Learning to be Careful; The Hard Way.

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One of the terrible things about being a physician who has spent his adult life working in emergency rooms is that you have a certain terrible clarity about the dangers of this life. It’s why we’re forever pestering our loved ones with phone calls and texts: ‘are you there yet!’ Or telling the children, ‘be careful! After midnight there are too many drunks on the road!’ Met, of course, with rolled eyes.

We see, we have seen, a shocking variety of ways in which people shrug off this mortal coil. However, it’s always a bit of an eye-opener when you walk through the valley of the shadow in person. I can think of a few times I did. Once, coming home from a residency interview, my dad and I nearly went full bob-sled under a jack-knifed tractor trailer driving downhill on an icy interstate in Maryland. There was the time I was almost stuck in the middle of a 10 foot wall of flames in the woods on our property. I ran out but only later realized how close I came to being barbecue. There was also the time I was bent over a tree that fell in an ice-storm, cutting it with a chain-saw. I stood up to stretch and another tree fell right where I had been bent. My doctor brain ran the possibilities and none were pleasant. I know what happens to the human body.

Now here I am, 23 years into my practice following residency, and I had another brush with my mortality. First, a little back-story. Like many families with multiple kids in high school and college, we are afflicted with vehicles. One of these cars (and I use the term loosely) is assigned to my high-school senior son, Elijah. For a few months the car (an automatic) would simply drop out of gear and lose all power. Thus it was consigned to the local transmission expert for a six week spa treatment, after which the transmission issues seemed fully resolved. But then it wouldn’t start.

So, one day last week Jan (my wife) and I decided to push it into a better location to try and jump the battery and trouble shoot. It was also in the way of the propane delivery truck, so it had to be moved. We were pushing it backwards, she at the front and I behind the open driver’s side door, pushing and steering simultaneously.

It’s a light car, an Infiniti I-10. Moving it was fairly easy. What became immediately clear was that stopping it was more difficulty. We pushed it across our driveway into the yard, which (we sadly forgot) slopes away at about 15 degrees.

The car picked up speed as objects on inclines are wont to do. But I was still behind the door. And it was headed for the many trees and stumps of our own forest. Jan yelled for me to be careful as I ran backwards. Then I tried (like the 52 year old fool I am) to jump into the seat and put on the brake. ‘Au contraire,’ said the involved force vector, which was hurtling the vehicle ever faster into the kingdom of the squirrels. And in my attempt, I fell to the side of the moving metal death-dealer, in front of the open door which my paramedic brother later described as a ‘scoop blade’ or some other horrible thing.

In a not very manly manner, I yelled. A lot. Perhaps to increase my strength as we do when lifting. Or perhaps because I knew it wasn’t going very well and I was very scared. I had visions of the car rolling over me and realized I had to push away. Finally, after being struck on the left shoulder and knee by the car door, I hit the ground hard and rolled away. As did the car, about 75 feet downhill into the woods, in the process nearly tearing off the driver’s side door, knocking down several trees and ending with a dent in the rear bumper and trunk.

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Many a small animal suffered panic attacks that day, and several trees crossed the rainbow bridge, or whatever it is trees cross when they are killed by hurtling bits of steel powered by stupidity.

Jan came to my side and I stood up, my pride injured, my arm black and blue, my knee tender and swollen. Nothing serious at all. The car? Less so. It had to be pulled out of the woods with a winch and hauled off on a flat-bed truck. In truth, I was ready to be shy of that car. I always had fears that it would lose power on the Interstate as Elijah pulled in front of a larger vehicle, or something like that. I’m ready to be done with it. I just didn’t realize we’d dispose of it by crashing it into the woods.

Christian that I am, I see divine providence all around. Maybe this was God’s way of making me sell the car; or scrap it. Certainly, God’s hand was in my escape from the Infinity that might well have launched me (somewhat ironically) to eternity. I am convinced that my guardian angel pulled me clear then threw his hands up and walked away for a snack break, or the weekend off. ‘Lord, I can’t be responsible when someone does something so ridiculous,’ he (or she) might have told the Father.

Even as I am thankful to God, I am also glad that I work-out, and so I have reasonable strength and agility. Among the many health problems associated with obesity and a sedentary life-style, one that is seldom mentioned, is that since life is dangerous, we must be prepared to rescue ourselves from said dangers as much as possible. As Rikki-Tikki-Tavi’s mother said, ‘A fat mongoose is a dead mongoose.’ I’ve always tried to live by that maxim. Except of course for not being a mongoose nor regularly encountering cobras.

I do think the lesson also reminded me to be more wary. I’m a guy who works in an emergency room. Not only do we treat the results of dangerous events, we are around the violent, the ill, needles, chemicals, infections and all sorts of things. I have to be diligent. Furthermore, I drive at all hours of the day and night. I work with power tools, including chain-saws. I handle firearms. I have a (sadly neglected) metal smithy where temperatures reach upwards of 3000 degrees F. I wrestle with my teenage sons. It is possible that God was just saying, ‘look, you’re no Spring chicken. I want you to do a lot more stuff for the Kingdom, so please be careful!’ To which I reply with a heart-felt, ‘You bet Lord, and thanks again!’

I shudder to think of the possible injuries I could have sustained the day the car rolled out of our control. They come to me in flashes of anxiety now and then, as I consider the horrific alignment of physics, anatomy and physiology. Head smashed against tree, hip dislocated, femur snapped like a dry branch, ribs broken, lungs collapsed. But the bottom line is I’m here, I’m fine, and God is good.

And I will try to never accuse any future victim of an accident of being stupid. Because bad things, dangerous and deadly things often start off with the most innocent of motives and accelerate much faster than we can imagine. All too often to terrible conclusions.

So we all need to just pay attention and think before we do, well, almost anything. Life is short. As one of my neurosurgeon friends used to say every time I consulted him, ‘hey, be careful out there, OK?’

On Veteran’s Day ask, ‘what would I die to defend?’

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Veteran’s Day has always meant something to me.  But then, I was born in 1964.  I’m the last of the ‘Baby Boomers.’  I grew up on stories of family members in time of war.  I remember my father, Keith Leap (my name also) leaving for Vietnam when I was four years old, and remember (vaguely) his return.  I recall my uncle’s stories of the Navy, and of a grandfather in the Army in Mississippi and a great-grandfather who served during the Spanish-American War.  There were others, back to the Civil War, the War of 1812 and the Revolution.

I grew up looking for dates of service on tombstones, and for flags, ranks and units of the fallen.  I grew up with toy guns, toy soldiers and war movies, in a time when we threw plastic grenades with caps in them, which sometimes actually went off and frankly surprised us.

A great-uncle I never met was a Col. in the US Army in France during WWI, and I always heard that he said he was determined to bring his men home safely.  Another great uncle gave me a bayonet he took from an ammo-dump in Italy during WWII; there appears to be a ding in the side from a bullet. A neighbor survived the Bataan Death March; not surprisingly, he suffered as an alcoholic as long as we knew him.  I once met a gracious gentleman who was a former Wehrmacht soldier, who (after a CT scan when his arms were held above his head) said ‘the last time I held my arms like that one of Patton’s soldiers had a rifle in my back!’

I was immersed in veterans and their stories.  And the ones I knew were ever humble and kind.

Was I taught to idolize war?  Was I taught that bloodshed was the answer?  Was I taught that violence was some sort of higher good, as if we were Lacedaemonian children of Sparta?

I don’t think so.  I think I was taught to idolize sacrifice, courage, and simply fortitude.  I grew up in Appalachia; fortitude was necessary, if only for my ancestors to survive against nature.

I suspect that much that these men did had less to do with bravery than determination; in practical application they can look the same, I suppose.

Many brave men and women follow that tradition of service.  They fight, are wounded and die on many fields.  They live or die by their conviction, by their camaraderie, by their patriotism and belief in something higher.

This is hardly limited to the armed forces.  Many live their convictions, in all sorts of fields of endeavor.  But what I wonder now is this:  who will die for their convictions?

We live in a time when many people, especially those in universities, are emotionally wrecked by the slightest challenge to their beliefs, the faintest intrusion into the coddled safety of their own fragile minds.  College administrators give them coloring books, Play-dough, therapy dogs.  Safe rooms are established where they can cry when things don’t go the way they perceive that they should, when there is no trophy or certificate for all.   I suppose this is included in the price of tuition?

But on Veteran’s Day, I must ask of all Americans, what beliefs will they, will we, go through life willing to die to defend?  We should all ask this. What matters most?  Faith, country, family, these are things men and women historically died for.  Ideology?  To some extent, but I wonder.

Will generations of young people learn the lesson of Veteran’s Day?  Not that they need to serve in the military to be real Americans; not that the only heroes are those in uniform, those in battle.  That is a heresy that would produce a warrior class, and we don’t need that.

The lesson, as I see it, is different.  What will you have the courage to stand up and live for, instead of lying down and weeping?  And what will you have the fortitude to die for, if it comes to that?

On this beautiful Veteran’s Day, contemplate that, whether you are or were or never were in the armed forces.  And find an answer.

The future may call on you to decide.

I Love America! My latest Greenville News column.

It’s an ugly political season.  But I still love America!  This is my most recent column in the Greenville News.  Please share liberally.

http://www.greenvilleonline.com/story/opinion/contributors/2016/10/23/ed-leap-love-america/92453876/

Over the Summer I was working in the ER at North Greenville Hospital, doing some temporary work for GHS. I arrived in Traveler’s Rest early one morning to get some breakfast and a drink for work.
As I pulled into a drive-thru, I looked at the nearby gas-station. I was amazed at how busy the place was. And I was suddenly overwhelmed with love for America and her people. It was about 6:45 in the morning, but there were cars and trucks of every variety. I saw utility company trucks and pest-control vans. Those pulling trailers full of lawn-equipment, with mowers and weed-eaters. Electricians, plumbers, contractors, police and EMS workers were getting out of all manner of vehicles. Many essential, difficult jobs were represented, as men and women were headed to work. Motivated by dreams of success, and by love for those they support, they were up with the sun. There were people of every race and ethnicity, many of them working on the same crews, for the same companies, laughing together.
It was going to be a long, hot day, so they were loading up on breakfast, coffee, snacks, water and other drinks. Trucks were being fueled, the staff of the gas station hurrying to keep up. There was an energy there that was quintessentially American. I felt honored to see it.
The wonderful thing is that America and Americans, for all our contentious behavior, remain wonderful. We work and innovate. We strive and create. We educate and parent and look after our loved ones young and old. And despite the reality of bias and discrimination, we are one of the most welcoming nations on earth. We adjust to social changes, we generate and rapidly adapt to technology, and even when it looks bizarre, the average citizen and average politician try to make democracy work.
We are conflicted at times, but usually over means, not ends. We want to help refugees even if we reasonably fear terror. We may worry about immigration but typically enjoy immigrants as our friends and neighbors. We desire to see the poor and their children lifted up. We still, as a nation, want to see justice done. Thus we are equally offended by false imprisonment of the poor and by the way the wealthy and connected sometimes stand apart from the law.
I meet all kinds of Americans in my work. I meet poor, rural Southerners struggling to find jobs, and facing chronic diseases with limited resources. I meet immigrant families trying their best to care for sick children. And even though we live in the South (where popular media loves to paint us as just so hateful), I regularly encounter doting white grandmothers and grandfathers cuddling and adoring their beautiful, mixed-race grandchildren, looking after their sons and daughters-in-law who have different skin colors, and sometimes different languages. I am often amazed at the men and women whose English grammar may not be perfect, but who learn Spanish out of love for a partner; not for a grade in a class or semester abroad.
I see my colleagues care for everyone, with never a thought to treating them poorly because they are gay, lesbian or transgender. I watch as physicians and nurses struggle mightily against the death and suffering of people different from them.
There are churches and pastors, congregations and church groups as well as government and secular organizations (and individuals) who help provide housing for the poor and drive people to work who are battling the nightmare of drug addiction. Those same people adopt children and spend time and money to give food to hungry families.
In America the laborer and the academic are both passionately devoted to fairness and those who never graduated high school are as important to the republic as those with advanced degrees.
Are there exceptions? Obviously. And it doesn’t take many hateful, cruel, manipulative people to cause great damage. ‘A little yeast works through the whole batch of dough,’ said St. Paul.
And yet, the lovely reality is that we remain a great nation, going through a hard time. I don’t know where it will lead. Maybe to darker places, maybe not. But for now in America, the America I see every day that I work, the America that starts the day early and ends it late, working together for common cause, the love outweighs the hatred, the strength outweighs the weakness, every time.
That’s something to celebrate.

Driving Country Roads to the ER

These days, I work most of my shifts about 45 minutes from my ‘house on the hill.’ At one of those jobs, the day shift starts at 06:30. Which means I’m rising from my bed at 04:30 in order to get on the road in time. I’ve started waking up at four, spontaneously, as if it were the most natural thing in the world.

I lay out my clothes the night before, so as not to awake my darling wife in her sleep. Sometimes I am able slip out without her knowledge. Others she wakes to kiss me goodbye. Then I go downstairs and put together some lunch, get the backpack and make my way out the door. I know that my wife and children are safe upstairs, as I lock the door behind me.

The door creeks a little, or did until my son Elijah oiled it. (One always wonders why a teenage boy oils a front door…) Occasionally I lock it as I realize I left my keys inside, and poor, tired Jan opens the door for me patiently. On the front porch, by the soft yellow of porch-light or the shock of flashlight, I step over dogs freshly awakened from sleep, who look at me with gentle annoyance. The sharp-eyed cats sleep in more secret places, so are seldom seen in the morning. Other dogs (we have five), sleep on the gravel drive in the summer and seem confused as to how to react when my Tundra rolls towards them, slowly, and I roll down the window. ‘Get up, you silly dog!’ Heads and tails down they amble away.

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Up the long drive and down the road, I am suddenly all but alone on the two lane roads that lead me to Tiny Memorial Hospital. Despite the early hour, I am ‘awake, alert and oriented.’ The sky is dark, and in winter stars shine down when clouds don’t lay low against the earth. I scan the roadside for deer, their eyes reflecting the truck’s headlamps. Opossums sometimes shuffle across, along with squirrels and rabbits. (One day I saw a big, black bear on a hill by the road. He ran away as I stopped for a photo.)
I drive through forests, past sleeping houses and across a dark, still lake where sometimes, the light from a bass-boat shines across the emptiness where someone has fished all night…or started very early. Or a campfire on the shore still burns as their line rests untroubled in the water.

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It is so early that I drive past gas-stations and convenience stores still dark and locked, the ‘closed’ sign reminding me to keep on moving. The air, even in summer, is cooler and in winter, positively cold. Winter is my favorite, I think, with the heat of the truck turned out, and the chill wind blowing past.

I think as I drive. And I pray. And I listen to the news, a recorded sermon, a pod-cast. Many mornings I turn on an oldies station from the North Carolina mountains; in the loneliness of the drive the music of Sinatra, Johnny Cash and others, make me feel I’ve gone back in time.

I cannot talk on the phone (hands free or otherwise). I pass through places where cell-signals are only a dream, and often even radio reception is poor. Remote areas, mountainous places, lonely and beautiful places defy cell signals and seem to say ‘look around! What else do you need!’ Even at 5 am, I agree.
Eventually I am near, and I find a fast-food joint for the obligatory chicken biscuit and tea, because, well, the South and all. And then I roll into the ER parking lot, lock things up and head to work.
Because this is no urban trauma center, the early morning is sometimes very slow and relaxed. A few patients may be waiting for turnover, but often none. I can sit and think, I can ask about the previous night. I can ease into work. My drive has already prepared me, but it’s nice to have a few minutes peace in the department before the chaos of the day begins. I text Jan. ‘Here safe, love you,’ and she answers. ‘Love you back, have a great day.’
There are those who don’t have to drive long distances. For most of my career it was about 15 minutes to work. And there are those who have long commutes through traffic, and through the waking body of a large city, people and cars just starting to fill its veins and arteries. Sometimes I am jealous. It can be lonely where I am.
But I think I’ll keep it for now. There is a solemnity, a serenity to my mountain and lake commute, with animals heading to bed and people not yet rising, with my own thoughts and prayers to myself.

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And I suppose that if there were a better way to prepare for the madness, badness and sadness of the ER, I don’t know what it is.

Appalachia Deserves Our Respect (And Already Has My Love)

This is my column in yesterday’s Greenville News.  Happy Birthday West Virginia!  June 20,1863.

http://www.greenvilleonline.com/story/opinion/contributors/2016/06/19/ed-leap-appalachia-deserves-our-respect/85974188/

 

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Tomorrow is June 20th, a special day in the hearts of my people; West Virginians. On June 20th, 1863, West Virginia entered the Union in the midst of a bloody struggle for the soul of the young nation. It was, prior to that, the sparsely populated, wilderness-filled backwater of the elegant, beloved Virginia, soul of the South. After June 20th, however, it was…well, a sparsely populated, wilderness-filled backwater all its own. But a free state that rejected slavery!
Those who live in South Carolina are generally well acquainted with my fellow West Virginians. I have a theory that West Virginians share a gene which, at various times of their lives, causes them to have an irresistible urge to drive to South Carolina’s coast. In fact, when the mines close down for two weeks every summer, untold numbers of miners and their families head to Myrtle Beach, which has been affectionately dubbed ‘the coal miner’s Riviera.’ Some of my earliest vacation memories are of the Grand Strand. My wife Jan, a true ‘coal-miner’s daughter’ has similar memories.
If you doubt the connection between SC and WV, I have a vignette: my brother-in-law Dave worked in the WV coal mines as a young man out of high school. His early cell-phone plan included, as local calls, Huntington and Charleston, WV and (you got it!) Myrtle Beach, SC.
I write about this today because West Virginia is in the heart of Appalachia, which stretches from Southern New York all the way to Northern Mississippi (passing through the Upstate of South Carolina). Appalachia is defined as a ‘cultural region,’ and indeed it is.
More to the point, I write this because Appalachia is struggling. Although poverty has improved over the decades, Appalachia as a whole still faces financial woes, much of it made worse by those who are all too anxious to kill coal, but provide no other employment options for those terminated as part of an environmental purge. As if the ‘coal industry’ is only some vast robotic behemoth, and does not represent the hopes and dreams, and often the only financial possibility, for an entire ‘cultural region’ of America.
Appalachia is also struggling with rampant drug addiction and broken by the many funerals, ruined lives and crimes that widespread addiction brings in its wake. From pill-mills dispensing oxycontin to meth labs and imported heroin, the toll in lost lives and lost hope is crushing.
When Jan and I have traveled home over the years, deeper and deeper into Appalachia, up Highway 23 through North Carolina, Tennessee, Virginia and Kentucky and then home, it’s easy to see a place of magnificent beauty, resilient people and serious, inexpressible hopelessness. I never know if the drug abuse is the cause of the loss of hope, or the result of it. Cart, horse. It’s all tragic.
Sadly enough, America frequently just isn’t interested. Appalachian people are still acceptable sources of scorn for much of urban, coastal America. They’re live in ‘flyover country.’ Trailer-trash, hicks, rednecks. People who ‘cling to guns or religion or antipathy toward people who aren’t like them,’ to quote a well-known political figure. When a culture is endlessly mocked and derided, its people get the message loud and clear. Don’t try. It doesn’t matter.
But this June 20th I’d like to speak for my ancestors, and the forebears of so many, who settled in the Mountains of WV and other portions of Appalachia after leaving the press and stagnation of Europe. I’d like to speak for those who still live there, and who find solace and connection in the ghosts of their ancestors, the starkness of the mountains and valleys, in the life, faith, culture and music of the cities and towns. Like me, they stay there because in Appalachia, the past and the present are difficult but inextricable.
And if nostalgia isn’t enough, let us remember Appalachian people keep the lights (and i-Pads, DVR’s and electric cars) on by mining coal. They also provide timber and produce, work in important industries and share their region for the recreation of any and all. All too many have also shed their blood in America’s many wars, and continue to boldly, proudly ‘stand on the wall’ around the world.
America loves to talk about its multiculturalism. And one of its greatest cultures is firmly entrenched, despite its pains and struggles, in the vast region we call Appalachia. It deserves our respect.

My uncle Darrell Leap; a mensch among menschen…

My Uncle Darrell Ivan Leap recently passed on to glory.  Let me set the stage for you:  Darrell accomplished much in his 78 years on earth.  He was raised, with my father Keith and my uncle Karl, in rural West Virginia, on a small family farm.  From humble beginnings he became a well educated world traveler.  He served for a time in the US  Navy, doing oceanographic mapping of the Persian Gulf.  He was an expert in hydrogeology, ground water, and worked on some of the Nevada nuclear weapons test sites,analyzing the effects of blasts on underground water.  The Navy never left him, and he loved recounting stories of it.  He was  a professor emeritus of geology at Purdue University and a consultant to communities on the effects of toxic waste.  He sang in Bach Chorales, played the piano, composed and published music and always loved working with tools.  Appalachia never left him; so much so that in the end my dear aunt, his wife Myra, helped him take online tours of his hometown and environs. The following is the tribute I wrote for him. I was unable to attend his funeral.  (Unfortunately, emergency medicine is job where schedules are difficult to change.  More on that in another post.)  This was read by the pastor who gave the service.

 

I remember Uncle Darrell from very early in my childhood.  Darrell was a kind of mythic

figure to me.  He was always off on an adventure and he always brought interesting things back to show me

at Grandma Leap’s house, on Grapevine Road in Huntington, WV.  I still have Maracas and an African letter opener he

gave to me many years ago.  I recall a time when he came home and was completely exhausted from travel, but we stayed

up as long as he could keep his eyes open, putting together a model engine in the dim, small kitchen in

Grandma’s house.  He represented many things to me as a child:  courage, learning, the exotic and the

benefits of hard academic work.  ‘Take more math,’ was his endless mantra.  Sorry Darrell, it just didn’t

click.  More on that later.

 

One of my favorite things of all was to sit and listen, quietly, while my dad, Keith, Darrell and

Karl (of blessed memory as well) would sit and discuss their memories, or world events.  I just wanted

to be like them.  Strong and capable, men among men.  Menschen, in Yiddish; men of of honor and

integrity.  Together they ever inspired to greatness.

 

Fast forward and I was on summer break after my junior year in high school when Darrell took

me on a field trip with his geology students from Purdue.  He brought me to Indiana where we prepped

for the trip.  Then, for two wonderful weeks of 16-year-old freedom, I was among college students in

hotels and dorms, wandering alone around the wilds of Montana while they worked on projects and

I tried to avoid rattlesnakes, and ate Vienna Sausages alone on hillsides over rushing streams.  Heaven

must look a little like that; at least to a boy.

 

Life moved on.  Darrell married the love of his life, Myra, my treasured Aunt.  I found a girl,

Jan, and we were married.  Darrell and Myra were always welcoming to Jan as my wife, and to us as a

couple.  And when, in due course, children were born to us, they were always excited for our new

additions, always curious and encouraging.

 

As the children have grown into near adulthood, Darrell remained a figure who loomed large in

their lives.  He gave them his collected recollections and genealogical material, with which to anchor

themselves in time, place and history. And he always asked them about their interests, or was leading them

into his. We still have rock hammers and hand lenses he and Myra sent.  Darrell’s life, whether as Naval

officer, researcher on nuclear test sites or academic has always inspired my three sons and one

daughter.  I recall going over some photos once and our daughter Elysa said:  ‘Is there anything else

incredible he did you haven’t told me about?’  In fact, our youngest son, Elijah, has made it his life’s

work to exceed Darrell in mathematics, and has always been terrified that he wouldn’t be able to take

differential equations and thus at least match his great-uncle.  Darrell’s status as a professor emeritus

fills Elijah with awe, as an aspiring academic himself.  And don’t get me started on the harpsichord

Darrell built, which all of my children find fascinating, but especially our very musical son, Seth.  Sam,

Seth, Elijah and Elysa viewed their great-uncle Darrell as an inspiration and a joy, and always looked

forward to visits with him; he was a story teller, like all Appalachians, and he loved sharing them with

us.

 

Perhaps one of our best memories of Darrell was the time, several years ago, when we met

Myra and him at their cabin in Colorado.  It was a brief time of hikes and meals and board games,

when we slept in the cool mountain air after the generator shut off the power and there was perfect

darkness.  Maybe he liked to pretend he was a pioneer. We all certainly loved the experience.

Alas, you are here to honor him in has passage.  I am not, because my work in the emergency

room will not allow me to leave. I will blame Darrell for encouraging my academic life.  (You can

laugh now.)

 

When I told my first-born, Samuel, that Darrell had died, he texted back:  ‘Don’t worry Papa,

you’ll see him again.’  Indeed.  I am confident that I will see him in glory; but I will have to seek him

out among heavenly mountain rock faces, or in the choirs angelic, or as he walks along with Bach and

discusses music.  And he will be vibrant and whole as always.  And forever.

Uncle Darrell was a man among men.  And he lived life fully; the physical life, the life of the

mind, the life of family, the life of faith, and in his love for Myra, in the life of the heart.

I will miss him.  But I will look forward to our reunion. As I hope all of you will.

Thank you.

Edwin

Tell me about your little hospital!

I’m putting together a project on small hospitals.  While I’m particularly interested in critical access facilities in rural areas, other small facilities (urban and rural) are welcome.  I’ve always contended that big teaching centers get all the ‘love.’ There are television shows and books and movies about the enormous referral hospitals in big cities.  But not so much about the little hospital at the end of the road on the mountaintop, or on the windswept coast or in the desert Southwest.

And yet those places have dedicated staff who do great things, save lives, comfort the sick and do most of it on a pretty limited budget and in all kinds of weather.

So if you are interested in being part of this project (I’ll reveal more in time), tell me about your hospital.  Where it is, why it matters, its great successes and struggles.  If you have anyone I can contact there, please let me know that as well.

I want to hear your stories!

You can respond here or e-mail me at edwinleap@gmail.com.

Sincerely,

Edwin Leap, MD

 

 

 

Learning to Love Freedom

I have to admit that I’ve become a bit of a freedom junkie.  As a native West Virginian, there’s this desire, deep inside, to be unfettered.  When I was a child I expressed it by wandering all day long through the hills and valleys around my home.  No phone, of course, and no radio.  No way to contact, or be contacted by, anyone else.  I remember being about 13 or 14 when my dad let me go off into the woods with my single-barreled shotgun to hunt.  I never shot anything.  But I was free.

Later I was encumbered in some ways by college, medical school and residency.  But when my wife and I moved to South Carolina, and ended up in our rural, hilltop log-house, I rediscovered the deep inner peace of freedom.  Our family roams at will through the woods around our home, the state forest across the road.  On July 4th and New Year’s Eve we set off fireworks as long as we want.  On Halloween our bon-fire roars high as the tree-tops.

We throw clay-pigeons over the back yard and shoot them; we have lost untold arrows in the woods, and have behaved like barbarians for years, simply for the joy of doing what we wanted to do.  Our five dogs and three cats collude in our freedom, and have furry smiles as we sling dinner scraps over the back deck into their un-caged, happy mouths.

In 2005, my wife and I discovered a kind of liberty that we had never imagined.  We began to homeschool.  That adventure liberated us from the constraints of state-determined schedules, curricula and ideology.  It allowed us delicious, lavish time together, whether the kids were playing in the pool while rehearsing Latin declensions with my wife, or traveling to the Grand Canyon during the off-season.  We were unencumbered, and while the children learned much and learned well, we had precious little oversight to pester or constrain our wild, free time together, when we rolled about in our fragrant love for one another.  If we had known how it would be all along, we would have started homeschooling much earlier.

Two years ago, I found more freedom.  I took the plunge, left my partnership of 20 years and Jan and I started a small corporation, LeapMedicine.  I began working as an independent contractor.  I worked where, and when, I wanted.  I still do.  If I don’t want to work a holiday, I don’t.  If I want to work, I do.  If I work a shift and don’t like it, I don’t go back once my committed shifts are over.

There are costs to freedom.   It’s magnificent but unpredictable.  The cost of owning a business is sometimes daunting in America today, although I wish I had done it sooner.  There are others.  We recently tried to refinance our mortgage.  We discovered, to our chagrin, that large companies want people in communities of boxes.  You can refinance a house in a subdivision.  But a log house on a hilltop is unnerving to banks and lenders.  It isn’t the same as everyone else.  It’s less predictable, and understandably.  It may not sell.  Only so many people are comfortable away from the crowd, away from the comfort of commonality.

Indeed, we are nationally obsessed with being members of a herd.  Ask a kid in school if it’s OK to be different, the way every kid book with a quirky penguin and a sad skunk says it is.  It isn’t.  There’s a price, and it’s paid in bullying or marginalization.  Maybe it’s good training, because the same dynamic certainly exists in the world of adults.  Try saying the wrong thing, wearing the wrong emblem, believing in something unpopular, standing for a viewpoint on principle not popularity.

Bullying just takes different forms; like social media campaigns, or lawsuits.  Being marginalized means ridicule by a professor, lack of promotion by a boss, firing by a corporation.  America, the land of the free, doesn’t really like freedom these days.  Freedom means you might hurt someone’s feelings, crush their fragile self-esteem, say something shocking.  Freedom of ideas is a beautiful dream, but the kids on the adult playground of modern thought are like the bullies from our childhood, dressed up in suits, with law degrees and political offices; and with the same fragile sense of self the old bullies had.  But they have more power to punish the free, more power to torment the outlier.  Fortunately, truly free people relish their freedom so much that they become hardened to the ways of bullies and go on living in joy and liberty.

I set out to write this as an homage to homeschooling.  But as so often happens, I discovered that homeschooling, and even business ownership, are merely some of the sweet fruits of an attitude, of a decision, to be free.  It was what made America, once upon a time, a great country.  It’s what real Americans long for, live for and are willing to defend and die to preserve.

I hope that my children, and their children and all the rest can remain free.  I hope that they can thumb their collective noses at those who silence, subjugate, manipulate and ridicule those who just want to live and be left alone.  I hope they take their children on trips and walk away from unnecessary constraints.  I hope that they forge new ways to be free and remake this nation.

Freedom.  Take every step necessary to preserve yours, and your children’s.  Because once it is surrendered it does not return easily.

And once enjoyed, perhaps the most addictive thing in all the world.

Summer Wants You Dead! My column in today’s Greenville News.

http://www.greenvilleonline.com/story/opinion/contributors/2015/08/08/ed-leap-careful-summer-wants-dead/31298333/

Enough of the tedium of politics and culture! Let’s focus on the real enemy. Which in the South is clearly Summer. I was working in a Southern ER recently, in a location which is beautiful, full of Northerners, and which shall remain unnamed. We’ll call it ‘Vacation Memorial Hospital.’ Lying before me was a charming lady of some 80 years, who had fainted.

‘What happened?’ I asked.

‘Well, my husband and I decided to ride bikes to lunch. It’s such a pretty day and all. And after about three miles I just felt funny and when I sat on a bench I passed out.’

(Relevant fact for the reader: The heat index was 115 that day.)

‘Oh my! It’s very hot outside. Where are you from?’

‘We’re here from Chicago.’

‘Do you ride bikes at home?’

Laughing, says ‘Oh no, only when we’re here!’

So, living in a city which feels nearly Arctic most of the year, my patient comes to South Town and rides a bike three miles in heat that makes the hardiest Southerner cling to the AC unit with something akin to worship. But this was certainly not the only misguided person I saw who did something similar. There were variations of course: ‘I drank a 12 pack and went to the beach for a few hours.’ Or, ‘I paddle-boarded for 8 hours against the tide, starting at noon.’ You get the picture.

Please excuse my bluntness and paranoia, but the fact that non-Southerns don’t realize about our summers is this: nature wants to kill you. Heat and humidity are its favorite weapons, and dehydration and heat stroke it’s favored techniques. (It’s the opposite of life in the far North, where nature wants to terminate you by turning you into a solid block of ice.)

However, as I realized long ago, it’s more than the heat. Summer in the South has many weapons at its disposal. For instance, it has water. More specifically, water and alcohol, the combination of which makes a fine cocktail but a very poor form of recreation. Summer doesn’t mind drowning the unwary.

Summer also employs creatures. I spend a large part of my summer finding, and destroying, the dozens of wasp nests that inhabit our property in the summer, and which make every expedition outside an exercise in looking for ‘booby traps.’ (I’m not vindictive; one of my sons is dangerously allergic.) There’s a nest on every door frame, in every shed, in the ground over which we mow, under the diving board, in the old can in the woods. Ditto for spider webs; a giant black widow was living happily under my wife’s lawn chair last week.

And I’d be remiss if I didn’t mention venomous snakes. Copperheads have been particularly busy over the last couple of summers, causing painful bites and no doubt receiving financial kickbacks from the makers of $2000 per vial antivenin. Apparently, they have also been communicating with the shark population on the Carolina coast to start some form of horrible insurrection worthy of a B movie.

However, perhaps the most insidious technique of summer is the use of the lawn. The lawn compels us to expose ourselves to the intense sun, to stinging insects and to power equipment. Now, I’m pretty careful about blades turned by engines. But if I ever have a heart attack, odds are it will happen while I’m trying to start the 2-cycle engine of a weed-eater, already partly destroyed by ethanol-containing gasoline. Furthermore, it’s not only a danger to my earthly body. The anger and profanity that boil up while working with the weed-eater, or reprobate mower, are surely enough to make a Baptist into a backslider.

I know, this sounds crazy, but I’m ready for Autumn. And especially for that first freeze when stinging and biting things take a break, when the lawn grows more slowly and when a bike ride needn’t be accompanied by a 9-11 call.

I have a theory about why Southerners make up such a large proportion of our Armed Forces. It’s because of summer. As Southern children we learn that nature, for all it’s wonders, has it in for us. And we spend our time fighting and enduring temperatures, creatures, Kudzu, Poison Ivy and every other nefarious thing thrown our way. We learn caution, appropriate distrust and how to fight dirty. These are lessons that our visitors would do well to understand. Because like it or not, Summer wants you dead.

Now go and enjoy your bike ride!

 

Sweet Tea: A Delicious Force For Unity

http://www.greenvilleonline.com/story/opinion/contributors/2015/05/09/ed-leap-divided-sweet-tea/26993623/

(By the way, I didn’t write the newspaper title for this piece.  I find it a little confusing given the context of the column.)

I have traveled all over America for the past year and a half. I have worked in hospitals large and small, in areas urban, rural and utterly remote. I have flown through so many airports that I have an internal list of my favorite concourses in which to be trapped by weather, and how to run through them when late for a flight.

Because travel for work is a lonely business, and when I’m lonely I eat, I have also accumulated quite a selection of favorite restaurants and fast-food places in the assorted towns where I have traveled and plied my trade. I find the Denver International Airport to be a place of delightfully varied gastronomic opportunity. I know that in Jasper, Indiana, nothing compares to the Schnitzelbank if it’s genuine German food you crave. The Double Barrel Saloon, in Craig, Colorado, has wonderful lamb stew, from locally grown livestock. That’s just scratching the surface.

However, as a wandering Southerner, it’s a lot harder to find proper sweet tea. This fact, dear reader, is just below ‘leaving wife and children behind’ as a source of deep pain and angst for this particular aficionado.

I think it’s important that we hold tightly to sweet tea as an integral part of our common bond as Southerners. So as we enter Spring and Summer, truly ‘tea time,’ it’s a good time to be reminded of what tea, proper iced, sweet tea, is and isn’t. Let me start with the negative. God did not intend tea to be sold in a large metal container under pressure, then poured through plastic tubes to a spout right next to the Coke, Pepsi, Sprite or Mountain Dew. It may say tea, but it isn’t. It’s heresy.

Next, tea shouldn’t be put into the ‘freshly brewed’ dispenser from a large plastic bag of tea, sent from some far away place where it was not made by loving Southern hands. That is trickery, mockery, disdain for all things holy and pure. When I recently discovered this travesty at a favorite establishment, I was out of sorts for days. ‘I can’t believe they, well, it’s…wrong!’ My daughter is tired of hearing about it. ‘That upset you didn’t it?’ Eyes rolling. These are not bags of tea in my opinion. They are bags of syrup, unpleasant at best.

Likewise, sweet tea isn’t just unsweetened tea with wretched little sugar packets poured into the cold, unrelenting water to collect on the bottom like dead sea-monkeys. How many times, dear Southerners, have we been in some northern clime and asked for sweet tea, only to be told by an unenlightened individual, ‘we have sugar.’ Ghastly.

Furthermore, as with fine wine, beer or bourbon, the tea lover can tell in a glance if things are right. In one Mid-Western restaurant, I was served a glass of iced tea that looked very much like red-clay from my yard, stirred and left suspended in dirty water. It appeared as if it had been made the year before and left in the back of the fridge for the next time some yokel asked for sweet tea. I took a picture to remember the horror.

There’s no single way to make sweet tea. Hot water in a pot, iced-tea maker, sun tea and others. We all probably have our own techniques and preferences. And to avoid contention and alarm, I won’t recommend any particular way of making the delightful nectar of Southern life.

In the end it is a medium amber color, sweetened with sugar and mixed with a little extra water to balance the flavor. It smells like hot days and cool evenings, like the beach and Thanksgiving. And when mixed with ice, it is truly the drink of the gods; ambrosia below the Mason Dixon Line.

It is one of our many gifts to the world, like shrimp and grits, barbecue, shag and camouflage lingerie. We drink it with our meals, by the pool, in the car, at work. We drink it at parties and picnics and it is, unlike Bourbon or beer (of similar color palate) fully acceptable and expected at church dinners. ‘Y’all, weren’t the Leaps supposed to bring tea? We should pray for them. Something must be wrong.’

God help us, we’re entering a Presidential election cycle. We are divided on many issues. But at least in the South, we should be united by one thing across all lines of race, sexuality, gender, religion and party alliance.

And that thing is sweet iced tea.