Stinging nettle leaf (Urtica dioica) has been extensively utilized for centuries as a folk remedy for many varied ailments. In this case report, the herb appears to be an effective preventive for vertigo related to baro-challenge-induced Eustachian tube dysfunction.
For some time, I’ve been troubled with vertigo associated with Eustachian tube dysfunction (ETD) that occurred with air travel, specifically termed baro-challenge-induced ETD. The symptoms I experienced were not trivial; they included nausea, difficulty keeping my balance, diaphoresis, inability to focus my eyes, and constant movement of my environment. Initially, my symptoms were somewhat ameliorated by taking vitamin C powder, in advance of and during my flight, because of its known antihistaminic effect and documented improvement of vertigo (1). During a more recent flight, though, I had concurrent vomiting and wondered if I should try conventional antihistamines beforehand, hoping they would keep my Eustachian tubes patent. Yet, I preferred not to deal with the potential side effects, such as drowsiness, dry mouth, difficulty urinating, and reduced coordination (2). So, I tried another option, stinging nettle, with its antihistamine and anti-inflammatory properties (3), and a suspected milder adverse reaction profile. Three hours before my next scheduled departure flight, I took three 300 mg capsules of wildcrafted, freeze-dried stinging nettle leaf, along with a hot cup of organic stinging nettle tea. I repeated only the capsules for my return flight. The results were astonishing. Not only did my eustachian tubes easily clear on both flights simply with sipping fluids and exaggerated yawning, I had no symptoms of vertigo whatsoever, and I experienced no adverse reactions to the herb.
Discussion
ETD is a problem that affects around 1% of the general population and can be categorized into three different types. Patulous, caused by overly patent Eustachian tubes. Dilatory, where inflammation and mucosal edema from rhinitis, upper respiratory tract infection, and/or gastro-esophageal reflux disease (GERD), leads to blockage and dysfunction. Baro-challenge-induced, which is the failure of the Eustachian tube to open with surrounding ambient pressure changes, such as with air travel or deep-sea diving, thus inhibiting the regulation of middle ear pressure (4).
Conventional
medical and surgical treatment options depend upon the type of ETD. For GERD-associated ETD, lifestyle changes
and proton pump inhibitors should be considered. Otherwise, avoidance of allergens
is recommended, and medical interventions may include oral antihistamines and/or
nasal corticosteroids. Antibiotics may be prescribed for rhinosinusitis. Surgical dilatation of the closed Eustachian
tube may be performed, and ETD from otitis media with effusion can be managed
with tympanostomy tube placement. If adenoid hypertrophy is felt to be a
contributing factor, adenoidectomy should be considered. Auto-inflation devices for reopening the
Eustachian tubes by raising the pressure in the nose have shown positive
results for correcting middle ear pressure and fluid clearance. (ibid., 3-4)
Urtica dioica, known as stinging nettle, greater nettle, common nettle, giant nettle, European nettle, or simply nettle, is native to Europe and Eurasia and grows wild in temperate parts of the world. The use of nettle dates to ancient times, having been mentioned by Hippocrates (ca. 460-370 BCE) and Theophrastus (ca. 371-287 BCE), by Dioscorides (40-90 CE) in Materia Medica, and by Pliny the Elder (23-79 CE) in Naturalis Historia. In the medieval period, nettle was recommended by German philosopher, mystic, composer, and abbess Hildegard von Bingen (1098-1179) in Physica, and by Swiss physician Paracelsus (1493 – 1541) in his writings on the doctrine of signatures (5).
What are the current clinical uses for stinging nettle leaf? The herb can be beneficial in the treatment of allergic rhinitis, osteoarthritis, and rheumatoid arthritis. Its diuretic effect has been demonstrated in vivo, and it has been shown in an isolated study to be effective in the treatment of migraine headaches (6). Stinging nettle root, as opposed to the leaf, has been utilized to improve urine flow, decrease residual urine volume, and reduce urinary frequency and nocturia in the early stages of benign prostatic hypertrophy (BPH)(5). Despite much previous clinical research on stinging nettle leaf, I have discovered no study that indicates the herb can be utilized for the prevention of vertigo in general, or specifically, vertigo caused by baro-challenge-induced ETD.
As far as safety is concerned, the Botanical Safety Handbook (1997) of the American Herbal Products Association (AHPA) assigns Urtica dioica as a Class 1 herb: Can be safely consumed when used appropriately (6).
I have carefully
evaluated the scientific data, and while the exact mechanism of how stinging
nettle prevented my disabling vertigo is unknown, one might intuit this effect was due to the herb’s unique antihistaminic
and anti-inflammatory activities.
Finally, on
a personal note, I can’t explain in words the sense of relief that I had after
my experience with the use of stinging nettle. I was, at long last, given hope
that vertigo might no longer hang over my head like the proverbial sword of
Damocles, dampening my enthusiasm for travel to faraway places.
Conclusion
In this case
study, stinging nettle leaf appears to have aborted vertigo secondary to
baro-challenge-induced ETD. Further human studies are needed for confirmation.
Acknowledgements
I want to
express my gratitude to Andrew Weil MD for his helpful suggestions and review
of this article. Thanks to Dr. Chris
Corbett for his adept editorial assistance.
Much appreciation to Dr. Stefan Gafner of the American Botanical Council
for his aid in information gathering.
References
1) R.
Jarisch; D. Weyer; E. Ehlert; C. Koch; E. Pinkowski; P. Jung; W. Kähler; R. Girgensohn, W. Hemmer, A. Koch. Influence of Orally
Taken Vitamin C on Histamine Levels and Motion Sickness. Journal of Allergy and
Clinical Immunology, Volume 127, Issue 2, Supplement, February 1, 2011.
2)
Khashayar Farzam; Sarah Sabir; Maria C. O’Rourke. National Library of
Medicine, National Institutes of Health. Antihistamines, January, 2022.
3) Bill Roschek; Ryan C. Fink; Matthew McMichael; Randall S. Alterte. Nettle extract (Urtica dioica) affects key receptors and enzymes associated with allergic rhinitis, Phytother Res. 2009 Jul;23(7):920-6
4) Sahar
Hamrang-Yousefi; Jimmy Ng; Claudio Andaloro, NCBI Bookshelf, National
Institutes of Health, Eustachian Tube Dysfunction, January 2022, updated July
15, 2022.
5) Gayle Engels; Josef Brinckmann. Stinging
Nettle, Herbalgram, American Botanical Council, Issue #110, pages 8-16.
6) Roy Upton RH, Editor; Teresa Soria BS,
Associate Editor and Monograph Coordinator; Teresa Soria BS and Diana Swisher
MA, Research Associates. Stinging Nettle Herb, American Herbal Pharmacopoeia,
2009.
About the Author
Gary D. Conrad, MD, is an integrative medicine physician and author who is currently retired from a forty-three-year practice in emergency medicine.
After my retirement from emergency medicine in March of 2022, I have enjoyed a softer, gentler existence. Besides spending more blessed time with my wife, Sheridan, and our dogs, Karma and Buddy, I can now enjoy added moments with my grandchildren, especially since the misery of Covid-19 has at long last waned. With that in mind, I decided to drive to Enid, OK, to see my granddaughter Sawyer play a soccer game with her rather incredible team, the Stingers, little knowing the inner journey I was about to experience.
And so, on that fateful afternoon, I hopped in my rattly, but still loved 2004 Honda CR-V, and headed north on I-35, expecting a drive of about an hour and a half. I love quiet moments in my car, as while my outer mind is focused on the highway, my inner mind can wander unfettered. Before long, I approached the first of two exits to Guthrie, and my consciousness was unexpectedly flooded with bittersweet memories. Guthrie was the town where I lived for a number of years on nine wooded acres, and where I was a devoted father to my three daughters, Sarah, Megan, and Hillary. I was married before I moved to Guthrie, and while there, I was divorced, with all the inherent emotional trauma. Guthrie was where I began my healing pathway, not realizing at the time how long it would take to approach normalcy.
I recalled taking my daughters and their friends to the Guthrie Country Club lake during the summer and frolicking for endless hours on our family jet ski. I thought of when I coached Megan and Hillary in fast-pitch softball. At the time, I wasn’t the laid-back person I am now, and I approached coaching with a fire and intensity that eventually led to a number of championships. I loved all my players deeply, and, at the same time, I did my very best to prepare them to win.
In Guthrie, I took the “Back to Earth” movement quite seriously. I raised dairy goats and milked them twice a day, maintained a large organic garden, and tended a flock of chickens, not for their meat, but for their delicious eggs. Besides all this, I was a beekeeper, oh, and yes, amidst all this busyness, I also happened to be an emergency physician. The days I labored at the hospital, I drove almost forty-minutes to get there, and the drives back home after my challenging shifts were tiring and difficult. Perhaps it was because I was younger that I tolerated so much simultaneous, frenetic activity, though even now, I honestly don’t know how. Continuing down the highway, I wondered what thoughts and feelings would come up next.
As the exit ramp to Stillwater approached, I remembered my three years as a student at Oklahoma State University, a place that admirably prepared me for my eventual medical training at the University of Oklahoma. I thought of the fact that my parents met at OSU and were later married in my mother’s hometown of Claremore. I recalled my three years of living at the now-demolished Willham Hall, where I roomed with my old U.S. Grant High School football chum, Phil Dean. Years later, my brother, Jim, and sister, Connie, also attended OSU. Being a longtime fan of sports, I loved OSU football, as well as intramural athletic events, including wrestling, softball, and volleyball. These were formative, explorative years for me, as it was the first time I had been away from the my parent’s protective mantle for any extended period of time.
Before long, I approached the exit to Perry, and I was reminded of the deep friendship my family had with the Paul and Lois Edmundson family. Paul was a veterinarian, and he and his wife, along with their two sons, Wade and Todd, lived on a small acreage just northwest of the interstate exit. One memory that came to mind was when Wade and Todd, along with my brother Jim and I, went swimming in their murky farm pond and made the questionable decision to scoop up and throw mud pies at each other. All went well until Wade hit Todd in the face just as he emerged from the water, and his irritated mother had to clean copious amounts of mud out of Todd’s eyes. Wade was in big trouble, and he knew it. Isn’t it odd how these memories can resurface when you least expect it?
Of course, the clear highlight of the day was seeing my granddaughter Sawyer’s team play soccer against their archrival, Enid. Here I am seen proudly wearing my official Stingers hoodie as I stand next to her.
The final score of the thrilling match was 1-1, but the main reason I was there was not to see a victory, but rather, to give my full and unwavering support to Sawyer. Isn’t that what grandparents are for?
After the game, I drove back toward my home in Edmond, deep in thought, my contemplations accentuated by the gorgeous sunset pictured at the beginning of this post. As I thought about it, it’s natural to have reactions to places of importance and intensity in our lives. Yet, it was hard for me not to have a sense of melancholy, after all, much of my life has passed me by, so much quicker than I ever could have imagined. While I hope to still have a number of healthy, happy years before my time on Earth comes to an end, the simple truth is that most of my life has already taken place. I feel joyful in the knowledge, though, that God has blessed me with such an interesting, productive, and service-oriented existence. Not that it’s all been peaches and cream – it hasn’t – but the hard lessons blended with many beautiful, sacred moments have helped me grow into a better person. Scarred, perhaps, but definitely an improved version of myself. Jimmy Stewart might pat me on the back, look in my eyes and say with his distinctive timbre, “Gary, It’s a Wonderful Life!”
And it has been.
In the meantime, when Sheridan and I enjoy an occasional glass of wine, I now pick out one of the best bottles we have, following the dictum of the French phrase, joie de vivre, “the keen or buoyant enjoyment of life.” Another way of putting it is the Latin adage, carpe diem, “seize the day.” Given the limited time I have in this incarnation, as we all have to one degree or another, I plan to do everything I can to experience life fully and completely, not delaying my joy for a nebulous and unpredictable future.
I love seeing the happiness on my grandchildren’s faces, travel with Sheridan to faraway places, singing with the Edmond Community Chorale, small-scale organic gardening, and deepening my relationship with God through meditation, living in the Present Moment, and simply being as kind as possible. The Dalai Lama once wisely said, “My religion is kindness,” and I couldn’t agree more. John Denver, in “Poems, Prayers and Promises,” said, “I have to say it now, it’s been a good life, all in all. It’s really fine to have a chance to hang around.” Amen.
The next time I need a growth experience, hopefully, it won’t require a trip to rural Oklahoma, but I’ll take any opportunity that God so graciously gives me.
After the death of my mother on August 12, 2016, my father was abruptly left by himself after sixty-five years of marriage. While we all missed our beloved mother, the family had a sense of relief, knowing she had suffered for years with polymyalgia rheumatica, and at long last, she was no longer in intractable pain.
We all did what we could to support Dad during this challenging time. For myself, I called him a couple of times a day just to check in, and I visited him weekly, oftentimes going to Olive Garden for a hearty Italian lunch. Sometime later, after the acute pain of Mom’s death had waned, I thought it was high time to inject a little humor into the situation. After all, according to author and world peace advocate, Norman Cousins, wasn’t laughter the best medicine? Given Dad’s farming heritage, I decided to nickname him the “Top Rooster.” When Dad answered the phone in the morning, our conversations would go something like this:
I would say, “Is this the Top Rooster?”
Dad would answer with a chuckle. “Yes.”
“How are you doing?”
“I’m okay.”
“Are you off the roost?”
“Yes.” Yet another distinctive chuckle.
“Are you crowing?”
“No.”
“Are you still kicking?”
“Yes, by golly.”
“Are you kicking high?”
“No, but I’m kicking.”
At that point, we would go over the upcoming events of our respective days, but conversations with Dad were never very long. Dad was not windy, as we say in Oklahoma, and he felt everything he needed to say could take place in no more than a few words. One was destined to failure if one expected to engage Dad in a long conversation. When I called Dad from the emergency department, sometimes others would overhear our brief chats, and Dad became known as the Top Rooster. It was not uncommon at all for my fellow healthcare practitioners to ask me later, “How’s the Top Rooster doing today?”
I’d answer, “He’s doing okay,” knowing that Dad would rarely complain. Dad grew up in a farming family in southwest Oklahoma while in the middle of the Dust Bowl and the Great Depression, yet these hardy folks somehow found a way to get by. Couple his upbringing with his role as an Army lieutenant on the front lines of the Korean War, Dad was as tough as a boot. Unless something was terribly wrong, I would never hear a gripe from him. It just wasn’t his nature.
While greatly missing his wife, Dad did the best he could to get by. He continued to garden, and his neighbors and friends said Dad grew the best tomatoes in Oklahoma. After sampling a few of his heirloom Cherokee Purple tomatoes, I was certain they were right. He enjoyed watching the Oklahoma City Thunder games, and usually once a week, my son-in-law Anthony and I would go over to his home and enjoy a game along with pizza and beer. Dad loved being with the family, and for a while he continued to have a massive egg hunt at his home on Easter, with the well-known and highly appreciated “money eggs” – stuffed with bills of varied denominations – which kept everyone interested, even the young adults. Dad was very proud of the fact that he was still able to live at home, enabled by the willing assistance of family and friends, along with a number of rather amazing neighbors.
Aging gradually began to take a toll on Dad, though. His balance became so poor that he sustained a horrific fall while working outside, fracturing his right shoulder, requiring an extended period of rehabilitation. This effectively ended his precious time working in the garden. His eyesight began to fail, caused by a deadly combination of macular degeneration, glaucoma, and corneal issues. His vision became so impaired that he was no longer able to read, something he had previously greatly enjoyed. Having family over for Thunder games was no longer an option, and he didn’t feel healthy enough to leave the home except for intraocular injections for macular degeneration. Dad’s life came to an end on May 9, 2022, a consequence of a fall after which he developed bilateral subdural hematomas – blood clots on his brain. He died at ninety-two – almost ninety-three – years of age.
As I reflect on Dad’s life, I recall once when I asked him, “Hey Dad, what’s the most important thing you have learned over your years?”
Dad paused not a second. “Family.”
Family was critical to Dad, as it was with Mom, and his priorities were being the best husband, brother, uncle, father, grandfather, and great-grandfather he could be. In all these roles, he succeeded admirably.
In retrospect, what amazed me most about Dad was his resiliency, and how he found reasons to live in spite of much that he loved being inexorably taken away. His will to live was strong, though, and he pressed on as a good soldier and Oklahoma farmer would.
Toward the end of his life, while Dad was still lucid, I explained to him that there was a chance that the blood clots on his brain could kill him. He said, “If I live, it’s okay. If I die, it’s okay.” As a Christian, Dad accepted God’s will for him, no matter the end result.
While I would have preferred that Dad had stayed in the world, he died on his terms. The course of his life-ending illness was comparatively short, he didn’t have to go to a nursing facility, which he had fiercely resisted, and to his delight, many family members paid him a visit as the end of his life approached. Even though his ability to communicate was limited in his final days, he still found a way to break into a smile when he recognized loved ones at his bedside.
I miss Dad greatly, and I expect the tears will continue to flow for a while. Letting go of my father, the only person left on the Earth who knew me for all of my sixty-nine years, will be no easy task. That said, the Top Rooster died well, and for that, I am most grateful. How could I not be? At ninety-two years of age, he lived as full and as rich of a life as anyone could ever imagine, and the world is a better place for it.
“To every thing there is a season, and a time to every purpose under the heaven.” – Ecclesiastes 3:1
The time of personal transition has finally come. I have given my notice, and sometime before the end of this year, 2021, I will walk away from my job as a physician in the emergency department where I have labored for over forty-three years. I made this decision with intense ambivalence, as overall I have received a tremendous amount of satisfaction from my occupation. I have worked alongside capable, compassionate, healthcare providers, who are as much friends as coworkers, and together we have cared for an enormous number of patients over the years. As a unit, we have helped many people, and on occasion, we have snatched some from the jaws of death.
Emergency medicine has inexorably pressed me on physical, emotional, mental, and spiritual levels, reminding me of the words of Friedrich Nietzsche, “What does not kill me makes me stronger.” Because of this trial by fire, I’m a much better physician and person than I was all those years ago when I first started my career. Emergency medicine has taken a great deal from me, no doubt, but it has given back so much more, and for that, I am most grateful. But the end of my occupation approaches soon, and I find myself wanting to focus not on what I’m leaving behind, but rather, on the positives of my upcoming existence. I have so much to anticipate.
First of all, I’m looking ahead to a more relaxed life. No more “sphincter moments,” when the actions I take in a few critical seconds make a difference whether a patient lives or dies. While I’ve taken great pride in my ability to act quickly and appropriately in times of crisis, enough is enough. It’s time to sleep in every now and then, spend more precious time with my wife, Sheridan, and when the coronavirus eventually wanes, enjoy longed-for moments with my father, children, step-children, grandchildren and dear friends.
I’ll also cherish deepening my meditation practice, and I can think of no endeavor more worthy than becoming more intimately aware of the God within and without. Music opens my heart, and I greatly anticipate singing inspired compositions with my circle of friends in the Edmond Community Chorale.
I look forward to future travels. Sheridan has convinced me that I would love visiting Italy, with all its varied culinary, historical and artistic opportunities. I’d jump for joy to go to Paris again, one of the most memorable places I’ve ever been, with a culture and ambiance that nourishes my soul. Most of you are aware of my fascination with glow worms, and the ultimate experience to satisfy this passion would be to visit the famed Waitomo Glowworm Caves in New Zealand. Domestically, I’d love to visit San Francisco, along with nearby Napa Valley, Seattle, and New York City. Can we eventually go to all of these places, and perhaps more? I’d surely like to give it a try.
Also, I want to go on many more challenging hikes, as nowhere do I feel the presence of God more than when I’m in the wilderness. Where? I’ve often asked myself. Of course, one of the best places in the world for trekking is Big Bend National Park in southern Texas, and I’d like to introduce Sheridan to its mystery and majesty. Also, Bandelier National Monument near Los Alamos, NM, has been calling my name. While I’m still physically able, I’d like to go with Sheridan to Sri Lanka and experience the vigorous hike to the top of Adam’s Peak, Sri Lanka’s most sacred mountain. Of course, how could I ever go wrong by taking day hikes at the Wichita Mountain Wildlife Refuge, the Oklahoma analogue of Adam’s Peak?
Of course, I’d like to pen more books. In the midst of a busy emergency practice, it’s hard to find time to sit and quietly be creative. No longer will that be an issue. After putting together five books, with one more coming out soon, I believe my writing skills are as good as they’ve ever been. I look forward to sharing my future inspirations with you.
The list could go on and on, yet I also want to be open to other unexpected happenings that God decides to bless me with. I wonder: What does She have in store for me? I smile as I think about it.
In my book, Oklahoma Is Where I Live, family practitioner Doctor Sather said in a lecture to a group of medical students, “As an individual, you are much more than a doctor.” After forty-three years of primarily functioning as a physician, I believe it’s time to explore fully the other aspects of my being before I cross the glowing, inviting entry to The Great Beyond. Besides that, this is the perfect stage of my life to just have fun and connect on a deeper level with those I love. At sixty-eight years of age, I can wait no longer. The time is now.
On June 20th, in Tulsa, Oklahoma, along with Vice President Pence, you are scheduled to do a campaign rally. No doubt the idea of thousands of rabid, screaming, white-knuckled fans wearing MAGA hats and waving their Trump/Pence signs in glorious shades of red, white and blue gives you goosebumps and sends chills up and down your spine.
I am concerned, though, that you don’t understand the implications of holding the event during the middle of the COVID-19 pandemic. Tulsa is already experiencing an explosion of such cases, and to schedule a large indoor gathering during this critical juncture has the potential to be a super-spreader event, where just one person can spread the coronavirus in geometric progression to countless others. Up to this point, our state has been blessed by a relatively low number of COVID-19 cases, especially compared to our southern neighbor Texas. But your rally has the capability to change all that, much like what happened in New Rochelle, when a single person spawned a nightmare beyond comprehension in nearby New York City and the surrounding area, directly leading to tens of thousands of deaths.
I must confess that your history concerns me. Your acceptance speech for the Republican nomination for the presidency was moved to Jacksonville because health concerns rightfully expressed by the governor of North Carolina could prevent the wild, narcissistic celebration you desired. I am certain you prefer old-fashioned gatherings where your adoring followers are jammed together like sardines, social distancing be damned. The promised masks – assuming they are worn – and hand sanitizer will be of some help, but without the cornerstone of social distancing, the protection they give will simply not be enough. Also, while you will be doing temperature checks prior to entry, remember that 25-45% of carriers are asymptomatic. In other words, they are infectious and checking for a fever does not adequately screen them. So, what are you thinking? Could it be that you still believe the coronavirus will go away without the vaccine, in spite of the lack of scientific evidence to support that notion? Do you think the pandemic will miraculously fade into the background before your event in Tulsa?
This whole scenario reminds me of the old Russian fable called “The Scorpion and the Frog,” and it goes something like this: A frog was peacefully sunning on the bank of a river, when a scorpion approached her and asked, “Would you carry me across the river on your back?”
The frog looked confused. “Why should I? If I do, you will sting me, and I will die.”
“Why would I do that? If I did, we both would die, because I would drown.”
Seeing the wisdom of his words, the frog nodded her tiny green head and allowed the scorpion onto her back. Midway across the river, the frog felt a sharp pain in the middle of her back. Shocked, she said, “Why did you do that? Now we both will die!”
As they began to slowly submerge in the water, the scorpion said, “I’m sorry, but I couldn’t help it. It’s my nature.”
So, Mr. President, what is your nature?
It remains my fervent prayer that you will change your mind and not come to Tulsa, at least for the time being. As an emergency physician, the health and well-being of my fellow Oklahomans is critically important to me. And I’m not alone. Tulsa City-County Health Department Director Bruce Dart has also expressed the hope that the campaign will push back the date of the rally. Much like New Rochelle, your event could precipitate a health crisis with overrun emergency departments and hospitals like nothing we have ever seen before in our state.
The primary question is this: For the short term, are you able to put aside your personal ambitions and desires for the greater good of your fellow Americans? Unfortunately, as evidenced by the time you ordered peaceful protesters tear gassed and forcibly removed from Lafayette Square in Washington, D.C., for a photo-op, along with your willingness to endanger those in North Carolina and Florida, you have clearly demonstrated that your nature is to place yourself first, no matter the consequences. Like the scorpion, you don’t seem to be able to help yourself.
Please reconsider your plans and prove me wrong by postponing your trip to Tulsa. If you don’t, it is likely that irreparable harm will result, and while I know you’d like to believe otherwise, you will be at least partially responsible for the pandemonium that follows.
“In contrast, I maintain that those who are most spiritual instead manifest a ‘full spectrum personality.’ In other words, these persons are completely capable of expressing themselves in all ways, even though the emotions may not be ones considered to be typically ‘spiritual.’”
From “The Pit: Memoir of an Emergency Physician”
I have tried to the best of my ability to have a positive attitude about the coronavirus pandemic. As most of you know, by nature I am an optimist. Today, though, I found myself unsettled about this cataclysmic virus for a number of reasons. First of all, I am saddened by all of the deaths and suffering we have experienced. To date, the coronavirus has infected almost four million worldwide and killed over 275,000, with many more to come. I find myself furious that our ineffective, inept leadership in America has allowed this situation to become far worse than it should have been. I am troubled by the pain inflicted on my brothers and sisters in healthcare, a number who have died from the disease trying to save the lives of others, while many more have been emotionally scarred as they watched the tragedy unfold before them. Who could not mourn the resultant devastation of our economy and those desperate folks who are scrambling just to get by?
On a more personal level, it breaks my heart that I am unable to safely spend as much time as I would like with my soon-to-be ninety-one-year-old father. As an emergency physician, I am far more likely to be a carrier of Covid-19 than the average person, and since testing is not readily available for me – or anyone else for that matter – my visits with him have to be limited and take place carefully. I went to his home today for the first time in a while, and I found myself feeling proud of Dad’s resiliency and ability to care for himself. He is a tough old man, and I hope that I have inherited at least part of his stamina. Still, I look forward to the day when I can spend more quality moments with him, and I pray to God that time doesn’t come too late.
Someday, I hope we have an effective vaccine, and our world will experience a bright new beginning, a renaissance of sorts as we move out of the darkness of this challenging conundrum. While I greatly anticipate the joy that will accompany that time, in the present moment:
“Yea, though I walk through the valley of the shadow of death, I will fear no evil: for thou art with me; thy rod and thy staff they comfort me.”
Psalm 23:4
I’ve always known that being an emergency department physician was not the safest job in the world. Oftentimes I have to deal with violent patients, some drug induced, some with psychiatric disorders, and others who become flat out angry and aggressive because I refused to give them the prescription they coveted, usually some kind of controlled drug. With that in mind, once I asked a police officer in the emergency department what I should do if someone pulled out a gun, pointed it at my head and said, “I’m going to kill you.”
With a concerned look on his face, he said, “Let’s do a demonstration.” Seeing my nod, he jabbed his right index finger into the middle of my forehead and said, “Pretend this is a gun. Now, the hand is quicker than the eye, so as fast as you can, reach up and grab my hand with your opposite hand and twist it as though you were removing a gun.” After doing what he said, the officer nodded. “Good. If you move as quickly as you just did, he might blow off one of your ears, but at least you’d live. Also, make sure a nurse isn’t standing beside you, or otherwise the bullet might hit her.”
Yikes, that was comforting, I sardonically thought before I thanked him for his time. While in retrospect, it seemed like an odd question to ask, given the gradual uptick of violence in the emergency department over the years, why wouldn’t I?
Besides dealing with violent behavior, another risk of being a healthcare provider is contracting a disease from a patient. Caring is sharing, but not in medicine. I’m very fastidious about protecting myself from infectious secretions, and the truth is that being overly clean in the emergency department is an oxymoron. There’s no such thing, and I’d rather not bring infections home to my family.
The coronavirus, also known as COVID-19, is a whole different animal, unlike anything I’ve seen before. The problem is that while the patient may have symptoms such as a cough, fever, diarrhea, fatigue and/or shortness of breath, some have no symptoms at all and can be contagious at the same time. Besides that, the virus can survive and still be infective on a hard surface for up to three days, and while the mortality rate with influenza is around 0.1%, that of the coronavirus is close to 0.5%, about five times higher. In addition, older patients who contract this illness are far more likely to have bad outcomes. At sixty-seven years old, much as I’d like to believe otherwise, I am no longer a spring chicken, and along with those who are immunocompromised or have other serious medical issues, I am at high risk should I become infected.
Nowadays, when I go to work in the emergency department, I have discovered that I am more-than-a-little fearful of contracting this dreaded virus. What if I place my hand on a contaminated surface and inadvertently put it to my face? What if my defenses against infection are somehow breached? Let’s face it, I work in a high risk area, and social isolation is simply not possible. But neither is it for the nurses, physician associates, nurse practitioners, x-ray, lab and ultrasound techs, and countless others who could be exposed to a potentially fatal illness. And what about paramedics and EMTs, policemen, firemen, and all those whose job is intervene outside the sanctuary of the hospital? All of us walk in the Valley of the Shadow of Death, and we have no choice but to resolutely step forward and do our jobs, much as we’d like to hunker down in our homes and protect ourselves. I’m proud to say that I work alongside heroes, those who are willing to risk their lives in order to help humankind.
I have also noticed that when I return home from a day in the emergency department, I am much more aware of the preciousness of life, realizing that the possibility exists that my Earthly existence might be taken away from me sooner than I had planned. I pay close attention to the look of love on my wife’s face, the conversations we share as we lie in bed and listen to music, the smiles on the faces of our dogs Karma and Buddy, treasured moments talking with my ninety-year old father, who I have playfully nicknamed “The Top Rooster,” precious communications with my daughters, and of course, cherished times spent with dear friends.
More than ever, I focus on little things, savoring the cup of honeyed Earl Grey tea I have in the morning, reading about the Oklahoma City Thunder in the Sports section of the newspaper, sitting quietly in meditation, watching colored birds as they flit in and out from the feeder, playing ball with the dogs, enjoying good food and drink, and so many other countless pleasures.
Sigh . . .
I want to live to a ripe old age and fully enjoy my time on Earth, but because of the coronavirus, I feel like I’m teetering on the razor’s edge, and there’s nothing else I can do other than to protect myself as best I can, experience each moment as completely as possible, and know that God is at my side. Whatever the outcome of my life – and there are no guarantees – I can ask for no greater blessing than that.
May the Divine be with us all during these challenging times.
My wife Sheridan and I have been together for thirteen years and have been married for over ten. Over the years, I have talked with her off and on about going to Utah for a hiking adventure. I had previously been to the Beehive State a handful of times to various trekking locations, including Zion and Bryce Canyon, but nowhere compared with wildness and intrigue of Canyonlands National Park in the environs of Moab, situated in the northeast part of the state. Yet, something always seemed to get in the way of what I wanted so desperately, though I must confess that this was not because of any resistance from Sheridan, rather, due to an overwhelming desire to put my inspirations on paper. Five books later, associated with numerous overseas excursions for research, at long last there was a gap in my schedule. No more delays or diversions, it was time to go to Utah.
The first few days Sheridan and I shared in Moab were magical beyond description. After a strenuous, breathtaking hike to Delicate Arch in Arches National Park, the following day we hiked the little-known, but beautiful, Moonflower Canyon, discovering petroglyphs at the entrance and a small, reflective pond deep in the canyon, where we sat in meditation. Later that same day, we drove to the Island in the Sky, a mesa which rests on sheer sandstone cliffs over one-thousand feet above the surrounding terrain. There, we had unforgettable views of the lower canyons at Mesa Arch and Grand View Point.
The plan for the following day was to hike the Chesler Park and Joint Trails in the scenic Needles district of Canyonlands, a vigorous ten mile trek far away from the beaten path. But, while on the road, Sheridan read about a hiking trail in the far northwest part of Canyonlands, a place called Horseshoe Canyon, one that comparatively made the Needles area look as busy as Manhattan during rush hour. Yes, it was that isolated, but on the flip side, the place contained some of the finest rock art in North America. While the location was challenging to get to – a two and a half hour drive from Moab – the eventual reward was a chance to cast our eyes upon the Great Gallery, a panel of pictographs that included ornate life-sized figures, created sometime between 1 AD to 1100 AD. It was an easy call, we had to see it, no matter the difficulty. Little did we know at the time what we were getting ourselves into.
The next morning, after a hearty breakfast at the B & B, the Red Moon Lodge, we set out on our great adventure. We traveled a circuitous route which led us north to I-70, west to highway 24, and then south for twenty-nine miles to a dirt road that led us back east thirty-two miles to Horseshoe Canyon. As the driver, the back-country road was frightening. In many places it was rutted, with patches of sand, rock shards and washboarding that occasionally caused our two-wheel drive car to lose traction and unsteadily swerve. Assuming we achieved our destination, I also knew that we would likely be returning at night, and I couldn’t imagine how much more challenging this route would be when I was unable to read the detail of the road accurately.
I’m happy to report that after about an hour of nerve-wracking driving, we arrived at the trailhead of Horseshoe Canyon, eager to experience the trail and what it offered. After hiking down the gradual incline for about fifteen minutes, the unforeseen occurred: the soles of both of my aged hiking books began coming apart. I offered to try and continue as they were, but Sheridan advised that I return to the car and replace them with my hiking shoes, and I agreed. As quickly as possible, I retraced my steps back up to the car, where I changed into my shoes and came back down to meet her, patiently waiting alongside the path. Valuable time was lost, though, and we did not want to be on the trail after sunset. We pressed on.
And what a beautiful trail it was! The slabs of grey rock comprising the pathway gently wound down for a while, then steeply switchbacked to the canyon floor. In the canyon itself, beautiful brown sandstone walls and green and yellow cottonwood groves greeted us, and the stark, visceral beauty of the area was breathtaking. While the seven mile round-trip trail was flat at that point, much of the hiking was through deep sand, and I felt like I was slogging through mud. The trekking was exhausting, and after seeing two beautiful panels of pictographs, we stopped to have lunch on the trail, exhausted, but satisfied with what we had seen.
Shortly thereafter, a young, dark-haired hiker wearing a baseball cap and a friendly smile approached us from the opposite direction. He informed us that he had seen two more panels of rock art, one being about ten minutes away, and the last, the Great Gallery, was around forty minutes further up the canyon. After sharing our chocolate with him, he headed towards the trailhead, and in spite of our fatigue, our inner fires had been lit – we had to go on.
After over an hour of trudging along the sandy canyon floor, we arrived at the awe-inspiring Great Gallery. Seeing these images painted so long ago was captivating, and we lingered there, sensing the presence of spirit. We sat in meditation, connecting with an ancient energy that cannot be described in words. One thing I was certain of, and that was the place was sacred. While sitting before the images, I wondered: What inspired these artists of so long ago to create this magnificent work? Was their spiritual presence still in that place? How many more years would I be capable of making such a difficult hike?
After chanting ‘Om’ three times and thanking God for allowing us to be in that holy moment, we began the hike back to the trailhead. Deep shadows appeared on the canyon walls, and we knew our time was limited. Sheridan led the way as we slogged through the exhausting sand, battling fatigue with every step. Soon my left big toe began to hurt, and every step was painful. I then realized that my hiking shoes were simply not sturdy enough for such a trek. We kept moving – we had to – we had no choice.
After what seemed an eternity, we reached the place for the steep ascent out of the canyon, and pausing frequently to catch our breath, we slowly worked our way up. After a while, I ran out of water and was grateful that Sheridan still had some to share with me. As much hiking as I had enjoyed in the past, and I’ve done a lot, this was one of the toughest treks I had ever attempted. When we finally sighted our car in the distance, I breathed a sigh of relief, knowing without a doubt we would make it back. Shortly after we reached the trailhead, the sun started to go below the horizon. We had arrived with no time to spare. After what we had been through, driving the dirt road back to the highway would not be a problem. After all, even though we felt beaten and battered, we had somehow survived, and I was glad for that.
Now, as I sit and think about our experience at Horseshoe Canyon, several thoughts come to mind. First, I feel empowered and exhilarated that I was able to reach down inside myself and find the strength to complete this challenging hike, in spite of the many obstacles. Also, I am reminded that most spiritual experiences are accompanied by some sort of pain, whether physical, emotional or mental. I’m glad we made the arduous hike to Horseshoe Canyon, though I doubt we’ll do it again. Other adventures, other expeditions await us, and I’m more than willing to accept the discomfort that accompanies them.
Just recently, my ninety-year-old father took a tumble and fractured his right shoulder. After a short stint in the hospital and some time in rehab, he returned to his home of thirty-nine years. Realizing that Dad was not capable of caring for himself for the short term, my sister Connie, Aunt Gayle, and I agreed to watch him around the clock until he recovered.
Since my mother’s death almost three years ago, Dad had been amazingly self-sufficient, and nearly all visits to see him were for social reasons, simply to spend precious moments with the patriarch of the family. But nothing stays the same, and we all knew Dad would need our help at some point in time. It’s a blessed, sacred duty to care for a parent, and I was happy to do my part.
This morning was the first day I would care for Dad, and I took over for my sister, who had watched him not only the previous night, but also for most of the days since he arrived home. After a brief update on what his needs were, Connie left for her home in Tulsa and some all-important time with her husband. As I settled in, it didn’t take me long to discover that Dad’s requirements were minimal, such as walking alongside him when he had to go to the bathroom, fixing simple meals, and addressing the little needs that invariably cropped up.
Dad loved reading western novels, which allowed me the opportunity to mindfully survey the living area where we sat, the most obvious feature being a potpourri of family photos. When I used to deliver Mobile Meals to the elderly and infirm, one common feature of nearly all of their residences were these depictions of the past, somehow giving meaning to the present and also to the future. One photo in Dad’s house that brought a smile to my face was one of me and my daughters taken while river rafting in Colorado, bringing back all sorts of pleasant memories.
Hanging over the fireplace was a beautiful painting by family friend and artist Colleen King, showing sister Connie precariously crossing a stream on a log in Red River, New Mexico, where our family spent many summer vacations. On nearby bookshelves stood various ceramic angels that I had gifted my mother. She treasured her collection of winged, spiritual beings, and she never tired of receiving them for birthdays or Christmas. On the wall above and alongside the bookcase hung depictions of a number of glistening, golden birds in flight, reminding me of the classic book by Richard Bach, Jonathan Livingston Seagull. To my left, in an adjacent room was the dining room table, where my family celebrated many a Thanksgiving dinner.
I was flooded with memories as my father quietly read, yet I knew that these sacred moments I was now sharing with him would someday also be in the past, and the glue that held all of these recollections in their proper place – my father – would no longer physically be in the world. All of these symbols of his and my mother’s life would eventually be dispersed from the home, and one day another family with their own unique hopes and dreams would live in this space.
Yet now, my father is sitting in the same room with me and reading, moments sprinkled with conversation, laughter and sharing of thoughts. I value this time with him, and I’m honored to be caring for Dad, just as one day, when I was a young boy, he cared for me.
“I’m not sure at what point the red-tailed hawk made the transition from simply being a bird I enjoyed watching to something more, something personal. I began to notice when I was in times of duress — more often than not — they would fly over or in front of me. I had the distinct feeling my hawk friend was there to provide me comfort, to let me know that in spite of how bad the circumstances seemed at that given moment, events were happening just the way they should be.”
– From “Oklahoma Is Where I Live”
I’ve had a lot on my mind lately. Life is never without issues, though certain events of the recent past have been weighing heavily on me. Nothing that was dangerous or life threatening, but rather a collection of unsettling annoyances that I was having a difficult time shaking off. By nature, I am an optimist, but not as of late.
With this background in mind, this morning, as I walked to the front of my home to get the daily paper, I heard a loud screech overhead. Looking upward, I saw a gloriously majestic hawk flying overhead, and close behind was a second, no doubt its mate. In the brief moment that they flew over me, I felt blessed by their presence, and the burden I felt encumbered with became a little less heavy. I breathed in and out, knowing once again that the Universe – God – is very aware of me and my current situation, as She is of all of us.
Gary D. Conrad
