I was blessed to be under the care of an extraordinary surgeon for just over a year. Dr. Ward J. Dunnican, whom I met a couple of years ago, was recently killed in a motorcycle accident. His specialty was minimally invasive surgery, with a particular emphasis in bariatric surgery. He was a physician, a surgeon and an assistant professor of surgery. He worked and taught at Albany Medical Center.
Everyone liked and respected him, and it was easy to see why. He was a physician who genuinely cared about his patients, he was compassionate toward an entire population of patients who, because of their size, have experienced first hand the dismissal of other medical professionals and society at large. His bedside manner was nothing short of stellar. He was personable, compassionate, accessible, ethical, professional and highly skilled. He was, in short, what every physician should be. When he greeted his patients, it was always by looking them in the eye, shaking their hands and smiling.
If I’m to tell the story of how much he affected my life, I have to reveal more information than I typically would. I’ll spare you most of the details, but I still need to disclose more than I generally prefer.
I am by nature a very private person, averse to revealing intimate details to anyone other than a select few. Most of the world knows me primarily for my sense of humor, which runs the gamut from inane to sardonic. The vast majority probably don’t realize that humor is a highly effective and reliable defense mechanism, emotional kevlar with a kick—not only deflecting rejection and judgment, but also capable of disarming opponents with rapier-like precision.
Those select few are the only ones, for instance, who know the full extent to which I have struggled with my weight—a battle I have waged for nearly my entire adult life—and the toll it has taken on me physically, psychologically and emotionally.
As an adult, my weight has swung widely on a clinical scale from normal to morbidly obese. When phrases like “co-morbidity factor”—or pretty much any term with the word “morbid” in it—start entering your medical history, it’s time to shit or get off the damn pot. My co-morbidity factors were high cholesterol, osteoarthritis and clinical depression. I am eternally grateful that I didn’t have worse co-morbidity factors, like hypertension and diabetes (both of which run in my family) or sleep apnea or heart disease.
I examined from every conceivable angle how I’d gotten to that point, how I’d “let myself go,” as it’s all too often phrased. Above all else, I had to acknowledge one fact: regardless of what the motivations were, what actions led to this point, I was behind the wheel. I drove myself here, intentionally or neglectfully, through my own actions. Unhealthy habits had built neural connections in my brain that were reinforced and strengthened through repetition. It’s easy to look at it from that perspective and feel defeated, to feel like the ultimate failure, to pile layer upon layer of guilt and blame upon myself. But it isn’t about fixing blame; it’s about fixing the problem.
Those bad-habit neural connections can’t be undone, but they can be rerouted to new connections through better choices and healthier habits. By readjusting the focus, this acknowledgment becomes tremendously empowering: If I drove myself here, then I have the power to get myself out of this situation and get to where I want and need to be. And believe me, there are a lot of detours and wrong turns I’ve taken (and occasionally continue to take) along the way, and all of my yelling at my nutritional/physiological/biological GPS system won’t get me on the right road. (Imagine if every time you had to pick yourself up, dust yourself off and try again, a little voice in your head repeatedly said, “Recalculating…recalculating…” Believe me, you’d bludgeon her with a chocolate glazed donut in a heartbeat.)
When you get right down to it, weight loss is a fairly simple equation: burn more than you take in and you’ll lose weight. (Highly evolved human physiology being what it is, nature throws in a few metabolic curveballs, especially after 40 and, in a particularly sick twist, for people who’ve lost and regained weight over and over again. But caloric deficit remains the basic premise.) But if I learned nothing else as a theatre major, it’s that “simple” and “easy” are not even remotely the same thing.
Having tried everything from Atkins to The Zone, from Diet Center to Weight Watchers (and even, yes, good old-fashioned diet and exercise more times than I can count), my experience was all too common: preliminary weight loss, then the inevitable plateau after seemingly endless plateau, finally hitting the inevitable peak of frustration that would send me plunging into despair—and the nearest pint of Ben & Jerry’s—usually muttering the all-too-familiar phrase, “What’s the fucking point?”
When my weight hit an all-time high, I began to consider the most drastic approach: bariatric surgery. I was extremely uncomfortable with the idea of “rerouting the plumbing” (gastric bypass), so I focused on gastric banding. After copious amounts of research online into the pros and cons, the side effects, and what to look for in a surgical program, I entered the bariatric surgery program at Albany Medical Center. There was no question that bariatric surgery was a drastic step, and after all of my research I had no delusions about what it could and could not do. Bariatric surgery is a tool; nothing more, nothing less. A tool that would only “work” if it was used properly. I wasn’t looking for a miracle cure or a magic bullet; I was just looking for the missing piece to the puzzle, the key that would open a door that had been locked for far too long. I was looking for something that would help level the playing field, if only a few degrees.
The program at Albany Med is unapologetically daunting. Anyone who thinks that bariatric surgery is “cheating” or “taking the easy way out,” should try jumping through all the hoops necessary just to get to surgery: screenings of every conceivable kind—blood tests, pulmonary evaluation, psychological evaluation, endoscopy, etc.—nutritional counseling, a thorough mandatory information session, attendance at support group meetings, and a requirement to lose ten percent of your weight before being cleared for surgery. All of that before I could even schedule a surgery date.
After more than a year in the program, I was finally cleared for surgery and had a date scheduled. I was going through pre-admission processing a few days in advance when I received a call that my original surgeon, Dr. Singh, was sick and wouldn’t be able to perform the procedure on my surgery date. I was crestfallen. I had jumped through every hoop only to get burned on the last ring of fire. Another surgeon, Dr. Dunnican, could perform the procedure, so I met with him that afternoon for a pre-op consultation. Dr. Singh had the reputation of being one of the best bariatric surgeons in the Northeast, if not the entire country. I was confident in his abilities and felt quite circumspect of placing my health in any other surgeon’s hands, even someone like Dr. Dunnican, who had fellowed under Dr. Singh. My other option was to wait more than a month for another surgery date to open up, and the wait thus far had been agonizing.
As I waited for my late afternoon appointment, I tried to imagine this Dr. Dunnican. For whatever reason, I imagined a balding, middle-aged Irishman with a condescending manner, a fondness for Jameson’s and maybe even a God complex. When Dr. Dunnican walked in the door, two thoughts immediately hit me, nearly simultaneously: OMG, he is GORGEOUS! (seriously, I used to refer to him as "Doc Hottie" to my close friends) and Crap, he is WAY too young to operate on me! I hope neither expression was written on my face, but I’m rather notorious for my lack of a poker face, so you do the math. He was the diametric opposite of what I had imagined.
As he took his time, reviewing my history, going through the details of the surgical procedure, how the band worked, how it was adjusted, etc., I was amazed that this man, who had been in surgery all morning and had been at the VA hospital all afternoon, was taking all of this time, carefully explaining everything, answering every one of my questions (even the stupid ones) and laughing at all my jokes (even the really lame ones). He must have been exhausted, but he never showed it. I had never met a doctor who was so patient and thorough. I had long since grown accustomed to the managed care reality of seeing a doctor for five or ten minutes per visit and trying to make sure I remembered all the important questions to ask in that tiny window of opportunity. Most of the physicians I have encountered spent practically the entire office visit looking at my chart or looking at the floor. The few who didn’t always seemed to leave private practice or move away or whatever just as I was getting really comfortable with them.
I left Albany Med that day feeling confident that this procedure was, in fact, worth all the effort, all the sacrifice, and that I was in the best possible hands. The following Monday, June 16, 2008, Dr. Dunnican performed the laparoscopic procedure to implant a LapBand around the upper part of my stomach.
Over the course of the ensuing months I would have regular follow-up appointments to evaluate my progress; discuss any questions, concerns or difficulties I encountered; and adjust the band through a port just under the skin below my right rib cage. Adjustment is more art than science, since there’s no one-size-fits-all proposition in banding. Oh, and it involves a big needle. So why go through all of this? Because for the first time in my life, I felt empowered. I felt capable. I felt like the playing field had been leveled just enough to give me a real fighting chance.
I ran into complications the following February when my band slipped. Once again, Dr. Dunnican and I had a date with the OR; this time, to reposition the band. Everything seemed fine again until I landed in the ER about four months later when my band slipped again.
It’s difficult to describe what a slipped band feels like. It’s one of the most common complications of gastric banding, and one I knew about from my research and from my first consultation with Dr. Dunnican. When I would describe it to my close friends, I used the term “kamikaze attack” because it came out of nowhere, without warning, without an identifiable catalyst. Sometimes it felt like intense pressure, sometimes it felt like no matter how much I tried to swallow, something didn’t get quite all the way down to my stomach. Sometimes it just felt…wrong. But it never felt acutely painful. (Even I’m smart enough to seek medical attention when acute pain is involved.)
I had three options: reposition the existing band, replace the existing band with a new band, or remove the band altogether. Dr. Dunnican fully supported my decision, whatever it would be. The uncertainty of the kamikaze attacks was tremendously stressful. In the end, if you’ll pardon the pun, my gut feeling was that my body didn’t want the band inside me. Despite my trepidation, I knew I had established the habits that would lead me to success and had gotten my weight down lower than it had been in well over a decade, and the confidence that came with that accomplishment helped steel my resolve. I opted to have the band removed. On June 16, 2009—one year to the day since it was first implanted—Dr. Dunnican removed my LapBand.
I told Dr. Dunnican afterward that I was determined to be his “most successful ‘failure’.” At every appointment, he had always looked me in the eye, smiled and shaken my hand when he greeted me and again when we parted ways. At the final appointment, I asked for (and got) a hug for good luck. Two, actually.
When I read of his sudden and tragic death in a motorcycle accident, I thought first of his family (in particularly, his young children), then of his colleagues, and finally of his patients. If our lives are ultimately measured by the number and depth of the lives we touch, then he died a very, very wealthy man indeed. For his family, I pray they will be comforted in their time of inexplicable loss. For his colleagues, I pray they will be inspired by his example. For his patients, I pray they will find the kind of trust and rapport they had with him in another capable surgeon. And for Dr. Dunnican, I pray for eternal peace.
So that person you thought of at the beginning of this post; imagine for a moment that you had an opportunity to say something to that person before (s)he was gone forever. What would you want to say?
To Dr. Dunnican, I would say thanks for all he did for me in a very brief period of time. I would tell him that his extraordinary care and compassion set an example for all physicians to follow. I would tell him about my running and that, as corny as it sounds, I would run this weekend’s Dunkin Run (my ninth 5k) in his honor (the “Dunnican” Run, as it were). The impact he had on my life played a crucial role in enabling me to run at all.
On most race days, I wake up reasonably well rested and eager to get to the race. On the morning of the Dunkin Run, I felt, well…meh. It was cloudy and dreary out, and even though I had slept pretty well, I just wasn’t feeling it today. I wanted to run it all and put in a decent time, especially after last weekend’s twin debacles of my fledgling 5k “career”. I gave myself a goal of sub-:37 but really just wanted to feel good running. Most of all, I wanted to run for Dr. Dunnican, for all the good he did, for all the compassion and laughter he spread, for all the life he put into his 37 years.
My Facebook friend, Tiffany, was competing in her first Ironman Triathlon in Ohio on the same day. Swim more than a mile, cycle for 56 miles, and then, oh yeah, run a whole freakin’ marathon. 140.6 miles of hard-core cranking. And all I have to churn out is five measly kilometers. Tiffany often talks about having an “attitude of gratitude,” and today I really took that mantra to heart.
I made a conscious decision that no matter what I encountered, I would have an attitude of gratitude. Long bathroom line? I’ll be grateful for the invention of the flush toilet so I wouldn’t have to poop behind a tree. Tired, achy legs? I’ll be grateful that I have legs, that they work, and that they have carried me this distance before (and for ibuprofen, of course). Breathing cadence that just won’t get with the program? I’ll be grateful for healthy lungs, for clean air, for the luxury of coming out on a Sunday to run just because. No chocolate glazed donuts? I’ll be grateful to spare my body the refined sugar. (But, um…I really wanted a chocolate glazed donut, refined sugar and all.)
I arrived at Albany’s Sidney Albert Jewish Community Center on Whitehall Road just after check-in opened at 7am. Even if I hadn’t already known where the JCC was located, it would have been a no-brainer today. Dunkin Donuts banners, giant Dunkin Donuts coffee cup by the starting line, Dunkin Donuts iced coffee mobile, huge Dunkin Donuts truck…good luck forgetting who put the “Dunkin” in the Dunkin Run. (Incidentally, it’s only been the Dunkin Run for a few years; it was previously the Bruegger’s Bagel Run.)
I checked in and the volunteer looked at the sheet and said, “You’re number one!” He checked it twice. Yup, I had bib number one. I said, “I’m registered for the 5k, right? Not the kids’ fun run.” He assured me I was. (The Dunkin Run was the first time I’ve seen kids in a fun run wearing regular bib numbers; usually, if kids get bibs, they all get #1.) He asked me if I was going to finish first. I joked that the list he was looking at was the only time in history when my name and the number 1 would appear on the same line of any race document.
I went about my usual pre-race routine: locate rest rooms, use rest rooms, check out the race day goodie bag, take pictures of all the goodies, attach my timing chip and bib, take pictures of the venue and, in today’s case, verify that there were chocolate glazed donuts. It turns out there weren’t any donuts per se, but there were munchkins galore (including chocolate glazed), so I wasn’t complaining. I usually don’t eat sugar before a race; I’ll eat a light breakfast after getting up, then a banana about an hour before the race. But as I surveyed the Dunkin spread, I decided I really didn’t want to chance missing out on the chocolate glazed munchkins, so I decided to relax a little an have a couple.
I walked around to warm up and did a little light preliminary stretching. I was really just biding my time until the folks from the School of Massage Therapy were ready with their massage tables. I hadn’t had a pre- or post-race massage since the Freihofer’s Run, and I wasn’t going to miss the opportunity today.
While I waited, someone finished hooking up the sound system and played a couple of U2 tunes: first, “City of Blinding Lights” and then “Beautiful Day”. I looked up at the gloomy, cloudy sky, and felt the slight chill of the breeze on this cool morning and thought, Beautiful day? Um, if you say so, Bono. Then I remembered my mantra: I have an attitude of gratitude and I was grateful for some great tunes to start the day.
When the massage folks were ready, I was directed to a purple massage table set up under a big, rather happy-looking, maple tree. Unfortunately, I can’t remember the name of the gentleman who gave me my massage, but it began with an L, so I’ll just refer to him as L and make him sound mysterious, like a double agent in a John LeCarré novel. I began the massage lying prone on the table, relaxing as L gently warmed up my leg muscles. When it was time to roll over onto my back, I looked up at the tree and just soaked in its bark and leaves and little clusters of helicopters. Over the five-minute massage, we chatted briefly about running and what my goals were for the race. He told me to come back for a post-race massage and tell him how I finished. I thanked him and walked away to finish warming up and doing my last pre-race stretching, grateful for a free pre-race massage and the skilled hands that delivered it.
One benefit of wearing bib #1 is that people notice you. Not that I don’t have a tendency to stand out just a bit in a neon green running jersey, but people I had never met before would walk by me, smile, and say, “Hey! Number One!” A couple of them asked how I got that number; I speculated that I must have been the first to register for the race, but not before quipping about signing up for the kids’ fun run by mistake. I have to admit, the unexpected attention was actually pretty cool. A girl could get used to that.
As we lined up near the starting line, the young woman standing next to me told me she was nervous because this was her first race. She asked if it was okay to start so far forward, since she was a slow starter. I told her she’d do great and just to stay to the right so the faster runners would have plenty of room to pass on the left. As long as she wasn’t planning to walk the start, she’d be fine where she was. I told her that I am a slow runner and always stay to the right, and I’ve never heard anyone curse me out for it yet. (I saw her again after the race when she called out, “Number One! How did you do?” It was then that I found out she had run the 10k. I told her how impressed I was that she chose a 10k for her first race. The smile on her face conveyed her agreement.) Thanks in large part to the atmosphere of the runners (and, of course, a nice pre-race massage), I was feeling much better; definitely more relaxed as we awaited the start o the race.
We would be taking over a rather sizable length of Whitehall Road, making a few people nearly late to church. (I know this because some of those people are fellow parishioners of mine at the Cathedral of the Immaculate Conception.) As soon as Albany’s finest finished clearing the route, the air horn signaled us to start running.
I typically thank some people along the course of a 5k, mostly the race marshals, but for this race I decided (on a whim as I started running) to extend my attitude of gratitude to everyone I could. I decided to focus not on finding my breathing cadence or getting to a comfortable stride, but instead on getting to the next volunteer, the next race marshal, the next cop. My goal was to thank every single one. At every intersection, I said “Thank you!” and either clapped or pointed. I suppose someone might have thought it was silly or even obnoxious. (I certainly wasn’t whispering, after all; and my voice does tend to…um…carry.) Some might even have thought I was wasting energy that I should have been spending on running. Did thanking everyone at every intersection cost me a few seconds on my time? Perhaps, but gratitude is a positive energy, and I find that positive energy yields positive energy. A couple of the folks I thanked looked surprised, but most of them smiled and thanked me back or clapped or said, “You’re welcome.” No eye-rolling, no bird-flipping, nothing negative. I felt more energy as I ran down the road.
I really wasn’t thinking much about my running. I wasn’t thinking about my breathing. Don’t get me wrong, it was still quite an effort to haul my heinie 3.1 miles. But today, that didn’t seem to take nearly as much effort as it had last weekend. The more people I thanked, the more energy I took in. I was Godzilla and gratitude was my electricity.
There was a lovely elderly couple sitting by the curb in their lawn chairs, the wife wrapped up in a blanket against the morning chill. The way the course is laid out, I passed them twice. The first time I just smiled at them. The second time, I thanked them. They beamed back huge smiles at me. Godzilla kept getting stronger.
As we approached one of the few turns in the race, where we would loop around a block and then run back along Whitehall Road in the opposite direction, we could see the flashing lights of the police escort vehicle ahead. We all moved over toward the left lane to make room. The police escort vehicle was followed by a motorcycle cop and the Dunkin Donuts iced coffeemobile. And then we saw the lead runners, nearly shoulder to shoulder. We cheered them on. As the escort vehicles passed me, I thanked them.
Once we made the block turn ourselves, we were headed back along Whitehall for what, at times, seemed like the endless trek to the Albany School for the Humanities, which would be the turnaround point for this race. I’ve driven Whitehall Road countless times, but this was the first time I’d run it. Big surprise: it seems a lot longer when you’re running it. Who’da thunk it? When we started to see the lead 5k runners heading back toward the finish line at the JCC, we cheered them again. And many of the runners cheered us on. I was overjoyed when I saw the turnaround at ASH. I literally said, “Hallelujah!” And I mean audibly. As I headed back up Whitehall toward the JCC, I saw Joe, who for once was behind me (and stayed that way). I was also rather surprised to see some fast-looking runners coming in the other direction after I finished the turn at ASH. Then I realized, those were the 10k runners, who were running the same route as the 5k, but completing it twice. So to them, I cheered, “Woo-hooooooo! Way to go, 10k!!!” One of them smiled and said “Thank you, Number One!” In a typical race, when I start to feel my legs getting fatigued, I look at the ground so I can just focus on one step at a time, listening to my iPod, thinking just get through this song. But in this race, when I would start to lose steam, I just kept thinking, This one’s for you, Doc, and look for someone to thank or to cheer on or to high-five. I never had to look very hard. Mmmmm…electricity…Godzilla liiiiiiikeeeeeee.
And so I chugged along, a neon green-clad, pointing/clapping/cheering/thanking, #1-wearing gratitude machine. Seriously, what’s the worst that could happen? People would remember me? For thanking people? Oh, hell yeah, I can definitely live with that.
When I got to the three-mile mark, I felt tired but strong. I could see the traffic cones ahead guiding me to the finish line. I resisted looking at the clock for as long as I could. I felt I had run a good race, had a good vibe, and thought I had a good shot at making my sub-:37 goal. As I neared within perhaps 30 feet of the finish line, I couldn’t resist looking at the clock: 35 minutes and change. I was going to beat my goal by more than a minute. Thanks, Doc, I thought, this one’s for you. I crossed the finish line at 35:49, let out what has become my characteristic whoop…and then, inexplicably, burst into uncontrollable tears.
I don’t know where the tears came from exactly, but they were coming fast and furious and I didn’t care that I was walking around on rubbery legs with tears streaming down my face. Maybe they were tears mourning the loss of Dr. Dunnican. Maybe they were tears for his family, especially his children. Maybe they were tears of relief from crossing the finish line on a morning when I woke up feeling meh. Maybe they were tears of sheer exhaustion. Maybe they were tears of realization that gratitude begets gratitude, that positive energy begets positive energy, that joy begets joy. Maybe they were all of those things.
I wandered over to the sidelines to cheer on some of the runners who were approaching the finish line, and I kept crying in wave after wave. As soon as I thought I was finished, I’d start back up again. After several minutes, the waves finally began to subside, but through it all, I kept cheering runners on. I finally saw Joe come trotting toward the finish line and cheered him by name. As I stood there in a cool breeze under a cloudy sky, the sound system again started to play U2’s “Beautiful Day”; this time, I didn’t even hesitate. Yes it is, Bono. It is a beautiful day indeed.
I headed over to L for my post-race massage. He was already massaging another runner and, even though other tables were open, I wanted to tell him how I had done, so I waited a few minutes. While I waited, I heard someone call out, “Number One!” By now, I was fully enjoying my new nickname. Ah, yes. A member of my public. It was one of the 10k runners I’d cheered on as I was on the final mile of my 5k. I recognized him because he was the one who responded to my cheering with, “Thank you, Number One!” His name was Ken and he was a marathon runner. We chatted a bit about running and he told me, “You’d love Boston.” Well, yes, I adore Boston. It’s my favorite US city. But I knew he was referring to running the Boston Marathon. Yeah…um…I’m still working up to running a 10k next year in Atlanta (on the Fourth of July…yeah, I know). He mentioned that he’s run Boston 15 times. (Well, I’ve certainly been to Boston more times than that.) I had to chuckle when he said, “At the risk of dating myself, I’ve run Boston every year since I was 20.” A 35-year-old telling a 47-year-old woman that he’s dating himself. We shared a laugh over that and then each went to our respective massage tables.
During my post-race massage on the purple table under the happy bird-less maple tree, I mentioned to L that I ran the race in memory of Dr. Dunnican. It turns out that L works at the Starbucks across from Albany Med. He wasn’t sure if he recognized Dr. Dunnican’s picture in the newspaper, but suspected that he probably served him on occasion.
I recently read this quote online: “Time goes by so fast, people go in and out of your life. Try to never miss the opportunity to tell these people how much they mean to you.”
So thank you, Dr. Dunnican. And thank you, my friends, for taking time out of your hectic lives and reading my blog. Thank you for your encouragement and support. Thank you for electronic high-fives and hugs.
If you enjoyed reading this post, don’t just send me positive feedback (although I love that). Go ahead and forward on to someone. Tell someone who means a lot to you, whom you may have been too busy to mention it to lately, how much richer your life is for knowing him or her.
An attitude of gratitude is contagious. And I want to be a carrier. Let’s go viral, shall we?
Absolutely beautiful - and inspirational - post. Thanks so much!!!
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