Inkwell: Authors and Artists
What is going to amuse our bouches now? (bumbaugh) Mon 28 Apr 08 12:59
We're please to welcome our next guest into the Inkwell: flash gordon. Dr. flash gordon attended University of Miami (Florida) for both his undergraduate and medical school. His Emergency Medicine Residency was at Henry Ford Hospital (Detroit) and he was certified by the American Board of Emergency Medicine in 1980. He has served as clinical faculty at University UCSF School of Medicine, was Director of the Emergency Medicine Residency Training Program at San Francisco General Hospital (Mission Emergency) and was Medical Director and Chief of the Medical Staff at the Haight Ashbury Free Clinic. He has been online since 1980, is married to a biophysicist / consultant / triathlete, and has practiced in Marin County since 1990. He has been writing about medicine and motorcycling since the mid-eighties; first for Citybike, Northern California's Motorcycling Monthly Magazine; for various national motorcycling publications, and for the last several years his column Medical Motorcycling has been featured in Motorcycle Consumer News, a national monthly magazine. Leading the discussion with flash is Michael Bettinger, a counselor, educator, writer and biker, originally from Brooklyn and living in San Francisco for the past thirty two years. He retired four years ago after a thirty three year career as a psychotherapist and family therapist, working primarily with gay men and gay male couples. He is the author of Its Your Hour: A Guide to Queer-Affirmative Psychotherapy. He has ridden motorcycles for the past forty one years and presently rides a 1992 Harley Davidson FXR. He is also the "disorganizer" of the annual Queer Biker Invasion of Death Valley. Welcome, gentlemen!
Michael Psycle Bettinger (mcpsycle) Mon 28 Apr 08 16:08
Hi Flash and everyone else, Im glad to be here and to be leading the discussion. Ive known you for the past 16 years through is role as the host of the ride, and other conferences on the Well, in addition to having read your column in various motorcycle publications over the years. With this book, we get a lot of you at one time. Let me begin by telling you and others of some of my reactions to the book. First, my impression is that the book is not just for the motorcyclist. It is more of a book on taking care of oneself. Since it was originally written as a column in a motorcycle magazine, it is talking directly to motorcycle riders. But most of the information in the book is helpful for anyone. It is a self help/taking care of oneself book which happens to be written by a physician, who happens to be a biker, who happens to be talking to other bikers. I believe it is much more about you, flash, as a physician, than as a motorcyclist. You draw on your knowledge of the kind of medical issues often faced by motorcyclists. But these are medical issued faced by most people at some time or other, not just bikers. And many of the subjects are completely unrelated to the motorcycle experience. They are just issues everyone, including motorcyclists deal with. This book contains a huge amount of information. Flash systematically goes over many of the body's systems and explains to the reader how it works, and what might go wrong and why. Even though I consider myself to be medically quite knowledgeable for a non professional, I learned a lot about my body and how it works from the book. It is a book that begs to be read slowly, to be able to absorb a lot of what is written. That it is chock filled with information also makes it a difficult book to read right through. These original columns were written to be read one a month, and absorbed for a period of weeks before the next one comes hits the news stands. In the book, you get it all at once. It is therefore a book to be read slowly, over a period of weeks. It is not a page turner that keeps one up all night. It might be a good book to read while commuting on a train or a bus (but not on the bike!). I liked how you took the complex medical information and simplified it in order for the readers to be able to understand how the body works. Seeing the simple in the complex is a lot more difficult than it seems. It is hard work to explain in simple terms something you understand as a physician in complex ways. This is one of the strengths of the book. My sense is that you appear to be trying to empower the reader to understand a lot of what might be happening to him or her, and to be able to triage what is going on. The goal of that is that you want the reader to be able to make an intelligent decision about whether and how to self treat, whether to call a doctor for an appointment, or whether to get emergency treatment. You are good at making it emphatic when to get emergency treatment (nice hearing that from someone Board certified in emergency medicine). I believe it is difficult for a lot of guys, especially macho bikers, to ask for help, particularly emergency help. We guys are taught to use a lot of self denial ("I'm ok. I can deal with this"). Macho bike riding men (and some women) have difficulty in acknowledging something needs immediate attention. You also have a nice writing style. I like the way you are direct, playful, self deprecating ("Don't ask me how I know this"). You are easy to read. Those are some of my initial reactions to the book. Glad to be here and looking forward to seeing how this discussion goes.
flash gordon md (flash) Tue 29 Apr 08 13:37
wow - what great things to read! how much do i owe you?? %^) very insightul comments, michael. i do try really hard to condense as much as i can into exactly 1000 words (which is the original length of each column - some have been altered for the book). as for empowering folks - well, that's the right thing to do. it's like the old saying: "Give a man a fish, you feed him for a day. Teach a man to fish, and run the risk of overfishing, contravening EU fishing policy, reducing the biodiversity of the world's oceans and increasing the economic decline of our once-great fishing industry." or something like that. i see the writing i do in the book as a kind of practice of medicine. when i practice, i try to keep in mind that the root words for "doctor" and "teaching" (doctor / doctrine) are the same. i think doctors (at least, primary care docs like me) have a responsibility to teach folks what's going on with their bodies and health.
Michael Psycle Bettinger (mcpsycle) Tue 29 Apr 08 15:14
flash - I find when I write about anything, I get clearer on what I believe about the subject. The process of writing changes me and empowers me. When I wrote a book about psychotherapy, I got a lot clearer on what I was about as a psychotherapist. I was wondering if you had similar experiences writing these columns and then compiling them into a book. Did having to write all that out in clear and simple ways have an impact on you as a physician, or how you went about practicing medicine?
Cynthia Dyer-Bennet (cdb) Wed 30 Apr 08 08:44
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flash gordon md (flash) Wed 30 Apr 08 11:16
well, having condensed that info helped when i was explaining things to patients. since i'd already put a lot of thought into finding the best way to express a concept, it was easy to "plagiarize" myself when i was talking to patients. and since i wrote about things that i saw the most as a doc, it came in handy a lot. so i guess you can say that it did make things easier. another benefit was that when writing about a subject, i'd do a quick review of the literature to see if there was something new worth talking about. this would sometimes lead me to information (sometimes on another subject) that was new and interesting. for example, i recently wrote a column about hernias and hernia repair. one of the questions was comparing repairs done the "old" way (with an incision, and often using mesh) to using a laparoscope. one of the advantages of using a laparoscope is that the cut in the skin is a lot smaller, which causes much less pain and promotes a faster recovery. laparoscopes are now used for everything from gall bladder removal (one of the original uses) to hernias. i found that now they're starting to use laparoscopes to remove gallbladders *through the stomach* - without any skin incision at all! the scope goes down the patient's throat, into the stomach, and through the stomach wall into the abdominal cavity. once in there, the gallbladder is removed, just as if the surgeon had enterered through the wall of the abdomen. this was news to me.
Michael Psycle Bettinger (mcpsycle) Wed 30 Apr 08 11:30
That kind of operation sounds so sci-fi. I'm happy that my personal experience leaves me knowing nothing about those kinds of surgery. But I do like the idea of a quicker recovery time that those kinds of surgery seem to result in. I find the same thing is true in that when I've written about something, it helps me to succinctly explain to someone else what that is about. I think some of that idea behind a physicians training, "see one, do one, teach one", involves getting clear enough on something to be able to simply explain it to another person. Now I understand this book came about as a compilation and expansion of columns published once a month in a motorcycle magazine. In the original form, they were read almost exclusively by bikers. I am aware that this world is filled with guys who have a tough, "I can take care of myself attitude". I was wondering what kind of feedback have you gotten from those guys. And, are you getting feedback on the book from non bikers? Is it any different from the feedback bikers give you?
flash gordon md (flash) Wed 30 Apr 08 16:44
i get feedback thru letters to the editor of motorcycle consumer news, which is where the column's now being published. most all of them are positive. now and then i'll write something that seems to generate more feedback: for example, the column on "farts" (it's in the book) got multiple letters, almost 100% in favor. another column on benign positional vertigo (dizzyness w/ head motion, that's usually simple to fix in a few minutes in the office) got lots of feedback, too. many people either had it themselves or had a friend or relative w/ the problem. not all docs know that fixing BPV is usually a quick, simple office procedure that just involves tilting and rolling somebody around in a certain precise way. since it's something i've had myself, i researched it and found out how to do it. in fact, i think that having had a fair number of medical conditions myself that i write about makes it easier to empathize and explain things. that's why it might be better to find an aging, semi-decrepit physician - he's already experienced a lot of stuff that he's taking care of first hand.
Public persona (jmcarlin) Wed 30 Apr 08 17:25
<flash> After seeing this topic I was reminded of meeting you IRL on the Harvey Gamage schooner in the Carribbean too many years ago. I started thinking about vacations since I really need one about now. Then I my mind wandered into the realm of how some vacations can have long term affects since I still remember that one pretty well. In turn that led me to wonder how your vacation experiences have affected you and perhaps have been reflected in your writing, if at all? For the curious, the schooner looks like this: http://sterlingcollege.edu/HTML%20e-mail/august%20e-news/images/seamester.jpg
Michael Psycle Bettinger (mcpsycle) Wed 30 Apr 08 22:22
(jmcarlin) - nice schooner. I can attest that vacations change me in a lot of ways. It was on a flight home from a vacation in China four years ago when I realized I really didn't want to go back to work and on the plane I decided to retire from being a family therapist, and spend the rest of my life riding my motorcycle, playing the conga drums, doing my spiritual studies, and getting laid. I have my priorities in my senior years. But what your post reminded me of is all the vacations I have taken on my motorcycle. From the first time I did a cross country ride on motorcycle in 1968, I've been hooked on long distance riding. Each summer I take a ride that usually winds up being about 3,000 miles. Last year it was to Yellowstone. It was on many of those rides that I got to experience many, many of the medically related issues to which flash refers in his book. That includes pavement dermatitis (fortunately, not for many years now), hypothermia, redneck, cramps, numb hands, stuff caught in the eye, butt farts, brain farts and monkey butt just to name a few. One of the things I have gotten away from in recent years is carrying a first aid kit in my saddle bags. It was always there and not needed. I started to leave it out in recent years. I'm going to take flash's advice and put it back in. There seems to be a lot of good advice in the book. Now all I've got to do is follow at least some of it. I tend to take good care of myself, but the book pointed out to me a number of ways I can take better care of myself. Having a simple first aid kit along is one of them. A lot of time in my role as a family therapist, I would recommend a book to people, hoping that they come away remembering just a few things from what they read. flash, if someone were to only get a couple of things from your book, and not remember most of the details, what would you they might get out of the book and take away with them?
flash gordon md (flash) Thu 1 May 08 07:56
>vacations i don't know if i learn much from vacations. nowadays, since i'm working as hard as i can to build my medical practice, i don't really take any. usually, over the holidaze my wife and i will drive to L.A., stay near the beach in santa monica, and spend a few days at museums. as far as what i'd like to have folks take away from the book - move it or lose it. if you've gained more than ten or fifteen pounds since you were in your early twenties (and if it's fat, which is typical) you need to burn 300 calories every day to switch your body out of fat saving mode into fat burning mode. 300 calories is about 1 hour of regular walking, or a half hour of more vigorous exercise, like swimming/biking/running. it takes about a week per decade of age to have your body make the "switch" from "cave mode" (as i call it) back into "hunting/gathering" mode, where you're using fat as fuel, not storing it. unfortunately, one of the things your body does while in fat-conservation or "cave" mode is to make exercise less fun. my wife, for example, does triathlons all the time - she's ALWAYS in "fat-burning" mode. and she loves exercise. but don't get me wrong - at heart, i love exercise, too. i could watch it for hours . . . %^)
Robert Hill (rob) Thu 1 May 08 08:14
>I realized I really didn't want to go back to work and on the plane I decided to retire... and spend the rest of my life riding my motorcycle, playing the conga drums, doing my spiritual studies, and getting laid. Ah, Michael! I realized that when I got out of the Navy. I was 20. Now I am old and still paying the bill. It seems posters here are giving a brief introduction. I'm Rob Hill, a wine merchant and long-time motorcycle rider. I like long trips like Michael does. I have read flash's articles in City Bike and MCN and I read the book - I have notes in the margins. I know him from discussions in the motorcycle conference on the well. I also met him and shared jokes and a flask of single malt with him at Song Dog Ranch (a motorcyclist camp-out) a few years years ago. Flash was somewhat of a techy camper. He slept on a cot (rare for a motorcyclist) and peed in some kind of gizmo that turned his urine into a colorless, odorless gel. I have since begun riding with a cot in my duffel but I still pee in the bushes. flash, I notice that the book is mostly directed at the "aging" biker, which is probably a good thing since the median age of all bikers is going up. Besides, young riders don't have as many health concerns. Most of the problems I discover riding seem to be because I'm becoming an old coot. (I'm 59.) Lately it's my knees and my eyes. In Blood, Sweat & 2nd Gear there is a chapter about eyes, but it is mostly how to remove grit - a useful skill. But my problem on long rides is that my eyes feel like they've been sunburned or something. What can I do about that?
Joe Ehrlich (static) Thu 1 May 08 09:45
Michael Psycle Bettinger (mcpsycle) Thu 1 May 08 10:07
flash - re: vacations, you appear to be are a very hard worker. that is clear from my limited interactions with you. It seems like you are in constant motion, doing one thing or the other. I think you are in a lot of ways a typical male, in that you get off on getting things _done_. Where you found the time to write all those columns and then turn it into a book is beyond me. It takes me a long time to write anything well (thank you all my editors!). I'm a relatively hard worker, but never on the level I think you are. After I signed a contract to write a book, all my friends heard was how I wrecked my life for the next 18 months. It seemed writing the book and working took up almost all the time. And I've never been a full time worker. Being in private practice as a family therapist, I was able to take off Fridays for most of my working career. Fridays were often dedicated to riding the bike. I have my priorities. Glad to see (rob) and (static) here. I appreciate what you say about being active. Gaining weight has never been my issue, but then again, when I finish writing this post I will head to the gym. When I was young, I made an agreement with myself to try to do something for my mind, something for the body and something for the spirit each day. So I've always gone to the gym, or taken a dance class, or something to keep me active (if I miss a day or two each week, I don't care). A lot of this just became habit, including eating the right stuff. Now that I'm getting older, like rob, I am feeling the effects of aging, and can relate to a lot of the stuff in the book. But despite my having some fairly serious long term chronic medical issues, I'm in pretty good shape. I try to give my body the same level of care I give my motorcycle. And I always follow the manufacturer's recommendations regarding when and how to get the bike serviced. I do the same with my body.
Joe Ehrlich (static) Thu 1 May 08 10:30
I use deferred maintenance on *both* my body and on my bike. Anyway, as I have been reading the book, I have been struck by three things (one of which was a bus, so I appreciated the chapter on fractures). One was the brevity. Short, to the point and as if you were being charged for each word. I appreciate that very much. I realize that the brevity is necessary when writing a newspaper column. I was speculating that the intended audience (male lunkheads like me) would not even crack over a thicker tome, and, if short, concise chapters were intentional, even though you could have expanded each chapter when not faced with the limitations of a magazine. So: ? Two, I was horrified that the puns and bad jokes that you are so well known for had made it into print, and if you realize that you will ride a pink Honda Aero in hell because of the puns, and... Three, how much more fascinating the chapters are to read than I had expected. It was as if you had written the book especially for me. (A grumpy, middle-aged, portly old biker who avoids looking after my own health) So: thanks!
Michael Psycle Bettinger (mcpsycle) Thu 1 May 08 14:17
Seems like we are having a bunch of older, slightly decrepit male bikers here who are poring over the book to understand a lot of what is wrong with their bodies getting together here. None of this aging stuff actually bothers me, having had a bunch of friends die young. I'm still here, I'm still riding, I'm happy to discuss with my doc all the age related issues that are coming up. My bike is also reaching late middle age being 16 years old now with 84,000 miles on it. We've grown older together. Both of us are showing signs of wear and tear. The book really is about what goes wrong and why in a normal aging process.
flash gordon md (flash) Thu 1 May 08 18:42
right. getting old's not bad, considering the alternative. joe, i'm delighted to hear you like the book. one of the reason's it's concise is that i make it a point of always writing exactly 1000 words in each column. and the reason the book chapters are short is that the publisher simply took the columns, did a little rearranging, and voila! a book!! i spent about 20 or 30 hours going over the book, updating stuff, and helping things flow together, but the editors at whitehorse press did a great job. i try to make the info painless, and easy to absorb. anyhow, if there are any health areas that folks want to hear about in the future, i'm open to suggestions. i've got to write a column this weekend, and i have not a clue what it'll be about.
Linda Castellani (castle) Thu 1 May 08 18:52
I'd like to know more about the relationship between biking and farting that merits a mention in the book.
Michael Psycle Bettinger (mcpsycle) Thu 1 May 08 20:00
I'd also like to hear more, if there is anything extra you can say about being sleepy behind the handlebars. I've often thought that this is more likely to do me in than driving recklessly, which I almost never do. After a good breakfast or lunch, long before I should be tired from fatigue, I tend to get sleepy from the eating. I can't stop eating. And I need to be alert. I don't drink coffee, and the only caffeine I get from my diet is in diet cola drinks, which is not a whole lot. So I've taken to having a couple of 100 mg. caffeine pills in my shirt pocket, just in case. I've pulled over at rest stops at 11 AM and have laid down on the grass and gotten 15 minutes of shut eye. That helps a lot. But other times that option is not easily available. That's when I pop the caffeine pill, which I find helps quite a bit, not only with keeping me alert, but I am able to concentrate on riding more. I don't think I have ever exceeded 200 mg. of caffeine in a day from pills while riding. But I've also drank more than a few Mountain Dew and Red Bull drinks for the same reason. One of the reasons I am concerned with is that I lost a riding buddy last year. The reasons are not clear but he might have fallen asleep while riding. He was headed from San Francisco to Los Angeles, along I5, and got a late start. As he was nearing Los Angeles he just rode off the road. He also was diabetic and that could have been part of the problem, but he was fastidious about checking his blood, even at lunch stops when we were riding. So it is a mystery but signs point to falling asleep. Any additional thoughts about this?
What is going to amuse our bouches now? (bumbaugh) Fri 2 May 08 12:33
Yes. This is relevant to everyone on the road, not only bikers.
Joe Ehrlich (static) Fri 2 May 08 12:44
<flash> rides long distances (and hopefully he will ride out to the Very Boring Rally in Duluth where he is giving a talk!) and I am also interested in his "staying awake" methods.
Michael Psycle Bettinger (mcpsycle) Sat 3 May 08 07:52
calling dr. flash, I'm dealing with the issue of sleep deprivation this morning !!! I was up late last night partying with friends, and here I am up at my usual early time. I seem to get up the same time regardless of when I go to sleep. I'll try to take a nap later, but I sure wish there were a magic cure (other than stimulants) for lack of sleep. I know there is no magic cure but still look forward to hearing how we as bikers are suppose to be able to party all night and ride our bikes all day. That is what we are suppose to be able to do, isn't it???
the strongest nurse you can get without a prescription (flanagan) Sat 3 May 08 22:18
hello all, i'm coasting in and it looks like so far i'm the only model 46xx rider among us. like the pseud says, i'm a nurse. my favorite way to commute to work is by motorcycle- when i lived in san francisco, my commute to work in burlingame was 16 miles down 280. i stayed part-time with that job when i moved here to the napa valley last year, and now it's a 72 mile ride to get there, and i still do it by motorcycle. my coworkers say to me 'how can you do that long trip on a *motorcycle* ?' and i say 'how can i not ?!?' my ride to work is such a scenic cruise: napa, sonoma, marin, across the golden gate bridge and through san francisco, and then along by crystal springs and down to the bay. as far as the road goes, there's a little bit of everything from twisty country roads to the high speed run of the waldo grade and coming through neighborhoods transiting the city of san francisco. the other thing my medical professional coworkers always ask me is 'aren't you scared?' i answer that indeed, every time i get on the bike, just about everything i do before, during and after i ride is in acknowledgment of the inherent risks. i wear leathers. i wear earplugs. i have a good helmet. i check the chain, and the tires, and my brakes, and the weather. that's all before i even kick start the cafe racer. flash, i've also been reading the city bike columns for a long time and i'm very happy to see another collection of them off the presses as a book. the 1000 word per topic format is great- each chapter has such a specific focus and covers that topic so well, it's an engaging read, and, as everyone here has said, for anyone with blood and sweat, not just motorcyclists. mcpsycle - i was thinking about your query about having a good breakfast or a good lunch and then feeling drowsy on the bike. just a thought- what about stopping more often, to stretch, take your helmet off, and having a bite- the small frequent meals way to go, rather than three big meals. you'd be giving your body a more consistent fuel supply and you might notice the difference in how your body responds. this does assume you haven't been partying all night though! my answer to 'how we as bikers are supposed to be able to party all night and ride our bikes all day' is ... find someone who wasn't up all night and ride bitch!
Michael Psycle Bettinger (mcpsycle) Sun 4 May 08 00:03
Hi nurse Flanagan, Welcome to the discussion. With both you and flash being in the medical field, I guess we can expect answers from two different medical perspectives to some of our questions. Regarding your suggestion to eat fewer and smaller meals to avoid fatigue. Yes, that does do it. Only trouble is it is hard to find anything decent to eat on the road. Fast food restaurants have become better with serving salads. But the choices for a good meal are often few on the road. And regarding commuting on the bike. That is one of lifes pleasures. When I commuted form San Francisco to Oakland, I often came back to the city around sunset with the sun setting behind the Golden Gate Bridge. Not bad. I once told flash after he bought the Tuono that anyone who has a daily commute that takes him over the Golden Gate Bridge and up and down the Waldo grade in Marin on a Tuono is leading a blessed life. People save their entire lives to come to the Bay Area and see the GG bridge once, and he gets to commute over it twice a day, every day. I found the way to deal with my sleep deprivation is the oldest method in the book. I took a nap today. Im not a party guy so staying up late for me is unusual. But sometimes guy just has to have some fun.
Robert Hill (rob) Sun 4 May 08 07:25
Hi Flanagan. Nice post. I've always commuted to work on the bike, too. I crossed the Bay Bridge to work four days a week for a couple years. Sometimes the motorcycle ride is the only thing that excites me about going to work. And the ride home makes a great way to unwind so you don't bring work shit home to the family. Michael, I have never had the problem of feeling sleepy while riding. Tired and stupid, yes, but never dozy and nodding off like when I'm driving a car. It's funny but other physical symptoms often fade while riding my motorcycle. I suffer from bad headaches and they often go away while I ride. Where's the doctor? flash must be off seeing people who pay him for it.
Michael Psycle Bettinger (mcpsycle) Sun 4 May 08 07:36
>Where's the doctor? flash must be off seeing people who pay him for it. I'm an optimist. Until I hear otherwise, I am hoping the reason the good doctor has not checked in is that he is busy riding that Tuono all over Northern California and has had a massive brain fart about checking in here. Perhaps he needs to reread his book and call us in the morning. For those outside the Bay Area, it is another perfect riding weekend in Northern California. The weather is a bit cool for early May, but still great riding weather. I'm up in Guerneville this weekend. That's a resort area about 70 miles north of San Francisco. Massive number of both bikers and bicyclists ride through this town each weekend, and this weekend has been no exception. Lots of groups of Harley riders along with other groups of sport bike riders. And then there are the BMW riders. They are easy to spot at a distance. They are all wearing Aerostitch riding suits. Each of the groups I just mentioned has their own particular dress code for a Sunday ride.
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