Random Thoughts from a Restless Mind

Dr. Darrell White's Personal Blog

Cape Cod

Sunday musings 11/11/18

Sunday musings…

1) Veteran. “War is God’s way of teaching Americans geography.” –Ambrose Bierce

Happy Veteran’s Day to all who have served. I sit in safety because of your service, wherever it may have been.

2) ¬†Riposte. To reply, as in fencing, to an advance. “L’esprit d’escalier”: the unfortunate tendency to think too late of the perfect verbal riposte to an affront or attack.

Likely more the rule than the exception I’d say.

3) Risk. None other than Michael Joyner of Mayo Clinic fame is now calling for the inclusion of “fitness testing” as a distinct variable when assessing health risk in adults. Of course he is talking about aerobic, “cardiovascular” fitness only, having chosen as his metric some form of VO2 Max. It is entirely possible that he and other adherents to the tenet that fitness is completely described by endurance in any domain that can be measured through a proxy like VO2 Max are correct. The absence of data, any data whatsoever, in support of the notion that physical decrepency is the actual cause of early mortality leaves scholars such as Dr. Joyner with no choice but to use endurance as the definition of fitness. When designing risk models they have no other options.

Some weeks ago I included a RFP of sorts here and elsewhere for a measurement of fitness that includes other factors such as strength. I specifically reached out to the CrossFit and functional fitness communities asking for a test or a measurement that could be used to apply a broader definition of fitness (e.g. work capacity across broad time and modal domains). Crickets.

You can’t out train bad nutrition. Fitness is going to be measured and included in cardiac/all-case mortality risk profiles. In order to be relevant in health, public health, and healthcare the functional fitness community (which is arguably led by CrossFit) must step up sooner rather than later and join the conversation in a meaningful and measurable way. As one with a foot in both sides of the conversation (who admits to his inability to conjure up the requested measure) it is my firm belief that it will be far better to engage in the welcome evolution of thought in the healthcare community than to hope to lead an insurrection.

All of the necessary elements are in place.

4) Loss. ¬†Half-blind, deaf, and dumb as a rock, Beth’s little mutt lived one of the happiest lives I’ve ever been privileged to witness. Tiny Tim died this week in his beloved “Mom’s” arms just a few days after his 17th birthday. It was quite a run for our little “shitpoo” (shitzu, terrier, poodle). Timmy was named after the famous Dickens character when he arrived in our home looking like a Beanie Baby with a broken leg. His bond with Beth was cemented when she broke her leg falling off a horse and they convalesced together on the couch. Though he was a perfectly sized lap dog he would only allow Beth to hold him for any but the quickest moments.

Like when he would go out in the snow and forget to come in before his little toes froze and he was “stranded” in the yard. As I said, dumb as a rock.

We are in our 50’s, Beth and I. We are surrounded by death. Friends and acquaintances pass unexpectedly and tragically in the middle of life, or lose children to any manner of mishap or misfortune. Our fathers are gone, each the victim of a terrible and agonizingly slow demise that left them but shells of the men we’d grown up with. Along with our siblings we were a powerless audience, spectators with a front row seat to their suffering. Like Tiny Tim both men lived lives far, far beyond what could have been imagined in their childhood. Both men, when they had control of their faculties, could look back with a smile at the lives they’d lived. We miss them both terribly. In the missing it is the men in full we remember as time blurs the final chapters of their lives and we turn the pages to our favorite parts of their stories rather than the end.

Some losses are expected; they are simply a part of living. The death of my 91 year old former partner. Our little Manster Timmy. We sit in a kind of “pre-Shiva” as my mother-in-law dances her last dance hand-in-hand with daughters who have loved her as we loved our fathers. Our sadness stems from the knowledge that what remains will be only the memory of that love. The last bedtime story has been read. The last ball has been tossed. The last pre-dawn wake-up alarm has been barked.

The last goodbye kiss has been exchanged.

I miss my Dad and Beth’s Dad. I will miss Beth’s Mom. I miss my dog. How fortunate am I, are we, that we had them for so long, knew them so well, were so well loved by them and allowed to love them so well. I asked for and offered forgiveness for any hurts that may have been occurred. I have been openly thankful for all of the gifts that they have given me. In the end I am comforted in the knowledge that I told each of them how much I loved them.

How fortunate am I, are we, to have loved so long and so well that we are so deeply saddened at our loss. How fortunate are we all to have one another, still, here to love so deeply for however long we may be so blessed.

I’ll see you next week…



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