Tamara Unleashed

I went to school with Ed from 6th grade through graduation. He lived down the street in the town of about 700 people that we grew up in. Ed was one of my brother’s best friends through school and adulthood. Ed contacted me about 2 months ago with a bladder problem following a knee replacement. I helped Ed understand the what and why of his problem and helped him get the care that he needed. It was not the type of problem that would likely have a quick solution so I was in communication with Ed once or twice a week for several weeks as he was managing his problem with the help of a local urologist. Ed liked to cycle and we talked about how good the cycling trails were around Des Moines and we planned on doing a ride together when I was in Iowa He said the best trail was the High Trestle Trail north of Des Moines and he described the incredible bridge on the trial. I was hoping that Ed’s bladder problem would be resolved by the time I got to Iowa for our ride.

About a month ago, a few days after a conversation with Ed, I got an email from my sister-in-law telling me that Ed had died. I couldn’t believe it and still do not understand what happened. I am heart-broken for his family and close friends.

Yesterday I rode the High Trestle Trail for a total of 30 miles and wished I had been able to ride with Ed. It was a beautiful sunny day. Below is a view from the bridge looking south over the Des Moines River.

The quality of the trail was outstanding. Smooth pavement with intermittent shade. The quality of the paved trail is a reflection of how far back from the edge of the trail the trees were planted. There appeared to be no trees closer than 10 feet from the edge of the trail. There was not much shade along the part of the trail that I rode, but it was the smoothest trail I have ever been on – like a newly paved road.

I look forward to returning to Iowa for more rides, however I think I will take riding RAGBRAI (Register’s Annual Great Bike Ride Across Iowa) off of my bucket list. The ri is always the last full week of July. As much of the ride would be in direct sun with minimal shade along the route, I am not inclined to expose my skin to that much direct sun. I am glad to have ridden in Iowa this past week to gain a better understanding of what I would be facing with RAGBRAI.

Ed’s life ended too soon. I greatly appreciate that he suggested riding the High Trestle Trial. I will return to do it again.

One of the friends I visited recently asked me where I considered home? I had to stop and think about that for a bit. I was born in California (lived there for 2 weeks); spent 30 years in Iowa; one year in LA; 10 years in Seattle, 5 years in Philadelphia, 10 years in Manhattan and 8.5 years in DC area now live in Nashville. After thinking about it, I said I still thought of myself as an Iowan. I have always been happy that I grew up here and never really had any intent to leave – yet I did.

After being in Iowa for the past 4 days, it no longer feels like my anchor. My father has been dead almost 11 years and my mother almost 9 years. Aside from my son, the rest of my family is in Iowa. I visited my parents’s graves and the house that was my “farm camp” for many summers. I drove the gravel roads and discovered that gravel dust is not good for the locking mechanism on the lock I use for my bike.

The farm was rather unkempt in appearance and the gravel road that goes past it is now a dead end because the small bridge over a small creek was taken out and the road is being overtaken by grass – a bit unsettling. I loved going over that bridge when I was young – I would get butter flies in my stomach. I prefer my memories.

Our family gathering on Saturday was held a a lovely state park and the weather was sunny and hot with enough breeze much of the time to make it tolerable.

The view was lovely and we had space for eating, a baby shower and lots of different lawn games for big and little kids. There was way too much food as usual. It was entertaining to watch a spirited game of kick ball.

Sunday I had a 15 mile bike ride outside of Iowa City – it was hillier than I anticipated but there was some lovely countryside and very occasional shade. It is haying season.

So while the countryside is familiar and comfortable, it didn’t provide the sense of “being home” that it once did. I may be metaphorically homeless for a while.

I seem to have acquired a weird skin infection in the area of the superficial skin abrasions when I fell off my bike on June 5th outside Cleveland. I was in urgent care this morning and left with an antibiotic prescription. The area doesn’t hurt but feels “woody” which really caught my attention. The skin is not worse tonight and may be a bit better.

I have cycle ride planned tomorrow in Des Moines with some neighbors of my brother and sister-in-law. Hopefully there ought will have some shade.

My ability to “control” weather worked out pretty well yesterday. When we went to bed Tuesday night, there was 70% chance of rain Wednesday morning. When we got up, the rain was delayed until 1 PM. We took off just after 9 AM and rode 33 miles through beautiful countryside on paved roads with minimal traffic the majority of the time. There did not seem to be any gravel roads like there are in Iowa. The low traffic roads we road on would have been gravel in Iowa.

After we got started, the skies cleared for a short period of time.

As we hit about 20 miles, the clouds started to build and the rain started as we hit 30 miles. We were soaked by the time we got back to cars but it didn’t matter – it had been a great ride. We all had brown bag lunch together. It was a great group of women who obviously had spent a lot of time together over the past decade creating a supportive community for each other.

Today I left Ohio and drove to Indianapolis where I had lunch with a college friend at her lovely home. After lunch we took her pontoon boat for a spin around the small lake.

The rest of the drive to Iowa was easy – sunny skies and minimal road construction. Tomorrow I will do a morning ride before it gets too hot. It is supposed to be sunny and in 90’s for the next week here. The crops look further along here than they were in Ohio.

The weather today turned out to be much better than predicted. We went for a hike in High Bank Park – part of the Central Ohio Metro Parks system. It is a beautiful park with great trials that are wide and well maintained. A cicada flew into me as I was entering the trail and the sound of the cicadas was apparent. I wanted to see and hear them this year and I hope to be around to hear them again in 17 years.

We then went into Columbus and saw some beautiful old architecture in Short North around Goodale Park and I really appreciated the twin elephant water fountains in the park.

Columbus is a really nice city which is hard for me to say – growing up a Hawkeye fan. The Buckeyes always seemed too aggressive for my taste back in the days of Woody.

I am sharing this bicycle windmill in hopes it is good luck for less rain than is predicted tomorrow for the Yakkers bike ride. This is group of women from this area who have been getting together to cycle or hike on Wednesdays for many years and I look forward to joining them. Fingers crossed.

Yesterday was a beautiful day in Cleveland again – mid 80s and low humidity. We rode 5 miles to breakfast in University Heights and back. There are a lot of deer in the wooded areas in suburban Cleveland. Friday evening, a small deer wandered into my friend’s backyard 5 times. The dog would chase her away and she would jump over a fence dividing properties, walk 10 yards or so, jump back over the fence and come back into the yard only to get chased away again. It almost seemed as if she was wanting to make friends with the dog. She came back again the next morning and then seemed to disappear.

I was able to get a badly needed pedicure (my feet are so ticklish pedicures are almost painful) before driving to the Columbus area (Delaware OH to be specific) to visit with friends from the Natchez Trace cycling adventure 2.5 years ago. These women are examples of how to stay active and enjoy retirement. This rural property has a barn with 3 older horses, 17 – 34 years old), a large garden and is on a dead end road which creates a small community of evening walkers. We walked the road for 2 miles last night and met many of the neighbors. Amazingly I did not get any mosquito bites on the walk at dusk.

Today there was intermittent heavy rain with very high humidity and we did not venture out. I had some additional aches and twinges after my cycling fall Saturday so I used the day to alternate ice, heat and stretching. I think it is better this evening.

Tomorrow will hopefully allow for some cycling and or walking in between rain in the morning and we will be going into Columbus tomorrow afternoon.

Weather is not looking good for the 30 mile bike ride on Wednesday but fingers crossed the prediction will change.

My trip is half over and I have had meaningful personal interactions and meaningful with 28 important people in my life with 2 reconnections via phone. By the time the trip is over, I will have visited with persons from high school, college and the last 23 years of my career. I am creating a tapestry that includes memories of past experiences and creating new memories. I will continue to work on filling in the gaps of the tapestry over time. This is time well spent.

I arrived in Cleveland last night to visit a colleague I admire. She has a lovely home and family. We had a great family meal with her 14 y/o and 10 y/o daughters each having a friend over and a drop-in resident for dinner. Young energy is wonderful to observe and be a part of.

Today was a spectacular day here sunny skies and scattered clouds, mid 80’s and humidity below 40%. It does not get much better than that.

We drove to Peninusula OH which is in the southern part of the Cuyahoga Valley National Park and rode south to just north of Akron. The ride in the park was mostly shaded and beautiful:

I didn’t see any geese today but there was this heron:

On the way back, as we were crossing a street and reentering the trail, I evidently lost focus and bumped into one of the barriers to keep cars from going on the trails. I wish I had a slow motion video because I think it was a pretty graceful fall. I landed on my back and did not hit my head and knew my neck was fine. I felt a bit of a sensation in my lower back that concerned me initially. I could tell pretty quickly that I had not broken a arm or a leg. I rolled over and waited a bit for the shock/anger at myself/embarrassment to wear off. I stood up slowly and checked out the bike which was my biggest concern. It looked fine. I spent a couple of minutes stretching my back and as I had good range of motion and limited pain I thought I was fine to ride the rest of the way back to the car and I was. While I could feel the scrape on my ankle while I was riding, this evening I noted the bruise on my foot.

When we got back to Peninsula, we had lunch before driving the 30 minutes back. After a shower, I took a muscle relaxant, a non-steroidal, used a heating pad and had a nap. When I woke up pain was no worse and perhaps a bit better. I went for a short walk to loosen up and had a gin and tonic before dinner. I quickly noted I was feeling far too good for the amount of alcohol I had consumed. As I had no responsibilities and was not going to drive I continued to drink my G and T. I felt wonderful but there is no way I should have been driving, operating heavy machinery or even using the knife in the kitchen. The warning on the label is a correct.

We had dinner outside. The buzz from the G/T slowly receded and it was the end of a wonderful day.

Hopefully, I will not be too sore in the morning. We are going to try to do a shorter ride around the neighborhood and get a pedicure before I take off for Columbus around 1 PM.

Uneventful drive from Sag Harbor to Williamsport. Light rain most of the way. Took about an hour to make it through NYC. Williamsport is in a beautiful valley and a bit larger than I expected. We are staying in the historic Genetti Hotel downtown.

This is in the lobby

I went out for walk in the drizzle and there were several statues to little league baseball:

I am listening to the book Caste by Isabel Wilkerson now – I highly recommend it. It may be a better way to frame the conversation about privilege in this country. I am looking forward to hearing more on my drive to Cleveland this afternoon.

It was a gorgeous day for cycling. I got out at about 1015 and headed for the North Haven ferry to the south side of Shelter Island. It was about 4 miles. It is a small ferry that holds about 10 vehicles. We just took off and you can see the destination in the distance of the photo. There are 2 ferries that run about every 10 minutes.

The roads on Shelter Island were good with cars and bikes sharing the road. There is not a huge amount of traffic so it was quite easy. Below is the map of today’s ride. The green dot is the where the ferry runs with Shelter Island above and North Haven and Sag Harbor below. I rode a total of 30 miles – my longest ride of the year. There were some challenging hills on Shelter Island. I rode north and to the east, then across the north end and then the west side before going back to the ferry. I stopped for a short water and energy break at the north end. If it were not for all of the landscape workers and equipment, the island would have been very peaceful.

When I got off of the ferry, I had ridden 22 miles and I wanted to get to 30 so I toured around North Haven and found many dead end streets or very private streets/driveways. I did some of the same road riding I did yesterday to get to 30 miles.

After a shower and rest, we took at 3 mile walk around parts of Sag Harbor I had not seen yet. All in all I felt I earned my margarita, chips and guacamole at K Pasa a local Mexican restaurant. We then drove to one of the South Hampton beaches for a view of the ocean south of Long Island. A very enjoyable day. I feel like I partially made up for my lack of activity on the rainy Sunday.

Tomorrow I had west to Williamsport PA, where I will meet up with a friend from Pfizer who retired to Ithaca. Friday I will make the shortish drive to Cleveland.

Midwest, here I come.

My drive to Sag Harbor was uneventful. The drive across the GW bridge just after 10 AM went pretty smoothly and while traffic was slow going across Bronx, it was not stressful as cars stayed in their lanes and there was plenty of room between cars – not bumper to bumper with cars darting around trying move ahead. I was struck by the complexity of the road systems and how many cars/people have to use the roads every day getting in and out of the city. It struck me as miraculous. I took the Throg’s Neck Bridge onto Long Island and driving on Long Island was a different story. Speed limit is 55 mph but that seemed to just be a “suggestion”. Literally everyone was going 70 mph and while there was no need for it, cars were passing crazily on right and left. Thank goodness there was not a lot of traffic. I noticed that there was a lot of traffic going in the opposite direction and I hope that is weekend people that stayed on an extra day and not what I will be experiencing on Thursday when I leave.

I am staying with the woman who co-authored a paper in the early 90’s that was like a jolt of lightening when I read it. https://www.sciencedirect.com/science/article/abs/pii/S1049386705801975 I knew immediately, that this was what I was searching for. I couldn’t provide good care for women with bladder problems without thinking more holistically about their health. I sent a copy of this article to the University of Washington Dean of the Medical School, the Medical Center CEO and Medical Director and the Director of Nursing and suggested that UWMC and School of Medicine needed to think boldly in planning for their new Women’s Health Center. I had no expectation that it would lead to anything. A couple of weeks later the Chair of the Department of Urology told me he had been asked by the Dean to attend a meeting to establish the vision for the planned Women’s Health Center and he asked me if I had any idea why he had been invited. He didn’t mind that I had seeded an idea without his knowledge, but he had no desire to attend this meeting. He got permission for me to attend this meeting representing Urology and I ended up Co-Chairing this Committee with the Medical Director of the Medical Center. I learned shuttle diplomacy during the 2 months we had to come up with the vision, primarily going back and forth between the chairs of Ob-Gyn and Internal Medicine trying to get them to understand the vision and not be threatenned by it.

The UW Women’s Health Center had multiple disciplines seeing patients in the same space but woman who was selected to be the Director did not really understand the vision. I think I was considered too junior to be selected as Director of the Women’s Health Center and I ultimately decided to not move practice there. It was during my time in Philadelphia the I proved to my satisfaction that interdisciplinary care was possible and worked well.

Today I walked and cycled get familiar with the area on the bike.Tomorrow I will take the ferry to Shelter Island to cycle.

I met a friend for a walk along the Hudson today north of Sleepy Hollow. Weather was still cloudy and cool but it was not raining. We have known each other for years – she is a urologist as well and we reflected on our experiences over the years as the only woman in the room with urology colleagues and pondered how our lives might have been different if we had chosen a specialty other than urology. I can’t actually imagine myself in any other specialty. I am still fascinated by the bladder and what we demand of it.

From the 6 mile walk I drove a short distance to have lunch with a Pfizer colleague who is still with Pfizer. It was a lovely meal with his wife and daughter. His wife is a hospital nutritionist who worked through the Covid crisis in Westchester County. She indicated the hospital went from having 100 beds dedicated to Covid patients to one or two beds occupied with Covid cases. His daughter was in middle school and indicated she adapted reasonably quickly to the remote learning a year ago and feels like she learned well. She has been back in school 5 days per week for the past 2 months. This school is having class size no larger than 15 and they stay in the same group all day with the teachers rotating to the classrooms. Students have the option for remote learning which is how they have been able to maintain smaller class sizes for those returning to school

The day ended with the sunshine and rather than cycling as I intended, I met my friend from Pfizer on the upper west side. I found a parking place on the street that I could drive straight into. Score – I did not have to try to parallel park under pressure. We took a lovely walk in Riverside Park. He worked in Labor and Delivery last June and July and is still impacted by all that he saw in the hospitals last year during Covid. While I had hoped to cycle today, it just got too complicated with the time compressed to late this afternoon. We would not have been able to have as much conversation as we did walking. As much as I wanted to cycle in NYC I am glad we had enough time to catch up.

There seemed to be less people masked on the sidewalks today than Friday. I hope that cases and deaths will remain low as the masks come off.

Off to Sag Harbor tomorrow.