To Sleep, Perchance to Dream

Sleep is way overrated.

At least that’s what I used to think, before I met my wife and before I started to get older and began to feel the very real consequences of not sleeping well or enough.

I went to college for three years, medical school for four years and then did a residency in psychiatry for four more years before I could start to work as a “real” doctor. All during that time, sleep was a very real luxury that one very quickly learned could be sacrificed for something else, like last minute cramming for a final, research that helped avoid a tongue lashing by a picky attending on morning rounds, or more coffee. We were basically trained by medical training NOT to sleep. In addition to my regular academic duties, I worked a third shift lab job in the hospital, had to go to class, had clinical rotations and had to read, like, all the time. Little naps were good, but an unbroken eight hours of sleep never happened.

Somehow, and I still don’t know quite how, that lack of sleep, perceived need for sleep, and inability to understand the need for sleep carried over into private practice and starting a family. As time went on, sleep deprivation became the norm. I’m sure it deprived me of some experiences and some moments of being fully awake.

As I age, I know in my head and my heart that I need more sleep, but I still begrudge the time lost. I love to sleep, but I hate to end the day and get to bed!

Funny thing is, if I get at least seven or eight hours of good sleep now, I can tell a night and day difference. I am sharper mentally, I feel much better physically, my tolerance is better and I am more creative.

I am trying to learn these key points:

Sleep is good for me. I need to sleep. A lot more than I do. Every night possible.

Routine is important, not just for my little grandchildren, but for me too. Get up at about the same time each day. Get to bed. Let the day end. You’ll have another brand new one tomorrow!

I have a feeling that if I do NOT learn these important lessons on my own, my aging body and brain will let me know in good time….

Growing Older

I have often heard people say, “I’m getting so much older”, or “I feel so much older!” They lament the aging process and rail against it, as if that is going to stop it in its tracks or make it any easier to get through.

I prefer to think of it as “growing older” and not getting older.

We have a lot of potential for growth as we age. We learn a lot about relationships, money, travel, work, children, grandchildren and a myriad other things almost by default. If we put even a little effort forth, we can maximize these growth areas and enrich our lives many fold. Simply deciding to age gracefully (or not so much!) is an option, but not the best one. Aggressive learning and growing as we age is much better.

A lot of this is based on attitude. When you wake up in the morning, are you glad to be alive? Are you excited about the coming day? Do you relish the challenges ahead and have a plan to attack them with vigor? A positive attitude can go a long way as we try to maintain an upbeat demeanor going into our senior years.

I have to do a certain amount of continuing medical education every year in order to maintain my medical license. Most years I do many more hours above the minimum required to meet the goal. It’s fun to learn new things or just to confirm that I’m on track with what I already do to treat my patients! You know, continuing education is not just for doctors or other licensed professionals. Anyone can continue a learning program, and make it as structured or unstructured as they like, all life long. If you never stop learning , you never stop growing.

As I mentioned above, one can passively accept the fact that aging will occur and do to us what it will, or one can choose to fight back, stay in shape and not go quietly into that good night! This includes staying healthy in mind, body and spirit. I worked my Telepsychiatry job the last three evenings in a row, so when I got off work today I was very excited about getting outside and walking in the heat and sunshine. I am very fortunate to live near a river and in a conservation community, so it is not unusual to encounter wildlife and birds and other creatures on a walk.

It was 97 degrees and humid today, brutal for this time of year, but I changed clothes immediately on arriving home (so I would not chicken out!) and went right out the back door toward the river. I was lucky enough to see a couple of hawks, a giant white egret, a blue heron, came within six feet of a beautiful doe standing in the swamp plants just off the boardwalk ( she didn’t move a muscle and stared me down as I walked quietly past her), and then on the other side of the neighborhood I saw a mother and the cutest tiny little fawn you could ever want to see. Although these beautiful creatures sometimes nip at our new lilies in the middle of the night, I still thrill every time I see them up close. I got back to the house after a three mile walk, overheated and tired, but so pleased that I am able to get out and feel my physical body straining against obsolescence.

If we are going to age gracefully, we must be positive, never stop learning, push ourselves in mind, body and spirit and always choose active growth over passive acceptance of aging.

Memorial Day

One thing about starting a new blog that celebrates getting older is that I, as the guy getting older and writing the blog, am allowed to have a good old fashioned old man rant every once in a while. It’s just the right thing to do. It must be done. This will be a small but important one. Please bear with me.

I love holidays. I really do. Holidays are usually fun, festive and bring people together to eat, drink, be merry and give each other gifts of some sort. Some holidays are religious, some are spooky, some are silly, and let’s face it, some are simply made up by the card companies to sell more greeting cards. That being said, today is Memorial Day in the United States. It is not Veterans Day. It is Memorial Day. Are they different, you ask? Read on.

Memorial Day is a federal holiday in the US that is designed to remember and honor those who have died while in the service of the armed forces of their country. It is observed on the last Monday of May. It is also considered to be the unofficial start of summer. Read more about the sometime controversial history of the start of Memorial Day here.

There are two other holidays that celebrate veterans and their service. Veterans Day celebrates the service of all US veterans. Armed Forces Day honors those who are currently serving in the armed forces of the US.

A couple of facts that you may or may not know about Memorial Day as it is currently observed: in the year 2000, Congress passed the National Moment of Remembrance Act, asking people to take a moment at 3:00 PM on Memorial Day to stop and reflect; on Memorial Day, the flag of the United States is raised vigorously to the top of the staff, then solemnly lowered to half-staff, where it should remain only until noon, after which it is raised to full-staff once again; parades are held across the land in big cities and small towns on Memorial Day weekend, usually involving marching bands and displays of vehicles used in our various wars; volunteers place thousands of flags on the gravesites of fallen warriors in national cemeteries across the country on this weekend.

Now, my rant.

Memorial Day honors those who have died while serving in the armed services. Thus, in my humble American old man opinion, it is not appropriate to wish anyone a “Happy Memorial Day”. Those who visit the national cemeteries, gravesites of their loved ones, and place flowers through their tears are not celebrating anything happy. They are grieving a painful loss, one that in no small part is why we have the precious freedoms we all enjoy today.

Thus, we do not celebrate Memorial Day, but we observe it, with respect and honor for those who died, and with a profound sense of gratitude for all they did to keep us free.

Veterans Day? Celebrate your heart out. That day, November 11th, will be for all veterans past and present, living and dead. It is also the birthday of my oldest granddaughter, so a doubly celebratory day for us! Thank a veteran for his or her service, give them a hug, salute them if appropriate for you to do so, and let them know that they are loved, cherished and valued by all Americans. (You may do this for my granddaughter as well if you see her. I kid….)

Enjoy the unofficial start of summer today (Lord knows where I live it is plenty hot already), but remember why we observe this solemn holiday in the United States. Take a moment to acknowledge the ultimate sacrifice that some of our men and women in uniform made in order to ensure that we keep and enjoy our many freedoms.

Thin Places

As we wrapped up our final meeting of the year in my Education for Ministry group this week, we went around the room sharing how we might approach things differently going forward, given the insights and inpact our studies had made on us. I thought about this, and decided that what I wanted to do was pay more daily attention to seeing and feeling the thin places around me. Read more about these places here. You may be familiar with this concept, which originates in Celtic tradition and denotes those places where the separation between earth and heaven is quite thin. Heaven and earth, the Celtic saying goes, are only three feet apart, but in thin places that distance is even shorter. The article above also says that you don’t really plan to go to a thin place-you stunble upon one. I agree and disagree, as you will see.

I have been lucky enough to travel to many places in my life, I have been on many mountaintops, and I have walked in many a lush, green forest. I have seen churches and cathedrals that awed me, cities and towns that inspired me, and driven madly over roads that made me feel that I was flying on the edge of the world. Most of the thin places that I have felt were quiet, but I suppose that would not always be the case. For me, getting out of and away from the hectic routine of my world, away from the cacophany of daily life, away from the many demands made on all of us, is the way to begin setting myself up to be in a position to feel and see a thin place. Some of my past and more recent thin places involve religious sites, historical places, flying and hiking.

One of the more recent thin places I visited was the Notre Dame Cathedral in Montreal, QC. See one of my photos of this magnificent place below. When we walked into this cathedral, I was quite certain that I would immediately burst into tears. The emotion that overwhelmed me, the sense that I was so much closer to God, in an instant, was powerful beyond description. Churches are most always beautiful in their own way (we saw at least a half dozen on our recent trip to Canada) , but the history and the presentation and the sheer magnitude of the earthly, physical response to the heavenly was almost close enough to reach out and touch. If you have not seen this cathedral, and you are ever in Montreal, go there first. As our concierge in the hotel told us, “There are three things you do in Montreal. One, go to see Notre Dame. Two, climb the mountain (Mount Royal). Lastly, eat and drink!

If you look upward, you can see “Mary in Her heaven” toward the spire.

Another place that I felt I was much closer to heaven was on a high ridge along a hiking trail in the Sandia Mountains outside of Albequerque. I had flown out, rented a car, driven to the very top of the mountains, and then hiked all day along a long, dry, beautiful ridge trail that spanned much of the mountains. The highest point, Sandia Crest, was 10,678 feet. If you look at a picture of these mountains and see the bristle of radio and TV towers at the top, that was where I parked my car before the hike! I did not see another soul for the duration of the hike. The terrain was wild, gorgeous and harsh, and I got lost at the very end of my trek, but I was able to find a road and regain my bearings. The solitude one feels at 10,000 feet, the feeling of being thousands of feet above the city and the valley floor below, and the trust that one must place in themselves to get in and get out, while exploring some rarely used trails, is exhilarating. I never felt afraid, lonely or isolated. God was there, I think, and maybe even an angel or two once they figured that I was really lost, exhausted and in need of some rescuing at the end.

Looking down over the dry, brown valley in the distance. The green forest below me was where I would essentially re-blaze a little used trail and get lost on my way back down the ridge, but God and a couple of angels helped me find my way, of that I am quite sure.

Another two places in nature that were overwhelmingly beautiful were Rocky Mountain National Park and Staunton State Park in Colorado. Trina and I have hiked there together when out to visit my daughter and her family, and both are huge, wild and gorgeous. It is hard to do justice to places like these with pictures, but I have included one of each below that might give you a little taste of the sense of awe that you feel when being a very small human walking in a very large expanse of God’s creation. Again, one does not always go looking for these thin places, but once you are experiencing one, there is no doubt that you are there.

A tranquil lake about halfway into our hike, where we took off our shoes, ate some lunch and chatted with a very friendly chipmunk.
A rugged, long hike through the relatively new Staunton State Park. Our destination was just to the right of Lion’s Head, the rocky outcropping in the distance.

The last and problably most important thin place for me is one that is close to home. The Church of the Good Shepherd has been my church home for many years now. It is a small structure that is big on heart, service to the community and sharing the gospel with anyone who will hear. I love going to the church anytime, but holidays are the times that I feel the real closeness of heaven. I will share pictures from Christmas and Eastertide below, two of the most solemn and important times on the Christian calendar, and two times of year that Good Shepherd is at her finest.

The altar at Christmas.
Easter Day

Thin places are all around us. Be vigilant. Be aware. Slow down, put down your electronics and listen. Feel your surroundings. Just when you least expect it, heaven might be closer than you think.

What the Funeral (Re)taught Me

In the liturgical tradition of the Episcopal church, a funeral is an Easter service. It finds all its meaning in the resurrection. It is characterized by joy. This joy does not make the human grief we feel unChristian or wrong.

None of us lives to himself, and no man dies to himself.

“For everything there is a season, and a time for every matter under heaven: a time to be born, and a time to die; a time to plant, and a time to pluck up what is planted; a time to kill, and a time to heal; a time to break down, and a time to build up; a time to weep, and a time to laugh; a time to mourn, and a time to dance.” Ecclesiastes 3: 1-4

“Help us, we pray, in the midst of things we cannot understand, to believe and trust in the communion of saints, the forgiveness of sins, and the resurrection to life everlasting.”

“Dust thou art, and unto dust shalt thou return.”

Rest In Peace, Reynolds Gracy Jarvis, M.D.

Here’s Looking at You, Kids

My oldest daughter sent me the cutest short videos the other day. My oldest granddaughter and only grandson played beautifully in their recent piano recital. They were poised, confident, and had learned their music well. At the end of their performances, they bowed and accepted the well deserved applause from the audience. I watched and then watched again. As a few tears formed in my eyes (I told you that this was going to be a blog about really growing older, not pretending to be cool), I immediately felt the upswell of four strong feelings.

Pride.

Something that no parent or grandparent is a stranger to. Watching your grandchildren ride a bike, draw a picture, play the piano, or even read a story out loud causes an instant, unconditional feeling of pride in them, their accomplishments and their potential to change the world. This is the best kind of emotion, raw, positive, deeply felt, and real.

Regret.

Why regret, you ask? When I was a child, younger than my grandaughter, my mother and father spent time and money that they could probably not spare easily at the time to get me to and from piano lessons. This included what I remember as a large white bound book of music, thick and impressive looking, that I was supposed to practice out of and learn from most likely for months if not years. I diligently pursued the art of music making for a little while, but soon grew bored with it and felt the tug of playing outside and participating in sports outpull my resolve to practice the piano. My mother let me quit. Not a day goes by that I don’t regret that decision to stop learning to play the piano. Could I have picked it back up later? Could I take adult lessons now? Of course. Did I? Will I? No, of course not. One thing getting older teaches is that time is precious, decisions cannot be made lightly and frivilously now, and choices need to be rock solid and backed by the conviction that once made, they will be carried through and followed through to the end.

Realization.

I made that decision long ago as a child.

I cannot go back and remake it.

I can still, as an adult, enjoy some of these experiences vicariously, through the adventures and talents of my three children and (so far) six grandchildren.

This realization is at the same time a huge relief and a lot of fun.

Gratitude.

On watching my rapidly growing and maturing granchildren play the piano through the magic of a small video clip sent to me on a handheld computer phone by my daughter who recorded the event on the same kind of device, I was flooded with gratitude that we live in a magical age. If we can’t always be away from work, no matter. If we cannot always drive four hours to a site, no matter. With just a very little effort, we can share time and experiences with each other by the magic of the age we live in. That is truly amazing, and I am very grateful for it.

Play it, Sam. (or Laine, or Lawton)

Death of a Mentor

My friend, teacher and mentor Reynolds Jarvis MD died on May 21, 2019, after a long battle with amyotrophic lateral sclerosis, or Lou Gherig’s Disease.

Reynolds was a man who came into my life in that period of time between 1983 and 1987 when I was learning how to be a doctor, and more specifically, a psychiatrist. Yes, I had earned my MD degree in 1983, and I was licensed as a physician, but I had not clue one what I was doing. We were all struggling back then, all the folks in my small residency class at the Medical College of Georgia in Augusta, Georgia, to find our sea legs on the ocean of pathology that confronted us daily. Reynolds was one of the men and women who was entrusted to teach us how to be knowledgeable, compassionate, competent doctors.

He was one of those rare physicians who was proficient and comfortable with one foot in the world of mental illness and the other in the world of internal medicine. He was at ease when diagnosing cogestive heart failure, pancreatic disease, hypertension, as well as depression, bipolar disorder, and schizophrenia. If a patient had more than one illness, and one of each type, then bring it on. He would help us learn how to tease apart the pieces of history that we needed to make accurate and relevent diagnoses.

He liked to tell stories and especially liked to put things in the context of what real people needed and wanted, and how they went about seeking the goods and services that they needed to make their lives better. These concepts had been formulated and taught by another of our mutual mentors, Dr. E. J McCranie, several years before. We all loved to stand around a keg of beer in those heady days, waxing poetic and scientific about the ins and outs of human need and psychiatric pathology.

Reynolds would rotate as attending physician on both internal medicine services and psychiatric services. Rounding with him, talking over patient presentations with him, was a treat. He had the respect of both departments, and that was not lost on his charges.

Another physician friend of mine made me aware of his illness one day at church. I had not known that Reynolds had been ill, as I had not seen him in many years. He told me about his diagnosis, which room he was in at the hospital, and said that he had been by to visit. I might want to stop by to visit too, he offered. I thought about this, knowing that it would be the right thing to do, and promised myself that I would consider it.

I never went to visit my old friend and mentor.

I feel sad about his death, but now I feel even more guilty that I did not go to tell him thank you before he died. Why did I not make the effort to go to the hospital to say hello?

There are many reasons, some of which are merely excuses. I can tell myself that. It doesn’t help, but I tell myself that anyway. I remember Reynolds being large and in charge, in that soft, confident, smooth talking way that only he could. I remember him being smart, so much smarter than me, and thinking that one day it would be great if I could be half as proficient at my craft as he was at his. I remember him being one of my teachers, only seven years ahead of me in his graduation from medical school, but seemingly light years ahead of me in experience and confidence. I was so angry inside when I heard that ALS was going to cut his life short, in that cruel way that any progressive neurological disease does, robbing one of all dignity at the end, and not respecting race, color, creed, class, or MD after a name as it ruins another life.

I did not want to see him that way, could not see him that way. I did not want to confront his death, for in doing so, in saying goodbye to my teacher, I would now have to realize that I am closer to confronting my own. Each loss we bear brings us closer to our own loss of this life, and I was not in a place to do that. I feel ashamed, but it is the truth as I feel it right now. Diseases like ALS take away all our control, and I could not bear to see my old friend, once so easy going and confident, in that state. Forgive me, Reynolds.

His funeral is on Saturday at our church. I will be able to attend, just before I take the short drive to Aiken to work a long emergency room telepsychiatry shift until midnight that night. I will go to pay my respects, as I should.

Do we really lose people, their ideas, their skills, their emotional imprint on this world when they die? Do we really? Or do we carry part of them with us, always, imbedded in us just as surely and firmly as any of our own DNA?

I choose to believe that when they are gone physically that we keep some of them with us until we are gone, and by that time we have passed some of that wisdom and wit and energy and intelligence and competence along to someone else that we care about very much. As the wonderful animated movie Coco taught us, as long as someone has a picture of us, thinks about us, and holds us dear, we never really die. It’s only when there is not a soul who remembers us that we truly pass away.

Dr. Jarvis, I will go to your funeral on Saturday. I will smile when I think about the things you taught me that I use to this day. I will leave your funeral, go to my office and see people in the emergency rooms of South Carolina who are in need. And I will be very, very glad that our paths crossed as you taught me what it means to be a physician.

Rest in peace and rise in glory, friend.

Amen.

(Image of Dr. Jarvis via Platt’s Funeral Home obituary in the Augusta Chronicle)