The Love Boat

“Is there a doctor on the plane?”

We were on our way to San Francisco to join my parents for a cruise to Hawaii when, for the first time in my career, I got to be the airplane doctor. I will freely admit that I have speculated about various scenarios wherein I did something medically clever on an airplane. These imaginings usually end with being served champagne in first class while my children ask me all about how I got that poor woman to cough up a chicken bone or whatever. For some reason, I never managed to imagine the part where I was totally spaced out in a book about elves and dragons while eating cookies and just generally totally unprepared to play doctor. But, when they asked over the intercom for any medical professionals, I pressed the overhead call button and tried to go from vacation-dad mode to competent, confident, doctor mode. This meant dusting an embarrassing amount of cookie crumbs off my lap and trying to remember a bunch of stuff from a podcast that I’d listened to a while back about what they carry in airline med kits.

Now, obviously Tiffany and I are both doctors and she has managed to save a kid on a playground with an epi pen just fine by herself, but it seems generally understood that they don’t call overhead in an airplane for psychiatrists. (Although if they did, I would probably be even more concerned) So, I followed the stewardess toward the front of the plane where, oddly enough, another psychiatrist had just arrived to help.

The airline staff had emptied the row except for the window seat, where a middle aged male passenger sat; pale, sweaty, and clearly confused. I introduced myself and told him that I was an emergency room doctor, but it was clear that he had no idea what was going on. He appeared ill and somewhat frightened by the attention. I ask the stewards to get the medical kit, call the airline medical director, and to page for any nurses, because nurses know how to actually do all of the useful things I might come up with. I’d rather have one good nurse than 5 doctors in most situations. We looked through his bag for clues, checked him for medical alert bracelets, and talked to his former seat mate.

His seatmate described what sounded like a seizure and his mental status was certainly consistent with the period of confusion that occurs after a seizure. By the time we got the glucometer to check his blood sugar, he was starting to follow some basic commands. I got him to drink some apple juice, in case he was hypoglycemic, and I was able to do enough of an exam to convince myself that it wasn’t a stroke. His vital signs were good and he seemed to be slowly improving but not really reliably answering questions. The medical director for the airline asked me by phone if they should divert the flight which was a bit more responsibility than I was ready for, but by then we had also gathered an internal medicine doctor and two nurses. We talked it over and felt like we could make it safely to our destination and that I would sit with the passenger and the med kit until we landed. (Incidentally, airlines don’t carry any seizure medicines.) I wasn’t about to ask them to page overhead for some Xanax or Valium, and accidentally lead the other passengers to the conclusion that the doctor was really stressed out.

But the gentleman steadily improved and we had a long pleasant conversation. He had no memory of what happened and had no prior medical issues at all. We had both lived in Lexington, Kentucky and we connected over a fondness for the place. I texted with his friends and family, some of whom were doctors and were going to pick him up at the airport.

It felt odd, but nice, to spend so long with a “patient” without actually doing anything, and it was really rewarding to have a little more connection than I normally have time for in the ER. There was no champagne, but they did speed up the plane and we made it to San Francisco almost an hour ahead of schedule which was cool. I didn’t know they could just sorta floor it when they needed to, but I bet they enjoyed that as much as we did.

*Coit Tower and Telegraph Hill from Fisherman’s Wharf, SF*

Adult Fortune Cookies

Asheville is wonderful place to live but despicably homogenous. If you’d like to agree with some white kayakers about the best place for tacos, it’s amazing. But San Francisco has always felt like a cross between a melting pot and a garbage disposal in a way that I like. The diversity and disparities of the place are astonishing and fascinating. It’s never been surprising to me that burning man grew out of this city where experimenting with freedom and its consequences is both tolerated and encouraged. The sheer variety of ways that people are going about living is impossible for me to wrap my Kentucky-made brain around. Being in a giant city helps me remember that the true range of options that we have in life is generally far greater than it seems amidst the routines of daily life.

*this is the cover shot for our first studio album*

We had just 24 hours in San Francisco before the cruise and we put it to good use walking miles along the pier, telegraph hill, chinatown and everywhere in between. I love the steep winding stairs and streets that create a feeling of an ancient mountain pilgrimage. The Mediterranean climate that lets citrus trees flourish next to succulents with tree like trunks gives me houseplant envy. The density of the city’s human occupancy is overwhelming and I think that I will never learn the big-city dweller’s trick of ignoring passers by, even though there are far too many humans to nod and say hello to. Seeing futuristic electric cars, bikes, scooters, and drones moving past and through sprawling tarp and tent cites is shocking. Given the developments of communication and shipping technologies in my lifetime, it’s astonishing to me how unevenly resources are distributed in our society. It’s hard to imagine that there are any real barriers to taking better care of strangers other than our long habit of doing otherwise.

Tiffany and I are both scientists and enjoy learning about the workings of the world. For me, science is a way to learn to see miracles that are invisible to the naked eye. The more I learn about the mysterious patterns of creation, the more convinced I am that the true order of the universe is incomprehensible. This leaves room for the inexplicable. This is a defensive prologue to the fact that Tiffany and I both enjoy all versions of fortune telling, astrology, and omens. Knowledge is built with words, but wisdom is sometimes better expressed with symbols. As a teenager, with less reasoning and more appetite, I once bought and ate an entire bag of fortune cookies, looking to see if I could tie their individual messages into a coherent theme, which was, apparently, that I would soon experience bloating and thirst.

In China town, we found a fortune cookie factory which offers a free tour on its website. The entire interior of the place, however, is full of equipment, leaving about 30 square feet to walk through, most of which is taken up by various forms of fortune cookies for purchase. The proprietors seem downright hellbent on distributing samples and it was hard to shop with both hands full of the circular disks of pre-fortune-cookie that they passed out with the fervor of street side evangelists distributing bibles and pamphlets. We settled on a bag of mixed flavor fortune cookies (chocolate, plain, and green tea) and a smaller bag which purported to contain “adult XX fortunes”. I was initially excited about these but they seemed to be puns that likely made sense in Chinese but were wholly lost in translation. Imagine someone bouncing their eyebrows at you and suggestively saying “Your uncle's flowered sheets won’t hold two pheasants for long” and you’ll get a feel for them. But me and the kids enjoyed them and I’m sure it was educational somehow. In general, homeschool parents use the word “educational” more flexibly than others.

Zooming out a bit

If you were to arrive at earth from space, having never seen it before, the largest and most impressive feature would likely be the Pacific Ocean, covering more than a third of the planet’s surface. And, in the middle of this swirling blue tapestry, thousands of miles from anything, you would find the tallest mountain on the planet, Mauna Kea, rising over 30,000 feet from the ocean’s floor. It is an active volcano and its smoking caldera has a 30,000 foot column of molten rock connecting it directly to the earth’s mantle below the planet’s drifting tectonic plates. The key to the mountain’s improbable and increasing size is its constant connection to subterranean generative forces more than six vertical miles below its summit.

Prior to the arrival of humans to the Hawaiian islands around 1200 years ago, 95% of the species that lived in Hawaii lived no where else on earth. The few species that had somehow arrived on these tiny islands, hiding amidst the immensity of the Pacific, had so much time to change and evolve that they no longer resembled their forebears enough to qualify as the same species. Many of the species that I always associated with Hawaii, such as palm trees, coconuts, pineapple, pigs, were all brought by voyagers from the Marquesas and other surrounding isles. Many of the original Hawaiian species were lost quickly after contact with humans and the plants and animals that they brought with them.

In much the way that species changed over time through isolation, Hawaiian culture became unique in its traditions, language, and religion. That is until, once again, invasive ideas were brought by outsiders and the character on the islands was irrevocably changed once again. It seems that in this unique place of continual rebirth by volcanic eruption, change is the only constant, and adaptability is the most useful evolutionary trait.

In reading about the natural and cultural history of Hawaii I was repeatedly astonished by the remoteness of the place and the astonishing skill and courage that was required to reach it and survive on its shores. Reading about it from a cruise boat almost brought on vertigo to imagine the dizzying pace of change that the last century has brought. We were essentially driving a high rise hotel tipped on its side and loaded with food for 5000, nightly live entertainment, two jewelry stores, an art gallery, and a sketchy drug dealer named Brandon. (More on him later). Contrasting this with the early oceanic voyager's canoes and celestial navigation abilities was mind boggling. This left me wondering whether our technological prowess was worth the loss of courage and connection to the natural world that previous travelers to the islands possessed. In contrast to prior explorers, it was at least clear that we had no intention of changing Hawaii. The goal for most cruise boat passenger’s seems to be to look at place quickly from a bus and get back to the buffet. Unless someone smuggled in an armadillo or something, we were relatively unlikely to affect the ecosystem much.

2000 miles of ocean

Boarding the cruise boat from San Francisco and passing under the Golden Gate Bridge was a dramatic beginning to what would be the furthest west I’ve ever travelled. I’ve ended more than a few cross country drives in San Francisco and it was exciting to finally keep pushing west toward the sunset. On the boat, we were almost immediately enveloped in dense and windy fog. Listening to the fog horns made it possible to imagine traveling in an earlier era, despite the option of having a latte in the hot tub and attending a disco themed floor show later in the evening.

Generally when we travel, hotels are a luxury between remote places or a place to clean up before boarding a plane home. They are rarely a destination in and of themselves. With cruise boats, it seems that being in the hotel is largely the goal and the preponderance of food, entertainment, shopping, and social activities is certainly one version of the American dream. Princess Cruiselines caters to an older crowd, primarily senior citizens, and I think this trip helped me to see cruises the same way that I see e-bikes; something that I’ll probably need someday if I want to keep getting out in the world.

Cruise boats are behemoths; 15 stories above the water line, 4 stories below it, and as long as a city block from bow to stern. We would be using radar, GPS, and over 200,000 gallons of fuel to drive a mostly straight line 2000 miles from San Francisco to Hawaii without stopping. At around 20 miles an hour, this takes 5 days of constant movement. We were cruising through waves that would tower 3 times my height and rarely managing to even upset the hundreds of liquor bottles at the various bars on the boat.

The seas were rough and kept the boat swaying in various directions. The swimming pools became wave pools and we liked getting sloshed around in them when they forgot to close them. It was a daily challenge to walk a straight line down the long narrow corridors that lead to all of the rooms. I feel confident that I would never fail a sobriety test with my new found sea legs. The positive feedback of navigating the straightest possible line to the delectable fruit tarts on the buffet trained my cerebellum to deal well with the unpredictable relationship between gravity and the floor. In the more open areas of the boat it was common for large groups of seniors to shuffle en masse like they were in a drunken musical. (Which given the free flowing booze and incessant Muzak, they kinda were)

The swaying boat was especially exciting on the stairs. We settled on a family policy of unrestricted lattes and deserts as long as we only used the stairs throughout the cruise. But often, as the boat went up and down through the waves, it would magnify your weight and make ascending briefly impossible or conversely you would feel possessed of superior strength and fly up a flight of stairs.

Sleeping at night reminded me of playing on my Aunt Elma’s waterbed as a kid; you’d stop playing and still just kinda slosh around. I found it comforting and slept well, but I heard from a lot of veteran cruisers that this was one of the rougher transits they’d experienced. The crew, however, generally rated it a 3 or 4 out of 10 on tumultuousness..

Hawaii
Whenever I see a Jeep I think to myself “dumber than a bag of hammers”. It’s a personal prejudice. I spend almost all of my time in the woods and I never see jeeps out there despite Jeeps’ ostensible readiness for woodsy activities. And, the idea that Jeep ownership is a personality trait, demonstrates the same amount of personal development and insight as following a jam band and considering it a calling. Somehow, however, we always end up renting jeeps on vacation. It’s like the Bloody Mary of vehicles; it doesn’t make any sense in daily life, but on vacation it’s what you do. Maybe this is the elusive “Jeep thing” they keep talking about.

From Hilo, on the big island, we got to drive our Jeep-for-the-day on Mauna Loa at volcanos national park. Similar to the way the Grand Canyon is impossible to imagine, the immensity of this volcano is almost too much to conceptualize. Just the caldera would be a national park in most places. It’s possible to look from the ocean to the top of the 14,000 foot summit and imagining the mountain to extend just as far in the other direction to the seafloor was mind-boggling.

*200 foot cliffs above a solid lava floor*

On of the older observation decks above the volcano’s caldera is closed because it is slowly slipping into the lava. The floor of the caldera dropped a foot and a half a few years ago, destabilizing part of the caldera’s rim. Seeing the steadily smoking ground and imaging a 30,000 foot column of liquid earth beneath it made the geology of the place seem more immediate than most mountains. I still tend to think of volcanos as “earth pimples”, but majestic all the same.

We hiked through lava tubes and along a dormant caldera that looked like a frozen lake. The weather constantly shifted between steamy sun and cool blowing mists requiring lots of clothing adjustments. Along the coast, where the mountain enters the water, we saw an immense arch of volcanic stone sculpted by eons of crashing waves. The endless unapproachable black cliffs and tumultuous pacific waves made for a desolate beauty but close at foot were orchids and brilliant shrubs growing improbably out of broken lava rock.

From Kona (on the west side of the Big Island), we jeeped to an inconspicuous oceanside city park in the middle of a tiny dense neighborhood and enjoyed some of the most amazing snorkeling I’ve done. I saw at least three colors that I’ve just never even seen before and had to significantly alter my notions about what shapes fish can come in. Jude finally got the hang of using flippers and trying to follow him around was like trying to catch some kind of aquatic hummingbird.

From Honolulu, we drove the perimeter of the island stopping to watch surfers at sunset on Sunset Beach, which felt appropriate. We explored some more remote beaches and watched rain clouds pile up against the steep green cliffs in the center of the island and shred themselves into low mists making frequent rainbows in the shifting sunlight. We also spent some time at Waikiki beach just to see what a big touristy Hawaii beach was like and it completely met our expectations. Tan buttocks, junk food, and hostile beach chair vendors as well as some nice surfing and friendly kids.

Ensenada, Mexico

The boat ride back was easier to settle into, having bled off a little wanderlust. We played lots of board games, checked to make sure that the older people around the pool were still breathing, and ate lots of poke bowls. Wandering the outer decks of the ship at night in the tumultuous seas and watching the giant waves crash off of the bow of the boat was exciting and perpetually made us imagine the terror of being lost in that ocean at night. Reading about how Polynesian voyagers relied on storms for reliable winds to travel long distances left me in awe of their courage and skill at navigating the endless uncertainty of a horizon-wide ocean for weeks at a time.

Thanks to some odd laws about commercial ships and American ports, we had to stop at a foreign port for greater than 4 hours before returning to San Francisco, and Ensenada, Mexico has made a business of this legal oddity. Pharmacies loudly announcing Viagra sales, gaudy sombreros, and waiters determined to pull you by force into their establishment regardless of our protests in English or Spanish. We tried to get out of the tourist zone but just ended up amidst a weird combination of strip joint and barber shops.

A New Friend
As we were heading back on the boat, I realized that we had just entered and left a foreign country without using a passport or going through customs, just by using our cruise boat “medallion”, a plastic disk that has our passport and credit card uploaded to it. This got me to thinking about how using a cruise boat to flee the country or engage in some clever smuggling might be a good idea. (I maintain a hobbyist’s interest in financial crimes because I have never identified a second profession that I would enjoy if doctoring ever quits working out). The kids and I figured out how exactly we would go about stealing a cruise boat medallion and living as a stowaway but I quickly found out that we were not the first to see the criminal potential in the relaxed cruiseboat approach to international boundaries.

As we motored along the Mexican and California coast towards San Francisco and the end of our 16 day vacation, I was lounging in a hot tub near the pool looking up at the sky and thinking about how to translate my time away from home into some useful changes and new approaches to things when I heard someone hollering for a pool attendant.

Above me, perched at the edge of the second deck above the pool, a young good-looking guy with dark glasses and a towel wrapped around his head turban-style was gesturing urgently to a bewildered pool attendant. He was mimicking a dive motion and seemed to be asking the attendant if he was allowed to jump from the decking into the shallow pool. The attendant was clear that this was not permissible (nor sane) and the towel-turbaned man walked the steps down to the pool level near the hot tub I was in and proceeded to take of his t-shirt, sunglasses, and absorbent headgear. He was strikingly handsome, a little sweaty and twitchy, and had “Fast Learner, Big Earner” tattooed across his chest in cursive. I had seen him throughout the cruise and wondered what exactly he was doing on a cruise line that caters to senior citizens. He just didnt look like a buffet and canasta type.

“Hey man what’s your name?” He asked me, somewhat intently. “Josh”, I told him. “Ok, well look, Rick, I’m gonna dive into this pool but I dont really know how so will you watch me and make sure I come back up?” He asked me this as if we shared an understanding of the importance of this moment for him. Being swiftwater rescue trained, good with CPR, and a firm believer in personal freedom, I said, “I got you, man!” Emboldened by my support, or Rick’s support as far as he knew, he went to the edge of the pool area and leaned his head against a wall, muttering, and looking to the sky occasionally before walking back to the hot tub and putting his sunglasses on. “Rick” he says, looking morosely at me, “I don’t think I should do this. I’m not a very good swimmer. Can I get in the hot tub with you?” (I tried a few times to be Josh instead of Rick, but gave up).

I enjoy conversations with weirdos more than most people. I’m old enough that I’ve been through every version of chit chat and small talk that exists and it’s all about as interesting as using the dewey decimal system. With weirdos, you’re guaranteed to explore new conversational terrain. “So, why’d you pick this cruise?”, I asked him. He proceeded to tell me that his boss told him to get on the cruise, pick some things up in Hawaii, pick some things up in Mexico and that he was going to sell these things in San Francisco. This is a summary of his explanation anyway. He spent a lot of time looking at me conspiratorially over his sunglasses, calling me Rick and telling me about how someone had stolen his cocaine, so he was on DMT this morning instead, which helped him see the true nature of things. And given his realization that being a capable swimmer is a good prerequisite for diving, I had to agree that his perceptions were certainly laser-focused this morning.

“Rick, I really need to be under water for a while. Can you hold my head under if I start to float back up?” he asked. I thought about it long enough that he would feel like I was taking his request sincerely and then told him that I wasn’t the sorta guy who held people underwater, but that I could ask around if he was really looking for someone. “Well, what if I just hold onto you ankles while I’m under?”, he countered. I thought this over a little bit and decided that I wasn’t really comfortable being aquatically grappled by a smuggler on psychedelics and encouraged him to use the little ladder into the hot tub which seems like an acceptable solution to him. After his hot tub submersion seemed to address whatever DMT-fueled mythic crisis he was experiencing, he said “It was good to meet you, Rick, you’re a good guy, not like some faggots”, and got up to leave. I feel like I learned that my realization that cruise lines could be well used for smuggling was validated and that “Gay Rick” was an alter ego I could deal with under limited circumstances if necessary.

We left the boat with a mix of sadness and joy. Slow time with family is rare time and I’m glad we had so much of it. But I’d walked around the cruise boat 3 or 4 hundred times and could pick a dessert off the buffet blind-folded at this point. And we all missed the cat. Getting from San Francisco to Dallas was smooth but in Dallas we ran into trouble.

“Due to unexpected storms over Atlanta, we will just be driving the plane to Charlotte at interstate speeds of 70 mph with light traffic.” This was what I expected to hear as we seemed to be taxiing in endless circles on a scenic tour of Dallas/Ft worth runway, hours after our scheduled departure time. It was sort of a comforting thought, really. I Imagined stopping at rest stops and gas stations and maybe taking short flights over slow moving traffic.

When we finally did get to Charlotte, we found the airport full of people who had their flights cancelled and were trying to get anywhere for the night which had caused a traffic jam and effectively shut down traffic in and out of the airport as well as the shuttle to long term parking where our car was.

It was 2 in the morning, the arrival sidewalks were shoulder to shoulder with disgruntled and hopeless passengers, and the last shuttle had appeared over an hour and half ago according to bystanders. So, I set off on foot to see if I could walk to the long term lot, which involved running across vast concrete expanses, climbing a fence, crossing a train track and finally ending up at a razor wire fence where I had to give up. I offered a security guard $50 to take me in his truck to my car and drove around to pick up the family, where a shuttle had still not arrived.

With some Red Bull, cookies, and irritating music we made the drive home safely and collapsed into bed with the worlds sweetest cat who purred so hard he drooled a little.

Domestic Vignettes

As Above, So Below