Author name: Diane

Michael Litrel, MD, FACOG, FPMRS
Dr. Litrel's Blog

Endless Love

It was Saturday morning, and already my wife had been working for several hours at the computer, sitting ramrod straight in her chair. No doubt she was stressed out, with too many projects on her plate. It seemed like the perfect time for the surprise I had been planning. With a flourish, I invited Ann to come with me to my office. She raised her eyebrows. “Can’t it wait?” I said no. Reluctantly she accompanied me upstairs. Once in my office, I moved to my computer and selected a song I had recently added to my play list. The music began, and everything was ready. I asked Ann to dance. Lionel Richie and Diana Ross’s duet “Endless Love” was all the rage back in the day. I remember dancing to the song, feeling deeply in love. The piano played softly, and then the lyrics came… “My love…there’s only you in my life…the only thing that’s bright…” What a charming romantic I was! Ann rolled her eyes and reminded me she had been busy. Her reaction surprised me. I thought she would gaze adoringly into my eyes with the look I remembered from years before. But Ann’s body remained stiff. Instead of feeling like the star high school quarterback dancing with the head cheerleader, I began to feel like the nerd the girls feel sorry for but try to avoid anyway. I was annoyed. Fall in love with me again, why don’t you already? Tactfully I expressed my concern that our once special memories of dancing to our song meant nothing to her now. “Our song?” Ann pulled her head back to look me in the face. “We never danced to that song – I never even LIKED that song!” Oops. That was an unexpectedly awkward revelation. Well, at least that explained why she wasn’t exactly melting in my arms. I could feel Ann’s body tensing even more as the implication of my mistaken memory became clear to both of us. Our dance became more and more stilted until we were essentially standing still in the middle of my office. I could feel the question coming. “So Michael,” Ann opened, “which one of your ‘past loves’ did you enjoy this wonderful song with?” Funny you should ask my dear, I thought to myself, I was just wondered the same thing myself. A surgeon in the middle of an operation would call this “getting into unexpected bleeding.” It had seemed like the perfect plan – play a song of tender memories, and instantly transform Ann from the “I have too many things to do” stressed out woman to the “I am so lucky to have you as a husband” happy wife. A beautiful Saturday afternoon would follow, with Ann gazing at me adoringly whenever I walked by, even if I was just scratching myself. Now all I wanted was to get this angry hellion out of my office. The music continued to play as I held a now jealous wife in my arms. This was not “Endless Love.” This was “Endless Dance.” Would you please shut up already, Lionel? “It wasn’t that we ever danced to this song,” I explained disingenuously.“It’s just that whenever I hear it I think about you and how much I love you.” It was the right thing to say, a good line, really – but I delivered it half heartedly voice, in a perfunctory oh-let-me-just-say-it- and-get-it-over-with sort of way. Ann surprised me by laughing out loud. She seemed delighted by my obvious lack of candor. ”Oh really?” She betted her eyelashes batting coquettishly. “Do you really mean it?” “Oh yes,” I responded, smiling at her like used car salesman. “I would never lie to you, my darling.” Ann laughed again. And remarkably, she rested her face against my chest with a happy smile on her face. Her body relaxed. “I’m sorry I’ve been so stressed out lately,” she said a few moments later. My plan had worked after all! Ann had actually melted in my arms. Womanhood, what a remarkable mystery. Maybe it’s not choosing the right song that matters most. Sometimes you get credit just for the effort. -Dr. Mike Litrel

Michael Litrel, MD, FACOG, FPMRS
Dr. Litrel's Blog

The Night the Caterpillars Ate My Dinner

Many years have passed since the night I delivered my first baby and, in retrospect, it is clear that practicing obstetrics was the path the Creator intended me to take. But I confess that after a thousand deliveries, the blaze of emotions that once accompanied each one has subsided to a softer glow, flaring up again only at those times when danger, or joy, bring the world more sharply into focus. So it was with a recent difficult birth. The mother and her family were well known to me. Two years earlier I had delivered my patient’s second daughter. Her first daughter, then an irrepressible nine-year-old, had gleefully cut the cord. But with this labor, the third daughter, there were complications. The baby’s heart rate kept falling. It was obvious to my patient that I was worried. Every five minutes I came into the room, obsessing over the baby’s heart rate like an anxious stockbroker watching the ticker tape. I maintained a professional demeanor with my patient, trying to give her as much reassurance as I could. Her anxiety level was rising and, for a moment, I felt bad. When confronted with worrisome clinical circumstances, doctors tend to pull back emotionally. It helps us think clearly and, hopefully, make the right decisions. It’s a mistake to think that any physician knows exactly what he or she is doing at all times, and, at this moment, I was no exception. I was uncertain about what was wrong. But finally a routine procedure improved the baby’s heart rate, averting emergency surgery. The baby was born. My patient’s first daughter, now eleven, delightedly cut her second cord. Her little sister’s cry filled the room. My tension dissipated. I was a third year medical student discovering my destiny once again, and my soul hummed with the joy that swelled the room. When I arrived home that evening, my stomach was also humming—with hunger. I looked forward to a nourishing meal and sharing the stories of my day. My wife, Ann, is my soul mate. Well, she’s either my soul mate or just a very good listener. It doesn’t matter. Ann is a loving person, a supportive friend, a great mother to our children and, most importantly, an attentive audience. So even though she’s heard me talk about clinical cases hundreds of times, I knew she’d listen to me with polite fascination. And, she would feed me. But this night I was wrong. When I walked in the door my first clue was that supper was nowhere to be seen. My second was that Ann expressed no interest in the heroics of my day. Instead, she wanted to tell me all about her day. It was an outrage. Incredibly, Ann and the boys were actually ignoring me. They were engrossed in a large glass jar on the kitchen counter which contained, upon inspection, caterpillars. I groaned under my breath—the evening’s conversation was going to revolve around Ann’s butterfly garden, again. She shot me a dark look. My groan had apparently been less discreet than I intended. I gave myself a mental kick. Now I’d have to work even harder to feign interest. Last year, after months of research—otherwise known as shopping from gardening catalogs—Ann created a butterfly garden in our backyard. She told me all about it but the details escape me—something about attracting lots of bugs to our yard. In its execution, the project fell short of Ann’s expectations. Deer and rabbits showed their enthusiasm by chowing down on her plants. In the end, Ann counted a grand total of five butterflies the entire summer. She was depressed. So was I. All the plants she’d ordered had been a waste of money, and now I had to console her about it, to boot. Then, one morning, Ann returned from a visit to her garden practically skipping. Two monarch caterpillars were eating her milkweed plants. Several times a day, Ann took our two sons out to watch the bugs. After a few days, according to their frequent and detailed bulletins, the caterpillars had eaten all the milkweed. So, I came home this particular evening in a good mood after a delivery to find that Ann and the boys had spent two hours gathering food for the caterpillars. The air went out of my balloon. Ann enthusiastically badgered me into pressing my ear against the jar so I could hear the caterpillars munching on the milkweed leaf dinners she and the boys had so thoughtfully and painstakingly prepared. I took the subtle approach: “They sound really hungry. I know how they must feel.” “Boy, it must be nice to eat your fill.” “You’ve done a really nice job fixing dinner—for the caterpillars.” I tried to be a good sport. I’d heard that Monarch butterflies are endangered. Freezes in Mexico and genetically-engineered corn with poison pollen are said to be wiping them out. These are the facts you pick up when your wife has a butterfly garden. I proudly recited my extensive knowledge about Monarchs in an effort to show Ann that, in fact, I was listening to her all those months. But she informed me, to my surprise, that Monarchs may not be so endangered after all, just underestimated by butterfly experts. That was the final straw! A couple of bugs not even on the endangered species list were keeping me from my dinner. But Ann was so enchanted, she didn’t notice how annoyed I was. I adopted the guise of supportive husband and took the family out to the local pizza parlor. The caterpillars came along for the ride. My mouth was watering by the time the cheese breadsticks arrived. Joseph, our five-year-old, launched into a rambling grace, thanking God for the caterpillars who had come to our yard … who were going to grow into orange butterflies … and fly away into the sky …. As I half-listened to his thankful litany, my mind wandered back to the delivery. I gave silent thanks

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Beauty and the Beast

As an obstetrician I take care of both mother and baby before the delivery. But once I cut the umbilical cord, I hand the baby off to someone else. Nurse, respiratory therapist, pediatrician – it doesn’t matter to me. I don’t pretend to have the skill set to care for a baby once it’s outside the mother’s body. So no one has ever handed a baby back to me. Particularly one with a dirty diaper. It was Friday evening a dozen years ago. Ann and I were sitting on the driveway with our neighbor Yasmin, watching our four year olds play. Ann and Yasmin each had a glass of white wine, and Joseph, our one year old, perched on Ann’s lap. I slouched in my chair, feet propped up and a cold beer in hand. Suddenly a foul odor penetrated the air. “I just changed his diaper twenty minutes ago!” Ann moaned. An expression of combined sorrow and resentment crossed her face. Poor Ann! I found myself thinking. Not even a moment’s rest to sit with her good friend and husband to have a sip of wine. I realized what Ann most needed: a loving husband jumping out of his chair like an eager prince to change that dirty diaper. At that same moment the question flitted through my mind: How do I get out of this? As a physician I am comfortable with all aspects of people’s bodies, up to and including bodily excretions. Indeed I surgically repair bladders and rectums on a routine basis. But there is something about a dirty diaper that somehow seems worse. From observation, I had noticed that Ann was far more skilled than I at changing diapers. She’d be done in five minutes flat – I’d be happy to save her seat. A decade earlier, our perfect wedding day had played like the finale of Disney’s “Beauty and the Beast.” Belle is the intelligent Beauty whose love lifts the Beast’s terrible curse. The song “Tale as Old as Time” plays as Belle and her handsome Prince waltz through the castle ballroom. I’ve often wondered about that fairy tale ending and the class action lawsuit the Disney Company deserves for setting up false expectations in American society. Fast forward the movie five years. There’s Belle with a baby on her hip, pregnant yet again, bemoaning her swollen feet and aching back, with a toddler running around the castle knocking over expensive fragile objects. The part I really want to see is when Belle hands Beast the baby with a foul smelling diaper at the end of a long work week, just when he’s settling down with a cold beer. If the Beast is anything like me, he’ll come up with some pretty good excuses. I wondered which one I should pull out. My personal favorite is the “I have to call the hospital – someone’s life is in danger.” That one wouldn’t work at the moment because I wasn’t on call. Besides, I didn’t want to spoil my best excuse with overuse. I considered the next runner up: “I think I’m coming down with something and don’t want the baby to catch it.” Instead of selfish and lazy, I might appear considerate. I pictured Ann rushing Joseph inside to get him away from my germs. If I worded it just right, maybe on her way back she’d bring me another beer? But sitting there with my feet propped up, looking pretty darn healthy, I knew if I tried that one Ann and Yasmin would exchange “what a loser husband” glances. I was trapped. It was a desperate moment. Drawing a blank, I jumped up and grabbed Joseph off Ann’s lap and feigned eager loving husband. What followed was ten minutes of absolutely repulsive labor. I was glad Joseph couldn’t speak yet, because I told him exactly how disgusting and inconsiderate he was pooping in his pants – in a nice tone of voice of course. I returned to the driveway wearing a big smile, pretending it was indeed an honor to help my beautiful wife. Ann and Yasmin fell for it one hundred percent. How naïve! The rest of the evening I got to listen to how wonderful I am. I was almost embarrassed. But it got me thinking – Maybe it’s a blessing when you can’t come up with a good excuse. -Dr. Mike Litrel

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The Logic of Women

Recently I heard an intelligent accountant express his understanding about women. His opinion could be called many things, but certainly neither “intelligent,” nor “understanding.” According to him, the reason men and women sometimes have difficulty relating is because women don’t think rationally. “Women are emotional, not logical,” he proclaimed, emphasizing his opinion with an index finger held skyward. The Neanderthal sometimes says the funniest things. I am guessing this particular caveman doesn’t have the best of marriages – unless his wife is so illogical as to find her husband’s primitive condescension charming. My wife Ann runs our household efficiently and intelligently, which includes managing our finances, our meals, our home, our work schedules – and of course, our teenage rug rats, both of whom are blessed with strong personalities. So I take exception to this accountant’s observation. There is nothing illogical about Ann. Except, of course, her ideas about home décor. My boys have often asked me about the uncomfortable pillows on my bed. There are big ones and medium ones and small ones. They are festooned with embroidery, or sequins, or knobby wooden beads, which makes them anything but comfortable for actually cushioning your head. At last count these pillows had multiplied to fifteen. Their various shapes and colors require that they be painstakingly arranged once the bed is made in a precise array I find impossible to remember. My boys think I should get rid of all the uncomfortable pillows. Privately I agree. These decorative objects defy all logic. Clearly the sole purpose of a pillow is to provide something soft to snuggle – not to increase one’s work load. But Ann seems to have different ideas. So instead of the “pillow talks” you’d expect between husband and wife, Ann and I have pillow arguments. Sometimes these occur when we are making the bed. I complain like a broken record, pointing out the extra work required to properly place her darn pillows. Or sometimes the dispute erupts when I am having trouble falling asleep and vent my frustration by flinging one of the unfortunate pillows onto the floor – sequins notwithstanding. “Why have so many uncomfortable pillows which are impossible to arrange?” I ask rhetorically, index finger pointing skyward. “I know an intelligent accountant who would call this illogical!” In surgery there is an anatomical problem that requires repair. Surgery is logical: a purposeful action performed in a concentrated, orderly manner that directly impacts the welfare of another human being. Operating rooms make sense as well. You can look in every nook and cranny – there is not one fancy pillow to be found. Never once have I received a logical answer from Ann regarding the fifteen pillows on our bed. Sometimes my questions about pillows make Ann laugh. Sometimes they elicit only eye-rolling. Once in a while she attempts to formulate an explanation. Ann, an artist, shares her consideration that esthetically arranged visual elements uplift the spirit, lending our mundane lives a touch of the divine. Balancing the functionality of the objects we use with an eye toward manifesting beauty is an act of meditation, even worship. Mostly I ignore all this profound crap. A minor marital squabble is far more enjoyable. I guess I am a caveman too. So over the years Ann has made it clear to me that if she ever wants my opinion about home décor, she will make sure to give it to me. Through the decades of my marriage and practicing medicine I have learned sometimes it’s best for a man to simply stand out of a woman’s way. What remarkable beauty you will see! I remember Ann’s cesarean sections in the O.R., the wondrous transformation of her frightened face when she heard our child cry for the first time. Indeed I have witnessed thousands of times the miracle of a woman bringing new life into this world. I am in awe and wonder and perhaps, confusion, too, about the beauty of womanhood. Why would anyone sacrifice their body and blood and soul to usher into this world in an explosion of God’s love a newborn baby? It’s simply not logical. -Dr. Mike Litrel

Michael Litrel, MD, FACOG, FPMRS
Dr. Litrel's Blog

A Prescription to Love

I can tell when a patient wants to get out of my office. It was Marsha’s first appointment, and she wasn’t making eye contact, her eyes kept flicking to the door, and she was answering all my questions with mumbles. Most people don’t like going to the doctor – especially the gynecologist – but Marsha seemed particularly, almost pathologically, nervous. She had come to me for a second opinion. Her original surgeon had recommended removing her uterus and ovaries for the severe pelvic pain she suffered. This represents a drastic approach for a childless woman in her early thirties. Marsha made it clear to me she didn’t want another examination from a male doctor. Now, I do what I can to make my patients comfortable, but a gender change is not on the table. I alerted Marsha that there are plenty of wonderful woman physicians she might like to see. After some hemming and hawing, Marsha elected to let me take care of her, and a few weeks later, I took her into surgery. Just one look inside revealed that her pelvic organs were virtually glued together with scar tissue. Instead of removing the uterus and ovaries, I cleaned out the scar tissue that seemed likely to be the cause of her pain. The surgery went well. Marsha’s pain dissipated almost entirely. Pain That No Surgery Can Cure Yet during the coming months, it became obvious in the follow-up appointments that Marsha suffered from a problem that went beyond a surgical diagnosis and cure. She was in her mid-thirties – living alone, estranged from family, and with almost no social contact beyond work and trips to the grocery store. Marsha chose to be virtually alone in the world. As her trust for me grew, Marsha’s story gradually came together, revealed in bits and pieces. It wasn’t totally unexpected that sexual abuse played a part in Marsha’s past. What was uncommon, however, was the degree and amount of abuse she had experienced. For as long as she could remember, Marsha’s male relatives – including her father and her brothers – had enforced sexual relations upon her. It had begun when she was five years old, and had continued until she was fifteen – old enough to finally fight them off, and shortly afterward, to move out of the house forever. Removing scar tissue from the human body is technically difficult. But it’s a simple job compared to removing the scars of childhood abuse. When you excise abnormal tissue, the remaining healthy tissue comes together and heals. But how do you remove the unholy, festering memories? Marsha was physically healed, but far from resuming the act of living. I couldn’t see how Marsha could learn to love other people, when those who should have given her those first lessons were the source of her earliest injuries. I pondered these questions in thought and in prayer. To Marsha, I recommended counseling, the church, volunteer work…but my suggestions were met with an unyielding resistance born out of deep mistrust for all people. Truthfully, it made me sad to have Marsha as a patient. It’s difficult to see a patient whom you’re not able to help. A Life-Changing Prescription Then one day, a simple solution presented itself. I decided to write Marsha a new prescription. On my pad I wrote: Do one good thing for someone else today. Write down what it was. Repeat daily. I told Marsha it didn’t matter what she did, or when she did it, or who she did it for: just keep the love in her heart, and search for the opportunity to share it with someone else in need. Once a day. I had no idea what Marsha would do with her “prescription.” Throw it in the nearest trash can, I suspected. I just knew she needed a different kind of medicine – the kind that isn’t manufactured by any pharmaceutical company. Healing of the body can only go so far: it is the health of our soul that makes us truly alive. Two months later Marsha returned for her next appointment. I was pleasantly surprised to hear that she had made a friend. She had simply helped someone at the store with her groceries. She attributed it to her new prescription, and promised she would continue to follow it every day. Six months later, I learned she had made some more friends. She had even joined a book club and was attending a local church. And a year later she went on her first date. Ever. Over the past several years, Marsha’s health has improved so much that now I only see her from time to time. Recently she sent me a card. She wanted to let me know she was getting married. And across the bottom of the card, in a small and hopeful postscript, was a note that she was hoping to have a baby. I have no idea why Marsha decided to take her “prescription” seriously. Maybe it was the fact that it was written on an official pad. Or maybe she could feel the desperation in my last ditch effort to help her.But perhaps it’s simply that Marsha recognized the truth. I believe that we are hard wired to recognize the truth when we see it, and the truth is this: Love is the necessary ingredient for a healthy life, and it is not always the love we receive that heals. More often, it’s the Love that we give. -Dr. Mike Litrel

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Marriage, Hot and Cold

Disagreement between a husband and a wife occurs even in the best of marriages. Sometimes this manifests as open argument. But other times, marital conflict can be more subtle, an unspoken tension permeating the relationship for years like an uncomfortable humidity. I met Ann when I was a sophomore at Wesleyan University in Connecticut. I was visiting my brother at University of Michigan, where Ann was enrolled a year ahead of me. We met at a fraternity Halloween party. She was dressed as Aphrodite, in a skimpy toga no father would have permitted his daughter to wear in public. I fell in love. Our entire three year courtship was a long distance relationship. Ann and I grew to know each other through letters and the periodic visits my budget would allow. She finished her degree a year before I did and moved to Atlanta. After my graduation we married. There has been nothing in my life I have looked forward to more than finally living with my beloved. My attraction to Ann was more than just her physical beauty; I admired her intelligence, her kindness, her discipline, her many talents. I still admire her. But after twenty plus years of marriage, I have to admit that the intelligence- discipline thing sometimes gets on my nerves. Conservation vs. Comfort Ann has tendencies towards frugality that do honor to her Scottish heritage. She also endeavors to be environmentally aware. These two qualities are evinced in the temperature settings Ann prefers for the household thermostat. During the hot Georgia summer the air conditioning is set at 85. During the cold of winter the heat is set at 60. In January when I am cold, Ann tells me to put on a sweater. In July when I am hot, Ann tells me to take my sweater off. It’s been a hot humid summer. So yesterday when Ann wasn’t looking, I snuck like a ninja to the thermostat and deftly dropped the temperature five degrees. It didn’t take Ann long to notice. “Who turned the air conditioning so low, Michael?” “Those kids,” I responded, shaking my head disapprovingly. I was not lying. I was simply making a declarative statement designed to misdirect. “The boys told me they didn’t touch the thermostat, Michael.” “Those kids,” I repeated, shaking my head disapprovingly. Ann laughed and moved the thermostat back to “where it belongs.” I didn’t argue. I understand her perspective: why burn fossil fuels to lower the temperature of my house so I am a tad bit more comfortable? But frankly, this thermostat thing can be annoying. I feel like I’m married to Al Gore, and every time I touch the temperature control it’s like I’ve sunk an axe in the trunk of the Earth’s last giant redwood. The Thermostat Battle, Redefined Over the years, Ann has also successfully colored “our thermostat decision” in what can only be called spiritual terms. With tactful language she has artfully conveyed to me sophisticated thoughts about the needs of the body versus the needs of the soul. I am not smart enough to fully comprehend exactly what she has said, but essentially her argument boils down to this: Jesus didn’t have air conditioning, Michael, so why don’t you spend more time praying and less time whining? Last month, Ann left town to visit her sister. It was like Dorothy’s house just plopped down in Oz on you-know-who. I ran to the thermostat like an unsupervised teenager and lowered it not five degrees, but ten. I was going to get all the air conditioning that compressor could muster. That night my house was so cold I needed another blanket from the closet. Immobilized by comforters, I slept like it was the dead of winter. Condensation covered all my windows in the morning. I shivered when I sat down by myself to my morning coffee. Now this is what July in Georgia should feel like! I thought about getting out that dang sweater. Maybe I should light a fire too? But after some reflection, I simply turned the air conditioning off. I missed Ann. Morning coffee is more fun with her. I remembered it’s far better to have a home that is too hot in the summer and too cold in the winter, than to suffer again through the fires and chills of a long distance relationship. A good prescription for a healthy marriage is an occasional few days apart. Truly, absence softens the disagreements – and reminds us of the love. -Dr. Mike Litrel

Cancer Screening, Dr. Litrel's Blog

A Cancer Operation

The operation has lasted three hours and is perhaps at its halfway point. The scrub technicians can rotate in and out as they tire. I watch a scrub tech named Josh arrive to take the place of Cathy. Cathy possesses a quiet competence, a pleasant smile – and has laughed at all my jokes. As far as I’m concerned, Josh can only be a poor substitute. Dr. Boveri bends over the patient, continuing the precise work of cutting and dissecting. As first assistant, I provide exposure, lifting and pulling aside muscles, ligaments and other structures so Dr. Boveri can see what he is doing. I work as Dr. Boveri’s assistant for the pure pleasure of learning. As an impatient resident under his training at Emory University, I once found the intensity of this Harvard-trained surgeon annoying. Ten years later, I pass my sickest patients into his skilled hands and regard his intensity as a miracle, and a gift to my patients. Josh, the new scrub tech, seems to think his job includes keeping up the chatter in the O.R., especially, it appears to me, during critical moments of the operation, when a slip of the knife could unleash a life-threatening gusher of blood. Did you see the game last night? You know, Dr. Snow always prefers the other kind of clamp. Whoa! Can you believe how many worms they ate on Fear Factor? Dr. Boveri ignores the chatter. A surgeon’s preferred language is one of action. His eyes carefully trace the fingers of cancer that have groped their way through my patient’s intestines. Working together we pry away the malignant flesh, piece by piece, reaching deeper and deeper into the body until we penetrate the abdomen to the cancer’s very source. We are deep inside the pelvis. Dr. Boveri leans forward almost imperceptibly, as the surgery reaches the zenith of its difficulty. He places a sponge over a portion of bleeding tumor and pauses in his dissection. Cancer is cellular growth gone amok, a raging fire that spreads through the body, burning nutrients and consuming flesh in its path. The cancer before us has obscured the boundaries between uterus, ovary, and rectum, binding them together in an unnatural mass of biological concrete. Dr. Boveri uncovers a chunk of tumor that seals the space between appendix and external iliac vein. He gently probes the vein. Its thin walls channel the surge of blood returning from leg to heart. Methodically, relentlessly, Dr. Boveri works to liberate the vessel, separating healthy from unhealthy tissue, cutting flesh to save a life. After forty minutes, the tumor is gone, and the vein is free. It is a master performance. Josh, however, is not to be outdone. As he receives the piece of malignant flesh from Dr. Boveri, he notches up his monologue, in a self-appointed role as court jester. For much of the operation, words have run from his mouth like water from an overflowing toilet. Now he reaches for his finest moments. Who do you think is the hottest on Desperate Housewives? Hey, what is this? Is it tumor? What do I do with it? “It’s cancer. Put it in the basin,” Dr. Boveri says. Two minutes later: What is this? Wow, this is something. Same thing? Put this in the basin too? Dr. Boveri gestures toward the basin. Five minutes later, Josh launches into a reprisal. Is this cancer too, he begins. Dr. Boveri explodes. “What do you THINK it is, Josh?!!” He struggles visibly for self mastery, and can be heard to mutter, tuna fish sandwich? He takes a deep breath, the furrows in his brow subsiding as he regains his equilibrium. A surgeon reveres self-control above almost every other virtue, and I suspect his outburst bothers him more than it does anyone else. But at least it has the desired effect – Josh keeps his mouth shut. As the operation nears its sixth and probably final hour, a quiet, smiling Cathy returns to the operating room. Dr. Boveri interrupts his work to thank Josh as he leaves the table, but it is not until Josh is completely gone, having scrubbed out and exited the room, that the surgeon finally allows himself the luxury of full expression. “Cathy,” he grimaces, “we are SO glad you’re back.” Dr. Boveri is a surgical oncologist affiliated with Cherokee Women’s Health. He and Dr. Litrel work in an integrated group with nutritionists, geneticists, molecular biologists, chiropractors, naturopathic doctors and others, including patients, to develop better models for health, and to help prevent cancer from occurring. -Dr. Mike Litrel

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Every Day is Father’s Day

Despite its lifetime warranty my bathroom scale is broken. No matter how many times, or how gingerly I step on it, it keeps telling me I weigh more than I do. Also, my clothes are all shrinking, despite labels which clearly state they are machine wash-and-wear. My problem is not weight gain. It’s defective merchandise. Okay, the concept of weight loss is not that difficult, just challenging. Eat less, exercise more. What could be so difficult? All I want now is to get back down to what I said I’d never get up to. So this past Father’s Day I decided to forgo the “all-the-donuts-I-can-eat” tradition and work out in the basement. Father’s Day Challenge #1: Health Years ago I made the unfortunate discovery about myself that I am less the natural athlete and more a natural couch potato. Thus I have developed my well-known personal interior decorating philosophy, which involves surrounding any and all television sets in the house with exercise equipment. My Schwinn Recumbent Cycle is the best piece of exercise equipment I own. The workout itself is not spectacular, But it’s very comfortable to sit in, and perfect for watching television. It’s like a lounge chair with pedals. So on the morning of my seventh Father’s Day, with the boys I love beside me, I began my First Annual Father’s Day Workout. Out of respect for the widely accepted traditions of fathers’ birthrights, I also commandeered the television remote. I chose something we could all enjoy – the CNN News Update. Regardless of Father’s Day tradition, it wasn’t long before Tyler and Joseph, sprawled on the floor in front of the screen, were complaining about my God-given right to choose the TV show. I capitulated and switched to the Cartoon Network, which was broadcasting some inane piece of animation I’d never heard of. Evidently the boys must have found it boring, too, because pretty soon they were arguing so loudly that the character dialogue was moot. My kids have me at a disadvantage when I’m working out, and they know it. When my breath gets short, I can’t yell at them so loud. Also, there’s always the chance that if I get up to discipline them and interrupt the workout, that will be the end of it. But this time the combat escalated to the point where I had to actually get off the bike to bring them into line. Which brings me to something ironic…. Father’s Day Challenge #2: Children I think it was George Bernard Shaw who said, “Never hit a child – except in anger.” Having gotten up, I was angry all right, angry enough to threaten bodily harm. But I’m not a fan of corporal punishment. My parents, if not big fans, were at least mildly enthusiastic camp followers. Back in those days, my father didn’t own any exercise equipment, so I think his major cardiovascular workouts consisted of the time he spent spanking my bottom. Ann and I don’t rule out spankings entirely, but more often we fall into the “Time Out” philosophy of our generation. In a burst of enthusiasm for parenting during the first six months of Tyler’s life, we listened to numerous tapes of experts with “parenting” advice. The main piece of wisdom we acquired from the hours we spent listening to these experts was the location of the perfect place in the house for “time out” — the bathroom. According to the experts, the bathroom is the most boring room in the house, the perfect place for quiet reflection. I suspect this to be true, because despite the inevitable first few minutes when my boys seize the opportunity of bathroom confinement to take care of essential bodily functions, they soon lapse into the crying and complaining that let us know the deterrent is working. Regardless of whether it works, it’s strangely satisfying. As I closed the bathroom door on my battling boys, a warm feeling came over me. Maybe I should have put them in separate bathrooms. But that particular nuance was not covered in the parenting tapes, and it’s easier to put them both in the closest one. After a while they seemed to quiet down into the appropriate reflective mood, so I let them out and resumed my workout. In a familiar routine which constitutes the classic defense for corporal punishment, Tyler and Joseph soon launched into another argument, which unfortunately coincided with my noticing that the pulleys on my Joe Weider weight set were broken again. That did it. I turned off the TV. “Stand up!” I ordered my boys. My face was dripping with perspiration, my teeth clenched in anger. “How many times do I have to tell you not to play on my weight set?” I demanded. It was a rhetorical question, but Joseph, my four-year-old, took me literally. “A million times,” he replied meekly. “You have to tell us a million times.” I smothered a smile and kicked them both out into the back yard. My decision was final. This Father’s Day, I wanted to spend my time as far away as possible from the two people who had made me a father. I told them in no uncertain terms not to interrupt my workout again – unless it was an emergency. Fifteen minutes later, Joseph came running into the basement. “It’s an emergency, it’s an emergency!” He pulled me into the back yard, and there, away at the bottom of the hill, were the bodies of Tyler and his friend Sami Leonard, lying prone on the ground. They didn’t appear to be moving. I fought my instinct to run down the hill. This was something you learn as a medical student at Grady Hospital. One night as I was urgently wheeling a gunshot victim toward the O.R., a surgical resident flagged me down. “Don’t rush when you are in a hurry,” I remember him saying. When I got to the bottom of the hill, I saw that the boys were

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