Profound article

Recently, I read an article in the New Yorker by Dr. Atul Gawande, a very smart and articulate surgeon from Harvard. It is about hospice care and much of what he writes about is relevant to all of us of a certain age and those caring for patients who are seriously ill. The link is

http://www.newyorker.com/reporting/2010/08/02/100802fa_fact_gawande?printable=true

If you have some time, it is worth reading. I was particularly interested in his discussion about the use of hospice care along with standard medical care for those with serious illnesses. In fact an article just came out in the New England Journal of Medicine this week showing that early palliative care along with standard oncologic care for metastatic cancer resulted in less depression, better quality of life and better mood scores than standard care alone. Also the hospice group had less aggressive care at the end of life but had on average a significantly longer survival than the standard care (about 3 months longer). Now 3 months doesn't seem like a lot, but it is the amount of benefit received from many types of chemotherapy. And, believe me, even a few months of good quality life is worthwhile, particularly for the surviving family--and I think for the patient as well who has a little extra good-quality time with loved ones. It may be that in the future, the paradigm of calling in hospice at the last minute may change to have hospice involved early even if the patient may have a remission.

Mountain Town

Today I went up to the little gold rush town of Julian about an hour from Carlsbad but up at about 4000 ft in the Cuyamaca mountains. It is like a stage set town with old storefronts and a single main street. Sally and I had talked about going up there, but we never got around to doing it. The town is known around here for its apple pies, which are really good. So I had to get a pie for dinner while I was there and we had it for desert tonight. Yummy.

The weather is warming up some and the ocean water is also getting warmer so it is ok to go to the beach and even get in the water. Looks like summer is finally arriving.

Experimental cooking

Kathie and I have decided it would be fun to try and cook something different each Friday. This week we may try a recipe from Padma Lakshmi "Tangy tart hot and sweet" book--Pipali Chicken Curry, Madras style. Not sure we can find all the ingredients, but will try and will let you know.

Also, yesterday I made plane reservations to Seattle to see my friends Alansa and Len Bates and Jim Goode (Sally's brother). We lived in Seattle from 1963 to 1966 and have been back only rarely. This is something exiting to look forward to--at the end of August.

Still unusually cool here in contrast with most everywhere else--can't complain.

Wild Animals

Last week Gavin and Christopher and I went to the Wild Animal Park, which is part of the San Diego Zoo, but is inland a little ways. Last year Sally and I joined the Zoo as members and went to the main zoo with the boys, and we were going to go to the Wild Animal Park, but the weather got too warm so we didn't. Since it is inland it can get into the 90's or even 100's there. We thought we would go this year. Well, when I got back to this area, I realized that our membership was still valid and since the weather has been cool, I decided that the boys and I would go. So we did and had a great time. It was warm (in the 80s) but quite nice. The park has a lot of acres and the animals have a lot of freedom to roam. Of course they keep the lions away from the zebras, but it is pretty natural in other ways. Anyway, we went and spent several hours there. I am posting a picture of three of the wild animals here (above). I am also posting a picture of a very young elephant born there with mom. It's worth seeing and I only wish that we had gone with Sally last year--but she was with us this year, I'm sure. .

Little things

I think I'm doing ok--then some little thing happens that jolts me. Recently I was filling out some forms and there was a check off for Married or Single. What do I do? I guess I'm single, but that seems too weird.

Also when something happens that is interesting or not expected and I want to share it with someone--who do I talk to. I can, of course share with my children and their families, but I think I miss most the ability to sit and talk with Sally. I can talk to her in my mind or occasionally aloud, but does anyone hear--I hope so.

Sun is out

We have had a long string of pretty gloomy days with overcast skies for most of the day and temperatures in the low 70's high 60's. But for the last couple of days, the sun has been up first thing in the morning and the days have been warm. This has helped my mood--can now go to the beach without freezing. I know, I know, most people in this country are suffering with triple digit heat, so I can't really complain.

Recently I was asked if I still feel Sally's presence here. Of course I do--This place is so Sally. For the last couple of days, an Oriole came and sat on our balcony--they are magnificent and I can't help but think that Sally had something to do with it. This is quite unusual for them to come to our railing.

Craig and his family have been great. I have been having dinner with them most every night and have been going to the Padres games with Craig and the boys also. Last weekend we went to see "Avenue Q" downtown San Diego. Very funny, but a little raunchy. It is basically a muppet like puppet show and they warn about "full puppet nudity" as you go in. But I don't think the boys were too traumatized by it.

We're going to try something new and hopefully fun. One day a week, I will join Kathie to make some sort of interesting, different dinner. She bought a Tajine, which is a Moroccan pottery dish for slow cooking meat and spices. We will try a lamb dish this week and see how it goes.

Bucket List

One of the movies that came out in the past couple of years was the Bucket List. Sally did not want to see it since it was a little too close to home. But thinking about her actions in the past two years it is clear that she had her own list of things that she wanted to accomplish. We never really talked about this, but I think she knew that her time was (or might be) limited and there were some important tasks to get done.

The first of these was the Goode family reunion. She felt that there were some members of the large Goode clan that didn't feel accepted by other parts of the clan. She felt that with her healing influence, she could get everyone together and make this all right. She did this. I think that it might have been the first time that all parts of the family had a dinner together and felt all part of the same extended family.

The second thing was to visit family and friends that we hadn't seen in years. On our drive out to California last year we went through Santa Fe to see her cousin Linda, and on our way back (when she was starting to get really ill again) we visited her nephew Brent and his family in Bakersfield and her cousin Rachel in the mountains of Colorado. We also had some quality time with some very long-time friends, the Thomsons, in Carmel. She also was able to go to her 50th high school reunion and reconnect with many of her high school classmates that she hadn't seen forever.

I know these things meant a great deal to Sally, and I'm really glad that she was able to get these things done. We never know when our time is up and we need to live each day with that in mind.