Agoraphobia

The Girl (calling from the bathroom): We might be out of toilet paper!

Me: I'll get you a new roll.

The Girl: No, I don't think we are all out, because I took the last roll the other day.

This conversation meant that there was no getting out of a small foray to a store. With two kids, in Denmark, on December 29th. Why, Universe? I've always had a touch of agoraphobia, but it has been evolving from a personality trait to an actual problem. Feeding on the burdens of life, work, kids, wife; my life has been saturated with stress the last 5 years and my agoraphobia has thrived.

Another problem with me, among the many I have, is extreme impatience with everything. It's always been impatient; I've gotten grief for it from when I was a little kid. We have called it my condition, and I've even been somewhat proud of it, like it was a sign of efficiency. But agoraphobia and impatience don't go well together.

One of the ways I get around my agoraphobia is that I only venture out, when I know there will be no crowds. I shop for our groceries 15 minutes before the stores close. We go swimming on Friday nights in a rural community pool, which we have all to ourselves. Any visit to a theme park or such similar attraction has to happen in the way off-season

But when the Girl announced that we were out of tp, I knew there was no alternative to diving into Danish Christmas craziness. Most Danes have the week off between Christmas and New Year's and it seems like they love to shop all day, every day.

The Lorax was crying most of the time; he screamed "skoldkopper!" (chickenpox) to get my attention and was hard to handle in the busy store. He is through his run of pox, but he still likes to be pitied, apparently. The toilet paper and other necessities were quickly located and I tried wrangling the kids toward the registers. Or, I should say kid, because Natali is actually more help than bother at this point.

In a packed store, with a screaming Lorax, without room to maneuver, it's gotten to the point where I have to control my breathing to prevent getting shivers. It's never bad when I'm alone; it's when I'm with the kids that it really ignites.

The stress is getting to me. There is no other way of looking at it.

At least I have been running well on the treadmill at the gym. I had a winter a few years ago, where I ran almost exclusively on the treadmill. That winter led to my 1:13 half marathon PR, so maybe this Wisconsinesque snow is good for something.

2010 Season in Review - Goals for 2011

I had a very unusual 2010 running season. For one, I wasn't injured; more than likely, I was safe from injury because of undertraining. There were some highs and lows, and all the highs came in marathons or ultras. As I am writing this, I am sorely out of shape and I won't have time to train properly in the next few months. My goals for 2011 are, as such, very vague.

My goals for 2010 were stated on this very blog a year ago:

5K 16:00 flat (under 16 would be too much pressure)
Age group national champion in the 5000
10K Under-34
Half Under 1:15
Win an ultra

Hmm. Only made one of those goals.

I started out the year with a winter marathon. Jogged the first half, sped up and finished in 3:04. Finished 2nd and in the money. Great start to the season.

The next race I remember was Hells Hills (no apostrophe after Hell, just so you know). A poor man's ultra at just 50K, I did win it. That was the one fulfilled goal for 2010. A fun race, but it's hard to compare times in trail races. If three faster guys had shown up and I had taken fourth, I probably would have thought I sucked that day. But as it was, it felt like a great race.

Then came another training marathon in 2:50. Felt good and relaxed. Stuck with the other two leaders till 13K to go and then raced the last bit on a good runner's high.

The Copenhagen Marathon. I was aiming for 2:42 and got 2:49. The end was terrible. Looking back, I was probably mining some good form that ran out just before this race. I ran one more marathon a few weeks afterwards, where I dropped out, proving that my peak was long gone. I won't run a road marathon again for a long time.

The rest of the spring, I was able to train really well. Because of my schedule, I had post-call days off every week, and I was able to put together two strong months. Ironically, my goal marathon for the summer (Grand Island in Marquette, MI) filled up too fast and I ended up just training through the summer.

I did run a 5K in 16:32 in Carlton the day before the Girl ran Voyageur. This was in 90 degree heat and it felt miserable the whole time. I bet I could have gotten close to 16:00, another of the goals above, but that 5K was the only short race I did all year.

Ok, not really. I forget some fun races, like a relay, where I ran two legs in high 16s. But the Carlton race was the only short race I truly raced. The last time that happened must have been 15 years ago. Wow.

What did we do in the fall?

It feels like there was some other race first, but the high point was certainly October's Brocken Marathon. 3:04 on that course is what I consider my "relative" marathon PR. The best part was that I got done with so much left in the tank, and a promise of faster times. That vein of form continued into running 46 miles at the Copenhagen 6 Hour Race.

High point? Either Hells Hills or Brocken. Both non-technical, hilly trail races, which would appear to have become my strong suit.

Goals for 2011.

Since I failed 4 out of 5 goals for 2010, I had better make my 2011 goals more attainable. Problem is, I don't know what next year will bring. I don't know if we're moving back to Wisconsin in September or in January. This winter and spring are going to be uber-busy at work. How are these for goals:

Keep a running log
Get under 65 kg consistently
Win a short race
Win a long race
Win an ultra

Merry Christmas and a happy New Year to all.

Drukket!

When I speak dreamily about a faraway fairytale land, sometimes referred to as Utopia and other times simply called Wisconsin, I always mention "snow in winter". Yet, how the hell come, whenever it snows here, I hate it.

Because my cross country skis are in Wisconsin?

No. Not really, although it would be cool to have them here. Snow profoundly paralyzes Denmark. We have gotten maybe 10 inches over the last week, and the resulting traffic chaos is amazing. Add to this the fact that I work 60 miles from my house. I usually take the train, but for night and weekend shifts, I drive. This morning, with an inch of fresh snow in 25 degree weather, some people were going 20 miles an hour on the freeway.

I should mention Natali.

She didn't take the news well; that her teachers had brought up the weight issue. I wrote to my ex about what had happened, and she responded with a nice email full of advice. Natali was pissed. She is a superb splitter and had lost a golden opportunity here.

The interesting thing is that she got over her anger very quickly. When I saw her the next afternoon, she seemed almost relieved that the can of worms had been opened. I know she has been thinking about it a lot, and of course the other girls have made fun of her. This process has made it acceptable to talk about her weight. Somewhat to my surprise.

So in the last three days, she has been very active and even skipped her evening snack one night. I asked her "are you really hungry?"; she smiled and looked down and replied: "I'm learning to speak to my stomach and he says no". She is so cool.

Meanwhile, the Girl is throwing up non-stop. If you wonder whether being an MD makes her less or more nervous of something happening to this pregnancy, here are a few examples of her state of mind:

- "I'm so nauseated. Then it can't be an ectopic! Hey wake up. I don't think it's an ectopic!"

- "Now I feel great. Oh god, what if it's an ectopic?"

- "My stomach is so big. What if it's a molar pregnancy? Molars make lots of hCG, so maybe that's why I'm nauseated.

- "Oh my god, maybe the Ginger is filling up my stomach. So if I take too much, I'll get nauseated again."

She is throwing up so much that the Lorax scream "drukket" (has drunk), whenever she makes a gaggy face. We're not sure why he screams "drukket", but we suspect that he thinks that she has drunk too much, too fast.

Time out!

Am I the only one who feels like life is happening too fast?

We've been back from our work/vacation trip for almost a week now. The apartment's a mess; there are a million little things we are behind on. The jetlag won't die. Christmas is coming, whether we like it or not, and we still have to buy 10 thoughtful presents. Oh, and the Lorax has chickenpox!

The kicker came today at Natali's parent-teacher conference. There were three teachers and one of me. Academically, she is doing fine. Ok, I knew that, but their concerned faces told me that the conversation was about to turn sour. In short, they think she is fat, and that I am not doing enough to prevent it. Her female teacher told me that if only I would spend more time with her, Natali would forget about eating. Don't I see that all the changes in her life are causing her to resolve to food as a friend that never lets her down? All three of them kept going on about how lazy and fat she was. One of them, a guy I don't know too well who runs the after school program, joked that Natali's first words upon entering the building was always "what's for dinner?". Har-dee-har-har.

It was like sitting in front of three Dr. Phils, only with more platitudes. I told them that from when I come home from work, Natali is never more than 3 feet away from me. I didn't tell them how the Girl sometimes complains that Natali acts more like my wife than she does, but maybe I should have; just think of the forthcoming bumper sticker logic!

I was up against the ropes.

We came to the following conclusions:

1. She can only eat the lunch/snacks we pack for her. No accepting leftovers from other kids. No begging snacks at the after school program.

2. One hour of moving around every day.

3. She gets weighed every Thursday, and her teacher will sit down and review the result and the preceding week's eating and exercise.

I like the rules; hopefully they will work. I did not like the attitude, though. They kept implying that she has too much responsibility for her age. That I'm too uninvolved. Talk eventually turned to our plans next year. I explained that my ex wants her back in La Crosse next year, but that I'm hoping to get her back the following year. They lectured me on the importance of stability, and I told them that I had no say in it. I mentioned that for all I knew, my ex could call the police and tell them I kidnapped Natali to a foreign country. That got a little respect, or at least generated some genuine interest, and I'm convinced our sorry tale will be shared over pipes and Birkenstocks in the teacher's lounge.

At first, I was a little angry. I was driving to work, cursing this outside-Green-zone Baghdad that is my life. Cursing my commute, cursing the distance to Andreas, cursing how Natali has to move next year. Cursing the day the Girl looked at me and said, "why can't we move to Denmark" and I said "why not?", because I was so in love and would go anywhere with her. A simple "nah, I can't leave the kids" would have sufficed.

Then a sense of despair set in. If only I could slow down life a little; if only I had more time. Time to mold our family into a unit so tight, with values and traditions so strong, that we could laugh at the mundane troubles of ho-hum life. Why don't we have a Christmas tree yet? Why do I work every day till Christmas, including a 24-hour shift on the 25th? Maybe our last Christmas in Denmark, and it gets swallowed up in stress.

We dream of an end to all this, of course, as idiots in our shoes always do. The end never comes, until one of us, most likely me, dies from a stress-related heart attack. But a short respite is on the horizon, at least. When the Girl goes on maternity leave in the fall, we are moving to Wisconsin for 6+ months. She'll work on her PhD with the UW eye people; I'll be done with fellowship and will freelance at odd jobs. It's certainly something to look forward to: imagine being close to the kids, working less but for more money, while living in an exciting new place (Madison, where I have never lived, but where the Girl went to college). This coincides beautifully with Natali's forced return to La Crosse. For the unlikely reader unfamiliar with Wisconsin's layout, it's about a two-hour drive from La Crosse to Madison. A cross-country trek by Danish standards; a well-deserved chance to catch up on some NPR by American.

Perhaps I wil get some sleep tonight and enjoy my post-call day with the Girl and Natali. Our poxed son is still with his grandmother, so the three of us shall form a tight unit and find a Christmas tree. It will be me and my two wives, all of us losing weight from the walking and the emesis.

December running log

1: 10 miles around Old Key west. Some decent fartleks.
3: 8 miles to the convention center and back. Horrible Orlando!
5: 8 miles around Orlando
6: 4 miles on the treadmill
7: 10 miles of fartleks around some residential areas in Orlando.
10: 3 perimeter loops in the snow. Tired legs
12: Two hours slow with the Girl. 20 minutes tempo around Buddinge/Bagsværd. Felt zippy.
14: 3 Perimeter loops, preceded by dropping Natali off at school. Slippery trails, but decent legs
17: It was supposed to be 8X800m on the treadmill but I quit after 6. It was hot. I gotta get used to it. First 4, including 200m jogs in 15:04. Pace probably around 5:45 and felt terrible.
20: Two tennis court loops (10K?) tempo. Started rusty; finished strong.
23: 6K jog in the snow around Bagsværd.
26: 8Kish tempo in the snow along freeway trail.
27: 12K on the treadmill. "4x800" in 14:56. Description: 200m@12.5kph, then 800 fast. Repeat four times. Feeling surprisingly peppy.
29: 10K on the treadmill. "4x800" in 14:50. Ok legs.
31: New Year Social Marathon with the Girl. Not exactly too social, as we got left in the dust by the group. Nearly half the field dropped back and I'm sure a few got lost.

Crazy trip

My last two weeks have been a little out of the ordinary.

We flew in for a wonderful Thanksgiving. That day turned out to be the most relaxing day of the whole trip.

Then I worked the whole weekend in the ER. It was moderately busy, but no one was seriously ill. I only shipped one lady out and admitted three, so that was probably below average.

I love working there. It's the exact opposite of the ivory tower medicine I practice every day, and I miss the general medicine stuff more than most of my colleagues. The fact that anything may roll in to the ER is unnerving, no doubt, but at the same time it's refreshing. It's increasingly obvious to me that my dream job would be that of a community hematologist, with an amount of general internal medicine thrown in. Hematology is such a specialized field that one almost has to work in a large center to see exclusively hematology, and I'm not sure that appeals to me. Some do combined hematology and oncology, which I won't be able to do unless I get trained in oncology, too.

We flew to Florida and Disney World. We were there two years ago and the kids loved it. I arrived two years ago, convinced I would hate it. I expected a fake, tacky plastic world full of fat people waiting in lines. And, of course, that's what Disney World is. Still, I ended up having a great time and looked forward to coming back. The second time wasn't as good as the first, but it was still a very good time. We visited EPCOT, Magic Kingdom and Animal Kingdom, and they all had their own charm. After the first day, the whole family glided smoothly through the parks with a shared purpose of having fun.

My son, Andreas, sees me as a fun guy who shows up every few months. He had a good time in Disney World, and he opened up a little bit to me on a few occasions. We will live away from him for another year, but at least there is an end to it. He is generally doing better in school than I have feared, but he has behavioral problems. I do wonder if he has a bit of ADD, and his teachers have voiced concerns about that, too. I need to get back in his life.

Suddenly, one night, I had to leave for my convention. We had gotten into a mode of riding Disney shuttles, racing to pools, and playing loud games in our condo. And from one moment to the next, I had to leave. Natali was crying and Andreas went into quiet beyond-reach mode. The taxi came quicker than I expected, and I had to leave a house full of wailing chaos.

So there I was, at the hematology convention, wearing a suit and talking about lymphomas with other hematologists, knowing the Girl and the kids were just a few miles away.

I want to describe Orlando. Partly because Orlando is a horrible place that deserves mention, but partly because I realize that my fellow Danish convention-goers think of Orlando as America. What a terrible place to live! Everything seems so unsustainable and fake. There are beautiful sidewalks that meander through flower beds and palm trees. They end suddenly, at arbitrary spots and are clearly built for people to look at through car windows. It's not possible to walk anywhere; I had to break several laws to find my way on foot to the convention center.

The grass is unnaturally green, and if one runs on it, it feels fake. It's watered several times a day, making it thicker than grass should be. If one runs on it, it's apparent that there is no normal soil underneath. It grows on some kind of rubber mesh. The grass is made to be admired from a car.

Orlando has a strip, akin to the Las Vegas strip, of hotels and restaurants. Universal Studios and Seaworld lie at opposite ends of this strip. Everything is manicured beautifully, and a trolley reminiscent of Europe or San Francisco will take you up and down the strip. But when one looks behind that row of glitzy hotels, there is nothing. Just abandoned lots and fences and, beyond them, an unhealthy-looking swamp.

And the people. The convention-goers all praise the service level here. I am struck by how unfair it all is. It's hard not to notice how everyone in a menial job is black or Hispanic. Every white person appears wealthy, thin and aloof. Every Hispanic, and I mean every adult person to the man or woman, is obese. There are restaurants so exquisite they import the entire waiting staff from Italy, while the people who actually live here eat mostly fast food.

Okay, so I have been away from my routines for two stressful weeks, and it shows in the above post. But I stand by the general sentiment. I hate Orlando.

Life in Limbo

My last 24 hours have been perfect.

I got off from overnight call at 9. I had gotten a decent amount of sleep, so I started my commute home by biking to a train station, a little farther away from where I usually catch the train home. It was a brisk 50 minute ride through the cold, bright morning, all on bike lanes.

Read two interesting articles on the train on two different kinds of leukemia. Got home and fixed a late breakfast. Read a bit of Last Night in Twisted River, the new John Irving book. I got done with A Prayer for Owen Meany last week and that was a great book. Twisted River is okay and it's getting better as I'm halfway through. I was about to take a nap when the Girl got home from her run. She has to change quickly into her work clothes, which is always fun to watch. We talked a bit before I dozed off. Post-call naps are the best.

When I got up, I did some sit-ups while watching Bones. Threw some running clothes on and ran to Natali's after-school care. She was happy to see me; there are times when she is a little embarrassed of me, but this wasn't one of them. Some of her friends came over to see if she could play on this or that day. I referred them back to Natali, who likes to hang with friends no more than every other day.

I ran while she biked. She has a bike that she loves; I just put some of those fancy induction bike lights on it. She likes to sing while riding one-handed. It's hard to keep up with her. We swung by the grocery store on the way back to buy stuff for dinner. She wanted home-made burgers, insisting on fresh ground beed, not the pre-formed patties. She had also seen a set of new sheets (duvet and pillow covers) that she wanted. I reminded her that she had spent her last money on a stupid Nerf gun and encouraged her to save up for the sheets. She mock-pouted.

At home, I agreed to eat in front of the TV. After all, Friends and Two Guys and a Girl were on. Then the Girl came home from music class with the Lorax. He had been singing loudly the whole way home, on the back of the Girl's bike, and now went straight for a burger (which he pronounces buh-guh in Danish). The Girl was off to look at retinas for a few hours and I cleaned up after dinner.

Then I played with the Lorax. Our typical game included me hiding and scaring him. Then I tickle him until he screams "sloot", meaning "the end". Then I freeze and he climbs up on my back. He says "start" and I start to buck until he falls off. Then I run off to hide again or, alternatively, he runs off to hide. We always end up giggling hard. Sometimes, he gets overwhelmed by the game and goes "hej far!" ("Hi dad"), touching my face, to remind himself that I'm dad and not some crazy wolf about to eat him.

Then I put him to bed. He can go from wild savage to fast asleep in 5 minutes. I offer him a rub and a song and he climbs into bed and lies on his stomach. I always sing "Superman Song" by Crash Test Dummies. I have sung that song to all three kids; perhaps I've sung it 500 times. If he's not asleep by the end of it, which he usually is, I sing "I've just seen a face" by the beatles, followed by "Long may you run" by Neil Young.

I read to Natali; a novel that takes place in Norway. We talked for five minutes before I turn off the lights and kiss her cheek. She always insists on me tucking her in under both duvets.

Then the Girl came home. Her study is humming along right now, and there has been no major crisis this week. We had an hour to ourselves before calling it a night.

This morning, I ran two hours on the trails that start behind our house. Up and down steep hills, trying to beat up my quads as much as possible. Beautiful running on beautiful trails.

24 perfect hours. I can't imagine life getting much better, and I can think of millions of ways life could get worse. I am convinced we'll look back at this time in our lives and think of how happy we were. I should be happy; And yet, I feel like I'm living in limbo.

There is a simple test to see if I am enjoying life. If I want time to go slower, I am enjoying myself. Up until high school, I wanted time to slow to a standstill. I loved my life and wanted it to continue forever. Throughout my marriage with my ex, I wanted life to go fast; I wanted to get done with college, medical school, residency etc. But the last year of residency, especially after I met the Girl, I wanted to slow things down. This lasted until we moved to Denmark, after which I have wanted time to fly by.

It's the limbo I can't take. Or limbos; namely two, and a bunch of smaller ones.

The first is Natali and where she will be next year. My ex wife hasn't decided what she wants to do and, as some readers may know, she has the power to decide where Natali will live next year. I think about this 500 times a day, as I am biking or running or clearing the table after dinner. We can't plan anything past next summer, or "N-day" as I call it.

My ex-wife, bless her heart, ignores my emails. We have had some minor arguments lately. Really minor stuff, but her lack of communication makes the situation unnerving.

I don't know what I would do if she demands that Natali come back to Wisconsin. My first move could be to tell her (in writing, so I could show InterPol that I wasn't trying to kidnap Natali), "okay, she is all yours; come and get her". Now, my ex has watched me bring and pick up Natali 6 or 7 times over the last two years, while she has driven a few hours, tops, to Madison to meet us. She has paid half of one of the plane tickets, while bithing endlessly about it. Just that fact, that she would have to come here to pick up Natali, may deter her from wanting her.

Of course, such a move on my part would mean that I would be even farter away from Andreas, and being away from him is another one of my worries.

He's a pit of guilt and regret, moreso than a limbo, though. The other big limbo is what we'll do when the Girl is done with her PhD. This depends largely on what specialty she goes into. Right now, she is torn between ophthalmology and sports medicine. People may ask, appropriately, how the Girl could do a PhD in ophthalmology and then go into sports medicine. I personally think the Girl would be happy doing either specialty, and if she would go into sports med, she would sell her PhD as more of a public health/epidemiology study.

She would do well in either career. Ophthalmology seems more obvious, but her interests right now lie more in sports medicine. As much ought to be claer to anyone reading her blog (ie. the five people reading this). Her choice is exciting, but it also represents a state of limbo for me. Ophthalmology would probably take us back to Wisconsin and Andreas, whereas sports medicine would most likely take us to the Pacific Northwest. So it's not just a career choice for her; it's me being close to Andreas and, god forbid, Natali, if she ends up with my ex. And it has implications for my career, as hematology is a specialty of large academic centers. If the Girl does sports medicine, I may end up working in the ER, for a while or permanently.

I think the Dalai Lama has said something like "don't worry about things you can fix; fix them. Don't worry about things you can't fix, because you can't fix them, anyway". It seems like such simple advice to give, but it's hard to follow.

November running log

2: 3 miles slowly. Recovering nicely from the 6-hour race. A little bit of plantar pain on the left.
6: Green Tunnel Hills, 5 repeats, one extra long stairs. The legs were ok, but not as peppy as a few weeks ago.
8-20: Forgot to log.
22: 3 Perimeter Loops.
24: 4 Perimeter Loops, feeling good.
26: Easy 5K or so before flying to Chicago
27: 3 hours at Lapham Peak. The Girl was cranky and pregnant. I ran a final loop alone and felt good.

Copenhagen 6 Hour - Report

This race is really well-organized, by some of the nicest people I have met in Danish running. I would recommend it to anyone thinking about venturing into the ultra distances.

The only minor complaint is that they have a marathon at the same time. I'm not sure why they do this; I think the two races combined capped at 150 runners, with just 30 or so runners going for the marathon. I wonder if they couldn't just have filled the race with 6-hour runners.

At the start, it's confusing that you don't know who's in the marathon and who's in the 6-hour race. I was just going to run my own race but, on the other hand, it's impossible not to look around to see how you are doing. I started slowly, trying to use the first couple of laps to warm up. After two laps, I steadily moved up through the field, always playing this little game in my mind to see if I was going too fast: whenever I was passing someone, I tried to stay behind them, and if I started to feel like I had to consciously slow down, I would pass. My game plan was to never run slower than "cruising pace", and I was sticking with this plan.

At a point, maybe around 40 minutes in, I found a guy, whose pace matched mine. We would yo-yo a little, especially around the aid station, but we ran together until two hours. This was Charlie George, who, despite his name, is Danish and runs for Hellas in Roskilde. We exchanged resumes, his including a 1:17 half marathon this spring, which at 51 earned him the M50 national championship for that distance. Incidentally, he beat our teammate, Per, in that race. He had never run an ultra before.

We talked about pacing, and we obviously had similar strategies: if it feels good, don't slow down. We got through 20K in 1:30 and kept this pace till 2 hours. I mentioned that we were exactly on 50-mile pace, and there was no way in the world that I could run 50 miles in 6 hours. He concurred, but on we ran.

Then at two hours, my plan called for walking breaks. I was starting to feel sore, but not sore to a point where I would usually consider taking walking breaks. It was hard to let my companion drift away, and it felt like the race was moving on without me. From two to four hours, I walked 4-5 minutes every two laps. This was brisk walking, of course, but it felt miserable as 15-20 runners would pass me during every walking break.

But here's the thing: once I started running again, I would quickly re-pass the people, who had passed me. My cruising pace was holding up nicely. I was watching one guy in particular, who I had just lapped before the walking breaks began. For the entire two hours (from 2 to 4 hours), I passed and was re-passed by this same guy, which I took to mean that I holding my place decently in the pack.

A 4 hours, I turned on my iPod. I kept using the walking breaks up until 5 hours, but they were a little less regimented. The music made me really emotional. I had looked forward to this moment, hoping to rekindle the tearful runner's high from the Brocken Marathon three weeks ago. The recipe calls for exhaustion and good music but, I have realized, an important ingredient is that I have to go low on calories and, just before I bonk, eat a lot. And it came: that wonderful, drugged sense of floating effortlessly. Most people walked intermittently at this point, looking dead tired. The lake and the fall colors in the sun looked so peaceful. It sounds sappy, but it felt like everyone was running together.

My well-orchestrated high lasted 10-15 minutes. I had saved my music and gone low on calories for this, so I was hoping for a little more. But it was well worth it.

Then the race began to suck. I was starting to cramp, which always seems to be my limiting factor. I was nauseated and just sick of running. One thing that got me going a little was that Charlie George lapped me; immediately afterwards, he stopped to get something to eat and drink and looked pretty dead. I sensed that I would be able to pass him if I kept my current pace.

The last half hour, I was joined by Helle, of mountaineering and cancer-survivorship research fame. This was wonderful, and I now realize why pacing in ultras is such a big deal. We stopped taking walking breaks, except waling up a little hill. Thanks, Helle!

At the very end, we got passed by Jakob Lindberg, and this was the only time I got passed the entire race, outside my walking breaks! Jakob notwithstanding, I think this fact made all the difference. Even as I was slowing down, I continued to feel fast, because whenever I ran, I kept passing other runners.

I ended up running just over 73K, which is more than I was hoping for. It's a minor breakthrough, as I see it. And this just three weeks after Brocken, which was another good race.

I ended up passing Charlie and opened a 1K gap on him, but otherwise I kept my place through the last few hours. I didn't know what that place was, but it turned out to be 5th. The winner, Ole Stougaard, ran over 80K and told me after the race that it was his first ultra. He is a retired elite triathlete, who "runs to stay in shape". Dang. A 50 miler in less that 6 hours in his first ultra...

The weird thing about these short-lap races is that you see the same people over and over again. But the ones you don't see are the ones who run your pace. Kim Hammerich, who runs on the national ultra team, stayed ahead of me, but on the same lap, the entire race! I saw him at the start, and then forgot he was even in the race. In the end, he was 900 meters ahead of me I asked Kim why he wasn't farther ahead of me; it turns out he ran a 100K last weekend, and is running another 100K next week.

I was trying to suppress 10 different cramps, while trying to understand how he can possibly run so much. I don't even run 100 kilometers a week, during my heaviest weeks, and he runs ultras three weekends in a row. I will begin to think about being able to run again next weekend, by the time he probably wins another ultra.

The Girl did well and got 63K. Her race was insanely close, with just a few hundred meters separating 3rd to 5th. Just as I could pretend to almost beat someone on the national team, the Girl almost beat May-Britt Hansen. May-Britt was coming back from a shoulder injury and ran the race to get some miles in. After the race, the Girl did less well. She threw up several times and looked like she was about to pass out. I should mention that once we got back to the car, I cramped up so hard that she had to drive, so I wasn't faring much better.

I'm sure we'll do it again next year...

Preview: Copenhagen 6-hour Run

We did this race last year. You run around a little lake on a paved 2.2K loop. Over and over again, until you have lost track of have many loops you have done or what place you are in. I had a miserable race last year, and along with Voyageur 50 miles, it was one of the two big races that I was disappointed with.

This year, my preparation has been different. Not better, neccesarily, but very different. Last year, I had done the Transalpine with the Girl and then run a low-16s 5K (which was probably a little short) and won a somewhat competitive cross country race. This year, I ran one of the best races of my life three weeks ago at the Brocken marathon. And last month, I set PBs on all my principal training routes.

The one thing I am worried about is whether I have bounced back completely from the marathon.

A 6-hour run is hard to plan out. Last year, I started slowly with the Girl the first hour and then sped up. I probably went from 25th to 2nd place over the next two hours and came through the marathon in 3:11. I was in second place for maybe five minutes, after which came 3 hours of being passed by seemingly hundreds of runners (some individual runners passed me several times). I think I got to 65K and took 6th, although at the finish I would have guessed I took 20th. Interesting how that works.

The lesson to me was that walking/jogging isn't as slow as it seems when you are doing it. I think this year, I will start out faster. Yes, faster. I don't think starting out slower than my usual cruising pace postpones my inevitable collapse. So if I use the first few laps as a warm-up and then start cruising, I imagine that will put me near the front of the race. Now, I know that this year, the field is much stronger than last year, but my optimistic cruising pace is still pretty fast in a 6-hour race.

A big part of starting out fast is I get to see the top runners. Last year, it sucked now knowing who was where in the race.

Then comes the master-stroke of my plan: I slow down. After maybe two hours, I will start to feel fatigued and sore, and that's when I start taking frequent, long walking breaks. I plan on the middle two hours being very slow, while I sink down through the field.

But. And here's the but. Then the last two hours, hopefully, I shall walk less and run more. Or run more talk less, as the hipsters say. I plan on eating a ton at four hours, which will propel me into a tearful runner's high the last two hours. Last year, everyone was suffering at the end. If I can be that guy with lots of energy, that wouldn't be half-bad.

Or I may ust keep jogging and walking, while enjoying a tearful painfest. We shall see.

I hope to get to high 60s, low 70s, in terms of distance.

A little something for the ladies...
As I recall, as this point, I had started out in these clothes, then stripped down after one hour, but after three hours I meekly re-robed and wore this dour facial expression.

Bilingual or no-lingual?

The Lorax speaks only Danish so far. Since we plan to move back to the US in two or three years, I figure he needs to completely solidify his Danish now. He will learn English soon enough and, hopefully, will end up fluent in both languages.

But, let me tell you, this bilingual thing is not as simple as one may think. First off, I botched both Natali's and my son, Andreas', chances of bilingualism 6 years ago. For the same reasons as the above, my ex-wife and I spoke only Danish to the kids. Whenever we were in the US, they spoke Danish and my ex-in laws had to learn baby Danish to keep up. Then I started residency and they started US day care for the first time - and everything changed dramatically. Within a month, they were perfectly bilingual. They spoke Danish to us and English to everyone else.

Slowly, they forgot their Danish. I showed them Danish movies and online TV, but slowly it disappeared. I read to them in Danish, but it became clear that they preferred the stories in English. I had my own translation of Dr. Seuss, but they weren't buying it.

Andreas is now completely uni-lingual and Natali, because we moved back, is bilingual.

But what does it mean? Is she really 100% proficient in both languages? No; this becomes clear as we read more difficult literature in both Danish and English. She lacks depth; not just knwoing all the words, but reading between the lines, picking up irony and appreciating grammatical intricacies. I'm not 100% sure if it's just her age, but I suspect it has to do with having to keep up with both languages.

We had a medical student rotate through our department last month. A child of Chinese immigrants, he had grown up in Denmark. He was smart, hard-working; a wonderful med student to work with. But his Danish, once he had to construct a hard, thoughtful sentence, was sorely lacking. He had no accent, but he lacked a certain depth that many people commented on. It fascinated me. I don't know if he has ever gone back to China; he probably has. I'm sure the Chinese think that his Mandarin(i'm not sure he speaks Mandarin) is sub-par, having only spoken it with his parents and other Chinese in Denmark.

Then there is my brother and his wife. My sister-in-law's first language is Malay English. What they speak at home is a variant of what Danes call "Danglish", ie. a mix of Danish and English. Most Danes think of Danglish as Danish with lots of borrowed English words. Their Danglish, however, is primarily English, but they share a complete disregard for grammar and sentence structure. Especially their prepositions are off, as they juggle English and Danish. My brother, for example, doesn't ride his bike; he "rides on his bike" or "cycles".

My brother grew up speaking Danish. He went to college in the US and got married in his early 20s. Since then, he has spoken mostly English, or their variant thereof, at home. Without a doubt, he has lost depth in his Danish, both spoken and written. If he were told to speak for a half hour in complete 100% Danish, he would be in trouble.

So my brother and the medical student, are they bilingual - or no-lingual?

As I sit here pontificating in my ivory tower, I can't ignore my own situation. Admittedly, I'm a little bit like my brother; it's hard not to be. But we do try to speak 100% Danish at home; mostly for the sake of the Girl and the kids, but also for me. We have almost lived in Denmark two years now, and I still speak Danish somewhat haltingly. I have no accent, of course, but I have definite trouble constructing sentences, especially Danish colloquialisms. Yesterday, in an elevator, I got the idea for this blog post. An attending had gotten frustrated with a notoriously non-compliant patient. She is sometimes a little too nice, or docile, so it was cool to hear her speak up. I wanted to tell her that I thought it was cool to see her.. get a little riled up, see her speak with a little oomph, gusto, fanfare, temper. Halfway through the sentence, choices such as these popped up in my head, but no Danish equivalent came to mind. I used the word "fanfare", which can only be used in its literal sense in Danish, ie. the sound that horns make.

And this happens all the time, especially with patients. "We'll cross that bridge when we get there", "just to rule out something serious", "we'll keep an eye one it"; I want to say this all the time: I start a sentence and realize that there is no Danish equivalent and often end up constructing ugly linguistic orphans.

And my English is going to pot, too! The in-laws were here to visit last week, and my English was certainly imperfect. Again, it lacked depth; it lacked that ability to construct a long sentence, while thinking about the subject matter.

Alas, I am also no-lingual!

So what do I have in mind for the kids? Well, this time, I think it's going to stick for Natali, so she might come out on top of all this. For the Lorax, I know we'll keep speaking Danish at home, and we might move back to Denmark at some point. Or he and Natali may go to college here. So I have high hopes for those two.

Andreas? My 7-year old son who lives an ocean away. My parents are visiting him right now, so I've been thinking about him a lot. If he learned to speak just a little Danish, even haltingly, and without any depth, I would be happy as a clam.

October log

2: 10 miles on hills. 5 repeats at end of Green tunnel
4: 8 miles
6: 8 miles in the mountains around Goslar. Very good legs; the uphills felt effortless.
9: Brocken Marathon. 3:04. Felt great; probably my best marathon.
12: 15 miles fair slowly. The legs have rebounded impressively.
15: Perimeter trails.
17: Hills at Green Tunnel. 3 repeats. Legs a little heavy.
20: 2X5K tempos with the Girl. Legs didn't feel good at all. Ran them both around 19 minutes.
23: Green Tunnel hills. I love this run. 5 repeats at the end. The legs were a little heavy despite the light training lately.
24: 10 miles. Turned out the legs were awesome. It turned into impromptu fartleks.
26: 10 miles on the trails
28: 6 miles slowly.
30: 6-hour race. 73.1K (43 miles). A new PR. 20K in 1:30, half in 1:34, marathon in 3:15, 50K in 3:56.

Brocken Pictures

The Girl cresting Brocken in howling wind and high spirits. She was still in 5th here and thought about top 3.

While top 3 never happened, she did have the best-looking legs of the field (women's field, at least). That's some toned-up shank right there.

Yours truly cresting Brocken, full of pent-up Danish rage and energy after walking the last several miles. Small children averted their eyes when they saw the facial expression of this particular bad-ass

The finish; looking you and without a care for the world. I felt this-is-what-life-is-about good.

This is my bro, who at his college-days peak ran a sub-18 5K. He is blessed and cursed with the looks, physiology and metabolism of Jan Ullrich. He also married a great cook and many an Indian curry later, he is fighting his way back into shape. He ran the 22K mountain run in well under three hours, thus posting the achievement of the day.

This picture shows Der Jan being pursued by my dad and uncle. My dad is the guy with my future hairline and my uncle is the bi-sected guy one step behind. Both my dad and uncle got lost; even though they started over an hour behind the marathoners, they somehow managed to follow the marathon course. Halfway up Brocken, they were met by crew disassembling an aid station. They accepted the light beer and soup offered to them and jogged back down the mountain.

The relaxed man in tights is my cousin's husband. He cruised the 22K, but was probably in marathon shape. The guy in front of him is unidentified, but judging by his overall sweatiness, his bleeding nipple and his scream, my guess is that he was amply challenged by the course. And check out the German power-lady on the left. Typical German power-lady look, camel-toe and all.

Like her husband, my cousin wasn't even halfway spent at the end of her race, the 11K. She should have done the 22K and she showed off this fact by bounding several feet in the air with each step.

We ventured down to Harz, Germany, this weekend for the Brocken Marathon. Most readers will have read the Girl's blog and seen the killer hill (Brocken) in the middle of the race. The course climbs approximately 800 meters in 8K (2500 feet in 5 miles?), ie. a 10% incline for the cycling afficionados. However, the 8K are preceded by a few K of gentle climbing and the hill gets steeper and steeper as you go. In other words, that mountain defines the whole race. But let's begin at the start line.

I fancied myself with a shot at the top 10, possibly top 5. But, above all, I didn't want to crack on the long downhill, so I started conservatively. The part of the course that may appear flat on the elevation map is anything but. In the first 5 miles, we ascended and descended hills that would be the centerpiece of a tough Danish cross country course. Of course, as opposed to Danish cross meets, which always are better-wear-spikes technical, we ran these hills on non-technical trails - and stayed on them the whole way.

I took it easy, and counted the people ahead of me to learn that I was in 16th spot at the position-wise nadir of my race at 5 miles. Then, slowly, we started climbing more than we descended, and this separated the pretenders from the contenders. The first few miles of low-grade climbing suited me well, and I advanced up through the field, always feeling like I had a lot left in the tank.

Then the hill got so steep that it made no sense to run. At least it made no sense to me. There were little plateaus, where I ran, but I made a point of walking and eating whenever it got really steep. I was passed by 3 or 4 runners, but they were barely running faster than me. I power-hike pretty efficiently and was almost able to keep up with the runners.

At a point, with a few miles left to go to the summit, the trail turned into an East German road made out of concrete slabs. It got so steep that running looked completely silly to me. One German guy passed me and yelled "I sink your sistem is werking. I try it too" and then we walk-ran together to the top. The views up here were amazing, of course.

Even though Brocken is only 1140-some meters high, it feels like the high mountains. It was really windy, which probably isn't a rarity up there, because there were no trees. The top is occupied by an old East German weather station. Cool stuff.

Then came the downhill, and with the crazy steep uphill, I had worried that it would be too steep for me to run. I'm not a good downhiller at all. But the downhills, except for very few sections, were the crusing types. I turned my music on and floated down the mountain. I chose to run on the grassy shoulder, which seemed like a good choice for someone not used to the pounding.

Just coming over the top, I passed a couple of people. The people who had run up, were all so stiff, that I easily put a couple hundred meters on them. Again, if anyone reads this as a preview for their own race: walk the hill. A fast power-walker may lose a minute or two on a runner over the last steep miles of the hill but that time will easily be reclaimed on the way down.

And, yes, the way down went well. I floated and floated and, purely by chance, always had the next runner in view a hairpin turn or two below me. I had lost count of the place I was in and just focused on picking off runners. Suddenly we were in the last few miles and I entered what I fancied to be an all-out Solinsky beast mode. It's been a while since I tapped a good runner's high in competition; last time must have been Hells Hills in April. Yes, there were some tears. At this point, the half-marathoners had joined the course and there were lots of spectators. I felt like I was absolutely screaming down the mountain and there was a even an uphill section that I ran all-out. I am sure I had the fastest time in the race for the last 5 miles.

The last two K are steep downhill. I passed a guy, who was in the marathon, and then probably took it a little too easily. I got stuck behind a half-marathoner and then, when 400 meters to go, got re-passed by the marathoner. He wanted it more than me, I guess. Had there been a flat section, I would have been able to use my fresher legs, but it was steep and I was worried about going insanely fast. Plus I am not a very skilled downhiller, to be honest.

As it turned out, he took 5th and I took 6th. Six people get to go on the big podium to receive prizes, so it all turned out all right. But still, I should have just have surged by him, when I first passed him. I expected there to be a flat finish ,but it was downhill all the way to the line. Good advice for other runners would be to run the last two K all out.

I finished with lots left. I would have been happy if they had converted it into a 50K. My time was 3:04, which is pretty wild compared to me PR of 2:49. I actually ran the first 10K in 40:46, which is PR pace, even though it felt easy and was hilly. It makes one wonder how fast I would have gone on a flat course. Needless to say, I am very excited about this race. I've been setting PBs on my training runs, but until you see a big result in an official race, it doesn't really matter.

Two hard months of bad sports on TV

As a sign of growing older, I pay more attention to the passing of the seasons. Growing up in Denmark, you could argue that the seasons are so bland that they don't legitimately influence people's daily routines.

When I moved to America at 19, though, I think the weather outside stayed an afterthought. And this was northern Wisconsin, where the variation in temperature is extreme by most standards. I remember winters that were very cold and summers that were hot, but I don't recall thinking, for instance, "my life is going to get a little better when the snow melts".

Sometime around 30, I started paying attention. Maybe because of the kids, but also because by that age, my job was so demanding that the tiny window of spare time to spend outside became so much more important. I stopped cross country skiing, for example, around age 30, because everything about it took too long for the time that I had available (waxing, driving to the trails etc.) So in a training sense, some seasons are now much better than others, although this is more true in Wisconsin than in Næstved.

These last few years, I have become aware of how the sports on TV influence my day-to-day happiness. Tonight, in the shower, a thought popped into my mind; a thought I remember forming last year, and possibly the year before: TV in October and November is the worst of the year. And let me tell you why.

Winter has skiing on TV. I watch cross country and biathlon and, if nothing else is on, nordic combined. This lasts from December to March, at which point the Diamond League (formerly Golden League) and cycling take off. This peaks in summer, with the Tour and most years an Olympics or track and field worlds. Once every four years, as was the case this year, there is no major international track championship. But I survive and pretend Zurich Weltklasse is a worls championships.

September sees the Vuelta and early October has the cycling worlds.

And then nothing. Not a single endurance sport on TV. What the hell gives? There are cross country meets out there, but they don't make it onto any TV that I have ever owned. There are still triathlons going on in warmer climes, including the Kona Ironman, but their presence on TV is too slight and sporadic for me to follow.

Part of the problem is that the endurance sports are up against formidable competition in the form of soccer in Europe and football in the US. And, gaad, do I hate to watch those sports on TV. Ok, so I dislike wathcing team sports in general, but the "Big 2" particularly annoy me, because of the money and hype involved. What is gayer (in a non-bigot hipster sense, of course): soccer or football? The prize would have to go to a sport, whose biggest star has a girly first name, a very feminine French (and mispronounced) last name, who cries everytime he retires (which is at every press conference).

15 years in northern Wiscosin taught me to tread lightly when it comes to Brett jokes, but now that he is playing for the Vikings, I'm safe.

Brett Favre. Farrrv. Just saying.

Sports on TV in October and November (excluding cycling worlds): you can kiss my ass.

Tri Club Championships

10 Triathletes swam 600m, biked 24K and ran 7.5K for yesterday's club championships.

Swim: the water was dangerously cold and we almost decided to cut the swim down to "across-the-lake-and-back" but no one wanted to be the one to declare openly that they were worried about the swim.

I don't know what the water temperature was, but apparently the Danish triathlon federation doesn't allow open water swims in water colder than 15 degrees Celsius (59F) and this was colder! 20 yards into the swim, I panicked. The water was so cold my face hurt. The wetsuit felt so tight that I was afraid of suffocating.

I breaststroked the first half of the swim in dead last. Then, I slowly got used to it and was able to crawl some. However, in the dark water and, presumably, because of the cold, I had no sense of direction and couldn't hold a straight line.

Finished the swim in 8th place (third to last). Rikke, who normally swims as fast as the Girl, swam even more zig-zaggy than me and got way off course. I should mention that the Girl swam very fast and finished 4th or 5th, a few minutes ahead of me.

The Bike: drafting was allowed, so I sprinted up from the swim to see if I could make up some time on the transition. Stig, who normally races a spacecraft-like TT bike had had a flat tire before the race, so he was on his wife's road bike. He was coming out of the transition just 30 seconds before me, and I eventually was able to get onto his wheel. I passed the Girl on the way up to Stig and yelled at her to get on my wheel. She was at her limit at that point, though, and couldn't get on.

Stig and I rode most of the bike leg together, although he drifted back a ways on the last section, which included a lot of hills. Runners like hills on bikes; that's just how it is.

The run went really well, as I caught a couple of people and ended up in third place. All in all, a great race, followed by a nice grill-out. The kids were along and another family also had kids, so they all played together. Good times.

Panic attacks

I should be thankful for what I have. But, like so many other things in life, everything is relative.

Life is good. It really is. We had a great weekend; I went for a run with Natali, initiated by her! She had this loop scoped out that she wanted to run 10 times. I don't know how far it was, maybe 1.5 miles total. She took walking breaks and didn't really want me close by. I ran around her, looking at her form and her walk-run strategy.

Then after our outing, she conned money out of me by doing little paid-for chores around the house. The Girl was out swimming, biking and running (I think she did all three) and I was trying to get the house ready for a friend's vists. I was getting bugged with the Lorax, so I paid Natti good money to take him down to the playground. Then, when she had made her money, she rode her bike the half mile into the old town and browsed the stores for a few hours.

She is doing so well. And yet, the panic is there. I revel in the nostalgia that will ensue once she is gone. Walking home through the old town Friday night, the wind was cool and the sun was setting over the roof tops. The first leaves were starting to fall. I told her "just think that this is the first day of fall and there will never be another first day of fall, when you are 9 and we're walking together like this". Completely sappy; she didn't buy it.

The thing is, I don't know if she is leaving next year or not, and I don't deal with that uncertainty well.

Then I panic about the responsibility. I missed a class meeting for the parents. It was listed online on an intranet I never check. Instead, I got a message from her teacher, recapping the events of the meeting - and reminding me to wrap her books. Which I still haven't done, and that was 2 weeks ago.

Her teeth are very crooked and she's supposed to get called in to see the orthodontist soon. But I don't know if I even want them to start working on her, if she will be back in the US next year. She is very aware of her crooked teeth, maybe because one of her front teeth reaches half way across the other. She wants braces now, and it frustrates me now know what to about it.

All this parenting stuff may sound so simple, like "get a clue" simple. Sometimes patients will describe how hard it is for them to get to appointments, and I generally have zero compassion. But this is kind of the same thing; a world where I have few skills, no experience and no confidence. I should just suck it up, get her that orthodontist appointment, wrap her books, anticipate that next meeting. And show up with homemade brownies.

Not that I am a bad dad. Natali proudly called me the coolest dad in her class; said that all the girls think I'm cool and funny. I had her at 26, which is very young for Denmark, and longterm student types do tend to stay hip. Ahem. No adult would ever call me hip, but these kids are delightfully unrefined.

Work is all right. Just all right. Again, I don't like the uncertainty; I don't know where this fellowship will take me. I don't have a dream job in mind. Working with critically ill or dying patients all the time is taxing. I have a weekly clinic day, where I see two or three new patients, who have been referred with a new blood cancer diagnosis. It's just a few patients, so it's not a lot of work; but the conversations drain me. They come in in profound crises, in packs of four or five, with daughters who are nurses or doctors. Sometimes, I feel like I'm about to pass out when I am done; after a few hard conversations, I collapse in my office with a candy bar for 10 minutes before I can venture out again.

Medicine in Denmark has pros and cons; overall, I'm glad we are eventually moving back to the US. I feel that, here, I'm just a cog in a big machine. The machine generally does a good job, but it's frustrating being unable to make a visible difference. This is compounded by hematology being a specialty, where the work-up for each disease is largely set in stone, even before the patient comes to the clinic.

I used to have this dream, if you can call it that, that I would be the type of hematologist that told patients his cell phone number. I thought I would say "here's my cell phone number; don't abuse it, but if panic sets it, you can use it". In the US, that would work wonders. But here, if someone called me at home on a Saturday, I would have no way of helping. All I could do would be to tell them to call the on-call hematologist or the hospital floor.

I'm happily married to a wonderwoman - who just happens to have the most stressful job in the universe. I don't know how she got duped into running her gargantuan study, but she did, and there's no other option than to tough it out. Tough it out for both of us, that is. We desperately need more time toghether, but none is on the horizon. I still dream about our 5 days in Duluth this summer. Best five days of the year, despite the Girl's miscarriage...

I mean, it could be worse. I'm on call right now, and will get home tomorrow before noon. Then we're running a 20-miler together on the trails. Yes, it could be a lot worse. I guess I had hoped there'd be more family dinners and quiet evenings watching a movie. But the Girl is constantly stressed out about her project; she would think of those things as a waste of time. This sometimes leads to evenings, where I'm a single parent of two, while she either exercises or works in her nearby office.

Oh, how I whine. The 30 people physically nearest to me right now (not counting the nurses) suffer from frightening nothing-is-ever-going-to-be-the-same blood disorders. If I one a loved one became that sick, we would pray and beg to have our blessed lives back.

Everything is fine. Relatively speaking.

Blogging blasts from the past

I just got through readng a few months worth of blog posts from the fall of 2006. This turned out to be downright eye-opening. I completely forgot how a friend was going to set me up on a date with this woman I knew from the hospital; I think she was a nurse, or maybe in training to be an NP. I do vaguely remember what she looked like, and that I was disappointed that the date never materialized. Weird; I remember every minor crush and romance up until I met my ex-wife.

In fact, a lot of the stuff that happened in 2006 seems to have been erased from my memory. I describe in my old blog how I had to be the ice-breaker between my ex-wife's family and her lesbian girlfriend at Thanksgiving dinner. I, again, don't remember that at all. I do remember being supremely popular in my ex-wife's family after the news of our divorce broke. Classic Al Gore effect. Reading about that time, I am very happy I got out in one piece.

I did copy one post, whih broke my heart a little:

INSIDE DAUGHTER'S HEAD (October 2006)



What can be gleaned from this photo? Well, the setting looks like a low-budget early eighties kitchen counter-top. A few items can be seen, including a bottle of vegetable oil and a bottle of cola. These are of the brand "Great Value", which means the owner is poor, cheap or both. Or maybe he just likes Walmart and its practices.

The attention then turns to a hand pump by the brand Bell. This is another low-budget acquisition. A needle can be seen; the owner is likely a volleyball, soccer or basketball player as well as a biker. He must have a wicked six-pack.

A bisected piece of paper can be seen as well. The piece of paper advertises Levoxyl, a thyroid hormone. Clearly, this guy has few moral principles, since he accepts gifts from drug reps. There is a drawing on the piece of paper by the hands of a 5-year old girl. It depicts her parents. They were meant to hold hands in the picture, but they no longer live together; that's why she cut it in two pieces. She told her dad that she felt is was her mom's fault; that's why the mom piece is wet.

Yes, she tried drowning her mom.

Sometimes I just don't know what to say.

I clearly remember the little drawing. In fact, I think I still have it somewhere. It's easy to forget how traumatic divorces are for kids. And for adults, too, if there are kids involved.

My relationship with my ex-wife has been fairly solid since the break-up, but we continue to argue about the kids and about money. I have blogged about this before, of course. Right now, we are playing a high-stakes game of chicken. We are planning a trip to Disney World in December, since I have a conference in Orlando at that time. I'm working in the ER in Wisconsin in November, so I plan on picking up Andreas, my son, before flying to Orlando. But Natali won't see her mom until the spring, if we don't figure out a way for her to fly via Wisconsin. To figure out a way to make all those tickets work out has been near-impossible. And natually it will be more expensive to have Natali fly via Wisconsin to Orlando than straight to Orlando.

After we put in the hours of searching for tickets, I asked my ex-wife to pay for some of Natali's ticket and she has refused. That was two weeks ago and we haven't communicated since.

I worry about this; my ex has an expectation that I will always be the one responsible for getting the kids back and forth. That I will always come to La Crosse in the summer, because that used to be our home. I have asked her before if this expectation will continue, once we move back, because we will not move to La Crosse. Even if we live in Madison, just two hours from La Crosse, sharing the kids will require tmie and energy spent on both sides and I think the burden should be shouldered equally.

It will probably all work out and the kids will grow up healthy, though slightly scarred and bruised. These worries about the kids may seem so minuscule in a few years.

And that's why I love blogging. I'll read this post in ten years and remember things and thoughts long forgotten. My old blog - now closed for eternity to the public - was so nakedly honest that it attracted a much larger readership, much like the Girl's does blog now. This blog will, hopefully, lead a quiet existence for many years to come.

Ten ways to piss me off

1. Say "it's all in the chart". I know it's probably all in the chart; actually, it's not ALL in the chart. Just answer the damn question.

2. Interrupt your sick mother or father, by saying what you think they are trying to say. Especially if we are talking about the serious stuff, like end of life care. Along that line, say "of course you want everything done, right dad? If there's even a little chance you could make it through, wouldn't that be worth a month in the hospital? Dad, are you listening?"

3. Show me your list of questions at the very end of the encounter, when I'm about to do the "ok, I'll see you in a few weeks"-spiel. Lists are fine, but please reveal them up front.

4. Show me any kind of pill. They all look the same to me.

5. Mention names of other doctors at other hospitals, when describing your health odyssey. Most people have an odd sense that they have been seen by the finest physicians in the universe, up to the point of having to endure a half-studied rube such as myself.

6. Say "oh yeah" stupidly, like you've so been there, at the wrong time, interrupting me. Example: "your mom is very sick. It's not really one organ that's sick. It's the way her electrolytes are out of whack; the way she is increasingly confused, and her blood pressure and heart rate are coming up and down; I think she is dying." Daughter says, "oh yeah" after "electrolytes", like she's been eyeballing that potassium for a few days and she figured it looked pretty ominous.

7. Talk about chronic stuff, when I'm asking about your acute illness. It's going to be a long day, when I ask a guy with a fever if he has been coughing, and he talks about his battle with bronchitis in May of 2001. Trick for med students and junior docs: when you see a tangent like the above coming, start examining the patient and ask "does this hurt?", while looking worried. Works every time.

8. Talk while I listen to your heart or lungs. And when I politely say "hold that thought, let me just have a quick listen", say something like "oh yeah! I guess you can't hear anything when I talk. That reminds me of the time..."

9. Breathe in but not out when I listen to your lungs. What is the deal with that? Most people get it, when I say "in and out" pointedly a few times, and yet some persist in holding their breath. I actually breathe along with patients, a la the way you open your mouth when you feed a baby, which makes it even more painful for me.

10. Ask "so what do they think is wrong with mom?". They? What do I look like? Ok, so I look like a balding, fidgety version of this guy, but still.

Otherwise, I'm, pretty easy to get along with.

Perfect day with Natali

The good thing about working as many nights as I do, is that I get a lot of weekdays off. I love those days.

On said days, I get up before anyone else to prepare breakfast; my monster commute has taught my body to be up at 6am, so sleeping till 7 is a luxury for me. On good days, I make pancakes and eggs; yesterday was a good day. We sit as a family and eat until Natali has to go to school.

On days when I'm at work, she bikes to school on her own. I have never been entirely comfortable with this; she goes through the hospital, where the rules of driving and yielding aren't exactly set in stone. So when I'm home, I bike with her to school before biking the Lorax over to his daycare.

I love riding through town in the morning, especially on a fall day like yesterday. I go through the old town, where cars are either discouraged or entirely banned. A few shopkeepers are setting up their wares and delivery trucks are idling on some of the main thoroughfares, but mostly the Lorax and I have city our humming selves. He points at sizeable cars and goes through a mini-seizure of excitement if he spots a semi truck or a bus.

Yesterday, the weather was perfectly crisp and clear. After dropping off the kids, I enjoyed my second breakfast (leftovers from the morning's feast) and took off on a two-hour run in the woods. Got back, looked at some work briefly and took a long nap.

The above describes many of my days off. I generally think of this time in our lives as a "rough patch", every day yearning for a better time. Surely, I will move on to different jobs at different hospitals and will one day wear a sports coat with gold buttons. But I may never have days off like these; crisp, cool fall days with the Girl and the kids in little Næstved.

And yesterday was even better than the average day off. The Girl was headed to Copenhagen for a 5K relay. The Lorax loves trains and came along for the trip, leaving Natti and me to enjoy a father-daughter afternoon evening. A perfect father-daughter evening consists of this:

- Getting her ears pierced. She has been begging to have this done for years, and this was the night. Boy, was she nervous beforehand and, boy, was she glowing and self-important when it was over. All night, I watched her smugly feel her earlobes, just to make sure the little diamond studs were still there.

- Renting Sunny With a Chance of Meatballs. It was ok.

- Eating huge greasy burgers from a little place we haven't gone to before. Eating them in front of the TV. Having so many fries that we didn't even fight over them.

- Presenting her with her new phone. The Girl destroys her phone every so often, so she will inherit Natali's old phone, while Natali gets this new one. This new phone is a smart phone-ish thing that didn't cost very much.

- After an evening like this, she will be eating out of my hand for days.

Half Ironman race report - It's all about muscles

My season of doing only low-key, odd-distance races continues. Looking back, has a 5K in Carlton, MN, really been the only race at a commonly accepted distance? Almost.

This was my first half Ironman, and it wasn't even a whole half. It was 1000m-76K-20K, so all the distances were slightly amputated. Still, it was pretty close to a half IM and that's what we have called it.

The swim went well. I have trained sporadically in the pool for a few years now, going from barely being able to crawl a lane to barely being able to crawl through a triathlon. The swim was over pretty quickly without incident. The Girl started 30 seconds behind me and, of course, passed me with a few hundred meters to go. Chicked. Still, I went a little faster than I had expected, so all was good.

I got really dizzy after the swim and almost couldn't stand up after getting out of the pool. A volunteer guided me back towards the pool, as though I had to swim another 500 meters; I didn't realize what was going on before the guy in front of me jumped into the pool. The volunteer then said "oh, you just looked so fresh that I assumed you were only half way". I must be able to hide my disequilibrium well.

The bike leg was interesting in that drafting was allowed. I tagged on to a guy, who seemed like a very capable rider on an exceedingly capable tri bike. After a K or so, we took a wrong turn, and the guy got off his bike to yell at the volunteers at the confusing intersection. We had just passed the Girl, and once I got back on course I passed her again. She was looking pretty capable, herself, with her fancy tri skinsiut, new helmet and new tribars. She had even bought that kind of handlebar bottle that you can drink from without getting out of aero, but opted out of using it. She looked 90% pro gazelle and 10% female Fred.

Many men were jealous of me that day.

But, anyway, the capable guy was gone (into a fit of rage, apparently). But up ahead was another guy, who seemed to be going my pace. I surged up to him and ended up riding the entire leg with him. If you ever read this, Claus Busk Andersen, thanks for letting me draft of you! Claus was a little stronger than me on the bike and rode very consistently. I pulled maybe 25% of the time, Claus pulled 50% of the time, and whoever else was in our group pulled the rest. We passed tons of people of various abilities. At times, guys would try to hold on to our little group, and some even took healthy pulls at the front, but interestingly everyone got dropped sooner or later and after 76K Claus and I finished together. We also got passed, of course, by a few leg-shaving plate-wheeled dudes. These guys go fast! At a point, a train of four such dudes passed us and I wanted to try to hold on to them, but Claus made it clear that it was too fast for him. Too fast for him would spell disaster for me, so we let them drift off. Good move.

This was by far the fastest I have ever ridden 50 miles. The average came out as 31.5kph, but that included the transition, so I imagine it was closer to 33kph. Very happy with that. Little did I know the Girl was breaking into new territory on a bike. She ended up riding at almost 30kph average speed. In windy, hilly, technical conditions. This was actually a pretty slow course. Holy shit! It's been almost to the point of me thinking she cut the route short, because I had no idea she could ride that fast. On our club rides, she sometimes gets dropped during the warm-up. What happened here was probably her strong competitive spirit kicking in. She was lucky enough to get passed by a woman soon after I passed her, and simply sucked onto that wheel like a estrongen-bitchy barnacle. Until a better wheel came along, and then she sucked onto that.

Then came the run. I had a shot a top placing (in reality, a top 10) and the girl was fighting for the podium. In all the other triathlons I have done, my running has been fine. After a few K, it's almost like I haven't swum or run at all. Not this time, though. The first K went beautifully, but then my adductors starting cramping up in both legs. I had to stop and the 10 or so runners I had just passed were left wondering if I was about to have a bowel movement or was passing a kidney stone. I honestly thought I had to drop out, but I walked a couple of minutes and slowly the legs started to cooperate. I had my music along, and it helped me get into a comfortable zone. I had to stop a few times with minor cramping but got through. I ran the 20K in 1:29, which was very disappointing. The running reminded me of an ultra-marathon in that cardiovascular fitness becomes secondary to how one's muscles are holding up. While the rest of my body wanted to go faster, my muscles didn't hold up well at all. Hopefully, this gets better when I get a few more ultras/long tris under my belt. Still, running is my forte in a triathlon and I went from 40th to 16th overall. It's not world shattering, but I'm proud of getting 16th out of almost 100 guys. This isn't like getting 16th in a running race with 100 participants, because triathletes tend to be much more serious and fit.

The Girl had a run that was a little less disappointing that mine. It wasn't as fast as I had expected, but even a mediocre Girl is a very fast runner. She went from 7th to 3rd overall, which is insane against a field of hard-core triathletes. After her miscarriage, she has hit a vein of form that could yield a few PRs this fall. She has a trail marathon in two weeks (I work that day, unfortunately); if it's not too technical, she could even PR there.

She is hard to coach but she is doing some of the things I have been trying to teach her, like taking easy days. She is strong and toned and has gained a few pounds of muscle. It's almost to the point where she cares less about her weight and more about looking good in a trisuit...

Big Engine - No Skills

Tried my first bike race yesterday. I have ridden a little in packs of up to 10 riders but never in competition. This race was a laidback citizen's race, ie. the slowest type of pack racing one can find. There were just a few guys with shaved legs and lots of excess subq to be seen.

I had been told that these races often break up into smaller packs almost immediately and I had planned on going with the second-fastest group. I figured that the second group would work together fluently, whereas the very front group would see the guys attacking each other for the win.

But the pack of maybe 80 riders stayed together. I sat in the way back, unsure of what to do. The pace went unpredictably from fast so the pack would string out, to slow so everyone would have to hit the brakes.I saw tires rubbing and a few guys having to ride on the loose-gravel shoulder; both made me nervous. I tried to be the very last guy, but this is harder to control than it sounds. A few times, I found myself with a guy on both sides leaning into sharp turns, completely unsure of which line to take, but hoping it would be the same as theirs. Scary.

Thankfully, people started falling off the back. Some would go out to the side and stop pedalling, to signal that they had to drop back. Some, however, would try to hold on to the very bitter end, so a gap of a few yards would open up. It was hard to gauge who was truly being dropped and who simply let a little gap form. In any case, whenever someone dropped off, I would pass them and sprint back up to the field.

This was fun and exhilirating stuff. This kind of knife's edge racing is not like a running race at all. A few times, a chunk of the pack would fall off together and a few (including me) had to bridge back up. It's a cool feeling of digging deep, being completely out of breath, and then getting back into the shelter of the pack.

We had gotten to a point, maybe 25 miles in, where the pack was down to some 35 guys. It had started to feel like we had shed the weaker riders. I saw no beer bellies in front of me and no one seemed like they were working insanely hard just to sit in. I drank a little from my water bottle, which meant having to fall back 10 yards before I dared look down to get the bottle. I had also had great plans for a Powerbar but it didn't seem realistic at the time.

Then suddenly on a little uphill, the pack broke in two. The gap formed very quickly. On TV, it looks so easy to find space in a pack but in real life, you have to worry about traffic (the course was open to traffic in both directions) and all the other riders, who were standing up pumping on the uphill. It took a little too long to see that the split was real and permanent, and by the time I got past the slower pack, it had grown to maybe 70 yards or so. I stared sprinting, hoping some of the guys would come with me to lend a hand. One guy came along and this happened to be one of my attendings from the department. We tried for a long time to bridge the gap but they were going really fast in front. I was hoping for a sharp turn, which always slows down and stretches out the pack, but none came.

We sat there for a good 3 or 4K and got as close as 30 yards from the back of the pack. Frustratingly close, of course, but we just couldn't close the gap. We decided to wait for the next group but they had fallen so far back they were out of sight. We rode on alone for a little while, until we noticed we had gotten off course. Long story short is that we found the course, but at the wrong place and decided to drop out.

Imagine sitting with a heart rate of 200, in your first bike race, all senses hyperacute. And then 5 minutes later, you're lost and out of the race.

Looking back, a smart move would have been to sit near the front of the pack. But, then again, I don't have the pack-riding skills and I would put myself and others at risk. After the race, people were commenting on the size of the pack. In some races, they send off riders in packs of 20 with 2-minute intervals. This seems like a safer option to me.

All in all, a fun day, especially talking about the race afterwards. Biking is a little more wild and adventurous than running, and the tales were a little taller.

The Girl did really well and rode around 18 mph on average. She had some minor mishaps including a little detour, but she also had a fun day. We'll have to do more of them, preferrable the ones with a staggered start.

Summer Vacation

Three weeks is a long time to be gone from one's normal life. It feels like we're different people - jetlagged, different people.

I'll offer a few impressions as a full account would be unrealistic.

The Lorax loves his grandparents. He loves seeing cars and trucks and trains and airplanes. Best of all, he loves to sit alone in "Gampa's car" erotically stroking all the buttons. He loves his brother, whom he sees for a week every few months. In fact, he does everything his older brother does, which is cute, comical and a little annoying to his brother. He is at a wonderfully impressionable age, where he is still young enough not to be embarrassed by anything.

Coming off a rollercoaster at Great America, he exclaimed (in translation) "dangerous train. Fun. Not the end". Sitting in a lazy boat ride, an attendant was swatting at a fly, and he waved back with a big smile, because he loves the world and it loves him back.

Andreas, my 6(almost 7)-year old son, expresses his emotions differently. We had some good times, but I am nothing but a pleasant distraction in his life. He thinks of me as his dad only because he has grown up with no other meaning to the word. He is so easily distracted that I worry that he has ADD. It's impossible to ask him a question and get a straight answer. I will ask about whether summer school is done, and he volunteers information about a superhero he just drew. As we were saying goodbye, he seemed completely unaware that I would disappear again for months. Still, we had some good times. He seems pretty happy with his life and is doing better in school.

Natali stayed the whole summer with her mom. She adores her new step-sisters and the best night of the whole summer was when they biked to Kwik Trip to get candy and stayed up till 3 am. She didn't do much while in La Crosse and seems to accept that she is back in Denmark for another year.

The best moments for me all occured in Duluth. For a little background, I lived in Duluth for a year when I was 20. I love the town, Lake Superior, the North Shore and the feeling of being at the edge of the world. That's where I met my first wife but we only visited Duluth for day trips over the years.

It's been a dream for me to move to Duluth (or Marquette, but for people who know both towns, they have many things in common). Duluth has such a cool history; it used to be bigger than it is now, which means it has a surprisingly regal downtown and very little sprawl. The geography is unique and reminds me of La Crosse. La Crosse is squeezed in between the river and the bluffs with zero room to expand. Duluth has expanded from the lake shore beyond the hills but there is the same feeling that geography played a commanding part in city planning.

We stayed at the William S Burrows Bed and Breakfast. We were supposed to stay in Duluth for just two days but because of the miscarriage and the fact that we forgot our passports, we ended up staying there five days. One day, there was a roaring storm sweeping in from the range. We were driving back from Gooseberry Falls, where the Girl had biked (having just run Voyageur) and I had run 20 miles on the trails. The rain got heavier; we needed some food and I got completely soaked springting from the car to Super One. We spent the afternoon in bed, from where we could see a sliver of Lake Supoerior out of the open windows. Best afternoon ever.

I thought I had the Girl convinced that Duluth is, indeed, the perfect place to live. But no, she says it's too cold. Besides, the chance that the two hospitals up there will be looking for an ophthalmologist and a hematologist in the same time frame is very slim. But one can dream, right?

US traffic. Hmm. Americans are nice people and this is reflected in their driving. My commute to and from Copenhagen is a war on wheels. In and out of the passing lane, letting faster cars by, while trying not to be slowed down by slower cars. I have gotten used to this kind of traffic and suddenly I'm on I-94/I-90 and people are passing each other insanely slowly. One semi is going 66 mph and a guy is going 68 (both on cruise, no doubt). Why should he be bothered to speed up when passing, just because there are ten cars waiting behind him? No one gets mad, beeps or flashes headlights like they do in Denmark. I used to have a one hour commute in the US and I never noticed this stuff before! By the end of the trip, I had wound down and didn't get bothered by it anymore, although I still noticed it. I had the same experience in grocery stores, where the lines aren't necessarily longer than in Denmark (often, they are much shorter) but the pace is toe-curlingly slow. Danes? They get bitchy and yell for more registers to open. Americans? They pick up a gossip magazine and leaf through it.

Wildlife in Wisconsin and Minnesota. The Girl pointed this one out. Everywhere we went, there were bunnies, deer, squirrels, foxes, insects, birds and fish. The forests were so thick you could see no further than 20 feet into them. It sounds like millions of crickets, birds and frogs are screaming at each other. Stopping to pee on the Superior Hiking Trail, I kept getting the feeling that tentacles would come out of the thick brush and attack my penis, possibly dragging me into the undergrowth to smother me. Neither of us had been aware of this difference before and we agreed that it had to be due to the fact that Denmark is so much farther north than Wisconsin.

Health care in the US. Contrary to what you may read and hear, the health care that the average American enjoys is far superior to what I see in Denmark. Far superior. The cost is much higher in absolute dollars and percentage of GDP, of course, but I'm strictly talking about the quality of care. The Girl and I came in to the ER in Duluth and, within an hour, got an ultrasound done. Within two hours, the result of the beta-HCG was called to us. In terms of outcomes, one could argue that both are unneccesary, and the Girl proved this by passing several big clots within a few hours. In terms of peace of mind, however, the approach was excellent, since we knew what had happened and what was to come.

Funny moment in the ER. The ER doc had a medical student with her. They were both nervous, as providers always are when they treat other providers. The Girl talked about the 50 mile race that she had just done, and the medical student later returned with an abstract from a Danish study showing that running in pregnancy is safe. The Girl may be the person in the world who has read the most studies about exercise in pregnancy and knew this study quite well, so for a while she forgot about the miscarriage and talked about one of her favorite topics.

Watching Voyageur is way more fun than running it! I remembered last year's suckfest vividly, as I served as manservant to the Girl. She took it pretty easily but was still crabby enough to yell at me for being to talkative. A great time, all in all. This year, I was also able to enjoy the post-race dinner and meet some interesting people.

We met Steve Quick and Helen Lavin for a run in St. Paul. It was weird, to say the least, at first, to be so full of preconceptions about them and yet meet them for the first time. It turned out to be a genuinely good time and it would be great to get to know them better. The big question for me before the encounter was to find out more about the enigma known as Steve Quick. In non-blogging life, I am known for gross exaggerations woven into my generally truthful stories. I sensed some of the same in Steve Quick, like when he told us that Basque separatists got so sick of him in the basement of an undisclosed Dutch museum that they paid for his trip back to the US. All told with a wink and a smirk, of course.

The food. I got to run a ton and still gained four pounds. I attribute this to being on the road so much. We ate out more than daily compared to bi-weekly in Denmark. I'm hoping it'll come off easily.

And now we are back. This trip resembled what we did last summer but it will be the last of its kind. If Natali truly is summoned back to Wisconsin next year, we'll spend the summer seeing Europe. By that time, it'll be high time for us to move back, too, and a good old-fashioned European vacation would seem in order. Natali wants to go north to Sweden and Norway. We shall see.

Flashes of our vacation

It's been a roller-coaster. Everyone reading this has already read the Girl's blog so they know what happened to her pregnancy. The last two days have had lows and, surprisingly, some good highs. One develops a morbid sense of humor on a day like yesterday and we both laughed when the Girl pointed out the fact that the remains of our would-be baby ended up in a trashcan outside Duluth Running Company.

I'm far from an obstetrician and the times I have dealt with pregnant ladies in the ER, I try to get them out to a "higher level of care" as soon as I can, ie. as far away from me as possible. My skills go as far as to do an exam to see if the cervix is open and the lab can check to see if there is amniotic fluid in the discharge, meaning that the water has broken. So I have never, not even as a student, seen a spontaneous abortion in progress. The Girl, as it turned out, had been carrying a non-vital embryo for weeks, although the pregnancy hormones were still quite elevated and she certainly had a lot of symptoms of pregnancy. I can't claim to understand this, actually, but that's the working diagnosis.

So she actually had to deliver this little 4mm sac, in a way. With back cramps and everything, she passed several clots over the day, each of which was inspected by us both. Sometimes knowing a little is worse than knowing nothing, as when we looked at a hard little seed, that had the shape and feeling of a scaled-down grain of rice. Could this be it? If so, it blew off the Girl's finger and now rests near Big Manitou Falls south of Superior, WI. But her cramps continued, and as I was looking at my fat, hairy legs in a pair of Sugoi running shorts in Duluth Running Co, the Girl passed the above-mentioned clot. In Danish, she briefly let me know what was going on and we went outside to play embryo pathologists. The ultrasonographer had told us that the actual remnants of the embryo, and who knows if there was ever a viable embryo per se, would be 1mm in size. We found nothing and dumped the clot in a trashcan. Miraculously, and this is the part of the story I have working up to, the Girl felt completely normal. No backpain, no cramping. Within the hour, her little potbelly disappeared and we even think her face changed a little from some swelling disappearing.

Okay, so we dealt with it through a very mechanistic lens. We already have the Lorax so we know we can make normal babies. This one just wasn't going to happen.

But out vacation has been other things than losing babies.

I taught my son, Andreas, how to ride a bike. After two frustrating hours of me trying every trick I could think of, he suddenly got it. Now, we have cruised around Riverside Park in La Crosse so many times that he knows every landmark there and comments on them. I run behind him with a broomstick stuck attached behind his seat. I save his life every quarter mile or so, but the saves are becoming less frequent and less impressive. It's our thing now; he even talks to me on the phone up here in Duluth, which he never did before. I can't wait to take him out again on friday, when we get back to La Crosse.

I ran a 5K race in 16:32 on a super hot night. The winner, Sammy Korir, ran more than two minutes faster... Still, I was happy with my time. A group of fast people showed up and I was actually in 6th place for most of the race. Did get into fourth with a half mile to go and was closing in on the Duluth Running Co guy in third. Didn't quite get up to him but the dead embryo in his trashcan should teach him a lesson.