Snow Day

I woke up to a blanket of white covering the ground. Unlike in childhood, this was not met with excited anticipation. Forced to skip my morning coffee, I layered up in my thermal gear and put on my boots, the blister on my heel reminding me to buy a pair that fits properly. I struggled to find gloves and settled on a mismatched pair as I braced for battle with the cold. I tried not to tweak my back while repeatedly yanking the starter cord on our stubborn snow blower. As I began to clear the thick snow off the driveway, the layer of ice hidden below was a reminder that I was not quick enough to clear the driveway last time. Obstacles and challenges now loomed ahead as I anticipate colder temperatures, icy windshields, hazardous driving, and ill-fitting boots and blisters.

When did snow become the enemy? When did it become a chore? When did it become something that added to the weight of my day?

I was nine years old when one of the biggest blizzards in Chicagoland history hit. My school day was replaced by a snow day. Multiplication tables and PE class were swapped for snowballs and snow angels, while mini-mountains of snow popped up all over the neighborhood.

I remember the frustration of trying to make a snowball out of fresh powder, the crystals sliding through my fingers like weightless sand. And finding success with heavier packing snow, hearing the scrunchy sound made while rolling it to form a giant snowman.

I remember hot chocolate in my stomach any money in my pocket after shoveling driveways in the neighborhood.

I remember a blizzard in Madison, Wisconsin. A snow day in college, of all places! Playing tackle football in powder up to my knees, my quads and hamstrings burning. Hot and sweaty, despite the cold air, and the sting of snow on my face after a tackle. The pleasure of finding that perfect balance, not falling backwards on my ass or forwards on my face, while skitching on the back of a car all the way down Langdon street.

I remember the joy in my son’s eyes the first time we went sledding, on a snowy day in Michigan City, Indiana. The cold air was no match for the warmth of Madison’s smile.

When I was younger, snow was white and light, scrunchy and fun. An invitation to play. An opportunity to explore. A far cry from its impact on me now.  Snow is now an obstacle to be shoveled, a hazard for my teenage drivers, slush and salt to erode the underside of my car. It’s work now.

My thoughts turn from snow to my relationship with medicine. Another area in my life that has evolved from joy and excitement to frustration and challenge.

I remember the first time I put on my short, white coat and entered a real patient’s room to take my first history. I was hesitant to cross the threshold, nervous I’d be discovered as a fraud, an imposter. But excitement trumped anxiety as I stepped into the room, introducing myself as a student-doctor for the first time.

I remember the pride of wearing a stethoscope around my neck. The thrill of learning and doing each new procedure, pushing through my fear of causing harm. My growing sense of accomplishment as I read up on an unfamiliar disease or diagnosis adding to my knowledge base. Each patient a potential puzzle of signs and symptoms to piece together, not knowing what the ultimate picture would be. It was unknown and exciting. A snow day.

Somewhere along my path, medicine, like snow, got flipped on its head. More electronic medical records and charting than direct patient care. More patients to been seen but not more hours available in a given day. Journals and review articles pile up, still left unread. And instead of hot chocolate waiting for me at the end of a long day, there are only unfinished documentation and lingering worries over difficult decisions made.

More work than play. More obstacles than challenges. More conflict and tension than excitement and possibility.

The other day, a medical student I’d hardly noticed on my ICU service asked to see a new admission. I looked up, and saw the enthusiasm in her eyes. And, for a brief moment, I saw what she saw. A giant snow covered sledding hill ready to be climbed up and slid down. And I longed to be there on that hill, launching myself off the edge and feeling the cold air stinging my face, not knowing when I might finally come to rest. Ready and eager to race back up to the top and do it again and again, until I no longer felt my fingers and toes.

And it feels like a snow day again in my ICU.


Seventeen-years-old and into the Great Wide Open..


Into the great wide open..
 Under a sky of blue”
                  -Tom Petty

In the absence of moonlight, the summer lake house had been pitch dark when we arrived. The five of us had made a spontaneous late-night decision to drive from the northern suburbs of Chicago to Michigan City, Indiana. Now, as dust particles dance in the glow of the morning sun streaming through the windows, I wake up in the large room known as the “dorm.” In other far too small single beds, three of my friends are refusing to acknowledge the start of the day.

The bed squeaks as I swing my feet onto the floor and walk outside to the concrete patio. The house sits on top of a bluff overlooking Lake Michigan. The cool morning air has not yet given way to the sun’s warmth. Peter is already up, coffee in hand. Slowly, the rest of the crew makes their way outside to sit on the stone steps that wind down to the street; Lake Michigan and the beach just on the other side. Hungry, we dig into a box of day old Dunkin Donuts brought from home.

It is the summer after our high-school graduation and we are at Peter’s summer house for a few days. A weekday or weekend? It doesn’t matter. Every day now feels the same. High school is behind us, yet college still feels far ahead in the distance. For the moment, there are no homework assignments, or grades to worry about. The ninety-minute drive to the beach house is as much a declaration of our growing independence as it is a fun forty-eight-hour getaway to squeaky white sand and mid-summer sun.

Still in our shorts and sweatshirts from yesterday, we eat the donuts and drink bad coffee. We talk about the Cubs and summer jobs. We retell inside jokes and repeat favorite movie lines. The afternoon will be filled playing catch on the beach, with the Cubs game on the radio, and cooling swims out to the sandbar. Our personal journeys lie ahead, but for the moment, we are carefree and at ease.

The memory of drinking coffee on the patio before spending the day on the beach is still vivid thirty years later. The cool rock on the back of my legs. The bitterness of that flavored coffee. The hot sand squeaking under my feet. My shoulder, sore from throwing the baseball all day long. The sun’s heat burning my back while lying on a sandy blanket. Swimming to the sandbar. Nowhere to be, nowhere to go. My future completely unwritten.

I didn’t recognize the significance of that day, or that summer, in real-time. I guess that’s the nature of being young and feeling immortal. Maybe it’s the slow and gradual accumulation of responsibilities that come with a job or marriage or children, that enable us to appreciate the days when we could just lie in the sand and bake in the sun. That summer, listening to the Cubs game on the radio with friends, the weight of future responsibilities had not yet entered our world.

Thirty years later, I am, once again, at a place in my life where things are yet unwritten. After 13 years as a pulmonary critical care physician, I chose to start working part-time in July. I have already encountered a few hiccups and speedbumps along the way, but this time I am able to appreciate the freedom and opportunities that lie ahead.

I am attending a TEDMED conference this week. Within the overarching theme “Limitless,” the talks highlight issues of medicine, both directly and tangentially. I am eager to see which talks will directly apply to me and what I can bring to the table. What mix of critical care medicine, parenting, water polo, and writing brief narratives stories related to those topics might spark a conversation with my colleagues? I am no longer a seventeen-year old kid lying in the sun, with no real responsibilities, but my future does require a similar shift in my mindset. And as I hear Tom Petty’s voice singing in my ear, I am focusing, not on what limits me, but on how limitless the possibilities are.

How did I get here?

And you may find yourself
Behind the wheel of a large automobile
And you may find yourself in a beautiful house
With a beautiful wife
And you may ask yourself, well
How did I get here?                         -Talking Heads


A middle aged father, critical care physician, triathlete, water polo goalie and Bob Mould stalker wakes up one day and asks, “How did I get here?”

The answer to that is probably longer than what is appropriate for this blog, the human attention span being what it is. But that question along with its logical follow up, “where am I going?” has been on my mind quite a bit.

How did I get here? Where am I going? My past. My future. With change coming just around the corner, it’s hard not to have my headspace taken up by these questions. But with some more introspection, I find that this is my brain’s default; to be looking forwards or backwards. I can be in the middle of a long run or bike ride, but instead of seeing the countryside around me, my eyes focus on last week’s battles with the kids, wishing for a “do over”.  Or I fail to see the sunrise in front of me, on my morning drive to work, as I have already mentally dived into the ICU to deal with the overnight admissions.

My past. My future.

But what about my present?

Read more