be meeting with both attorneys shortly to talk about the trial.  I will be spending time with other jurors, trying to make sense of the whole thing and trying to get our lives back on track. Then maybe I'll give you the details and the countless questions.  In the meantime, I'll be working on a novel about the case, hoping the writing will release me from the mental squirrel-caging I can't seem to control.

Update:  It took quite a while, but I finally finished that novel.  I called it The 15th Juror.    You can find it on Amazon in paperback and ebook formats.  Let me know what you think.  And, If you get a chance, , please check out my other novels.
​

The media has been going crazy recently talking about fake news, conspiracy theories, lies, and damnable lies.  With the advent of Social Media, how does anyone know what's true anymore?  Has truth become relative? Has it always been so?  Do facts exist?  

The credibility of the mainstream media has been called into question.   Is there any difference between what mainstream media says and what the average person says?  After all, much of our news today comes from real time video by people who happen to be on the scene, not professional reporters.   We see much more unfiltered reality this way than we ever did before.  Whether it's natural disasters or a police shooting caught on video,  we don't rely on mainstream media as much as we used to.   

Adding to their credibility problem, the mainstream media has demonstrated strong biases in their reporting.  This has become more pronounced as print media has suffered from the onslaught of online information. Budgets have been cut, and formerly reliable print media sources have been purchased by large corporations focused on profits, not truth.  Many of the large corporate owners demand that these once reilable sources slant their coverage or  sensationalize it in ways that were never done before.  

But if news can come from anyone, and people have their own agendas too, who can you trust?

Fake news has made headlines lately with the election.  Was it the Russians, teenagers looking to make some fast cash by getting lots of hits on their nascent sponsored sites or posts, or political operatives trying to sway people?  Will the Internet always be susceptible to these types of 'schemes'?  Will we see more incidents of people so convinced that falsehoods are true that they resort to violence in order to right imagined wrongs?  Will propaganda become the currency of our modern internet age?  Or has it already?

If you have millions of social media contacts and can shout your message out to them, a large percentage will believe almost whatever you say.  The more contacts you have and the more people who propagate your claims, the more your message sounds true.  Fake news uses this, jihadists use it, political extremists use it, and now, it's becoming mainstream.  We're overloaded with propaganda.  How do we find the truth?

Many pundits claim that we just need to educate users to differentiate what's true from what's not.  Information consumers need to learn to take the time to look deeper into stories and their sources. Unfortunately, I don't think this could possibly work.  Some of the most intelligent people I know have shared misleading stories that have cherry-picked facts to appear more credible. Usually they've propagated these stories based on headlines that seem to support their own points of view. After all, we love it when we're proven to be right, don't we? 

If college-educated, internet-savvy people can do this, is there any hope for internet neophytes?

Is it really reasonable to expect us to fact-check everything we see on the Internet especially if it comes from our favorite, trusted social media sites and our friends?  

I don't think so.

We know that major players like Facebook, Twitter, Google, and others are now looking at how to protect their users from misleading and potentially damaging information without violating first amendment rights to free speech and freedom of expression.    But so far, interviews with their technologists seem to indicate that the problem may be intractable.  I'm not so sure.  It might not be that difficult.

I've noticed that some sites, like Yahoo News, offer a scoring mechanism for stories they publish. If you roll over the headline for the story, a meter pops up showing the number of people who liked the story versus the number who didn't or who were neutral about it.  This certainly doesn't address the problem at hand as it just indicates how popular a story (and its positions) might be. But it might be an idea that can be built upon.  What if we could roll over a story, post, tweet, search result, etc., and see a credibility meter instead?

As a technologist, I often look to working solutions to see if they can be applied to new problems. In this case, a proven model has been staring us in the face.  

A Proven Model We Can Start With
Not so long ago email spam was a major problem.  We'd receive hundreds or thousands of emails a day. The majority were just junk; some were dangerous (with viruses attached); many were scams; and then lost in the midst of all that junk, were the ones you really wanted to read. It was a disaster for most of us, causing lost productivity, wasted time, and in some cases damage to systems or pocket books.

And yet, in spite of the fact that there are a reported 400 BILLION spam messages per day on the internet,  you don't hear much about spam anymore.  It exists, but we now have spam filters that protect us.   

Spam filters work through a combination of software running on our Internet Service Providers' (ISPs) mail servers and on our own computers.  

At the highest level, these programs look at the email headers to track the path of the message back to its source.  They then validate the sources against blacklists that include known spammers.  Many compare against white lists (known and approved email servers).    Next, they apply content filtering using algorithms to recognize common content in known spam.  They assign a score to each email.  Based on that score, which is computed from a combination of the reliability of the source and the content, they decide whether to delete the message, to designate it as probably spam, or pass the message as valid.  If you look closely at your complete email headers, you can usually see each message's spam score.  It's not a perfect system, but it works well enough to spare us from being innundated by unidentified spam.   

Social media networks, search engines, news outlets, etc. could use a very similar method to validate posts.  It's not terribly hard to find the sources of posts, messages, or stories, and from that, to assign a credibility score based on the originator's history of reliability. When displaying the story, it could include a rollover  'Credibility Meter'.  Move your mouse over the search result, post, message, etc and a widget would appear giving you the score for this particular content.

A simple version of this filter could be developed and deployed very quickly. Later, as content dissecting algorithms become more sophisticated, so too can the accuracy of the reliability score.  

I note that even in its simplest form, a Credibility Meter of this sort would at least let us know if we should dig deeper into the source and credibility of the story.  At the same time, sources with low credibility scores would be motivated to create more factual posts to raise their scores.  Ultimately, we'd see more reliable information on the internet.

Clearly, I'm not advocating a right or wrong, absolute fact or lie approach here.  I'm just suggesting that news and social media assign scores to information we receive, based on the likelihood of it being reliable and on the credibility scores of the originator and the people who repost.  That way, we can decide if we need to dig deeper or just want to believe what we see on the Internet.

I mentioned this idea to my former team over lunch today and one of my engineers is already at work to create a prototype.  But as I told him, with such an obvious solution, I'd be surprised if someone else isn't already working on it.

by Steve Jackowski

​I like to solve problems.  I also appreciate the instant gratification I get in solving Sudoku, KenKen, Minesweeper, or even FreeCell games as fast as I can.  The faster the better.

During my career, my teams and I were often faced with problems that couldn't be solved in minutes, hours, or even days.  We used systematic methods which required laying out multiple approaches to get to as many possible answers as possible.  Collaboration usually helped. Persistence helped.  But often we needed to walk away for a while and let our subconscious do the work; the answers arriving at odd times, like while taking a shower. 

I must admit that I worry about our problem solving abilities.  It seems like almost everything we do today is about faster and faster.  If we can't get gratification in a matter of minutes, we move on to something else.  Our attention spans are getting shorter.  Computers and our intelligent portable devices make this easier and easier.  I wonder if these addictions will lead us away from the sustained efforts needed to solve real world problems.  

In thinking about this, I remembered the first sustained problem-solving effort I faced.  I was 16.   My high school Calculus teacher presented a challenge to the class.  The first person to solve it would receive bonus points which could lead to the ever-sought-after A+.  He had discovered the problem in that month's issue of Scientific American.  It sounded simple enough:

Create all the number from 1 to 100 using exactly four 4s.  

I dove right in, even before class was over and several numbers fell out quickly: 

1 = (4+4)/(4+4)
2 = (4*4)/(4+4)
3 = (4+4+4)/4
etc...

​But it didn't take long before I got stuck.  I decided to keep moving on, skipping those that I couldn't get quickly.   Once I realized I could use 4! (4*3*2*1 = 24), many more fell out.  But I got really stuck on several.  Days passed (I worked on this in my spare time) and one or two would fall out, then I'd be stuck again.  Skip the next two paragraphs of this post if you don't want any more hints.

Ultimately, I understood that to solve the harder ones I needed to create tools - combinations of 4s (e.g. 4/.4 = 10) that I could use in other expressions ( e.g. (4/.4)*sqrt(4)+4 = 24 - note that I used 'sqrt' here because I couldn't easily add the square root symbol in this post).  

The key was to think about other representations of 4, like factorial or square root, and then combine that with other representations to create numbers I could use to multiply, divide, add, or perform other operations with. It was a week or more before I had the tool building realization and then it took longer to build all the tools I needed.  When I got really stuck it was usually because I needed to create a new tool.  

Skip to here.

All told, it took me about 3 weeks.  I was pretty proud of the fact that I was the first in the class to come up with a solution and my Calculus teacher admitted that he hadn't solved it yet.  By the end of the term, as it turned out, no one else in all of his classes had solved it either.  I'm not saying it to brag, I'm just laying down the challenge.  Granted I've given you some hints that took me a while to get, but I'd be curious to see how long it takes you. 

Since I haven't looked at this problem in decades (and I didn't keep the solution anywhere), I'm going to start on it myself.

If you get really stuck, contact me via the website and I'll give you more hints or some additional tools.  Have fun!

I'm a skeptic.  When I studied philosophy, I called myself an empiricist.  Essentially, I don't believe in things unless they're proven.  This is especially true when it comes to medical fads:  vitamins, supplements, dietary changes, alternative medicine - you name it.  Unless I can see some double blind studies that show solid evidence of their efficacy, count me out.  

Of course sometimes my skepticism goes too far.  I like to think that I'm well-read and well-informed, but the reality is, you can't know everything, no matter how hard you try.  So what about the things you don't know about?  Me, I try to do the research, but it's usually only after I bump into these unknowns in some way or another.  

This was the case with Osteopathy.  I knew Karen's son (Victor) and daughter (Sabrina)  had enrolled in medical school and I knew that each of their schools specialized in Osteopathy.  From my rudimentary understanding at the time, it seemed like it had something to do with manual manipulation to supplement standard medical care - something like chiropractic.  But, since it didn't affect me, I didn't pay much attention.  

Fast forward a couple of years.  It's the day after Christmas and I'm surfing with a couple of friends on the north coast.  Perfect morning, excellent uncrowded waves, good company.  I climbed the cliff, drove home, and took a shower.  Within an hour, I couldn't raise my right arm. The funny thing was that I couldn't remember hurting myself in the surf.  Sure there were some tough duck dives and a few rail grabs, but usually I know when I've pulled something.  Not this time.  

It was officially a holiday and I knew my sports-med doc wouldn't be available so I went with the standard RICE treatment (Rest, Ice, Compression, and Elevation).  I also loaded up on Ibuprofen. The next day it was worse, not better.  I called the Doc's office and found out they were closed until after the first of the year.  I called back-up sports-med docs and all were out for the rest of the year as well.  All I could do was continue my RICE treatment.  

At one point, I tried some stretching, but no luck.  I had to eat left-handed, drive with one hand - do everything left handed - I couldn't raise my arm more than an inch or two and then, only with extreme pain.  

Of course I went to the internet and quickly determined that the main area of pain was the coracoid process with radiating pain into the scapula and bicep, but I was unable to find anything that seemed to relate to my specific problem.

The following weekend, Karen and I were on a call with Karen's daughter, Sabrina (who now runs Resilience Health in Eugene, Oregon) and soon-to-be son-in-law, Steve (another Osteopath focusing on Family Medicine).  I described my problem and Sabrina proposed the following: "Lie on your back. Have my Mom put the index finger of her right hand on your coracoid process and simultaneously lift your right arm into a fainting woman's position - palm outward on your forehead.  Have her re-position the arm until you have minimal pain in the coracoid process. Have her hold that position for ninety seconds.  Then have her return your arm to your side and rest for five or ten minutes."  

We did as she asked.  Ten minutes later, I sat up and raised my arm to shoulder level.   After an hour, I could raise my arm over my head with zero pain.  Later that afternoon, Karen and I were Salsa dancing at Salsa by the Sea and I had no recurring problems.

In between we called her back and she explained how this worked.  I'm not an Osteopath, so I'll paraphrase.  Basically, sometimes nerves send bad signals to the brain and the brain reinforces a problem by trying to fix it.  Swelling and pain may increase and your body gets into a feedback loop.  The technique she used is called Counterstrain.  The pressure on the specific point and re-positioning sends a reset signal to the brain allowing the body to move on.  It certainly worked for me.   After a week with a paralyzed arm, this instant recovery seemed truly miraculous.  

As I often do when I find something new, I went crazy doing research into Osteopathy.  I discovered that Osteopathic physicians are regular physicians - they can do family medicine, psychiatry, surgery - anything an 'Allopathic' doctor can do.   But, during medical school, in addition to the standard medical training, they study Osteopathy.  They also are trained to do more holistic evaluation and treatment of patients, focusing on causes, not just treating symptoms.  Osteopaths try to tap into the body's ability to heal itself before moving on to more aggressive treatments.  Officially Osteopathy is:

a system of complementary medicine involving the treatment of medical disorders through the manipulation and massage of the skeleton and musculature.

You can recognize Osteopaths by the 'DO' after their names as opposed to an 'MD' for an Allopathic doctor.  

A year and a half after that first incident, I was surfing the same spot. I pulled into a barrel which collapsed on me.  I held onto my board and felt my left shoulder tear.  By time I got my wetsuit off, my shoulder had swollen to the size of a grapefruit.  I raced home.

Fortunately, Karen's son, Victor, an Osteopath who focuses on Neuromuscular Medicine and now runs Seek Optimal Health with his wife Lee Ann (also a gifted Osteopath specializing in Neuromuscular Medicine), was visiting.  He stretched me out and started working on me.  He discovered (without an MRI), a small rotator cuff tear and a misalignment.  He treated me for about 45 minutes (most of it was painful), after which he explained that he had opened up passages (my word) to release the built up fluid (swelling), and had re-positioned my shoulder and upper back.  He suggested I follow up with RICE and Ibuprofen for 3 days after which time I could get back in the water.

As I got up, I discovered that at least 90% of the swelling was gone as was most of the pain.  I followed his advice and sure enough, 3 days later, I was back in the water.  

In the years since, Osteopathy has become a regular part of my treatment for acute injuries.  It has proven very effective, especially when combined with good physical therapy.  Most Osteopaths suggest regular treatment to keep the body aligned and fluids flowing.  I haven't gone that far yet, but I may well be on my way.  

If you're like me and injure yourself from time to time, I strongly suggest consulting an Osteopath. Of course, check to see if your family doctor or Sports Medicine expert is a DO.  I think you'll be pleased to find that miracles still exist in modern medicine.  

It was a spectacular day on the north coast.  A friend I hadn't seen in years came up to surf with me and there were only four of us out in perfect shoulder-high waves with a few plus sets.  An hour into the session, I raced down the line hoping for a barrel in the section ahead, but at the last second, the water under the section drained with the dropping tide and I tried to turn down and out. 

Unfortunately, the back rail of my board hung up and did an el-rollo with my foot while my knee went in the opposite direction.  I felt a major tearing.  I paddled back into the lineup and talked to the physical therapist who was surfing with us.  He suggested that from the symptoms, it was a MCL tear - one of the most common surfing injuries.  He also said that if the injury didn't involve other ligaments or the meniscus, it likely wouldn't need surgery.  

Ironically, a few minutes later, my friend hurt his back, so we hobbled up the cliff together, disappointed at the number of uncrowded perfect waves we were going to miss.  

I raced home, showered, iced, and elevated my leg, then waited patiently for the arrival of Karen's son and daughter-in-law, both Osteopaths and specialists in Neuromuscular Medicine. They were planning to spend part of the weekend with us.  Two rounds of disc golf were scheduled for the next day and I envisioned being able to play.   Little did I know.

By the fifth week, I was feeling pretty good.  The swelling was almost completely gone and although my knee would get stiff if I sat for a while, doing the passive knee extension and flexion after getting up seemed to work well.  I bought a brace with a strap, and decided to try to surf.  The strap is cool because you can wrap it around the weak parts of your knee to provide much more support.  It stretches so you can make it really tight and it velcros to itself.  

I paddled out into easy, mushy rights and lefts.  My first wave was a right (backside for me), and as I started my bottom turn, I felt my knee give and pull.  It hurt like hell but the pain subsided quickly,  I decided to try a left and had no pain at all until I did an aggressive cutback.  I stuck with lefts for the next hour and surfed cautiously.  Unfortunately, I discovered that when you duck a wave, the wave pulls at your legs, sometimes to the side, and when that happened it definitely hurt.  I was sore after the session but I was glad to have surfed.  Still, I knew I wasn't ready.  It wouldn't take much to re-injure my knee in the surf.  Anything unforeseen would do real damage.  

I worked hard with the exercises and the gym the following week and tried again.  This time the waves were small but quick and mostly lefts.  I had a great time until I tried a right.  Again, driving off the back leg hurt.  It wasn't unstable like it was the week before, but still.  

It's now been eight weeks.  This past week, I was able to make full backside bottom turns and aggressive cutbacks on my lefts.  I surfed four really fun days.  On the last day though, I punched through a large set and got tossed around by the last wave.  I really felt it in my knee.  It didn't tear, wasn't any worse later, but I know that I can't let up on the strengthening exercises.  I still have a ways to go for 'full recovery'.  In the meantime, I can hike, dance, and play disc golf (took 4th in a tournament yesterday with no pain).  

Mistakes I made.

Realistically, Karen's son was right.  It's going to be 12 weeks for full recovery, particularly for surfing.  I seriously underestimated how much inward force you put on your knee in a backside turn or frontside cutback.  I seriously underestimated the force of the ocean, which is a very stupid thing to do.  And at the beginning, I tried to do too much too soon.  I'd try to push walking and tried to do the harder strengthening exercises when I wasn't ready.  Each time I did, it set me back a couple of days with renewed swelling and loss of flexibility.  

Overall though, I'm almost there.  Still, perhaps you can avoid some of the mistakes I made.

Set your expectations - it's going to take longer than you think.
Don't do too much too soon.  Be very cautious as you restart any activity.
Spend the extra for the best brace possible.

And, I think the main reason for my successful recovery is the dedication to the daily (or more) stretching exercises, and consistent and progressive strengthening exercises.  

The good news is that if it's an MCL tear with no other damage, you can rehab it yourself. But above all, you need Patience, Patience, Patience!

Update January 2018.

It's been a year and a half since I first injured my MCL as described above.  The rehab program worked, and I was back to full activity with maximal stress (surfing, extreme skiing, etc.) within 4 months (with a lot of hard work in rehabbing it).  Everything seemed fine and then, six weeks ago, while Salsa dancing on a rough surface, my foot caught in a fast turn and I felt my MCL pull.  It was too painful to continue dancing so I stopped.  By time I got home, my knee was hugely swollen.  I started the RICE treatment, but underestimated the severity of the injury.  Yes, it was only a grade 1 injury - there was no looseness under the Valgus test, but almost any activity caused huge swelling.  I consulted my muscular medicine doc and he informed me that re-injuries are often worse from the point of view of healing time.  Unfortunately, he was right. 

I hate being sidelined from the surf during one of the best seasons we've had in years.  And, not being able to run, dance, ski, etc. is depressing at this time of year.  

So here I am, six weeks later.  The pain is gone.  Most of the range of motion has returned (with lots of stretching), and I'm working on strengthening.  The plyometric exercises are still tough.  I did try surfing and easy front side is okay but I can tell I'm not quite ready for more aggressive turns.  I will be giving skiing a shot this week (now that there's a bit of snow in the Sierra).  In the meantime, I'm working hard on the strengthening and I now realize that to avoid re-re-injuring my knee, I need to keep up these exercises even after I'm back to 100%.  They're going to become part of my daily routine, much like core strengthening has.  Core strenghthening  resolved all of my back problems and I expect I can avoid further knee injuries if I keep up these knee exercises too.  

So, a final word of advice.  Once you're back to normal, don't stop your strengthening and range of motion exercises.  Do them regularly and hopefully, you can avoid a re-injury that will sideline you for several weeks.

If you liked this blog, please check out my novels.
​

Okay.  I'll try to keep this from being too much of a rant, but the truth is, I hate Daylight Savings time.  I hate it most here in the United States.  I may not like it much in other countries, but the US version makes no sense at all. 

Of course I know all the arguments in favor of Daylight Savings time.  It saves energy.  It helps tourism and leisure businesses as people stay out playing later.  It reduces car accidents during later commute hours.

But did you know that more people die of heart attacks, strokes, and car accidents in the days after a time change?  How about the fact that kids have to go to school in the dark, or that early commuters have more accidents.  Worse, here in the US, the 2007 change that took us out of step with most of the rest  of the modern world actually reduced the energy savings we had before. 

Daylight savings time has been around a long time.  Ben Franklin is often credited with the idea, but from what I've read, this was from an article joking that Parisians could benefit from getting up earlier.   It didn't get officially implemented until over a century later.  Most of modern Europe adopted it in 1916 and the US quickly followed suit, matching the times of year for turning your clock forward and back.  During World War II, the US went on War Time - Daylight Savings Time ran year-round. 

In the 1960's the US and most of the Europe coordinated their Daylight Savings time.  If you're going to have it, this makes sense. 

But then in 2007, the US decided to advance the change in the spring by 3 weeks and delay the return to Standard Time in the fall by a week.  I wasn't happy with the idea before, but this just seemed insane. 

First, it took us out of step with the rest of the world.  And of course it meant that more kids had to go to school in the dark for longer in the year.  The US Department of Energy conducted a study that showed this change had ZERO benefit, and subsequent studies proved that although a trivial amount of energy for light was conserved, there was a substantial increase in the demand for heating, far offsetting any potential benefit. 

I know, I'm biased.  I'm an early riser and like to be in the surf at sunrise.  I hate the fact that in March, I can't get in the water at 6am.  But what really gets me about Daylight Savings time is how illogically it's implemented. 

Let's think about this in terms of its goal - to take more advantage of daylight hours.  Sure, near the summer, particularly in northern latitudes, it makes sense.  Very few people get up at 4:30 in the morning, so why not make the sunrise 5:30am and give us more light in the evening.  I get it. 

But in Winter?  As far as I know, it's still winter. 

Look, if we're going to have Daylight Savings time, it should be symmetric with respect to the solstice.  The winter solstice is the shortest day of the year and the summer solstice is the longest day of the year.  Right now, we start Daylight Savings Time about 10 weeks after the winter solstice.  Europe starts 3 weeks later.  We end Daylight Savings Time about 6 weeks before the winter solstice.  This is crazy.  If it was too dark to start Daylight Savings less than 10 weeks from the darkest day, why would you wait to end it until 6 weeks before the darkest day? 

I heard one argument that the US extended the ending date to make it more light for kids on Halloween.  Who goes out trick or treating when it's light? 

Aside from the loss of early surf sessions and the confusion working with other countries caused by the inconsistent time changes in the US, the lack of any proven benefit to that 2007 change, and the studies that show it has actually caused harm, suggest to me that we should at least go back to the policy from before 2007, or better yet, revisit the whole idea of Daylight Savings Time.

Last week, I paddled out to the Lane and, politely waited a couple of sets before grabbing a larger set wave.  A guy dropped in on me.  These things happen from time to time, and I expected him to kick out once he knew I was there, but he didn't.  At the end of the wave I paddled over and asked him why he'd done that.

"Did what?" he asked.

"Dropped in on me," I responded as I paddled back out to the lineup. 

"I'll do it again," he challenged.

"Why?" I asked. 

I was met by silence so I made my way back out where several people just shook their heads at his rudeness.  It was the dawn patrol and it's not generally terribly agro out there.  People wait their turn in the rotation. 

A few minutes later the guy made it to the lineup and said, "Okay.  I'll tell you why I dropped in on you.  It's because you almost ran me off the road on Highway 1, passing on a blind curve."

I responded that he must have had the wrong guy.  Being someone who bikes up Highway 1 and who has seen some bad incidents there, being retired, and not in much of a hurry anymore, I drive a sedate 55-60mph up Highway 1, respecting the 45mph in Davenport.  Aside from farm equipment, I can count on one hand the number of people I've passed on Highway 1 in the past several years.  I'm just not in that much of a hurry. 

"What kind of car was it?" I queried, hoping to prove my innocence.

"I don't remember."

A couple of people in the lineup told him they found it hard to believe that Steve would run anyone off the road. 

"It was you.  I saw you," he argued.

Much later in the session after a long ride where I was coming around a section near the end of the wave, he dropped in again, preventing me from making the section.  It was clearly symbolic as there was no real wave left.  He went in after that. 

The incident bothered me.  It really bothered me. 

I spent a sleepless night, trying to figure out how he could be so sure it was me when I know I don't drive like that. 

An then it dawned on me. 

I don't remember exactly when, but I was driving my Audi up the coast (Karen must have had the electric car since that's what I usually drive).  I was north of Santa Cruz in the right lane just past Granite Rock approaching Dimeo Lane - the road that leads to the Santa Cruz dump.  The passing lane ends just after Dimeo. 

I saw a van on Dimeo approach the stop sign but didn't think anything of it.  I figured he'd stop until I went by.  But, he didn't stop, didn't even look.  I had momentary hopes that he'd stay to the right since there were still a few yards until it became a single lane and there was a wide shoulder on the right, but no, he pulled out into the middle of the merging lanes going maybe 10 to 15mph.  I slammed on my brakes and felt the ABS kick in.  Just before slamming into the back of him, I swerved left across the double yellow line, stepped on the gas and zipped around him.  

I don't think I honked - there wasn't time.  I just wrote it off as someone who was completely distracted.  But it was a close call, almost ending my accident-free driving record. 

As my speed got back up to my usual 55-60mph, I looked in my rearview mirror and there he was, honking his horn and crawling up my butt.  When we reached the passing lane by 3-mile, he didn't pass, he just kept surging behind me and honking his horn.  I continued driving sedately and he eventually pulled off at four-mile as I continued up the coast wondering what had gotten into that guy. 

I guess he's been holding a grudge for a long time.  It wasn't a blind curve - the road was perfectly straight and no cars were coming.  There was a wide shoulder that he didn't need because I passed in the other lane.  But somehow in his mind, I raced up behind him at a million miles an hour and blew by him passing where I shouldn't have.  He's sure I'm some asshole driver who tried to force him off the road. 

And of course, now he has to pay me back in the surf. 

I'm sure I've done it and you've done it.  We lock into our perspectives and are sure we're in the right.  The other guy is in the wrong.  The other guy is an asshole.  It might be on the road; it might be in the surf; it might be in politics or in the Middle East.   

But we're not always in the right.  We all make mistakes.  We often fail to see them. 

Wouldn't the world be a better place if we could keep open minds, listen to the other side, and at least consider the possibility that we might not be in the right?  If this approach doesn't solve the world's problems, it could at least make the roads and the surf a little less stressful.

You've read about Karen's physical challenges over the last few years and the determination that led to her successful completion of the Big Sur Marathon Walk as well as some recent strenuous hikes in the Pays Basque. 

As I described, it was a rough few years.  We met dancing, and our dancing, hiking, whitewater kayaking, surfing, and skiing were all significant parts of our lifestyle and to some degree, who we were and what we shared as a couple.  The deterioration of her hip changed all of that. 

But there was an upside.  It may be a bit of a stretch, but her inability to walk more than 100 feet ultimately led to her fluency in French.

When I met Karen in 2004, in addition to being impressed by her dancing, her athleticism, and her drive, I was blown away by her fluency in Spanish.  Part of my dream in wanting to come back to France was to become truly fluent - something that I believe is impossible unless you live in a French environment and immerse yourself in the culture and language.  The fact that Karen was completely bilingual was a surprise to me and I was envious. 

Of course, she had a major advantage.  From an early age, she grew up in a Mexican household - her stepmother was Mexican. 

When we started coming to France, I learned that Karen had taken some French in high school, but had never kept up with it.  She did visit France in 2000, but discovered that she'd lost it all and other than the fact that her last name (Noël) was everywhere (it was Christmas time), she really couldn't understand any French at all.

When she and I first visited France together during the summer of 2005, I had to do all the talking.  Karen could say 'Bonjour', 'Merci', and 'Au revoir', but not much else. 

On subsequent trips to the Pays Basque, we had a deal - I would speak for us in France and she would speak for us in Spain.  Having spent some time on business trips in Spain, I can get by with my rudimentary Spanish, but like Karen, if you've got someone with you who is fluent, why would you speak?

Of course we spent more time in France than in Spain on our trips, and as our social circle started to expand, I found myself in the difficult position of attempting to do simultaneous translation while trying to be involved in a conversation at the same time.  It was awkward to say the least.  You may remember the challenging interrogation with the Basque family I described in Our Place in France - Part 3. 

So what does this have to do with Karen not being able to walk?

Well, just before one particularly miserable trip where we had problems with wheelchairs in the airports, Karen had begun physical therapy for her hip.  She had exercises to do and did easy workouts at Curves in Santa Cruz.  Her physical therapist suggested she find a gym in France, if at all possible, to keep strengthening her weakened muscles. 

The day of our arrival, we noticed a Curves franchise about a five minute drive from our mogul-ridden apartment.  It was closed.  We returned the next day.  They had just opened - it was their first week in business.  Since Karen spoke no French and the owner spoke no English, I had to be there to sign her up.  Of course, I couldn't be there during her workouts because Curves was for women only.  Karen was a bit nervous, but one of the physical trainers who spoke just a 'leetle' English assured me that Karen would be okay. 

Over the course of the next several weeks, Karen went to Curves faithfully, often twice a day.  Life continued as it had on previous trips with me speaking French for Karen and me encouraging Karen to try to order meals when we ate out (which was often). 

Early in the trip, we were walking around the Place Louis XIV in Saint Jean de Luz visiting with many of the artists who had their work on display there, hoping to find artwork for the apartment.   We fell in love with the work of Patrick Pierart and after a long discussion, decided to meet with him at his studio in Bayonne where he could show us more of his pieces.    Ultimately, we bought several of his works which grace the walls of our place today.

Just before we left France to return to the US, Patrick called and asked us to  join him for lunch at the Trinquet Saint-Andre in Bayonne.  This is a  racquet club in Vieux Bayonne (the walled city) that was built in the early  1600s and which has hosted people like Louis the XIV who played there. 
Patrick took us on a tour of the club, then we settled down to a superb lunch in the courtyard.  Patrick spoke very little English, so I interpreted as best I could while trying to maintain a conversation. 

At one point, I excused myself to go to the restroom leaving Karen alone with Patrick, hoping she'd be okay for a few minutes.  When I returned, Karen was speaking French with him.  While she made a lot of grammatical errors, she was perfectly understandable and she and Patrick "s'entendaient bien."  I was shocked.

I justified my obvious surprise to Patrick, and Karen, in decent French,
explained that as someone who loves to talk, she couldn't have survived at  Curves without talking.  Over the course of the six weeks we were in  France, she had spent several hours a week hearing and speaking French with the  women there and in particular with the trainer we'd met in our first visit to  Curves.  This trainer, Martine, has since become one of Karen's best  friends (as I described in my post My Miraculous Wife - Hiking in the  Pyrenees).

Discussing her much improved French on the way home, Karen decided that she needed to find a way to practice it while we were in the States.  Just before our departure, she set up Santa Cruz Speaks French - a Meetup Group for people who want to practice their French.    They (we - I was required to go) now have over 130 members and meet twice a week. 

What brought all this to mind is the lunch we had yesterday.  Several members of the nearby disc golf club  invited us to a Sunday afternoon feast to show us the food of Landes.  Landes is the area north of the Adour River and thus is not part of the Pays Basque.  For surfers reading this, the famous Hossegor is in Landes.

We had a sumptuous meal of duck confit, a salad which included the white asparagus of Landes, huge piles of grilled mussels in a spicy sauce, and magret de canard - duck filets, along with a huge potato dish, multiple desserts, and of course lots of French and Spanish wine, including some very rare vintages and one bottle from our host's uncle.  Normally, a situation like this would be very stressful for Karen.  And while she didn't understand 100%, she held her own, even in political discussions and discussions about morals and raising teenagers and the differences between France and the States.  'Lunch' lasted 6 hours - six hours of no English and several people talking and debating and telling jokes non-stop in rapid-fire French. 

I think you get the theme here.  Karen is tenacious.  When there's something she needs to do, something she needs to learn, an obstacle she needs to overcome, she digs in and works and works and works until she succeeds.  She truly is my miraculous wife.

One of the things we really missed during the years that Karen was injured was hiking in the Pyrenees.  For those of you who read my previous post of My Miraculous Wife, you know the joy we experienced when Karen crossed the finish line at the Big Sur Marathon 21-mile walk.  Now that we're in France,  I'll do a few travel blogs chronicling our experiences here. 

We've been walking daily on the spectacular Sentier Littoral (coastal trail) - I'll do a blog on that soon - and have been doing a few hikes in the mountains.  Last weekend we joined Karen's friend Martine and a group of local hikers for a climb up the Iramendy peak southeast of the village of Saint Jean Pied de Port.  Martine is a local personal trainer who Karen met when she was just beginning her hip rehabilitation.  Martine was a great help and she's since become a close friend.  She's even taken up disc golf here in the Pays Basque. 

We met up with Martine and the rest of the hiking group in Bayonne where the Adour and Nive Rivers meet just before entering the Atlantic in Anglet (a few hundred yards from the formerly great La Barre surf break).   The hiking group meets once a month and tackles a challenging peak somewhere in the nearby Pyrenees.  According to Alain, a well-tanned man in his mid-sixties, who does strenuous hikes 3 times a week and leader of the group, there were usually 6-8 people for these monthly Sunday excursions.  Today we were 14.  We caravanned to the parking area passing through Saint Jean Pied de Port about 45 minutes inland.   

As some of you may recall, Saint Jean Pied de Port is the starting point for the  Way of Saint James, the pilgrimage described in the film, The Way.  It's a picturesque village with restaurants bordering the Nive River.  There's a Citadel which dominates the village providing spectacular views of the surrounding Pyrenees and of the Nive River valley.  Not that long ago, the Citadel served as a lookout to help protect the town from Spanish invaders.  Control of this area changed hands countless times over the centuries.

Reaching Saint Jean Pied de Port, we stopped at the restrooms in the parking area for the pilgrims, then continued up the small road bordering the Nive for several miles.  We parked on the side of the river not far from the tiny villlage of Esterençuby, loaded up our packs, and started up the mountain. The beginning of the trail is not marked and we made our way past an abandoned farmhouse up a steep trail.  For the next hour and a half, we continued climbing among the beech trees (hêtres in French).  

We emerged into a clearing and encountered a rough dirt road with two rustic structures.  According to Alain, this was a Bergerie - a way station in the mountains where sheep were managed.  It was inaccessible in the winter and  the cabin-like stone building was occupied from time to time by the shepherds.  The other structure was also constructed of stone (hand built), and served as a covered shelter for the sheep.  He called for a 15 minute break.

Alain indicated that we were now about halfway to the peak.  We should have taken some shots from this vantage point because the peak looked pretty intimidating.  I haven't mentioned Karen.  While Alain made it clear that he had to lead (even when the trail was clear), Karen and her friend Martine (in the photo on the left) were never far behind.  At the half-way point of the climb, Karen wasn't even tired.

After the break, we turned onto the rough dirt road.  A mile or so later, we saw a trail to the source of the Nive River.  Apparently, this is a pretty spectacular place, though it's not the actual source.   At this 'Source' the Nive emerges from the side of the mountain in a rushing torrent.  The real source is a trickle in Spain which drops into a cave and travels several miles under ground before emerging at this 'Source' in France.  We're hoping to hike to the real source before we leave if weather permits. 

Walking on the road was pretty tame compared to the beginning and although the peak loomed above us a few miles away, everyone picked up the pace and conversations took the place of the heavy breathing and even panting heard during the initial climb. 

Our dirt road met up with another in a relatively flat area where horses meandered,  uncorralled.  Alain turned off the road and started up the peak without looking back, expecting everyone to follow -  no  trail, just rough hillside, rock, and occasional dried tiny streambeds.  The picture at the left is looking down just before it got steep and a bit challenging.

Everyone except Karen, Martine, and I had brought hiking sticks, but several of them were struggling with the next section and had to stop to rest and to find better, easier paths among the often loose rocks. 

We pushed to the top only to discover that there were two peaks and this was the first.  The next was only about fifteen minutes away but it was a couple of hundred feet higher.  The leader called a short break which let the stragglers catch up, and we were rewarded with our first of many exceptional views of the valley below and the surrounding mountains.

Minutes later we were at the top.  Martine, who is also an expert in ecology of the region as well as endangered plants and animals, described and named some of the rare plants and the huge vultures and raptors that soared upwards in the thermals racing up the peak.  I couldn't help being envious, wishing I had a hang glider.  I later learned that this peak did host a paragliding championship last year.

Alain called for an hour lunch break.  We pulled out our sandwiches as others broke out bottles of wine, exotic salads, breads, cheeses, sausages, pâtés, and deserts.  No wonder several of them struggled up.  Their packs must have weighed a ton!

We refused the wine but shared what we had and after an hour, we made our way down.  The descent was uneventful once down the peak as we turned onto a well-maintained dirt road for a leisurely hour and a half walk back to the cars.

We dropped our packs and made our way to a deserted local bar in the small village which the 14 of us quickly took over.  Karen and I had brought an apple tart made specially for us by the bakery about a block from our apartment and we shared that with everyone.  As it turned out none of the drivers (us included) paid for their drinks.  We didn't talk much about the hike.  Conversation went to the next one scheduled for the 15th of June.  Unfortunately, we'll be back in the States then.  With luck, we'll get to join them for their hike in September. 

And, in spite of climbing over 2400 vertical feet and hiking over 9 challenging miles, Karen was fine.  I think she was almost ready to do it again.  If we hadn't scheduled a dinner with friends in Ciboure that evening, she might have wanted to see the source of the Nive.  Hopefully we'll do that very soon.

I met my wife Karen almost ten years ago.  I was struggling to recover from a very painful divorce and spent most of my non-surfing, non-working time dancing or taking dance lessons.  I was trying to make the transition from years of dancing Lindy Hop and Swing to Salsa, which had taken Santa Cruz by storm.   Anyone who has tried to do this understands that the big, fast, muscular moves and lifts of Lindy Hop don't translate easily into the small, quick, light-touch moves of Salsa.  My lesson partners suffered. 

But Karen was patient and over time we danced together more and more often.  She had her own small business, was physically active, intelligent, beautiful, bilingual, a little OCD, and she could often beat me  at Scrabble.  

During the summer of  2005, she accompanied me to Paris for the IETF meeting.  We spent my non-meeting time at Paris plage where we danced to the bands along the Seine.  Our dancing was even featured (and replayed) on TF1, the French television station.   In subsequent years, Karen joined me for my annual pilgrimages to the Pays Basque where we surfed, danced, and hiked the Pyrenees.  She was much more fearless than I walking up to the edges of gaping precipices while I cowered several yards away.  (Yes, I have a fear of heights.  It's not a problem with a hang glider strapped to me or if I feel I'm protected in some way, but out in the open, the edge could give way, there could be an earthquake, I might get distracted and slip - you get the idea.)

We danced several times a week, hiked, surfed - a very active life. 

Then, a few years later, Karen started having hip problems.  Her left hip swelled and she was in great pain after any significant activity.  She saw doctors who diagnosed hip bursitis.  A first cortisone shot worked and she was fine for several months.  A second shot worked for a few weeks.  The third did nothing.  Her ability to walk, dance and to be physically active diminished quickly.  Ultimately there was no more dancing. 

As a couple, you plan to grow old together.  But somehow you never envision just one of you declining so rapidly.   Somehow you think it will be gradual.  Somehow you think both of you will decline simultaneously.  Karen's sudden disability was a shock.   It was difficult for me to see our very active lifestyle come to a complete halt, but it was ever harder for Karen. 

The doctors were at a loss.  They proposed surgery, but the surgeons couldn't find anything specific to cut (though one wanted to do surgery anyway).  Karen's condition continued to deteriorate to the point where she couldn't walk a hundred yards without pain.  If we stopped and I did several minutes of massage, we might get another hundred yards.  Instead of walking, we had to drive everywhere and I had to find parking very close to our destination. 

If we travelled, Karen needed a wheelchair to get through airports. 

And then a friend recommended a physical therapist.  I sat in on the sessions.  In the first, the therapist had Karen sit in a chair and asked her to stand.  Karen stood up easily.  The therapist then asked her to stand up without putting her knees together.  Karen couldn't stand up - she was stuck in the chair unless she put her knees together.  "But this is how I was taught to stand up," Karen protested.  "I grew up wearing miniskirts in the 60s and you had to keep your knees together at all times."

Karen and the therapist jokingly called the problem 'the miniskirt syndrome'.  Officially, it's hip adductor syndrome. 

They worked together for several months and while Karen got progressively stronger (and she could stand up with her knees apart), her pain didn't diminish and her walking didn't seem to be improving much.  The therapist suggested Karen see Jeff Moreno at Precision Physical Therapy.  Jeff specializes in gait problems and works on correcting posture and muscle imbalances.  He gave her exercises, making it clear that after decades of sitting, standing and walking incorrectly, it would take time to retrain her body.   With her incredible sense of commitment, Karen went to work.  If she got discouraged, she never showed it.  She did her exercises faithfully and continued tirelessly as Jeff added more and more - month after month after month. 

Eighteen months ago, Karen was in a wheelchair during our annual trip to France.  When we returned to France six months later, she was able to walk about ten minutes without stopping for massage, and succeeded in making airport connections without a wheelchair (after several stops).  Returning from that trip, she signed up for the 2014 Big Sur International Marathon (21-mile walk) which was to take place less than a year later.  I was skeptical. 

We began walking four to five days a week, slowly increasing distances, with regular massage stops.  When we arrived in France in September of 2013, Karen could walk a mile without stopping.  Just before we left seven weeks later, we did our first walk into San Jean Luz along the beautiful sentier litoral (coastal trail), five miles away.   This was a dramatic improvement, but getting to Marathon distances in 6 months seemed unlikely to me. 

Upon our return to the States, we started a formal training program.   Each week, Karen got stronger, walking further, faster.  Unfortunately, her son's destination wedding interrupted her training and then Tax Season hit.  After several setbacks, we got the training going again, but we were behind schedule by several weeks.  We pushed a little to try to catch up and so delayed the prescribed taper.  On the Sunday before the big day, we did 14 miles at a 3.8 mph pace.   Unfortunately, she suffered from shin splints during the last half mile.   We did the taper the last week and Karen carbo-loaded for the first time in her life.  The shin splints were still present each of the taper days.   

On Race Day, we got up a little after 3am.  Karen ate her race breakfast, I massaged her legs, and she stretched.  I delivered her to the bus at 4:30am then went back to the hotel to watch as the results popped up.   Highway 1 is closed for the race and spectators are only permitted at the finish line in Carmel.   The tracking program was the best way for me to keep an eye on her progress.

At about 7am the tracking program showed that she'd crossed the start line at 6:31am - results appeared to be delayed by about 30 minutes).  I was nervous.  The next tracking point was at 4.8 miles and indeed, at about 8:25am, her time popped up - just under an hour twenty minutes.  A rapid calculation showed she was averaging 3.4 mph, the pace we'd discussed - a pace at which she could finish within the required time - a pace which she could walk comfortably, saving any push for the end (if she made it that far). 

The next tracking point was at 8.2 miles.   At her current pace, she should have been there by 8:50.  I expected a delay, but by 9:30, no results had posted.  I was very worried. 

The subsequent tracking point was at 10.6 miles.  Maybe they had just missed her 8.2 mile passage.  At her somewhat leisurely pace, she should pass the 10.6 mile mark by 9:30 or so.  But by 10:15, there were still no results. 

I packed everything up to get ready to go find her, saddened,  knowing how disappointed she'd be not to have been able to accomplish what she'd trained so long for.  I decided on one last pit stop before shutting down my computer and just before I clicked on shutdown, both mile point results popped up.  She was right on track - like a clock - exactly 3.4 mph.  But, she was only halfway there.  The next tracking point was 17 miles - a big gap. 

I checked out of the hotel and drove to the finish area, very lucky to find parking.  I booted my laptop, connected via my Audi's hotspot and waited.  Less than 15 minutes after she passed the 17 mile mark, the results appeared.  I couldn't believe she was still at EXACTLY 3.4 mph - unbelievable!  She was going to finish!  I quickly calculated the time for her arrival at that pace - 12:40.  I bought roses and made my way to the finish line.   The forecast rain which had held off all morning never came, but some light mist was falling at 12:25.  I had decided I'd pull out the camera about 12:30 to be prepared for her finish.  As I watched the finish line, I saw her coming.  She wasn't walking, she was running!  I fumbled with the camera and clicked off two unfocused shots before she was in my arms at 12:29.  She had jogged the last four miles and beat my projected time by more than ten minutes.  I've never been so proud of anyone in my life. 

She wasn't even tired.  Aside from two damaged toenails, she's perfectly fine. 

We were on a plane for France the next day and she had no  problems walking.  It's raining here but beautiful weather is forecast for  Sunday.  I can't wait to go hiking in the Pyrenees again.  And of  course we'll be playing disc golf Sunday morning, doing the thé dansant Sunday afternoon, and we'll be  Salsa dancing Sunday evening. 

You think your life is headed downhill and then it's not.  I'd call her recovery a miracle, but it's not.  It's the result of her work ethic, her dedication, and her unwillingness to give up. 

My wife is the miracle!

It's April Fools Day.  My wife might consider this a joke blog posting. 

A few weeks ago I bumped into a former associate on Facebook and LinkedIn.  He's a technologist and serial entrepreneur who has had some significant successes, but whose latest company, even after raising two solid rounds of venture funding, didn't make it.  I read the press when it happened and heard a lot of speculation about VC interference, competitors using unethical tactics, pushing a product to market too fast, quality issues, and improperly-set customer expectations.  Most of the industry analysts at the time thought the company could survive or even thrive, but that the VCs had pulled out too fast.  All or some may be true, but knowing my former associate and his technological prowess, I suspect management of VC expectations may have been at least a part of the problem.  I'll get the full story when we meet for lunch in a week or so. 

Once we'd reconnected on the social networks and set up our catch up meeting (he's out of the country on a well-deserved vacation), he asked me a very pointed question:  Am I DONE?

I suspect he's nearing the same place I was when I decided to pursue writing for a while.  While it may look glamorous from the outside, the Silicon Valley can be a cutthroat place.  The best technologies don't always win; the hardest working don't always get rewarded; and you can do everything right and still end up down and out - or at the very least, viscerally discouraged. 

When I stepped out, most of my former team as well as executive level friends and other entrepreneurs predicted I wouldn't last six months.  My dream of writing, staying in great shape, and pursuing the sports I love wouldn't stand up to the excitement of developing new technologies and getting them to market. 

To some degree, they were right.  I do miss the technology and my team.  I stay current on what's going on, but I rarely design a new system or see it solve a customer problem.  Managing my team, doing my best to encourage their professional growth, and seeing them accomplish things together that would have been impossible alone, inspired me.  And, writing is a solitary pursuit.  I spend a lot of time alone.  Still, I don't miss the stress, the long hours, being available 24x7,  or seeing world-changing technologies crushed by the big guys who feel threatened.  But am I really DONE?

Not long ago, I came up with an idea that would take advantage of new systems which collect medical records electronically to predict outcomes of treatments based on history, genetics, environment, etc.  It seemed particularly fortuitous because not long after formulating the idea, while waiting for an EV charging station,  I met the head of strategic partnerships for a major medical manufacturer.  They were interested in predictive outcomes based on analysis of application of their equipment in treating cancers - what an amazing coincidence - it must be fate!  He seemed to think he could raise sufficient funding to build a prototype.  Maybe I wasn't DONE after all. 

I discussed the idea with my wife as well as with a couple members of my former team.  My wife was shocked.  She'd been working hard to get her business to a place where she could exit to join me in retirement and now I was going back into startup mode with all the stress.  And I was going to abandon her? 

Of course my team members were enthusiastic.  I started laying out a business plan.  Then I had a second thought.  Did I really want to do this?  Maybe I could just get it started, build the prototype, line up at least the first major customer, raise some funding, and step out. 

I contacted a VC friend who convinced me that the medical industry was a mess I didn't want to step into.  He urged me to enjoy my 'retirement': pursue my sports write, relax.  Sadly, it didn't take much to talk me out of it.  So maybe I was DONE.  Of course I've since learned that he had just retired when he gave me the advice that he was following himself. 

So, am I DONE?

Well, I am meeting with this former associate.  He's a brilliant guy and a great technologist.  I'm pretty sure he's looking for ideas for his next startup.  On the other hand, maybe he just wants to know what it's like to be DONE.  But ultimately, who knows what will happen when  two technologists who are both former entrepreneurs decide to brainstorm over lunch?

I had a long conversation with a family member yesterday.  She's entering a graduate program that will keep her far away from home for a few years and she feels guilty.  Her mother is mentally ill.

Guilt seems to haunt many of the family members of those with psychological disorders.  We feel guilty for not giving up more of our time to help care for them.  We feel guilty for not being able to solve their problems.  And worse, we often feel guilty, thinking we  contributed to the problems to begin with. 

In this particular case, the young woman's mother had been diagnosed with Bipolar Disorder while in her 20s.  For years it was managed well with Lithium, then later with a cocktail of several drugs.  While there were periodic episodes of depression and extreme manic behavior when she convinced herself that she was cured and didn't need her medication, for the most part, she was able to raise her children and thrive at a job she loved. 

One day, after deciding she could stop taking her meds, she went manic again.  This time, she took her daughter out of school and hit the road.  Not long into the trip she abandoned her young daughter in a motel and continued on her manic binge until she was ultimately arrested by the police and placed in a psychiatric institution.  Fortunately, a very wise psychiatrist explained to her that her condition was physical, a chemical imbalance in the brain, and that she would have to be on medication for the rest of her life.  There was no cure but the condition could be managed.  Family members and social services made it clear to her that she would lose custody of her daughter if such an incident ever occurred again and this resonated for her.  Over the next several years, she stayed on her medication and worked tirelessly towards doing the best job she could to raise her daughter. 

But life is change and her daughter grew up.  Her daughter started spending more and more time with friends as teenagers are wont to do.  Unbeknownst to her daughter and family members, she quit going to work.  She pretended to, fooling everyone.  As graduation approached, she had a complete psychotic break, losing all touch with reality.  This was no longer Bipolar Disorder. 

She was hospitalized for several months and then moved into a care home, a place where trained nursing staff could ensure that she took her medications and could recognize signs of impending crises.  Her daughter went to college nearby but then took an internship on the other side of the country, promising to return to care for her mother and feeling both guilty and relieved that she could get away from the situation. 

So back to yesterday's conversation:  it started off about the unique opportunities of the particular graduate program she's chosen, then quickly moved to guilt about not being there for her mother.  She believed that if she could be there, perhaps she could make a difference. 

We discussed the fact that her mother experiences a different reality, and our ideas of logic don't make sense to her.  She hears voices, is convinced that she's responsible for all the problems in the world.  She'll see a television program on tainted water and will ask to be arrested because she's at fault.  She doesn't believe that her daughter is living far away, even when shown the documentation.  And yet, the daughter believes that she could make a difference if she were there. 

We talked about the fact that like the Bipolar Disorder, the psychosis her mother suffers from is incurable with current psychiatric techniques/medications.  It's somewhat manageable, but the medication and therapies don't bring her a normal life.  Her daughter's presence won't change the incurable physical aspect of her disease. 

And then it came out.  She believes she caused her mother's mental illness.  Because she grew up and graduated from High School, her mother lost her reason to remain sane.  It's her fault that her mother had the psychotic break and is now in the state she's in. 

And maybe it is her fault. 

But was there anything she could have done to avoid it?  No.  

The reality is that she had to grow up.  She didn't have a choice in that.  Whether her growing up was a fault or not, time and genetics guaranteed that the break would have occurred at some point. 

It's a terrible thing that her mother suffers from this debilitating mental illness.  But it's just as terrible that her daughter suffers from such guilt.  You and I know that it's not her fault.  Blame it on genetics.

If you don't have much experience with people who are severely mentally ill, it's easy to think that cures are possible.  The right medication, the right therapies, there's got to be a way. 

But after you've lived with it for a while, after you've outgrown the arrogance that makes you think that you have the power to fix it, you come to realize that people in this state don't think like we do.  Their perception of reality is completely different.  Their logic is not a logic we can understand.  Their brains are wired differently. 

Maybe someday, science will invent a machine that can scan the brain and see these broken or mis-wired circuits.  Maybe someday, they'll figure out how to fix them.  In the meantime, we need to understand our limitations and understand that as family members or friends, we can help manage, but we, ourselves, can't fix something that's this badly broken. 

All we can do is the best we can.  We need to live our lives too.   And, we shouldn't feel guilty that we can't do more.

I've been called crazy many times, usually because of my extreme sports.  People who don't understand that risk sports are about learning the skills necessary to control the risks think that since they would have to be crazy to try these things, I must be too.  And maybe I am.

I just finished my first draft of The Shadow of God and I sent it out for review.  The story has characters who suffer from mental illnesses and as I raced to the conclusion, I began thinking about the people in my life who suffered from mental illnesses.

I think the first that I recognized was my High School Civics teacher.  I had always been a science and math geek and Civics, Sociology, Psychology, and similar subjects seemed a little 'soft' to me.  But my Civics teacher brought life to what had previously been a boring subject. 

Over the course of the school year, we had lively debates about history, politics, and the future.  I have to say that he actually became a friend.  That hadn't happened before either. 

I did notice that he smoked a lot after class and that his hands shook, but the day it was announced that he'd committed suicide after being on medication for years was the day that I learned that mental illness was all around us, but often hidden from view - or that you needed to look closer to see the signs.

Over the course of my relatively long life, I have encountered mental illness often.  Sure, we see the people on the streets who really should be in institutions.  But beyond them, I have family members, best friends, employees, and even an ex-wife who suffered from mental illnesses. 

I'm not talking about run-of-the-mill depression either.  I think that for most of us, depression is real, but it's transitory and often situational.  A period of medication and/or daily moderate exercise (as several prominent psychiatrists have recently published), will help people get past situational depression.  

No, I've seen much worse: chronic depression, schizophrenia, various forms of psychoses, borderline personality disorder, histrionic personality disorder, bipolar disorder, and even dissociative identity disorder.  In many cases, these illnesses have led to suicides and other violent deaths. 

And yet, if you met any of these people at a wedding or other social function, you would never have sensed that something was wrong. 

What I've discovered is that virtually all of the people I've known who suffered from mental illnesses had learned to mask their problems when in public, or even with friends and family. 

As tolerant people, we tend to accept slightly aberrant behavior.  We may find people charmingly eccentric.  The boundaries of 'acceptable behavior' are broad.  

In other words, people you know and admire may suffer from a debilitating psychological disorder that you just don't see.  Several studies claim that ten percent of the population suffers from significant psychological disorders.  I find that number high, but it's believable.

Many of these people have illnesses with genetic roots.  The potential for schizophrenia, for example can lie dormant for years until triggered by a major life event, or by drug use.  I've had the misfortune to know several teenagers who started experimenting and inadvertently triggered schizophrenia.  It doesn't happen to most, but it does happen to some.

Still, the single greatest cause of mental illness is childhood abuse - sexual, emotional, and/or physical.  But most of these victims, too, learn to adapt and do what's necessary to get along in our society and to fit within the bounds of 'normal' - until something pushes them over the edge and tragedy results.

So why did I write this blog?  Like I said, I just finished writing a book about the subject.  It brought back my desire to help these people.  In my youth, I think I believed that I could help them myself.  In my old age, I think I finally recognize that in most cases, I would have been more helpful by encouraging them to seek professional care at the first real signs of a problem.  

So I ask you to look around you at your friends and loved ones.  I'm not suggesting you should become a grand inquisitor, but do look around.  If you see the signs, don't ignore them.  You might help save someone's life.