Posts Tagged ‘saxophone’

Another Road Trip 7: A day off, and practicing my saxophone

June 14, 2015

You know where you catch the train?

Where you stand to get out of the rain?

I practiced my sax

Down by the tracks

Nurturing the right side of my brain.

Synopsis: I’m a Family Practitioner from Sioux City, Iowa. In 2010 I danced back from the brink of burnout, and honoring a 1 year non-compete clause, travelled and worked in out-of-the-way places in Alaska, Nebraska, Iowa, and New Zealand. After three years working with a Community Health Center, I am back having adventures in temporary positions until they have an Electronic Medical Record System (EMR) I can get along with. I spent the winter in Nome, Alaska, and I just finished an assignment in rural Iowa. Right now I’m working in suburban Pennsylvania, combining work with a family visit.

You can drive from New York to San Francisco in silence, but it will be a much nicer trip if you have some music.

If I don’t bring my saxophone with me on a trip lasting more than 2 weeks, I make arrangements to rent one when I arrive.  Of course I have to find a place to practice.

When I went to Barrow, Alaska (find it on the map, and gasp) in the summer of 2010, a knock came one evening while I practiced.  I answered the door to find my neighbor.  I apologized profusely, and asked if there were a time we could set up that I could play and not disturb him and his family.

“We want you at rehearsal on Thursday,” he said.

In a hotel, finding a place to practice becomes more difficult.  So on Friday, my day off, Bethany and I went downstairs to the light rail station, in the heat of the mid-morning.  I’ve always wanted to play in a train station.  This time, however, I didn’t have the foresight to make a sign saying, “Give your money to someone else.”  And I didn’t have a music stand.

We sat on a bench in the shade.  Bethany held the book of Barrett etudes, and I started to play, and found I had world-class acoustics.

It’s always more fun to play in front of an audience, and, in this case, a young woman sat at the other end of the platform and gave us the active ignore.

After the battering I took yesterday in the Urgent Care, my heart went into the music.  I have practiced these pieces, so that the notes find themselves under my fingers, and the sound soared across the tracks in both directions.

After a while, a young man with a guitar slung over his back walked past.  I said, “Whoa, sorry.  Dude.  I just needed a place to practice.  If this is your spot, I can move.”

On his way from one place to another, he hadn’t come to play.  He played in a 10-piece band, he said.  They had a horn section with a trumpet and a trombone, and they were looking for a saxophonist.  He expressed pride that ages ranged from 14 (guitarist) to 54 (trumpet).  After I explained that the instrument I played was a B flat soprano sax, I could tell he wanted to invite me to jam.

In another time and another place, I would have.  But I have passed the age when I can work a day job till 8:00, work a gig till 2:00, then get up at 6:00 and do it again.

He asked me what I was playing, I said, “Barrett.  He mostly wrote for oboe.”  I could tell he enjoyed what he heard.

Erode away your problems, ten minutes daily

November 4, 2012

If you can invest minutes ten

Every day, not now and again,

You’ll accomplish great things,

You’ll play and you sing,

And they’ll say, “You find time?  Tell me when!”


Synopsis:  I’m a family practitioner from Sioux City, Iowa.  In May 2010, I left my position of 23 years, and honoring my non-compete clause, traveled for a year doing locum tenens work.  In June of 2011 I joined up with the Community Health Center, which provides care for the underserved.  I’m now working part-time, which, for a doctor, means 54 hours a week.

Erosion, the powerful force of geology, accomplishes more than cataclysms.

Sometimes I talk to young mothers overwhelmed by the mess in their house.  The child, they complain, has strewn everything possible all over the floor, and they don’t know what to do.

I explain that because children dwell on the floor and because they inherently generate chaos, the situation falls squarely into the normal category, and that trying to change the base cause of the mess ranks in futility with trying to stop the tides.

Maintaining steady erosion, I say, has a better chance of accomplishing the task at hand than trying to clear everything up at once.  Every time you pass a haven of disorder, put one thing back in its place.  If you have enough energy to sigh at the mess, you have enough energy to improve it a little.

Bethany and I started decreasing the number of our possessions 6 years ago.  We keep at it steadily, and every year we have less clutter.

One hour a day, 5 days a week, for eight weeks, separates you from the 300-word vocabulary that constitutes the basics of another language.  At the end of the first term you can make your needs known, and understand rudimentary concepts.  You won’t have fluency but you’ll have the foundation to build fluency.

In the last two years I have found practicing the saxophone 10 minutes a day more feasible and more pleasurable than the hour a day I use to aspire to. 

One can find ten minutes in a schedule easier than an hour, and ten minutes regularly brings more learning and finesse than an hour that doesn’t happen all that often.

Any activity we enjoy for ten minutes tends to extend as time goes on.  If I can get my diabetic patients into the habit of walking 10 minutes three times a week in September, by the time March rolls around I can coax them into 15 minutes at a time, and in a year or two I’ve gotten them up to 30 minutes six times a week.

When I set out to practice my saxophone for an hour, I often shorted my time.  Now that I only aim for 10 minutes, I get more out of my playing, I make more time to practice, and when I cheat, I go long, not short.

Barrett and a borrowed Yamaha

April 4, 2011


I’m printing announcements in stacks,

I’m sending the news out by fax

   I’m doing the deed,

   I’ll moisten my reed.

Tonight, I borrowed a sax.       

Synopsis:  I’m a family practitioner from Sioux City, Iowa.  On sabbatical to avoid burnout, while my non-compete clause ticks away I’m having adventures, visiting family and friends, and working in out-of-the-way places.  Just back from a six-week assignment in Barrow, Alaska, the northernmost point in the United States, I completed my first week of work around Wellsford, a small farming community on the North Island of New Zealand.

Bethany and I set out this evening on foot for the Sawmill Café here in Leigh.  A local industrial landmark tracing continuity to 1863, new owners turned the mill buildings into an eatery and lodge in 1994 and 2006, respectively.  They established a microbrewery in 2008.

With clear, clean air and a perfect temperature, as we walked up the street one of our neighbors stopped to say hi.  After we chatted I mentioned I still hadn’t been able to “hire” (Kiwi for rent) a saxophone.

In short order, he had invited us in, introduced us to his wife and dog, and produced a Yamaha E flat alto sax, which he lent me.

Alto saxophone, borrowed

I was walking on air all the way to the café, Barrett etudes playing in my head. 

We ate locally caught snapper and locally grown kumara (a tuber much like a sweet potato) fries.  We also ordered a sampler of four ounces each of the five beers.  Between the two of us we managed to consume about 40% of the brew.  Outside, the night deepened and the stars shone hard and clear against the moonless sky.  As we walked back we heard parties in progress at the rate of two to a block, and when we got back to our beach house, I got out the saxophone.

I brought my own Selmer C** mouthpiece and a reed.

My sax mouthpiece and reed, brought from home to New Zealand

I assembled the instrument, marveling at how much larger it feels than the soprano which has been my mainstay for the last ten months.  I put the horn to my lips and started to play scales.

The first time I went to college I thought that I would be a Great Composer and change the world for the better with my music.  But I didn’t do the scale practice needed to develop my meager talent.  I played little through med school, and less in the years after, but when I made my career decision (see my posts from a year ago) I brought music back into my life.  While I was in Barrow I joined a group and we played gigs. 

But I left my horn when I came to New Zealand, figuring that I could rent one here.

It felt good and full to be playing again. My mouth piece on this saxophone produces a clear, clean but gentle sound.  I brought out my book of Barrett duets.

In the fourth measure I stopped.  The C sounded wrong, sharp by nearly a half-step.

I kept playing, but I couldn’t make my scales sound right if I played in any key with fewer than two sharps.

I peered at the horn, and found a missing piece of cork and a set screw that needs tightening.

I’ll dream up a solution tonight.

Full mornings and evenings in clinics, walks in the evening, and a jam session

February 9, 2011

We’re seeing more cases of strep

At the end of the day I’ve lost pep

   But here is an upper

   I pause briefly for supper

Or else burnout becomes the next step.

Synopsis:  I’m a family practitioner from Sioux City, Iowa.  Avoiding burnout, I’m taking a sabbatical while my one-year non-compete clause winds down, having adventures, visiting family and friends, and working in out-of-the-way places.  Currently I’m on assignment at the hospital in Barrow, Alaska, the northernmost point in the United States.

The outpatient section of the hospital in Barrow has six exam rooms and two ER bays.  The morning schedule contains only appointments, the afternoon schedule is open to walk-ins.  Not surprisingly, we see more patients in the afternoons than in the mornings, and in the mornings we have lots more time to spend on each case.  Sometimes questions pop into my head.

When government agencies keep statistics, I wonder how they classify Barrow injuries.  Does a broken leg from a snowmobile rollover count as a motor vehicle accident or a hunting injury?  Do we file a finger laceration sustained while preparing muktuk (whale blubber) for consumption as a whaling injury, a fishing injury, or a cooking injury?  If two snowmobiles collide in mid-air, do we have to report to the FAA?  How do we classify a crick in the neck from pulling out a whale?  Should we be keeping stats on the number of people constipated from eating muktuk?  Does a hunting accident for a subsistence hunter qualify as on-the-job injury?

I would not have believed the number of people I’ve met here who survived plane crashes.  People here cannot believe the number of patients I’ve had who survived lightning strikes.  Residents in the bush spend more time flying than those of us in the lower 48.  They also spend more time on boats.

Walk in clinic brought a few more cases of influenza and a lot more cases of strep.  People slip and fall on the ice and sprain and break things.  Most of the worst injuries come from snow machine accidents; collisions hurt more than trying to turn too fast.  I haven’t seen a car-snow machine injury, but I’m sure I will.

Two days into the week and I have 19 hours on my timesheet.  Afternoon walk-ins routinely last two hours longer than planned.  I have stopped trying to work all the way through the dinner hour; to do so is to take the first step back towards burnout.

I returned to the walk-in area after my fifteen-minute break, helped my colleagues care for the outpatients, then I came back to the apartment.  I suited up to walk Bethany to her Tuesday knitting group, a mile away at the library.

With a light snow, the temperature had risen to almost zero Fahrenheit (minus 15 Celsius), and I knew I had overdressed before we’d gone two hundred meters.  I left my parka and my bib overalls unzipped but my arms sweated.  On the way back I took off my mittens.

I picked up my saxophone and went to my guitarist friend’s house.  We played some popular and some esoteric tunes, and by the time my lip started to fail I had more energy.

I walked back to the hospital in the gentle cold and snow of the Arctic night.  I felt like dancing because I’m not carrying a beeper.

Hanging with real hunters, egg fu young, playing saxophone, and Northern Lights

February 4, 2011

Long are the dark arctic nights,

If you’ve come out just to see sights.

     Be cautious, I swear,

     Of the great polar bear,

And look up to see Northern Lights.

Synopsis:  I’m a family practitioner from Sioux City, Iowa.  Avoiding burnout, I’m taking a sabbatical while my one-year non-compete clause winds down, having adventures, visiting family and friends, and working in out-of-the-way places.  Currently I’m on assignment at the hospital in Barrow, Alaska, the northernmost point in the United States.

When I tell people in the lower 48 about Barrow, they frequently ask, “Why would anyone want to live there?  In this day and age?  Are you kidding me?”

I read the Unabomber Manifesto when it appeared in the Washington Post in 1995 .  The distillation of his treatise comes down to this:  modern society’s problems result from people having their basic needs of food and shelter met without working for them; most people are bored and without psychological fulfillment because they haven’t had to overcome obstacles to avoid death from starvation or exposure.

To my dismay, I agreed with his sentiments till Ted Kaczynski tried to justify killing and bombing other people.

Twenty-first century American ennui doesn’t happen in Barrow because most Natives are subsistence hunters.  

One of the reasons that I love Barrow is that the folks here really are happier than most places.  If I go to the store, I see smiles on most of the faces; I don’t see that many grins anyplace outside the North Slope except at a comedy club.

I also get to hang out with real hunters all day.  Their lives and the lives of their families depend on the success of their hunt.  The people here exist because of a combination of modern firearms and the ancient accumulated wisdom of centuries of hunting and fishing in the planet’s most hostile environment.

I talked with a man who shot more than five hundred geese during the whaling season; he told me about getting three with one shot.  Another person, who has harpooned seven whales over the course of his life, recounted killing two of those whales in one day.  A fisherman I spoke with caught eight hundred smelt on a day when his friend caught three thousand and expounded on how great they are to eat frozen.

Even though I hunt, next to the subsistence hunters here I feel like a tourist with a muzzleloader.

Tonight, the mercury sits at 11 degrees below zero Fahrenheit.  Bethany and I walked a kilometer to Brower’s café and ordered egg fu young with hot and sour soup.  The prices of restaurant food run high here but the portion size stacks up with the largest; we brought home leftovers, though polar bears have been sighted in that part of Barrow during the last two weeks.

After I dropped Bethany off at the apartment, I took my saxophone to the house of the guitar player who anchored the band when I worked here last summer (see my posts from June and July).  We miss our trumpet player and leader, but we still like making the music.  Halfway through, Bethany called to tell me to go outside.

We came here with the intention of seeing the Northern Lights.  This evening’s Aurora Borealis streaked green across the sky from horizon to horizon.

Jamming with my nephew, much easier after I practiced scales

October 5, 2010

In the meld of the horn and the strings,

Ah, the joy that harmony brings!

     In past times I failed,

     Then I started scales.

Not only do I play but I sing.

I grew up in Denver, and going back for the American Academy of Family Practice Scientific Assembly brought back a lot of memories.

When the conference finished I prowled my way through the traffic to the house of my sister, Ilise, for a family gathering. 

I got to catch up with another sister, Hava,  and her family and meet my twin niece and nephew.

After supper, the two toddlers melted down (normal for age) and went home.  I got out my saxophone and jammed with my teenage nephew, Ilise’s son.

Unlike mine, his musical talent hasn’t been hampered by a lack of lessons nor a deficiency of desire to practice basic exercises.  He plays well, he’s gotten a good sense of rhythm and he learns quickly. 

I’m not sure if he composed the two numbers we played, I am positive I hadn’t heard them before.  Keeping up with contemporary music requires a lot of listening and cannot be rushed.  I have had little time to just sit and listen to music for the last forty years, it has always formed an accompaniment to doing something else, like bicycle repair or driving or cooking or sweating over a hot elliptical machine.

I put my horn together, tuned up, and said, “OK, what key are we in?”  I received a blank look and asked, “How many flats?” 

Let me explain that my soprano saxophone is in the key of B flat; a piano is in the key of C.  In order to get onto the same musical page I have to transpose everything in my head.  In the beginning, my brain rebelled against such cognitive dissonance, but since my experience in Barrow, Alaska (see my posts on musicianship from June and July) the exercise has become more like dance and less like calisthenics. 

When I had my head wrapped around what musical neighborhood I should play in, I said, “You start, I’ll follow.”

A youth in his mid-teens doesn’t expect such a statement from an uncle with a markedly grey beard, particularly if he’d never heard me play. 

Now in contemporary American Cinema the protagonist walks into musical group, picks up an unfamiliar instrument, says, “OK, C minor,” and immediately the group turns out a highly polished number, leading the audience to believe that you don’t really need to practice scales to sound wonderful.  Such was the illusion I labored under for a very long time.

But I have been playing scales, and I have improved my musicianship.

He started with a very compelling rhythmic structure under a (thankfully) simple harmonic.  With my new-found ability to play scales, I enveloped his melody with good, solid counterpoint.  Our right hemispheres melded.  We sounded great.

And we had a great time.

Shotguns, saxophones, and Tae Kwon Do: being a teacher and being a student

September 2, 2010

I went out with Aaron and Max

With shotguns, just to relax

     I didn’t joke

     Those targets I’d smoke

Though missing the ones with the quacks.

I drove down to the firearms range this morning to shoot clay pigeons with a friend, Aaron, and his cousin, Max.  I’ve been teaching young men (and a few young women) to hunt and shoot since 1983.  Aaron is my most recent apprentice.  He’s old enough now that he can drive himself and buy his own shotgun shells. 

At the trap thrower we ran into a man who had just purchased a “coach gun,” a double-barreled, side-by-side 12 gauge shotgun with a short but legal barrel.  He plans to start into Cowboy Action Shooting, the latest shooting game on the American firearms scene. 

Clay pigeons are neither clay nor pigeons; they come in boxes of 90 or 135, they fly like Frisbees, most are colored blaze orange, and they shatter easily. 

While setting up, I learned that the man with the coach gun is a twenty-seven year vet, and now retiree from the army.  I said that I was taking a sabbatical. It turned out he’d not shot clay birds before. 

I told him I could help him learn.  We set clay targets against a dirt bank, and starting five paces away; I had him destroy stationary targets at increasing distances.  Then I had him stand by the thrower and track the movement of the flying clay bird with his shotgun.  When he was tracking well I had him load his scattergun and shoot.  He broke the first two pigeons, and we applauded. 

When it came my turn, I shot my 20 gauge over-under well, turning target after target into small clouds of black smoke. 

We left when the rain started.

I lunched sushi with Aliya, our youngest daughter.  I came home and napped and went to my saxophone lesson.

My playing brought a smile to the face of my teacher, Diane.  She explained some very simple, very basic things about jazz pentatonic scales.  Then she put on a Miles Davis disc, showed me the sheet music, and we traded solos at the breaks.  I don’t know who was more pleased. 

Had I had the kind of musical encouragement, nurturing, and education forty years ago that I got this summer, my career might have gone differently.  All in all, I think things have gone for the best, and my teacher would agree. 

I’m sure my music has acquired a depth that it would haven’t had if I had stayed in the music world.

At five I drove with my friend, John, to Onawa for Tae Kwon Do.  John hopes to test for his fifth degree black belt in October.

I can’t stop being a doctor, and in Onawa I’m outside the thirty-mile limit of my non-compete clause.  Nor can I break confidentiality about what advice I gave in the parking lot (no, I didn’t send a bill).

I will say that real hypoglycemia occurs less often than people think.  Growing adolescents make a lot of a growth hormone called Insulin-like Growth Factor (IGF), and hypoglycemia in that case tends to come in the morning.  Good treatment demands good diet, with low glycemic index foods, and especially a good breakfast.  But that’s good advice for everyone.

Though four years have passed since my last Tae Kwon Do lesson, I remembered my form well.  John gave good instruction.

Being a student is part of the human condition, and there are those of us who have the urge to teach.  I had a day of being both teacher and student.

A gig at Pepe’s and a visit to a whaling captian

July 11, 2010

I didn’t know it would happen

While I sang with maracas a-snappin’.

    But I dealt with the stress

    Of financial success

And went to the home of a whaling captain.

Saturday the weather turned windy again, the air temp went down to 38 degrees and the sky clouded over.  I called family and friends in the afternoon.  I looked out the dining room window while I talked and watched sea ice floes form and disappear.

It is difficult for people not on the North Slope to imagine what it’s like to live in a place accessible only by plane or by water.  It’s a lot like living on an island and affects the sociology of the town.  Theft is uncommon and mostly petty.  Interpersonal violence is unusual; when the young and the drunk lose their tempers, a wall is the more likely victim of their fist than is another person.  Few households are without a small arsenal of firearms, but shootings (accidental or not) are rare.

At four-thirty in the afternoon I carried my saxophone case in a light, spitting rain to the house of the guitarist, meeting there with the trumpeter.  A Tagalog-speaking cab driver drove us and the equipment to Pepe’s where our other vocalist waited.

Taxis, long a symbol of urbanism, have integrated into North Slope villagescape.  Waits are short, rides are cheap, and tips are not expected.  Most of the taxi drivers come from Pacific islands or southeast Asia.

We played to a crowd that occasionally numbered into the double digits and we had a great time.  I qualified as the percussionist because a waiter handed me a pair of maracas.  I excelled in songs of post-Victorian vintage through the old standards, from Summertime and Five Foot Two through Georgia On My Mind and Sentimental Journey. When I didn’t have the notes under my fingers, I sat out and played maracas and sang.

We played two and a half hours without a break till the trumpeter/ leader had to go back to the hospital to take call (he’s also a family practitioner).

I don’t know who put out the tip jar, nor did I notice people putting money in it, but at the end we had $22 to split four ways.  We also got to order off the menu and Fran, the owner (who deserves her own post), let us eat for free.  We elected the guitarist to be the treasurer (I had to stuff the bills into his pocket) and he paid for the taxi to carry the equipment back to his house.

I’m ambivalent about the money.   I play for the sheer joy of playing, making music I like to hear and seeing peoples’ heads bob while they’re eating their enchiladas. 

Forty years ago when I was a musician we ended jobs at two in the morning and rarely got into bed before four.  I don’t want those kind of hours any more.  Playing dinner music appeals to me much more than playing a dance.

As it is I had time after the gig to go to the house of a whaling captain, taking a taxi all the way across town (about three miles, six dollars).

I got to heft a harpoon and a shoulder gun.  We talked about grades of black powder, number 11 percussion caps, and powder measures.

I watched footage that including him harpooning a whale.  He talked about whaling as a religious experience.

Having a blast in lousy weather in Barrow

July 5, 2010

On this gig we won’t make a dime.

We might end up covered with rime.

    From the end to the start

    I play from the heart,

Having the greatest of times.

The skies are leaden and the air a few degrees above freezing.  I’m riding on the tailgate of a pickup truck in a light drizzle.  I’m having a blast.

My saxophone wails Summertime as the pickup runs along a fifty-yard wide neck between the Arctic Ocean and a lagoon.

I’m playing direct from the heart.  I’m playing for all the months of vacation I never took, for the years of pain that have evaporated, for the decades when I didn’t have time to play, and for the liberation of not being the boss anymore. 

I’m playing because I want to, not because I have to.  With no obligation or compulsion, no interior or exterior force, no ought to fill the interstices in the notes; with nothing else to compete for space, joy overflows with my breath.

By bits and turns a parade hospital project casually mentioned on Tuesday grew here and tweaked there, eventually obtaining a vehicle and a band (us).  We debated seating arrangements more than anything else, finally deciding that we could make it a tailgating expedition for the vocalist and guitarist-turned-banjoist, and a walking trip for the trumpet and sax. 

At quarter to one, by prior agreement, I gave call over to one of my colleagues, and suited up in layers for the cold.  I went down to the parking lot and helped put the finishing touches on the truck/float.

What is safe and acceptable at parade speeds is not necessarily a good idea even four miles an hour faster, and the trumpeter and I climbed into the back of the pickup touting the Friends of the Library.

The parade staging area bordered on the airport, near the ice rink, City Hall, and the high school. 

Small town Fourth of July parades have really interesting floats, and Barrow is no exception.  Most every business and institution sends a representative. 

While we waited around in the intimate atmosphere, we hacked around musically, as much to get the creative juices flowing as to keep warm.  The banjo player remarked that banjo is a Bantu word meaning cannot be tuned.  The cold compounded the tuning problem. 

At last the parade starts, the trumpeter and I begin walking and playing and in short order the parade speeds up.  Soon, we have to run, which neither of us, at our ages, should do.  We accept a ride on the running boards of the Friends of the Library truck, catch up to our vehicle, and sit on the tailgate.

We play while the people in the truck, including Barrow’s resident fashionista (transplanted from sub-Saharan Africa to South Dakota to Barrow), throw candy, Frisbees, and bouncy balls to the crowd.

With no single group of people being able to hear more than a few minutes of a song, we start with St. James Infirmary.  We try new riffs and licks and watch the audience react.  We polish that number till it shines in the gloom of a cloudy Arctic afternoon, then our leader, the trumpeter, calls for Summertime.  As the people lining the road bend to pick up the candy and the treats, we see the heads bobbing in rhythm to the music. 

The parade stalls while we’re between the ocean and the lagoon.  Fireworks go off to our right.  When we start again, up the hill to Browerville, we play and sing When The Saints Go Marching In.

Under leaden, overcast skies, in a light drizzle just above freezing, with my fingers starting to numb, I am playing from the heart and having an absolute blast.

Three critical patients and two planes

June 17, 2010

By now I really should know

If a morning is starting out slow

     I won’t get a break

     To finish my steak

Working nine hours in a row.

Euphoria opened my morning.

My stack of lab results started with a hypothyroid, a hyperthyroid, and a testosterone deficiency.

The thyroid gland is mainspring of the time clock at the plant: it tells the whole show how fast to run.  Thus most hyperthyroid patients can’t sleep, can’t tolerate heat, and lose weight.  Hypothyroid patients may gain or lose weight, but they can’t stand cold and they can’t get going in the morning.  Both conditions lead to lack of energy.

Thyroid problems are very gratifying to treat; I get to save the patient’s life for pennies a day and make him or her feel better.

Testosterone deficiency is much more expensive to treat, but the patient always feels better.

Morning walk-in and emergency clinic was slow and enjoyable but I was the only doc there.

A call from an outlying village elicited my advice to send the patient by commercial plane to Barrow but the patient didn’t arrive till after six.

I got to go to lunch early but I was called back to an emergency just as I was sitting down.  I bolted part of my lunch and threw the rest away. 

The afternoon waxed progressively frantic.  

In Barrow as in Sioux City infidelity leads to divorce, and divorce leads to health problems rippling through the family.  People come to me with ailments, and I can prescribe things like amoxicillin and hot soaks, nicotine and alcohol cessation.  To ease the real pain all I have are the ability to listen and words of wisdom. 

At quarter to six I realized that if I didn’t get to the cafeteria I’d miss supper and I was already ravenous.  I scurried down the hall and grabbed a Styrofoam box with what would have been a decent steak.  I bolted the cookies on the way back to ER.  Over the next three hours I managed to whittle away half the steak, a third of the potato, and all the vegetables.

I dealt with three life threatening situations at the same time.  A patient in town had developed a sudden compromise of a major organ system.  The patient from the outlying village had arrived with alarming physical findings.  A different village called in with information about a potentially salvageable patient. 

With three patients to transport and two planes I had to prioritize.  The in-town patient ranked highest; the outlying patient whom I had never seen got a plane directly to Anchorage.

I called Alaska Native Medical Center (ANMC) about the patient who had flown in at six.  The proper doc on call dialogued with me; with the recommended whomping dose of steroids the patient improved enough to keep in Barrow for the night.

Each Medevac transport south costs between $30,000 and $80,000 and as a result involves a number of hoops that must be jumped through. 

Two of my colleagues came through while I jumped through hoops and organized data; one because of call and one to be supportive.  The cozy outpatient area hummed with activity: two Medevac transporters, three docs, three nurses, a pharmacist, an X-ray tech, two patients with a total of six relatives, and a medical records tech.

I got back to the apartment at nine, put the steak fragment in the fridge and got out my saxophone.  I worked thirteen hours, the last nine without a break.

What had started off slow and clear and solo finished frantic and ambiguous and supported.

Contrast is still  the essence of meaning.