Dr. Greg's Ride to Remember 2

Dan and Tom in Paceline during RAIN 2011

2011-08-11T16:59:00.004-04:00

Does Tom look as if he is having fun? I don't think so...but determined, YES!

Remembering 700 at the end of RAIN 2011

2011-08-02T14:47:00.011-04:00

Our team carried laminated cards with the names of more than 700 patients, family and friends who have died since our last Ride to Remember in 2009. Each team member rode 160 miles on Saturday, July 16th in their memory. To date, sponsors, friends and other well-wishers have contributed more than $17,000 to this year's ride in support of our Palliative Care bereavement program!

Wishard Cycling Team Prior to RAIN 2011

2011-07-29T13:38:00.003-04:00

Here is the Wishard Cycling Team the evening before the Ride Across Indiana (RAIN)--after carbo loading!

2011-07-18T12:38:00.008-04:00

Yetta, a Wishard RN, models the new and exclusive Wishard Cycling Jerseys!

2011-07-14T10:48:00.003-04:00

See pictures of Wishard's Ride to Remember 2 Team below the names of those they will be riding in memory of!

2011-07-13T14:32:00.005-04:00

Ride to Remember 2- July 16 2011

Vindetta B. Harold S. Mary N.
Regina C. Frank L. Sandra S.
Pearlie D. Don Juan M. Bernice M.
Doris M. Yvonne G. Scott H.
Leah M. Joseph W. Gary G.
Deloris M Mary J. Rick R.
Michael M. Susan V. Cheryl H.
Othella P. Michael B. J.T. T.
Christopher W. Morris W. Linda H.
Rebecca P. Delores C. Michael F.
Herman E. Lillie W. Ricky P.
Michael T. Alan C. Ross K.
Donald B. Alice M. Donzell G.
Deborah M. Dianna N. Kirk F.
Gordon S. Charles C. Edward B.
Ben C. Willie P. Bessie P.
Maurice B. Marcus A. Angela T.
Tummy R. Harold B. Charles G.
Barbara M. Teresa Q. Rhyman R.
Cynthia H. Devan T. Doffey B.
Isaah Y. Rodney G. Cynthia B.
Charles P. Scott S. Rosie S.
James B. Louis B. Rose C.
Mary J. April S. Mary S.
Nathan B. Michael S. Sharee F.
Dean Whitehead
Karyn B. Kenneth W. Dorothy S.
Felix E. Gordon G. Vasil M.
Renee S. Ifeolu A. Erna K.
Derek G. Walter D. Mary J.
Frank S. George W. Ovenia M.
Mary L. Brian H. Joseph H.
Robert W. Howard H. Lizzie B.
Richard J. Ulus W. Rita K.
Debbie B. Daisy H. Geraldine M.
Shirley H. Johnny J. Charles M.
Regina B. Gary S. Maxwell M.
Leo R. Booker D. Charles H.
Bobby W. James K. Dennis K.
Leslie W. Ralph H. Roosevelt H.
Josie B. Carol O. Harry G.
Ritchie P. Jacqueline D. Nicki P.
Kenneth W. John B. Janus B.
Florence G. Patty B. Robert F.
Daniel B. William C. Bobby G.
Karen W. Michael C. Eva G.
Carl P. Jessica M. Mitchell H.
Gwendolyn J. Joella W. Donna D.
Johnnie T. Paul G. Virgil B.
Dora J. MarLynn D. Lucille H.
William P. Henry D. Terry C.
Debra R. Linda B. Sally M.
James B. Milton W. Dennis W.
Shawn S. Phillip C. Leroy H.
Janine S. Jimmy M. Peggy F.
Deborah W. Ned K. Cigaree D.
Michael D. Jerry B. Morris Ajanice N..
Dwayne S. Jessie R. Dale B.
Ruby W. Phillip S. Walter H.
Mable N. Archie T. Hazel G.
Clara D. Gerorgia C. Enoch T.
Steven J. Alice L. Pamela P.
Frank M. Millie B. Roger D.
Claude S. Catheryn S. Sherry C.
Marshall T. Tiffany D. Augusta C.
Roberta B. Cesar R. Larry B.
Connie H. Roger T. Norman W.
Judy M. Mary F. Francisco B.
Bill A. Kantilae P. Nova W.
Julian S. Beverly M. Gwynne T.
Alverta T. Velma M. Gary J.
Yuseff D. Joseph D. John G.
Guadalupe C. Shirley G. Sharon M.
Raymond O. Earline H. Felicia L.
Brenda B. Susie W. Donna C.
Sharda S. Linda H. Jeannette H.
Charley Taylor
Wayne H. Jimmie B. Elizabeth M.
Karen H. Bernard J. Lawrence S.
Steven T. Archie P. Geraldine E.
Edwin F. Willie G. Wanda H.
Rodney H. Dorothea H. John S.
Denny V. Kenneth W. Vera W.
David C. Phyllis P. Mack K.
Dawn S. Guillermina R. William M.
Robert C. Bryan W. Alfreda S.
Amanda F. Joe G. Nancy H.
Leroy S. Robert B. Carlos E.
Catharine V. Judy M. Raymond I.
Larry R. Mildred M. Seoul S.
Samuel J. Jack T. Mary K.
Malyn M. Robert A. Alice S.
Cecil C. Delma L. John K.
Michael B. Robert P. Larry B.
Eugene R. William N. Thaddeus R.
Sammy T. Mary G. Eva F.
Myra B. Jamar P. Coada H.
Sylvia P. David G. Virgil W.
James P. Roy F. Edna S.
Mary C. Nancy A. Steven J.
Ana V. Janet K. Eunice H.
Eva S. Celia W. John F.
Paul C. Lucy G. Kathleen M.
Clarence G. William S. Maureen O.
Albert D. Barbara P. Phyllis D.
Elizabeth S. James B. Nuoit N.
Homer H. Frank P. Joseph R.
William B. David W. Patricia D.
Carlton G. Shaun Q. Samella S.
Charles L. James R. Edmond W.
Mario R. Edward B. John L.
Mauda N. Charles I. Richard V.
Mary H. Alfreda H. Man N.
Bennie T. James B. Amanda G.
Linda S. Caroline F. Joann S.
Onis G. Carl T. Wilma W.
Russell T. Onis G. John K.
Gertrude H. Nahil E. Wayne S.
Horace K. JoAnn C. Jerry B.
Ernest C. Ronald R. Dorothy L.
Ray M. Dale S. Lula F.
Richard S. Veronica G. Billie K.
Cornelius M. Anthony E. Steve H.
Larry P. Mackey K. Christopher W.
Jonathon S. Jason A. Barbara C.
Oddie L. Roland G. Juan R.
Willie R. Carol T. Jacqueline W.
Donetta D. Rosie P. Charles S.
Iva W. Laura F. Danny S.
Nancy B. Kimberly D. Michael B.
Mamie L. Joseph B. Jerry R.
Jim B. Yebgenia P. Eva H.
Jarrett T. James P. Luther P.
Clarence K. Timothy R. Nannie B.
Jane W. Mary L. Darrell L.
John G. Rickey C. Octavina M.
Pearl J. Christopher M. Michelle M.
Roxana W. Lemont B. Walter W.
James B. Darrell W. Vernon S.
Booker F. Raymond C. Ernest S.
Ella B. Ralph V. Margaret T.
Tulla M. Jennifer F. Barbara O.
Glady S. Diane O. Gregory H.
Gary A. William "Tom" P. Edward C.
Ronald H. Elijah M. Douglas C.
Patricia D. Ronald C. Clifford R.
Truman N. Leroy T. Mary M.
Katie T. Lena C. Mary B.
Darrell D. Matilda H. Marie E.
Robert M. Rodney W. Robert A.
Jane M. Betty N. Beverly M.
Constance C. Blan G. Beverly R.
Larry T. Danny H. Dorthea A.
Michael M. Zoneice G. John C.
Frieda F. Walter R. Brett S.
Kenneth S. Willie W. Yada J.
John G. Donald W. Marian M.
Ronald M. Willie A. Sharon S.
Daniel H. Jeffrey M. Daniel M.
Sally S. Darrell C. John S.
Marcia R. Kelly H. Daniel P.
Clara E. Dick C. Steven G.
Vida H. Casey W. Mabel A.
Glen P. Betty P. Nellie S.
Beverly B. Kristi G. Robert C.
Eugene B. Margaret M. Yanzhen W.
Dale A. Daryle W. Erwin M.
Betty V. Doris D. Robert O.
William A. Chistopher F. Gunnar T.
ConstanceM. Mary H. Benjamin V.
James H. Maylon P. June S.
Kenneth T. Willie F. Gerald F.
Florence H. Randall L. Dana S.
Patrick L. Thomas C. Susanah M.
Wendy B. Sharon K. Evelyn S.
FG F. Rosa F. Monica S.
Edwin S. Roxie A. Thurston C.
Martina S. Dorothy M. Melody R.
Terry M. Richard B. Rex V.
Charlotte D. Michael D. Janet W.
Anita S. Brenda C. Lamont S.
Elsie T. Jeffery J. Mary O.
Jerry A. Charlie L. Estelle S.
Paul L. Kenneth S. Rita C.
Tom S. James W. Odessa F.
Christina S. Ronald M. Norman S.
Lawrence W. Shirley B. Jane B.
Lynn C. Charlotte W. Juanita C.
David P. Robert S. Arthur A.
Paul K. Rita H. Antonio M.
William J. David G. Daisy M.
Billy N. Janis L. Hosie B.
Yvonne P. Dorothy K. William L.
Linda M. Wayne R. Christopher F.
Robert D. John H. David R.
Irene R. William S. Ronald W.
Gerald M. Joe W. Omer T.
James C. Karen T. Truxton K.
Wayman G. Judith I. Raymond G.
Nathaniel K. Daniel C. Maggie M.
Mamie R. Sarah S. Doris A.
Larry L. Helen H. Angela W.
Gregory H. William L. Bennie P.
Raymond L. Brenda K. Ray T.
Virginia G. Mamie P. Gary S.
Martha R. David E. Roderic H.
Martha B. Emma M. Sheldon J.
Gerald L. Edith J, Steven H.
Maxine C. Ebby Z. Billy A.
Henrietta W. Roberta J. Patti F.
Delores P. Celeste F. Patricia P.
Judy P. Douglas C. Lonnie W.
Paul M. Glenous W. Clarence J.
Bessie R. Clara H. Anna B.
William R. Myrtle B. Charles B.
Louis G. David K. Electford E.
Ollie W. Benjamin S. Susan R.
Mable W. Sharon J. Henry S.
William S. Melinda S. Robert B.
Jesse B. Katherine S. Annie D.
Eli I. Floyd N. Alsie P.
Gene B. Samuel C. Mary W.
Mismak A. Thomas C. Mitchell P.
Linda F. Elizabeth U. John M.
Chrystene L. Anthony A. Stephanie G.
Daniel M. Philbert B. Augustine M.
Patricia M. Donald P. Francie C.
Elisha G. Judy W. Anna M.
Sylvia J Danny A. James W.
Patricia S. Randy H. Fred J.
Wayne S. Margaret W. Iris H.
Raymond L. Annabelle L. Paul F.
Jodie M. Christine D. Jane N.
Lemon S. Thomas D. Lucille B.
Jerry S. Vincente C. Alberta P.
Jerry R. Michael C. Rockie K.
Marion J. William T. Rheua H.
Jason K. Mia E. Patty L.
Sherwood J. Larrio A. Bobby H.
John M. Mary N. Sandra E.
Paul B. Danny H. Phil Boberschmidt
Bernice B. Paul H. Dr. Nathan Hellman
John P. Margaret M. John Becher
Norma W. Christy L. Brenda Christensen
Kip G. Patty L. Paul East
Jeannette M. Mack S. Lora Waters
Darrell P. Glenn S. Dennis K. Smith
James V. Henry R. Bill Betty and Theresa Ann Gasper
Ollie H. Dewayne H. Lois Healy
James A. Bruce H. Helena and Daniel McDevitt
Pauline G. James B.
Richard S. Mary H.

2011-07-12T14:13:00.009-04:00

THE TEAM

Greg Gramelspacher and Thomas Whitehead

C.E. Taylor

Dan Fowler

Kathy Cummings

Ken Dau-Schmidt

The Glasscock Family Foundation

2011-07-07T16:01:00.003-04:00

A special, BIG, and heartfelt thanks to the Glasscock Family Foundation for their generous contribution to again support and sponser our second Ride to Remember. We will remember them as we cycle the 160 miles from Terre Haute to Plainfield on July 16th.

Planning for R2R2

2011-07-06T13:54:00.010-04:00

Stay tuned to meet members of our Wishard Bike Team who will participate in the Ride Across Indiana (RAIN) to remember more than 700 patients cared for by Wishard's Palliative Care program since the first Ride to Remember in the fall of 2009.

RAIN is the one way, one day, 162 mile ride from Terre Haute to Richmond, Indiana on Saturday, July 16, 2011. You can find the route @MapMyRIDE

Ride to Remember 2

2011-06-03T16:48:00.003-04:00

On July 16th, a new Wishard Bike Team will participate in the Ride Across Indiana (RAIN) in order to raise awareness about Palliative Care and to remember our patients who have died since Dr. Greg's first Ride to Remember in 2009. Return to this blog to view regular updates on this event. To learn more, contact Mr. Tom Whitehead at (317) 630-7767 or email: twhitehe@iupui.edu
Look for our announcement in Sunday July 10th's Indianapolis Star!

2009-10-30T09:52:00.002-04:00

As a big thank you to all our donors and friends,

please join us in celebrating our

10 Year Anniversary and

Dr. Greg Gramelspacher’s

RIDE TO REMEMBER

The Palliative Care Program at Wishard Health Services cordially invites you and a guest to attend

A Wine and Hors d’oeuvres Reception

Thursday, November 5, 2009

6 p.m. to 9 p.m.

The Indianapolis Art Center

Marilyn K. Glick School of Art

820 East 67th Street

Indianapolis, IN 46220

R.S.V.P. by Nov 2nd

Christine Slater-Turner

317-630-7767 or cslatert@iupui.edu

Business Casual attire

Atlantic Ocean!

2009-10-24T09:36:00.018-04:00

On Thursday October 22nd, we finally pedaled our way through Charleston, South Carolina and across the Cooper River over a fantastic bridge giving us our first glimpse of the Atlantic Ocean. Oh, Happy Day! After a quick stop at Poe's Tavern (as in Edgar Allen), we rode together, 16 strong in our Trek Cross Country jerseys to the Boardwalk at Wild Dunes on the Isle of Palms.

It is difficult to describe the depth of emotions, but happiness was near the top. Now that the trip is over, I can admit that I had my doubts along the way. Most of these were before I left for California but I also seriously considered calling it quits during the first week. The Mojave Desert was beautiful but it wasn't a lot of fun. I don't think one is supposed to ride a bike across it. The desert begs for another mode of transportation: an airplane comes to mind.

But I had to get to Poplar Bluff, Missouri to see Hilbert Joseph Gramelspacher. At that point, we were more than half way and I knew that I could make it to Nashville for another day of rest. We only had seven more days of riding and some flat terrain ahead once we cleared the Great Smokeys and the Blue Ridge Mountains. How I love the flats...

I know that I could not have completed this trip without our intrepid Trek guides, Dave "Big Wave" Edwards and Eric "Mr. Bill" Berkas. Also, Tara "the not-so-tender-tenderizer" kept our muscles supple enough to pedal each day and finally, sweet Bet who never failed to arrange everything with a smile. Thousands of thanks to each of them for their tireless efforts and impeccable professionalism over thousands of miles.

Each of these 3280 miles was ridden in memory of a particular person. During the past 40 days, Drs. Lyle Fettig and Rafael Rosario continued to care for the dying poor in Indianapolis with expert help of Mary Smith-Healy, Karen Estle, Judy Hetzel, Brenda Mason and Christine Slater-Turner. Our labors of love for our patients do not stop with the end of this ride. I look forward to joining the home team on Monday. The journey continues because it's about how you live.

Finally, I'm certain that I could not have found two better people to ride with than Katherine "Kryptonite" Dayem and Mike "Smash Mouth" Hobin. These two excellent cyclists have become even more excellent friends and I can't wait to ride with them again. I am missing them...

Cowboy and Dying Well (Part 3 of 3)

2009-10-22T08:05:00.002-04:00

At that time, we didn’t have the Visiting Nurse Services' Abbie Hunt Bryce home to shelter the dying poor. We didn’t have many options. And Cowboy didn’t want to leave his cave. As it got colder, the people at the trucking company built a "room" underneath the culvert out of plywood, and we planned to heat it with an electric heater attached to a gas generator outside the cave. I’m certain that this was one of my craziest ideas and it was probably also illegal.

I went by the cave one Saturday in January with the generator, but it was so cold that I suggested to Cowboy that he should stay in a hotel. He liked that idea and so we found a room downtown. He was thrilled with the double beds.

However, the next morning, he didn’t answer the phone when I called, so I asked the hotel staff to check on him. They found him in the middle of the floor. The bed was untouched. He’d fallen and injured a nerve in his arm, and he was having trouble breathing. I picked him up and brought him to the hospital. He couldn't go back to the cave, or the hotel, and he stayed in the hospital for a couple of weeks until we were able to find a room for him at the nursing home next to the hospital.

During these weeks of commotion, as Cowboy shifted between places, Cowgirl had gotten lost. As Cowboy was close to dying, team members Linda and David, went out and searched until – amazingly – they found Cowgirl. They brought her to the nursing home and coaxed her into the elevator up to the fourth floor. Cowboy had just received a blessing from Chaplain Barbara.

When the elevator doors opened, Cowgirl ran down the hallway until she found Cowboy’s room. She jumped up onto the bed with him. And David was there to take this picture of how Cowboy died, with his beloved Cowgirl resting her head on his chest.

So when people ask us "How can you do this work?"

Our easy answer, "How can we not?"

Day 39 (miles 3171-3280)

2009-10-22T08:00:00.009-04:00

On this last day of his cross-country bicycle ride, Dr. Greg will ride 111 miles from Orangeburg to Charleston, South Carolina in memory of the following people. The final mile onto the Boardwalk at Wild Dunes on the Isle of Palms is in memory of Larry Fleck:

Jeremy W
Robin W
Glenn W
Ida W
Louese W
Geraldine W
Johnnie W
Arnold W
Thomas W
Damon W
Alice W
Cleo W
Molly W
Robert W
Olivia W
Lillian W
Stanea W
Izetta W
Carol W
Arbutus W
Joe W
Clyde W
Ila W
Ruth W
Patricia W
Jill W
Scott W
Vera W
James W
Catherine W
Gerald W
Rose W
Mary W
Timothy W
Xing X.
John Y.
Dennis Y
David Y
Michael Y
Phillip Y
Helmut Y
Carl Y
Frances Y
Julie Y
Glenna Y
Robert Y
Belinda Y
Kathy Y
Ot Y
Lonnie Y
Dwayne Y
Joyce Y
Harold Y
Dorothy Y
James Y
Mary Y
Robert Y
Dennis Y
Lorraine Y
Francis Y
Anna Y
Larry Fleck

We Finish Tomorrow

2009-10-21T21:51:00.013-04:00

It's difficult to believe that our ride ends tomorrow...only 111 miles to the Isle of Palms and the Atlantic Ocean outside of Charleston, South Carolina. At times it seems as if it was a quick trip but then I look over at my suitcase that I've been living out of since September 11th and I realize that it has taken us a LONG TIME to cross the country.

After a dip in the Pacific Ocean at Santa Barbara, we rode the Pacific Coast Highway, Angeles National Forest, the Mojave Desert, north into Arizona and the Grand Canyon, Navejo, Ute and other Indian Reservations, Monument Valley, through the San Juan Mountains, the Tusas Mountains and Carson National Forest, across the Rio Grande River Gorge, through Cimmaron Canyon State Park, through Sugarite Canyon State Park onto the Great Plains, thorough the Kiowa and Rita Blanca National Grasslands, through the Optima National Wildlife Refuge, through Boiling Springs State Park, through the Osage Indian Reservation, through Mark Twain National Forest and the Ozarks, into the Mississippi Valley and a ferry ride across the Mississippi to Kentucky, then across the Tennessee River and the Land Between the Lakes National Recreation Area, through Nashville and onto the Cumberland Plateau, along the Little River and into the Great Smokey Mountains, across the Newfound Gap, Blueridge Parkway, Pisgah Forest, Sumpter National Forest, and then tomorrow over the Cooper River Bridge with views of Charleston and it's Harbor before arriving at the Isle of Palms and the Atlantic Ocean.

I've pedaled nearly 3200 miles in order to remember our very special patients, family and friends who will remain with us forever. Another 111 miles on this last day for 111 souls until our finish at the Atlantic Ocean. Thanks to the home team for all of their work and for making this trip possible. You're the BEST!

Cowboy and Dying Well (Part 2 of 3)

2009-10-21T20:05:00.000-04:00

Neither the primary team of doctors nor the cancer doctors knew that Cowboy was homeless. He had an address where he picked up mail so until he admitted to us that he lived under the roadway, no one knew he was homeless. The doctors knew that he had lung cancer and that he needed chemotherapy. They didn’t know that he was homeless, or that he had a dog that was his best friend, and that he left each day to take care of his dog. I think that most of the staff assumed he left the hospital to drink or use drugs.

He invited us to visit his spot under the bridge, which he called his “cave.” There are four big tunnels underneath that intersection, and he’d blocked off one end to make a home, a nest, for him and Cowgirl. There was a trucking company across the street, where he would get coffee and rags dipped in fuel oil to heat and light his cave. The police and fire departments knew that he lived there but none of the thousands who drove in cars over his roof each day knew that he lived there. Until our visit, that included me and all the other hospital workers who drove over that road.

But we would visit him there. It was his home.

Winter came, and it was starting to get cold. Cowboy was not doing well with his cancer treatments. He was getting weaker and more sick. Our team talked a lot about what to do to help him.

We knew that he had 3 children, 2 boys and a girl. We finally managed to find one of his sons, a man with a degree from Harvard Divinity School, a scholar and poet. They’d been estranged for years, and he didn’t know that his father was living underneath a road that he, too, had driven over many times. With our help, they reconnected before Cowboy died.

In the meantime, our social worker Linda tried to find a more sheltered place for him to live. This proved to be difficult. We found a house and paid rent, but the son of the lady who owned the house stole the rent money, and the situation deteriorated. Cowboy stayed briefly at the Y, but that didn’t work out either. On really cold nights, he would sometimes stay in the garage of a lady friend. But he always ended up back in the cave.

Day 38 (miles 3057-3170)

2009-10-21T08:00:00.005-04:00

Today, Wednesday, October 21, 2009, Dr. Greg will ride 123 miles from Union to Orangeburg, South Carolina in memory of the following people:

Dolly W.
Dewey W.
Xavier W.
Gladys W.
Ethel W.
Gladys W.
Helen W.
Suzi W.
Ruth W.
Dr. David Wilcox
Glenn W.
Donald W.
Opal W.
Hazel W.
Paul W.
Edward W.
Mary W.
Mark W.
Perrine W.
Dorothy W.
Mary W.
Nola W.
Annetta W.
Jaime W.
Marsha W.
Cynthia W.
Sherry W.
Lula W.
Bernice W.
Willie W.
Edward W.
Harrietta W.
Stanley W.
Michael W.
James W.
Ralph W.
Robert W.
Paulette W.
George W.
Kelvin W.
Duke W.
Edmond W.
Leola W.
Marjorie W.
Nancy W.
Naomi W.
Nennetta W.
Ruby W.
Albert W.
Renard W.
Dorothy W.
Virgil W.
Vernie W.
Cecil W.
Robert W.
Pearlie W.
Gwen W.
Joseph W.
Joseph W.
Robbie W.
Duncan W.
Margaret W.
Shirley W.
Constance W.
Mary W.
James W.
Carolyn W.
Norvella W.
George W.
Patricia W.
Dorothy W.
J.D. W.
Willie W.
Strand W.
Rosalind W.
Sheila W.
Sandra W.
Marilyn W.
Cory W.
Fredrick W.
Dorothy W.
Emmett W.
Johnny W.
Kenneth W.
Rollin W.
Donald W.
Jerry W.
James W.
Lillie W.
Louise W.
Nealie W.
Rheta W.
Sandra W.
Geneva W.
Stella W.
Richard W.
Britannica W.
Harold W.
Jacqueline W.
Robert W.
Betty W.
Sally W.
James W.
Curtis W.
Lillie W.
Rita W.
Lois W.
Ruth W.
Melvin W.
Donna W.
Dorothy W.
Harold W.
Robert W.
Robert Wolen

Cowboy: On Dying Well (Part 1 of 3)

2009-10-20T08:05:00.000-04:00

This is the story of Milton “Cowboy” Smith. Wishard's Palliative Care team met this cantakerous 73 year old man when he was hospitalized for treatment of his lung cancer. He also had bad emphysema. The primary team asked us to help because he was a difficult guy. Mr. Smith would frequently disappear from the hospital without a word, and then return many hours later despite his chemotherapy and test schedule. The doctors and nurses thought that he must be "up to something" when he left the hospital and they were frustrated trying to treat him.

When we met him, we asked the question we always ask at the end of our first visit. “Is there anything that we can do for you now?”

Cowboy answered, “You could find my bicycle.”

“OK,” we said. “Where did you leave your bike?”

“I left it downstairs,” he explained. “I went to the Emergency Room because I couldn’t breathe, and I left my bicycle in one of the restrooms on the first floor. When I went back, it was gone.”

We said we’d see if we could find it, and immediately located it through Security. When we brought the bike to his hospital room, he was very happy and from that point on, he decided that we were on his side. Every morning from that visit on, he’d greet us with a smile, and he began to share a little bit about his life with us. We learned, for instance, that he’d been voted the best-dressed Black man in Chicago one year. He loved old blues songs, and would often sing us a tune before we left his room. We even have some audio-recordings from these visits.

One day, when we were visiting him in the smoking area behind the hospital, we noticed that he had a plastic bag full of food he’d picked up from leftovers in the cafeteria and from the trash cans. We asked him why he collected the food.

“Well, I have to go feed my dog, Cowgirl,” he told us. That is when things started to make more sense. That’s why he needed his bike right away. He needed the bike to leave the hospital each day so that he could peddle 6 blocks up the street to the intersection of 16th Street and Martin Luther King. He lived there, under the roadway underpass with his dog, Cowgirl for the past three years.

Day 37 (miles 2953-3056)

2009-10-20T08:00:00.008-04:00

Today, on Tuesday, October 20, 2009, Dr. Greg will ride 104 miles from Asheville, North Carolina to Union, South Carolina in memory of the following people:

August Watanabe
Bard Beesley
John W
Taylor W
Susie W
Laura W
Brian W
Lue W
Michael W
Sampson W
Cheryl W
William W
Barbara W
Kenneth W
Mancie W
Sebran W
Phyllis W.
Jerry W
Maxine W
Larry W
Rochella W
George W
Violet W
Finch W
Clarence W
Henrietta W
Gerald W.
William W
Becky W
Daeshawn W
Linda W
Annette W
Clifton W
Azeliz W
Dovie W
Gordon W
Frank W
Freda W
Sandra W
Irene W
Andrew W
Wilbur W
Isele W
Tracey W
James W
Pamela W
Charlie W
Charlie W
Frank W
Reba W
Jessie W
Algene W
Johnny W
Mary W
Timothy W
Paula W
Randall W
Eddie W
Pamela W
Evelyn W
James W
Robert W
Marjorie W
David W
Robert W
Barbara W
Walter W
Charles W
Mary W
Eloise W
Michael W
Darrell W
Deborah W
Rodney W
Kennis W
Phyllis W
Rose W
Raymond W
Clifford W
Davis W
Ethel W.
Mattie W
Glendell W
Willie W
Betty W
Joe W
Henry W
Barbara W
Viola W
Fred W
James W
Murray W
Al W
Linda W
Cora W
Stanley W
Lonnie W
Ansil W
Sandra W
Nancy W
James W
Robert W
Willie W
Kevin W
Arletta W
Marcia W

Melanie's Snow-Capped Mile

2009-10-20T07:00:00.001-04:00

As we rode our bikes out of Townsend along the Little River, I had no idea what to expect at we made our way up the Great Smokey Mountains to over 5000 feet. But I suspect that Melanie knew. Even after riding twenty miles with cars full of camera toting leaf hunters and seeing this scene, I didn't have a clue about the road conditions ahead. But why wouldn't the roads below these trees not be covered with snow? Was I hoping for some type of magical bicycle thaw?

I'm certain that Melanie was smiling down on us. She probably let out a good belly laugh as she watched us try to ride our bikes up her snow-capped peak at Newfound Gap. I was expecting a lot of challenges on this trip but I didn't anticipate riding my bike through snow and ice. But for Melanie, that is exactly what I did. I wouldn't want to do anything else.

At the end of her mile, it was too difficult to stay on the bike so I walked it up the hill to where our van was waiting to safely transport us down the other side.

Pretty funny looking guy, eh, Melanie?

Portraits of the Dying as Dignity Conserving Therapy

2009-10-19T08:05:00.000-04:00

The concept of dignity-conserving therapies was coined by Dr. Harvey Chochinov, a psychiatrist from Canada. Chochinov’s research aims to minimize patients’ suffering at the end of their lives. He has studied terminally ill patients who want to end their lives and he has tried to find ways bring meaning back into their lives. Dr. Chochinov work centers around approaches to support, conserve, and enhance patients’ dignity.

What can be done to conserve dignity for a dying person? The phrase “death with dignity” rings hollow for many people who are dying. How dignified is death? Often, the dying person experiences a lot of suffering, not just in terms of physical symptoms but also in terms of an existential angst. What can be done to help a person in the face of that?

Dr. Chochinov found that, even though pain control and symptom management are very important, it was also important for patients to engage in some sort of generativity. One generative activity that he devised to transcend the person’s death also resonates with meaning after they are gone. Chochinov records interviews with patients about their lives and he asks them what they want to be remembered for. The patient then edits the transcript and in this process, they discover new meaning about their life. They often feel connected again and find a purpose in working on a lasting legacy for their loved ones.

Patients can then share the completed and edited transcript with their family and friends. This very personal, very human interaction draws patients to a new level of understanding about their place in the world, their life and what it has meant to others. The document gives depth and meaning that can counter the despair and loneliness that often accompany the dying person.

I think that our portraits might do a similar thing. Simply the act of asking and then taking a person’s photograph can serve to validate that person’s life and it may heighten their sense of dignity and worth. In our limited experience, the photos seem to have this effect. Familes will often ask for additional copies long after their loved one has died. An example is this photo of my friend Stephanie's son and her husband that was taken more than six years ago. Just recently, Stephanie asked me for additional copies. Her son is now a teenager.

Day 36 (miles 2888-2952)

2009-10-19T08:00:00.006-04:00

Today, Monday, October 19, 2009, Dr. Greg is riding 65 miles from Cherokee to Asheville, North Carolina in memory of the following people:

Randy Habig
Fannie T.
Donald T.
Thomas T.
Jessie T.
Steven T.
Calvin T.
Dorothy T.
Mattie T.
George T.
Janice T.
Janice T.
Daryl T.
Betty T.
Larry T.
Merle T.
Ginger T.
Ruby T.
John T.
Jack T.
Patricia T.
Alvin T.
Adrienne T.
Charles T.
Carol T.
Mattie T.
Mary T.
Takeda T.
Myrtle U.
Earl U.
Carlos U.
Nancy U.
Helen U.
Betty V.
Clyde V.
Allen V.
Winona V.
Edward V.
Paula V.
Jesus V.
Javier V.
Glordean V.
Roger V.
Ernestine V.
Jacqueline V.
Shirley V.
Robert V.
Dagmar V.
Carolyn V.
Charles V.
Robert V.
Virginia V.
Marvin V.
Charles V.
Maria V.
Barbara V.
Laura V.
Thomas W.
Charles W
Robert W
Mary W
David W
Linda W
Albert W
Wilbur W
Raymond W

Day 35 (miles 2833-2887)

2009-10-18T08:00:00.004-04:00

Today, Sunday, October 18, 2009, Dr. Greg is riding 55 miles from Townsend, Tennessee to Cherokee, North Carolina in memory of the following people:

John T.
Matthew T.
Allen T.
Robert T.
George T.
Michael T.
Icilda T.
Melanie Christine Thompson
Ida T.
James T.
Walter T.
Ed T.
Darlene T.
James T.
Eric T.
Wilda T.
Georgia T.
Gertrude T.
Thaw T.
Reuben T.
Azeb T.
Bryon T.
Leila T.
Fonzo T.
Mamie T.
Betty T.
Robert T.
Robert T.
Michael T.
Donald T.
Marcuelle T.
Lillian T.
Lucinda T.
Willie T.
Larry T.
Frank T.
Frank T.
Eugene T.
Hazel T.
Celia T.
Ovan T.
Tice T.
Jose T.
Inez T.
James T.
Linda T.
Jason T.
Matej T.
James T.
Orville T.
Walter T.
Leepoleon T.
William T.
Ray T.
Mary T.

Melanie - A Precious Gift

2009-10-18T07:54:00.002-04:00

I received some of the most important advice for my medical career from one of my most important teachers. I met Melanie for the first time last August as part of a special section of our Introduction to Clinical Medicine course which pairs medical students with patients suffering from terminal illness. I’d visit her at home every couple of weeks, we’d share stories, and each visit deepened my sense of her beauty and strength. We talked about everything from her childhood and watching Sunday Colts games with her family, to religion, to the health care system, her favorite foods, and the role of being a mom. We laughed, we told jokes, and even shared a few tears. No matter what we did, I simply loved being around her.

Melanie taught me about the power of hope and family, about becoming a good parent and a good person, about appreciating the simple things in life and living a life of purpose. She taught me the simple beauty of making another person smile, every day. Above all, she taught me the power of listening and maintaining a sense of humor even through the most difficult times. Her gifts to me will help me take better care of every patient that I will ever see. My future patients will receive better care because of the things that she taught me.

Melanie died at the age of thirty this past February, and I miss her each day. Despite her wide-spread and painful cancer, she showed an amazing passion for life. She didn't want to die. She wanted to watch her 12-year-old son grow up. She wanted to teach others how to love their families. And she wanted to help medical students learn how to listen to their patients.

A week before she died, we made an audio recording of her final thoughts and wishes. Before I left, I asked her what advice she had for me as a medical student and future physician. It was the last question I asked Melanie before she died and I know her answer will always guide me:

“Just treat your patients as people, not as their illness, because they have all this life that they are leaving behind. And that is huge! That is bigger than any illness you can throw at them. Huge! Even if it doesn’t mean a lot to them now, it will, and they will have regrets. They are going to remember you. You are going to be the first and last person they remember.”

Melanie’s lesson was that all of us, no matter what our role, carry a precious gift: an opportunity to make this world a better place. I hope that Melanie’s legacy will live on through us all.

Contributed by Rob Cantor

The patient and her family gave permission to use her name and Dr. Greg is climbing a tall peak in Tennessee today in her memory.

Ted: On Rediscovering the Fight

2009-10-17T08:07:00.000-04:00

Ted Riley reached a point where he was ready to give up.** He was the first to concede that he had zero tolerance for pain. But as cancer ate its way through his HIV-weakened body, he was in a lot of pain. Ted wanted his doctors to perform a miracle.

His physicians were doing everything they could to make Ted comfortable, but at one point, he lost spirit and stopped eating and getting out of bed. He was rapidly weakening and heading toward the wrong kind of death. He and I had developed a strong and open relationship by this point, talking about everything from love and work to his latest online discoveries. He’d started a web business geared toward helping people in the community find homes and financing. He was a chatty and fun guy, and I knew I could be direct with him. So, when he’d apparently resigned himself to wasting away, I confronted him.

I told him I’d heard someone say that if he didn’t get up and start fighting, moving and eating, he was going to die. "Is that what you want?” I asked. It was not. I knew that what he really wanted was to find a hero, a man he loved who would care for him and somehow relieve his suffering. But at that moment, Ted was himself the only person who could make any difference. So I told him to get up.

He grimaced at me, but started moving around in the bed. Then he sat up, wiggled to the side, stood and walked a few steps to a chair by the window. I talked him through moving because I knew he had to do it with me there so he would do it again when I wasn’t there. With some prodding, he started to eat again, and he grew strong enough to leave the hospital. He moved in with a few friends and his brother. Because he was able to find the fight inside himself, he won a few more months and a few more memories before his body gave out.

*Contributed by spiritual advisor, Karen Estle

** The patient’s name has been changed to respect his privacy.

Day 34 (miles 2731-2832)

2009-10-17T08:00:00.005-04:00

Today, Saturday, October 17, 2009, Dr. Greg is wearing his Notre Dame jersey as he rides 102 miles from Crossville to Townsend, Tennessee in memory of the following people:

Donald S.
Brenda S.
Cheryl S.
Robert S.
George S.
Donald S.
Nancy S.
Clifford S.
Marvin S.
Vernon S.
Annette S.
Eugene S.
Dorothy S.
Georgie S.
Marie S.
Mary S.
Ira S.
Earl S.
Christine S.
Carolyn S.
Julia S.
Aaron S.
Freda S.
Jerry S.
Mary S.
Vernon S.
Phyllis S.
Daisy S.
John S.
Robert S.
George T.
Donna T.
Marthena T.
Albert T.
Reneea T.
Frank T.
Virgil T.
William T.
Deloris T.
Ralph T.
Letiate T.
John T.
Clara T.
William T.
Nathaniel T.
Harry T.
John T.
Leon T.
Edna T.
Dayton T.
Joseph T.
Robert T.
Christina T.
Alberta T.
Frank T.
Nathan T.
Archie T.
Rosetta T.
Douglas T.
Thomas T.
Mary T.
David T.
Kathy T.
Jennifer T.
Brenda T.
Sammie T.
Robert T.
Troy T.
Doris T.
John T.
Meshack T.
Maxine T.
Joann T.
Ruth T.
Willie T.
Eva T.
James T.
Nathan T.
Evelyn T.
Arthur T.
William T.
Martha T.
Rosie T.
Willie T.
Frances T.
Anna T.
Frances T.
Rayetta T.
James T.
Willie T.
Cheryl T.
Joann T.
Myrtle T.
Jenny T.
Hannah T.
Zelma T.
Charles T.
Joseph T.
Mary T.
Willie T.
Michael T.
Ronald T.

Making the invisible visible again

2009-10-16T08:05:00.000-04:00

When a person is told that he is dying, he is forever changed.

Even though all of us know that we are going to die, we don’t know when. Death is something pushed off in the future. But when a doctor tells a patient that she has incurable cancer, THAT changes her life—in a way that probably nothing else can.

When faced with such a certainty, what do you do? A terminal diagnosis alters everything forever. You are never the same and your relationships with others are never the same. You must find a way to get say goodbye for the last time to your family and friends, even if you don’t want to. Your physical appearance changes. You lose weight. You become weak. You lose your ability to work. You can’t do the things that you used to do. It becomes hard to go out. You don’t see as many people. Eventually, you become confined to your home, and then to your bedroom, and then to your deathbed.

You become less visible, almost invisible.

People treat you differently. They don’t see you as often and when they do, they don’t know what to say. Certainly, they don’t see you the same. They may even be afraid to be too close to you. Psychologically, it’s just the opposite of what a dying person needs.

In the hospital, the dying patient is often in a private room at the end of the hallway. The doctors and nurses may not spend much time in the patient’s room. The dying patient might be the last person to be seen on rounds. The patient might not get another visit that day. Doctors often feel that there is nothing that they can do for that patient. However, it’s just the opposite of what the dying patient needs. A dying person needs to feel loved and alive.

In our experience, taking a photograph of the patient makes them visible again. Patients, even when they are very sick, agree to having their photograph taken because they value it. The request to take the photograph, and the photograph itself, is life–affirming. “You are still important to me and to others and I don’t want to forget you. I want to visit with you. I want to take time to take a portrait of you. I will print copies for you and your family. I will keep your picture here on my computer and look at it from time to time.”

We’ve found these photographs to be a “dignity conserving” therapy for both the patients and their families. The pictures help us to remember and they help to make visible the invisible.

Day 33 (miles 2604-2730)

2009-10-16T08:00:00.011-04:00

Today, Friday, October 16, 2009, Dr. Greg is riding 127 miles from Nashville to Crossville, Tennessee in memory of the following people, including his good friend Al Sondej:

Paula S.
Oneil S.
William S.
William S
Alberta S.
Dora S.
Edna S.
James S.
James S.
James S.
James S.
Mary S.
Matthew S.
Ora S.
Phyllis S.
Phyllis S.
Truemack S.
Glenn S.
Curtis S.
Johnny S.
Josephine S.
Dollie S.
Barbara S.
Anna S.
Robert S.
Debra S.
Kelly S.
Majorie S.
Barbara S.
Maxfran S.
Ricky S.
Tina S.
DeAndra S.
Edna S.
Maggie S.
Ruby S.
Willie S.
John S.
Mary S.
Jack S.
Aubrey S.
Dollie S.
Michael S.
Rita S.
Rosemary S.
Kathy S.
Keith S.
James S.
Al Sondej
Kathi S.
Edna S.
Reainer S.
Betty S.
Charles S.
George S.
Birdie S.
Blane S.
Tyronzo S.
Donald S.
Courtney S.
James S.
Leon S.
Melvin Simon
Mary S.
Duffia S.
Carter S.
Walter S.
Luvenia S.
Edith S.
Sheila S.
Carl S.
Charles S.
Robert S.
Charles S.
Barbara S.
Eugene S.
Charles S.
Frances S.
Charles S.
Robert S.
Marshall S.
Bessie S.
Carol S.
Carol S.
Deborah S.
Patricia S.
William S.
Barbara S.
Beverly S.
Marilyn S.
Ola S.
John S.
Alvin S.
Bernard S.
Willie S.
Howard S.
Betty S.
Stanley S.
Carolyn S.
Mary S.
Michael S.
Emma S.
Rebecca S.
Myrna S.
Carolyn S.
Faye S.
Mamie S.
Alvin S.
George S.
Debra S.
Donald S.
James S.
Wilma S.
Carnetha S.
Robert S.
Paul S.
Martha S.
Patricia S.
Marvin S.
Lewis S.
Theodore S.
Boris S.
Anna S.
LT S.
Eddie S.
Roxie S.
Walter S.

October 15, 2009--Day 32 (Rest Day)

2009-10-15T08:00:00.004-04:00

Today, Dr. Greg is enjoying a rest day in Nashville, Tennessee before starting the final seven days of his cross country ride.

Day 31 (miles 2534-2603)

2009-10-14T08:00:00.012-04:00

Today, Wednesday, October 14, 2009, Dr. Greg is riding 70 miles from Erin to Nashville, Tennessee in memory of the following people:

Annie S.
Willa S.
Paula S.
Craig S.
Lois S.
Clarence S.
Oscar S.
Dorothy S.
Rosa S.
Donald S.
Joanne S.
Charles S.
Raymond S.
Nina S.
Lucille S.
Alice S.
George S.
Twyla S.
David S.
Dorothy S.
Larry S.
Ronald S.
Terry S.
John S.
Douglas S.
Michael S.
Mel Simon
James S.
Helen S.
Kyle S.
Carrie S.
Helen S.
Robert S.
Sue S.
Patty S.
David S.
Glenna S.
William S.
Robert S.
Geneva S.
Hester S.
Freeda S.
Cornelia S.
Michael S.
Joe S.
Charles S.
Tonya S.
George S.
Mary S.
Joseph S.
Timothy S.
Veleda S.
Melinda S.
Linda S.
Elizabeth S.
Aubrey S.
Charles S.
Mattie S.
Mary S.
Ernest S.
Felicia S.
Leonard S.
Luvenia S.
Milton S.
Beatrice S.
Marian S.
Kim S.
Jay S.
Vickie S.
Christina S.
Mattie S.

Robert: On Seasoning

2009-10-14T08:00:00.010-04:00

I met Robert four years ago in my first semester of medical school, through Dr. Gramelspacher's Special Section of the Introduction to Clinical Medicine course on Palliative Care. Robert was an 85 year old man dying of cancer, but feisty even though he was nearly blind. He lived alone, with just a little help from a kind neighbor who kept an eye on him and did his weekly grocery shopping. He took pride in cooking his own meals and managing most of his own daily activities.

I spoke with him by phone every week, and made home visits every 3-4 weeks. We never talked about his pain. Instead, our calls were usually about cooking – he loved cooking soul food, and would give me thorough instructions on my own cooking. He liked to prepare greens and sweet potatoes, ham, fried chicken, meatloaf and cornbread. He’d often go into detail about the seasonings he was using that day. After getting an earful about seasoning for his greens, how to make hotwater cornbread or his secret for sweet sweet potatoes, I would end the call by reminding him that I was going to visit him later that week.

During our visits, we talked a lot about his life. He’d tell me about growing up Baptist, and shared that he felt close to God and still prayed, even though it had been years since he’d attended a church service. He told me about his family, the ex-wife who still visited him when she was in town visiting their daughters, about the daughters he was so proud of, and about his extended family in Tennessee. We talked a lot about Indianapolis and how he’d watched the neighborhoods change.

He’d lived with his ex-wife and daughters in the area where IUPUI is now, which used to be a unified Black American community full of popular nightclubs and restaurants, beautiful homes and apartments. The residents of those long-gone communities seemingly had a good time. From the stories he told, it was a supportive, unified and golden time for the residents.

His life back then was a bit dicey, too. He told me about going to the nightclubs, where sometimes he had to fight and defend himself. He carried a knife when he was younger, for protection. I understood that. And at the time I was visiting him, he kept a pistol by his side as he sat on the porch. He never flashed it at me and I never felt like I was in danger, but I did make sure to call out to him from the car as I approached him for a visit. I understood the pistol as a bit of defiance against the vulnerability of his illness and blindness. Robert’s illness didn’t change his spirit, and he approached his own death with the same fearlessness with which he’d lived his life.

Robert passed away while I was home on Christmas Break. I’m so grateful I got the opportunity to learn about him as a man and not just as a patient. Over the course of that semester of visiting and listening, I learned a lot from his spicy approach to cooking and living.

Contributed by Joanna Fields, MD, MPH, MS

The patient’s name has been changed to respect the family's privacy.

On the Patients Who Taught Us

2009-10-13T08:05:00.000-04:00

The team of investigators brought together by Dr. Gramelspacher and his colleagues met many individuals whose personal thoughts and stories contributed to the creation of the Wishard Palliative Care program. Three patients I met in one of these focus groups “stand out” in my mind: One patient blurted out in a session, “It’s not the dying that bothers me so much; it’s this suffering crap!” What better reason is there for palliative care?

I also remember a pair of patients who formed an unlikely bond as we talked about feelings and hopes and fears. He was an African-American man, single, living at home, admittedly “wild” and brought to the meeting by his mother. The other was a Caucasian-American woman, a young mother who was also brought to the group by her mother – since her husband was caring for their children. The group adjourned, and these two stayed around and continued to talk over a second pastry and soft drink. My colleague had been leading the group of caregivers in a separate meeting, and when she and I “debriefed” afterward, I was somehow not surprised to learn that the mothers, too, had quickly become close and had continued their conversation after the group had been dismissed.

Facing death somehow seems to remind us all that – down deep – we are fellow humans. Let’s not forget people such as these who did not have the advantage of a palliative care service but began to teach us how important that care could be.

Contributed by Dr. Jim Greene, currently living in the mountains of North Carolina.

Day 30 (miles 2436-2533)

2009-10-13T08:00:00.010-04:00

Today, Dr. Greg is riding 98 miles from Union City to Erin, Tennessee in memory of the following patients and several beloved family members:

Samuel S.
James S.
James S.
Beverly S.
William S.
Michael S.
Betty S.
Ninfa S.
Lorena S.
Christine S.
Linda S.
Joseph S.
Kimberly S.
Ralph S.
James S.
Ernest S.
Gregory S.
Joan S.
Robert S.
Sondra S.
Marilyn S.
Marilyn S.
Garnett S.
Lillian S.
Sherry S.
Christopher S.
Deborah S.
Virginia S.
Ann Schneider
Hildegarde Schneider
Juanita S.
Caroline S.
Karen S.
William S.
Ronald S.
Tom Schutz
Robbie Schutz
Medeline S.
Ruby S.
Dorothy S.
Charles S.
Samuel S.
Thelma S.
Reginald S.
Curtis S.
Robert S.
Charles S.
Carolina S.
Timothy S.
Julia S.
Mary S.
Katherine S.
Rose S.
Sharon S.
Lonnie S.
Josephine S.
Robert S.
Orie S.
Margaret S.
Richard S.
Billy S.
Scott S.
Michael S.
Carlos S.
Dorothy S.
Mary S.
Arval S.
Royal S.
Linda S.
Kimberly S.
Judith S.
Clarence S.
Mary S.
Doris S.
Clara S.
Lynda S.
Oscar S.
Deanna S.
Mary S.
Theresa S.
David S.
Robert S.
Jerry S.
Darrell S.
Effie S.
Louise S.
Patricia S.
Kimberly S.
Larry S.
Sandra S.
Harold S.
Lee Roy S.
La Chester S.
Lakeesha S.
Robert S.
Janet S.
Alice S.
Carl S.
Gevon S.
Essie S.
David S.

Remembering Cowboy Bob

2009-10-12T08:05:00.001-04:00

My father, Bob Bonifer, died on July 15, 2003, at the age of 81, after living a rich and productive life that was filled with love, laughter, tears and joy. This is a story about him…

My father grew up on the Great Depression. In the 1930s, his father, my grandfather, lost his job as a Cadillac mechanic in Louisville. When my dad was thirteen, they moved from the glamour of movie theaters and racetracks (they lived three blocks from Churchill Downs, where the Kentucky Derby is run) to the quiet and unglamorous town of Ireland, Indiana, where my grandfather opened a small garage and machine repair shop.

It could have been depressing for him, I guess, but my father clung to his love of movie cowboys and horses, and got to be known to the people in his new hometown as 'Cowboy Bob'. They moved to a farm. He got a horse. This was the beginning of my family's nightmare.

He claimed that 'horse aroma' was the first thing he smelled when they brought him home from the hospital as a baby, and whether that was true or not, what's true for sure is that he was intoxicated by horses, drunk on them, and my mom and my five brothers and sisters and me were his co-dependents.

We grew up on a small 200-acre farm, and all the while I was growing up, my dad would arrive home from some business trip on one of the many jobs he held down off the farm, hauling a horse he'd acquired that someone was otherwise going to sell for pet food. A horse with one lung, a horse with one leg shorter than the other three, who ran like an out-of-balance washing machine. A blind mule. Biters and kickers and malcontents. He had some fabulous horses, too. Arabs and Quarter Horses and Tennessee Walkers and Thoroughbreds. But these got to be out-numbered by the bad ones. Regardless, He loved them all indiscriminately and gave them all a home. At one point, when I was growing up, we owned as many as 40 of these horses. It was like we were running a rescue shelter for horses. And if you think this was a nightmare, it was at times a nightmare for me, but it was not the nightmare that I'm talking about.

And then, in a move that only my father would make, we opened our farm to the public, as a kind of outdoor recreation facility centered around a riding stable and a half-mile track we'd built. And let me tell you, there's nothing funnier than a dozen or so members of the riding public trying to control horses with the kinds of issues our horses had. A fat lady bounding around on the washing machine, whose name was Queen. The horse with one lung, whose name was Old Grey, who, on the rare occasions she could be coaxed into a run, made a sound like a saw going through wood. We had this one little half-pony, half Tennessee Walker named Duke. His best friend was a gigantic half-Morgan, half Quarter-Horse named Tony. Little Duke would walk so fast, and big Tony would walk so slow, that Duke would have to turn in circles every ten yards or so to let Tony keep up. And this is how they had to be ridden. Duke's rider turning in circles while Tony ambled along in slow motion, like he was pulling a plow.

Every now and then something bad would happen. A girl got thrown from her horse and sustained a concussion. Old Grey's saddle would come off mid-ride. Queen would wade into our lake with a rider on board and refuse to come out. These were depressing. I began to want to move away from all this madness. But none of it was anywhere near as depressing as what happened after I did move away.

When he was 19, my younger brother, Brian, quit music school and moved back home to the farm, to go into business with my dad. Their 'start-up' was thoroughbred horses. Brian became the Trainer. My dad was the Owner. It was a real Don Quixote/Sancho Panza situation, let me tell you, because the horses in their stable weren't much faster than Sancho's burro. My father did a terrible thing to my brother. He inflicted his dreams on Brian. Cowboy Bob wanted a sidekick, someone who'd inhabit the same singing cowboy fantasy world he did, in which burros had wings and would win the Kentucky Derby someday. They fought one night over Christmas holidays, my father slapped Brian and it was bad and there were lots of loud voices and lots of tears and wounds were opened that would never fully heal. It hurt us all to experience it, but the hurt was nothing, a paper cut, compared to what we were yet to experience.

My brother finally started seeing things his own way when it came to the horses, quit listening to my dad, snapped out of it, began keeping his own counsel, and trained and fed their most promising colt, a smallish horse with a biggish heart. He won a race, the first race of his career. The horse was 40-to-1. And while I, Mr. Hollywood cynic, wondered if some kind of fix might have been in, and had visions of some of the other jockeys in the race cashing their own 40-to1 tickets on Denny's Gold, I was happy for Brian.

A month later he was dead. He drowned in the lake on our farm while swimming with a horse. My sister who was there and could swim tried to save him and almost drowned herself...my mother who was there had to scream at my sister to let him go and then ran for help as my sister crawled out of the water and watched our brother's hand wave goodbye.

This was the nightmare. The most depressing thing I've every known. Anyone who has lost a sibling or a child can tell you that it does not get any worse. And as bad as it was for me, it was much, much worse for my parents. They didn't sleep, and would walk the country roads all night, just to keep moving, because to keep moving was the only way they could know for sure they were still alive. They sold or gave away all their horses, and for the first time in my lifetime, there were no horses on our farm.

In the spring after the summer my brother had died, the farm was weeks away from getting foreclosed. And then one day my father disappeared. The child of the depression, the father of the depression...we wondered if it had been too much, wondered if he'd taken his own life. He had threatened it. My sister had found him one day sitting at a picnic table under what we called the shade trees, staring at a loaded rifle on the table in front of him. He did not own a rifle. So we wondered.

But no, he did not take his own life. And this was the first hand-hold out of the depression, the dark hole of nothingness in which we were all living. Three days after he'd disappeared, he showed up back on the farm with a couple of guys driving a truck loaded with heavy equipment. They drove it back to the lake where my brother had drowned, unloaded the equipment, and began drilling for oil.

Three days later, they hit oil.

I happened to be there on the day it happened. I kid you not, it was Easter Sunday. My father was back there at the lake wearing a red nylon Indiana University Basketball jacket, standing at the well-head, filling quart jars with the oil that was bubbling up from the ground and handing them out to friends and neighbors as souvenirs. Unbeknownst to any of us, he'd gotten several of the neighbors to invest in the well. And so it became a kind of party. All of a sudden things were not so depressing any more. My mother and sister came back to the lake for the first time since the day my brother had drowned. And my sister, who had not shown any kind of emotion since that day, cried.

It was not a gusher by any stretch of the imagination. Well, except for my dad's I mean. I am sure Cowboy Bob saw it as the scene from Giant, where James Dean stands in the shower of oil coming from the gushing well and screams with joy. He came up to where I was standing, threw an oily arm around my shoulder and said to me, 'Well, we're oil people now.'

What could I do but laugh with joy at the idea that Cowboy Bob was back in the saddle again? From that instant on, everything turned around. The oil from that well paid off the last of our student loans, and there was enough left over for my father to buy a couple of questionable thoroughbreds, you know, the kind only he could see the beauty in. We were back. And all because my father remembered who he was, and acted on that. He was a dreamer, a cowboy, a rider-to-the-rescue. He was oil people. At least, in the movie, it's oil. In life, In life, it's love we drill for and re-discover. Only love can remind us that no matter how rough the ride or how sad the horses may be, our best day is somewhere on the trail ahead of us.

* Submitted by Mike Bonifer

Day 29 (miles 2334-2435)

2009-10-12T08:00:00.007-04:00

Dr. Greg is riding 102 miles from Poplar Bluff, Missouri to Union City, Tennessee in memory of the following people:

Jerry R.
George R.
Virgil R.
Mary R.
Dorothy R.
Shirley R.
Dorothy R.
Thomas R.
Harry R.
Robert R.
Alice R.
Gladys R.
Carl R.
Napoleon R.
Leroy R.
Juan R.
Jeffery R.
Steven R.
Edelmira R.
Janice R.
Sylvia R.
Patricia R.
Rick R.
Rudolph R.
Douglas R.
Theresa R.
Georgia R.
Cyrenus R.
Sharon R.
Agnes R.
Walter R.
Gerald R.
Eva R.
James R.
Henry R.
Bertha R.
Charles R.
Johnnie R.
Lige R.
Alfred R.
Bernard R.
Lena R.
Katherine R.
Deangelo R.
Larry R.
Winifred R.
Clifford R.
Roy R.
Jimmy R.
Walter R.
Charles R.
Albert R.
Albert R.
Trennie R.
Refugio R.
Polly R.
Rick R.
Hazel R.
Randy R.
Sara R.
Gregory R.
Dorothy R.
James R.
William R.
Phillip R.
Ralph R.
Rita R.
Barbara R.
Charley R.
Sally R.
Cora R.
Clifford R.
Shirley R.
Rose R.
Reggie R.
Amanda R.
John R.
Frances R.
Adelheid R.
Gretchen R.
Josephine R.
Margaret R.
Bobby R.
Bobbie R.
Betty R.
Larry R.
Ricci R.
Helen R.
Thelma R.
Robert R.
Dorothy R.
Geraldine R.
Wanda R.
Charlotte R.
Judith R.
Gina S.
Carl S.
William S.
Catherine S.
Lorraine S.
Esteban S.
Kendalyn S.

Meeting Hilbert Gramelspacher in Poplar Bluff, MO

2009-10-11T22:02:00.006-04:00

I've been looking forward to today's ride for the past six weeks, ever since I received a phone call from Mr. Hilbert "Bert" Joseph Gramelspacher who lives in Poplar Bluff, Missouri. I didn't know that I had a relative in Poplar Bluff until Bert called my office just before I left for this cross-country trek. At age 89, Bert regularly searches the internet for other Gramelspachers. He reports a couple million hits but apparently follows me since he says that I'm mentioned on most of the Google pages.

During one of these searches, he came across this blog and saw the small map that shows us traveling across southern Missouri. He assumed that we would be coming through Poplar Bluff and called to invite us to visit. Like me, Bert was born in Jasper, Indiana. He left Jasper at age 14 in 1934. I believe that his grandfather (and my great, great grandfather) John was famous for fighting on both sides in the Civil War (changed from the Confederate to the Union side as the tide turned). Bert said that his father, Joseph, was 77 years old when he was born to a younger Schneider. I'll have to get my family's help on the genogram.

What a treat to stop at Tom Crutchfield's home to greet Bert and his new bride, Frieda. Since I talked with him several weeks ago, Bert has had some serious medical problems. He recently spent a week in the hospital and will soon travel to St. Louis for additional tests. Despite this, he put on his Sunday best and made the trip across town to shake hands, tell stories and pose for this picture. Many of my fellow cyclists as well as our Trek crew stopped for tea and cookies. It was a great way to finish a difficult 112 mile day over the Ozark "rollers."

Worth noting: this blog encouraged Bert to open a Twitter account and he has been reading my posts on Twitter as well. However, he needs a lesson from Chris Sacca to learn how to send tweats. Bert will be 90 years young on December 31st. How many 90 year olds do you know that use Twitter! Keep going Bert! Take good care of him Frieda and I hope to see you both again very soon.

On Physicians Who Believed

2009-10-11T08:05:00.000-04:00

As we remember the 3000+ patients who have been cared for by the Wishard Palliative Care team, I think it’s also important to remember the patients and physicians whose brave fights predated the program. I was a member of the team that listened to patients and caregivers a decade and a half ago, gathering data to “make the case” for a Palliative Care service at Wishard Hospital.

In order to explore the possible need for a palliative care service, we asked physicians at Indiana University School of Medicine to talk with those who had been diagnosed as “terminally ill” and if their patients were willing to talk with us, give us their names. Many helped us compile the lists for our focus groups. After we had done our study, I wrote to IU faculty members, explaining what we had done and what we had learned from terminally ill patients and their care-givers.

I received a striking letter from an older physician in reply to my explanation. In essence, he wrote, “Anyone who acknowledges that they will die in the foreseeable future is, in my judgment, mentally incompetent and "I will do all in my power to circumvent their death wish!" According to this physician, acceptance of the inevitability of death is proof of incompetence and ought to be opposed.

There were other physicians -- perhaps more compassionate or perhaps more realistic -- who had faced the imminent death of their patients and acknowledged as much. They’d seen that their patients’ conditions had reached the level where the best medicine would be palliative rather than curative. I remember these courageous and selfless doctors just as I remember the courageous and inspiring patients they’ve cared for.

Contributed by Dr. Jim Greene, now living in the mountains of North Carolina.

Day 28 (miles 2224-2333)

2009-10-11T08:00:00.004-04:00

Dr. Greg is riding 110 miles from West Plains to Poplar Bluff, Missouri in memory of the following people:

Richard P.
Ira P.
Martha P.
Jessie P.
Donald P.
Elizabeth P.
Violet P.
Larry P.
Janet P.
Sondra P.
Robin P.
Lazaro P.
Melvin P.
Alfred P.
Mary P.
Ernest P.
Jeff P.
Vitolous P.
Kozetta P.
Eugene P.
Andrew P.
Doloris P.
Delores P.
Richard P.
Emma P.
David P.
Marcia P.
Mary P.
Flora P.
Sherlyn P.
Ruth P.
Robert P.
Ellen Q.
Gemalene Q.
Mario Q.
James R.
Michael R.
Carla R.
Carla R.
Annie R.
Marcus R.
Glenda R.
Annie R.
Hugh R.
Jacqueline R.
Paul R.
Barbara R.
Jennie R.
Paulette R.
Virginia R.
Ilene R.
Gino R.
Dorothy R.
James R.
James R.
Sidney R.
Marie R.
Carol R.
Mariah R.
Charles R.
Evelyn R.
Edna R.
Robert R.
Evelyn R.
Barrett R.
Robert R.
Ernest R.
Tamara R.
Barbara R.
Joe R.
Doris R.
Peggy R.
Ruth R.
Virldeen R.
Ella R.
James R.
Esther R.
Richard R.
Anna R.
Minnie R.
Robert R.
Eileen R.
Willie R.
Patty R.
Marcia R.
Nellie R.
Aaron R.
Kevin R.
Robert "Bobbie" R.
John R.
Mary R.
Richard R.
Archie R.
Henry R.
William R.
Sylvester R.
Clarence R.
Shirley R.
Martha R.
Baxter R.
Betty R.
Dorothy R.
John R.
Mattie R.
Vivian R.
Hoover R.
Richard R.
Arletta R.
Michael R.
Jaime R.

Portraits of the living: how photography can enhance the care of the dying

2009-10-10T08:05:00.003-04:00

Many years ago, about the time I started to care for the dying poor, I decided to carry a small digital camera in my pocket. Occasionally, I would ask a patient if they would be willing to let me take a picture of them. Almost always, they would say yes. At first, I was a little surprised.

Originally, the idea was to have a visual record for me of my patients – so I could remember what they looked like, so I could put a name to a face. I took many single patient portraits over the years. I was amazed that, even when patients are really sick and not looking too good, they would allow me to take their photograph. Often, the family would be in the room, and I would ask them to get into the picture. This is when it became something more.

I would share these photographs with the family, after the patient died. My photographs were usually the last photographs they ever had of their loved one. Families found it very meaningful to have that photograph. By taking these photos, by giving copies to the families, and by looking at them myself, what began as a visual record evolved into something much larger—something with more meaning.

Here is an example. I took this photo of a homeless man in the hospital room during my consultation. He later died of advanced cancer. The second photo is another poor man who allowed me to take his photo while he was sitting on his hospital bed. Who knows when either of these men had their photographs taken before I took these pictures but I suspect that both of these photographs are these patients’ last portraits.

I plan to tell you more about the “Portrait” project in the days ahead as we remember our patients and remind ourselves that it is about living, not dying.

Day 27 (miles 2124-2223)

2009-10-10T08:00:00.005-04:00

Today, Dr. Greg is riding 100 miles from Branson to West Plains, Missouri in memory of the following people:

Walter P.
Sylvia P.
Valarie P.
William P.
Henry P.
Judy P.
Frazier P.
Beatrice P.
Helen P.
Stella P.
Harry P.
Robert P.
Gene P.
Dwight P.
James P.
Rickey P.
Billy P.
Michael P.
Bobby P.
Dzevad P.
John P.
Anne P.
Lula P.
Helen P.
Radjibhai P.
James P.
Rickey P.
Delphia P.
James P.
Mildred P.
Kenneth P.
Katherine P.
Jace P.
Renea P.
Louis P.
Halik P.
Annie P.
Charles P.
Albino P.
Buford P.
Earl P.
Charles P.
Charlotte P.
Mary P.
John Penn
Larry P.
Robert P.
Carole P.
Andrew P.
Mary P.
Irene P.
Irene P.
William P.
David P.
Fredonia P.
Lula P.
Loretta P.
Ada P.
Floyd P.
Josephine P.
Walter P.
Joe P.
Freeman P.
Ernest P.
Mien P.
Evelyn P.
Bernice P.
Christine P.
Connie P.
Shirley P.
Donald P.
Alan P.
Sheila P.
Peter P.
Charles P.
Betty P.
Mary P.
Betty P.
Lebern P.
Mary P.
Robert P.
Gerald P.
Keith P.
Larry P.
Angela P.
Edward P.
Roxie P.
Loyce P.
Regina P.
Crystal P.
Maceo P.
Emitt P.
Carl P.
Susan P.
Alice P.
Phyllis P.
Denise P.
Jeffrey P.
Irvin P.
Lewis P.

Soaked on the way to Branson

2009-10-09T21:28:00.003-04:00

Yesterday's ride was only 90 miles (I never thought that I would say that) but rain soaked us for most of the day. Despite hard rain and wind just before lunch, Kryptonite Katherine and I were lucky enough to get to the trailer first. We enjoyed our meal in soggy bike clothes sitting in the back of the trailer. When the other riders came in, they said we looked like a couple of stow-aways trying to hide.

The rain subsided enough, to just a drizzle, that we decided to ride the rest of the way into Branson. It was a hilly (7000+ feet of climbing), wet and cool ride even after finding some dry clothes to wear. I decided to ride without socks since I didn't have a dry pair and my shoes were already soaked. Having 90 patient names in my back pocket gave me the determination to finish the ride.

I couldn't help but think of the wet, rainy days that so many of our patients had to endure during their life. I imagined our homeless patients who spent many days without a dry or warm place to sleep. I thought of our patients who died in prison where everyday must seem cold and cloudy. And of course, I thought of our many geriatric patients who live out their lives in urban nursing homes with few visitors, family or friends. They must feel soaked all the time.

So, yesterday's ride was a gift for me to remember these special souls who enriched my life by allowing me to help care for them.

Today's photo was taken by Nadia Butler and matched what I saw through my rain-soaked glasses as we pedaled into town. You can see some of her other wonderful pictures of Oklahoma on our Facebook Fan page. Thanks Nadia!

Five Tasks Taught by Hospice Nurses--Poem by Patrick Clary

2009-10-09T11:59:00.003-04:00

FIVE TASKS TAUGHT BY HOSPICE NURSES
to my brother

1. Say Goodbye

You called me at work to ask for a loan
And said goodbye as sweetly as if I'd said yes.
I was unhappy, and probably rude.
It was the last time we talked.

2. Express Forgiveness

I forgive you for stepping over the edge,
Wearing a roofer's safety harness
Clipped stylishly to nothing,
Momentary angel over Arizona.

When you were seven
You flew the swing set outside
Our Chilean house through an earthquake
As walls and ceilings collapsed into themselves.
"More, make it do that again!"

Your life was not as short as I feared
Nor as long as I hoped.

3. Request Forgiveness

Forgive me for not lending you the money
To buy that motorcycle,
For not admiring your poetry,
For never taking a photograph of you with my sons.
Forgive me for not wrestling with you into more
Sunsets the summer before I was drafted.

Forgive me for being your imitation angel,
For leaving you with that elephant in the living room.
Forgive me for living.

4. Affirm Affection

I love you
For being obvious about loving me
When I was fifteen and
Thought I couldn't bear to be loved.
You were too young to know better.
You were so alive,
Your death seemed impossible-
If you could die everyone would.

5. Express Gratitude

Thank you for giving me back
My lost family and Montana,
Where we scattered your ashes
According to your instructions:
Up Big Creek Canyon
And n the hundred-year
Flood plain of the Bitterroot.
West Yellowstone burned all the week
Of your death, frosting windshields white in July.
Now, when I visit - and I visit often - I do work I love,
While I stay in a lodge built ten years ago
Of first-growth timer
Salvaged from that fire.

Now I see: living is a kind of slow burning,
And love is what we salvage from the fire.

Taken from Dr. Patrick Clary's book Dying for Beginners Lost Borders Press, Big Pine, California 93513, USA

Day 26 (Rest Day)

2009-10-09T08:00:00.006-04:00

Today, October 9, 2009, Dr. Greg will try to dry out in Branson, Missouri before getting on the bike tomorrow to cross the rest of Missouri on his way to Tenneessee.

Clare: On Physician Humility

2009-10-08T09:00:00.000-04:00

Sometimes our role in Palliative Care is humble, and I learned this lesson from one of the earliest patients who made a deep impression on me, and from her dedicated daughter. Clare was an incredibly sweet woman suffering from a variety of medical problems that included heart failure, bad lungs, and kidney failure.** She’d grown up with her twenty-some siblings in Haughville, a neighborhood close to Wishard but invisible to most of the doctors who drive around it or away from it on their way home. Her illnesses made it difficult for her to move without shortness of breath. When I took over as her primary caregiver at the rehabilitation center next-door to Wishard, I began to get to know Clare and her family, particularly the daughter who worked two jobs yet still managed to frequently visit her mother.

One afternoon, I received a page from her daughter. She was with her mother in the radiology area at Wishard, and the technologists were struggling to get Clare in the right position for an x ray. She was in acute pain. I happened to be around the corner and managed to get to the radiology department in less than a minute. Though I don’t remember what exactly I did when I got there - I might have simply held Clare’s hand and born witness to her suffering in that moment - I do remember the gratitude shown by both Clare and her daughter. This simple instance, a demonstration of compassion and sympathy, solidified the doctor-patient-family relationship that would be so important to all of us during the next two years before Clare’s death in 2007. It was also this instance that revealed the full value of giving patients and families direct and immediate access to their physicians. I was lucky to have been right around the corner when Clare’s daughter paged me, and if there had been a phone triage system between us, I wouldn’t have been there when she needed me.

The summer before she died, Clare moved into a handicap accessible apartment with her daughter on the East side of town. When she moved into the apartment, she was still well enough to get to an upstairs bedroom. But her health problems worsened and eventually she was restricted once again to her bed. I remember paying a visit on a Friday afternoon to try to help her daughter figure out how to solve this new complication. What if she needed to get to the hospital quickly? What if there was a fire? Clare was resting upstairs while her daughter and I quietly talked below about the need to somehow get her downstairs. There didn’t seem to be an easy solution. I went back to my office to ponder the possibilities and enlist the help of our social worker. I didn’t think anything could be done over the weekend. But on Saturday afternoon, I received another page from Clare’s daughter. She had rigged up a homemade system involving milk crates, which enabled her and some other family members to get Clare and her hospital bed down the stairs and into the apartment’s front room. I’m still trying to figure out the engineering behind this accomplishment.

Our team takes pride in our dedication to our patients, but it’s humbling to witness such ingenuity and commitment from families caught in the most difficult circumstances.

Contributed by Dr. Lyle Fettig

The patient’s name has been changed to respect the family's privacy.

Day 25 (miles 2034-2123)

2009-10-08T08:00:00.007-04:00

Today, October 8, 2009, Dr. Greg will bicycle 90 miles from Neosho to Branson, Missouri in memory of the following people:

Eleanor N.
Henry N.
Michael N.
William N.
Hershel N.
Janie N.
Daniel N.
Virginia N.
Tejar N.
Clara N.
Wallace N.
Delight N.
William N.
Shelda N.
Maxine N.
Clara N.
Lena N.
Barbara N.
Hazel N.
Lucious N.
Jack N.
Lillian N.
Rosie N.
Jin N.
Kaew N.
Maureena N.
Darlene N.
Robert N.
Jack N.
Kurnie N.
Lucile N.
Constance N.
Camillia N.
Imogene N.
Joan N.
Robert N.
Steve N.
Marcella N.
Douglas N.
Cathy N.
Thomas N.
Audrey N.
Nancy N.
Gloria N.
Tom N.
Ora N.
David N.
Victoria N.
Elnora N.
Donald O.
Danny O.
Patrick O.
Norma O.
Mary O.
Gussie O.
Edna O.
Early O.
Janice O.
Philip O.
Doris O.
Camelia O.
J.D. O.
Thomas O.
Norma O.
Marion O.
Ruth O.
Kenneth O.
Jesus O.
John O.
Betty O.
Raymond O.
Emilie O.
Angelo O.
Minnie O.
Betty O.
Geraldine O.
Dorothea O.
Jacqueline O.
Dorothy O.
Pearl O.
Larry O.
Sarah O.
Howard O.
Ocine O.
Robert P.
Erika P.
Terese P.
Margalina P.
Geraldine P.
Darlene P.

Luke "Spoon" Mehringer Part II

2009-10-07T13:02:00.001-04:00

From Bucket, he got a strong work ethic, an aptitude for enjoying life, an ability to get right to the heart of a problem and get it solved. There was no wasted motion. He got to it and got it done.

From Anne, he got kindness and compassion, a love of family, and the twinkle in his eye. From her he got his love of horses. Even though he was allergic to horses, he loved them so much he rode them anyway.

He was a planner. A doer. A giver. If you needed firewood for a day, you’d get enough firewood for five days. If you needed something to eat, he’d fill your refrigerator. One and his buddy Ben sat on top of silos and acted as lookouts so his sister Anden’s Senior Party didn’t get ‘interrupted by the local law enforcement officials’. (Sorry, Brock!)

He planned the family photo this Christmas. Coordinated everyone’s schedules. Figured out when Dustin and Ali would be home. When Anden would be down from Indianapolis. He hired the photographers, and kept the whole thing a secret from his parents. He wanted it to be a tradition. And it will be. But there will be a big hole in that picture every year where Luke should have been.

They tell us that enough flowers were sent to the funeral home for four large funerals. People have given the Mehringers three refrigerators full of food. The Southridge football team sent flowers. Now, you’ve got to realize that nobody on the team or the Southridge coaching staff today was there when Luke was playing. They didn’t know him as a football player, they knew him as a human being. That’s how he affected people, not as a football player but as a human being.

His organs have been donated. Because of him, a person will walk. A person will see. People will be healed, and they will live longer lives, thanks to Luke. That’s what Luke did. He touched lives. And that is what he continues to do, even after his death.

HE TOUCHED LIVES

He was great son. A brother. A grandson. An uncle. A cousin. A teammate. A classmate. A roommate. Or even if you didn’t know him, if you were the new kid in town, the new kid in school, or on the team, that didn’t last long. The only condition of being friends with Luke is that you’d have the conversation with him, because by the end of that conversation you’d be friends, didn’t matter if you’d started off that conversation with two contrary points of view, by the end of it, Luke would have found a third point of view that both of you could agree on. Some people spend their entire lives learning how to do that. Luke was born knowing.

It didn’t matter who you were, he’d make you feel though you were the most important person in the world, because when you were with him, you were the most important person in the world. He could talk to anybody about anything. That was part of his gift, too.

People say he was the life of the party. That he was always where the action was. I don’t think that’s quite the whole story. I think he was the party. He was the action.

Anden, Erika, Dustin and I sat together last night reading the quilt squares that people had written at the funeral home. And what they wrote said what kind of person Luke was. They said things like, ‘The one friend I could tell anything to.’ ‘A go-to person.’ ‘He’d do anything for you.’ One of them said, ‘I never had a little brother of my own, but if I did I’d want him to be just like you.’

HE MADE THINGS BETTER

Among his friends, Luke is famous for saying, “I never met an ice machine that could keep up with me.” I guarantee you that somewhere, someone is working on a better ice machine thanks to Luke Mehringer, because that’s what Luke did, he helped make things better. Part of his gift was that he improved every situation.

In his senior football season, he tore his ACL in the first half of the first game of the season. He was an All-State player. A star. That kind of injiry would destroy a lot of people, they’d get over it. I see Jim Van Huysse out there. He and I still talk about losing to Salem in the regional finals our senior year. But that wasn’t Luke. He never looked back. He never let anything get him down, or give him regrets. Through his knee injury, he found a way to become a stronger and more positive person.

When he was a kid, maybe ten years old, someone found him wandering around making mischief in the back of Mehringer’s shop. They told him, “You look like your mom.” He said, “Yeah, but I act like my dad.” That’s how he was. He knew who he was. He took the good things and made them better. He was the best parts of his mother and his dad.

HIS LIFE

No doubt about it, Luke’s passing leaves a hole in all our hearts. But let’s remember that the life he lived didn’t have anything to do with loss or sadness or defeat. Those of you who came to the funeral home saw the newspaper headline: ‘Wildcat Far From Gloomy.’ That’s Luke. He was as far from gloomy as a person can get. There’s no reason to believe that his passing isn’t another gift that he’s given us. The challenge we have right now is to find a way to accept that gift.

To those who are his age, his roommates, his classmates, his friends, who have come here to honor him…I want to say this to you in particular: The memory is not enough. It is not enough to remember him. The challenge you’ve got is to live the life the way Luke showed you it should be lived.

If someone is down, lift them up.

If someone is lost, give them directions.

If someone is lonely, give them company.

If someone is your adversary, find common ground.

If the breaks go against you, bounce back stronger than you were before.

Eat life up like it’s a hot summer day and you’re a kid at the Dairy Queen. Because that’s what Spoon would do.

‘UNDEFEATED’

He lived only 23 years. Too short, we say. He left us too soon, we say. Such a loss, we say. And that may be true. But here’s the thing: When God puts us in the game, we get no guarantee of how long we get to play.

Luke might not have been in the game as long as we think he should’ve been. But it is not for us poor players to decide, it’s the Coach’s decision. While he was in the game, Luke Mehringer made every play he could possibly make. He elevated everyone else’s game. He gave it his all. And that’s all the Coach expects of any of us. Luke finished his season on earth undefeated.
Anne and her great friend, Maureen, and I were sitting up late last night talking, and I think Maureen said something that got it just right. She said, “It’s perfect.” That says it all. Luke Mehringer lived a perfect life.

So here’s what I think Luke would say to all of us who feel so sad about his passing:

“Tomorrow’s Christmas. Tonight, there’s going to be a new star in the sky. A child will be born. It’s cause for celebration. Smile.”

Born Smiling: Luke Mehringer Eulogy

2009-10-07T08:00:00.007-04:00

God must have asked why should I hold the whole world in my hands when I could be using a Spoon?

September 17, 1985, Memorial Hospital, Jasper, Indiana. A child is born. As the legend goes, that child, Luke Alan Mehringer, arrives in the world with a smile on his face. And for 23 years, the smile never goes away. And not only doesn’t it go away, it spreads to the faces everyone he ever knew or ever met.

Luke always put the best face on every situation, beginning with his own. He made everyone around him feel welcome and at home. He brightened every room. Perked up every party. Lifted everyone’s spirits.

When he had a scooter wreck and lost two front teeth, it didn’t keep him from smiling. If a horse threw him, he found a reason to laugh about it, and got back on that horse. If his Grandpa Bass tore into him for doing work that Bass thought was sub-par with words that cannot be repeated here in church, before the day was through Luke would be laughing about it, I’d be laughing about it, you’d be laughing about it…and Bass would be laughing about it, too.

Luke specialized in sharing happiness like Peyton Manning specializes in throwing a football. He had a special kind of genius for it. When Dustin got engaged to Ali and Luke helped stage the proposal, Brenda, who works for Bucket and Anne, said that when he got home he was so happy for his brother it was like he’d gotten engaged himself, and he told her, “I hope I can marry a girl like Ali someday.”

His nickname was Spoon. I think it stuck because it’s a name that makes everyone smile. It doesn’t cut or slice like a knife. It doesn’t poke or pierce like a fork. A spoon is what you eat your ice cream with. And that’s how he went through life, like a kid at the Dairy Queen on a hot summer day. He ate life up with a spoon.

Contributed by Mike Bonifer of GameChangers.com

Day 24 (miles 1922-2033)

2009-10-07T08:00:00.006-04:00

Today, Dr. Greg is riding 112 miles from Bartlesville, Oklahoma to Neosho, Missouri in memory of the following people:

Carolyn M.
Barbara M.
Larry M.
Richard M.
Bob M.
Judith M.
Eula M.
Barbara M.
Joseph M.
Daniel M.
Clarence M.
Jerry M.
Yvonne M.
Lois M.
Earl M.
Eddie M.
Annabelle M.
Joan M.
Lucas M.
Veronica M.
Leonard M.
Ruby M.
Marjorie M.
Benjamin M.
Dorothy M.
Norma M.
Bryan M.
Lavone M.
Deborah M.
Sally M.
Mary M.
David M.
Wendell M.
Mary M.
Cynthia M.
Cecelia M.
Flossie M.
John M.
Lillian M.
Lillian M.
Willie M.
Anna M.
Julia M.
Rodney M.
Johnnie M.
Ellen M.
Agnes M.
Lisa M.
Henry M.
Louise M.
TJ M.
Rosie M.
Pearl M.
Clyde M.
Avon M.
Lee M.
Stella M.
Jose M.
Jo M.
Juan M.
James M.
Lewis M.
Gina M.
Loretta M.
Geneva M.
Roger M.
William M.
Brenda M.
Margaret M.
Stevie M.
Steve M.
Oliver M.
Richetta M.
Dyllis M.
James M.
Jerry M.
Mary M.
Edna M.
Tony M.
Diane M.
Michael M.
Silvanus M.
Andrea M.
Agnes M.
Leroy M.
Howard M.
Barbara M.
James M.
Lucy M.
Will M.
Mary M.
Harry M.
Arthur M.
Betty M.
Robert M.
Rose M.
James M.
Joyce M.
Johnny M.
Vera M.
John M.
Charlotte M.
David M.
Billy M.
Leonora M.
Clarence M.
James M.
Glenda M.
Shirley M.
Freeda M.
Larry M.
Timothy M.

Leaving Oklahoma

2009-10-06T21:40:00.005-04:00

After nearly 2000 miles of bicycle riding, we will leave Oklahoma tomorrow. We've nearly reached the 2/3rds mark and everyone is intact except for our intrepid guide, Big Wave Dave. Dave took a spill on wet pavement a couple days ago trying to hold our group together. It happened right in front of me and it didn't look too bad at first.

However, he was unable to resume riding and after xrays in Enid, OK we learned that he had a small fracture in the greater trochanter. No surgery, just crutches for five days and no bicycle riding for one month. For now, he is staying with our tour and cheering us on with his usual gusto. Here is a picture of the Big Wave at lunch today. It was a good day of riding--73 mile "recovery" ride. We have 113 miles on tap for tomorrow.

Richard: We Will Control Your Pain

2009-10-06T09:00:00.001-04:00

Every day for several months, I could expect to hear my phone ring and a voice on the other end, saying, "Hey Mary, it's Richard, how you doin?"** These calls got to be a dependable part of my days.

Richard was an outgoing young African American man with abdominal cancer. He’d lived a hard life and didn’t hold back details about that life, including the fact that he’d used cocaine and heroin, and he told us from the beginning that he'd use again if the pain ever got too bad. Dr. Greg promised his pain would be controlled, and thus began my relationship with Richard and the daily phone calls about his medication and pain level. Because of his previous addictions, controlling his pain required higher doses of opiates. He’d be dispensed large quantities of morphine solution, but the range on the prescription was so broad that we could not easily predict how much he would use in a 24 hour period. So Richard would call me every day to report either how much medication he had or, more likely, how much medication he didn't have.

Sometimes he’d call with other issues. Once, a drainage tube slipped inside his body, and we had to get him to the hospital for some radiological procedures. Another time he called to tell us that he and his brother were getting kicked out of their apartment, because the landlord had suddenly sold the place. The entire team rushed to help them find a new place and move.

Although Richard often had pain and other distressing symptoms, he never complained. He was always pleasant and never failed to offer a heartfelt "thank you" for anything you did for him. The pain got worse at the end of his illness, but Dr. Greg stayed true to his promise and controlled his pain with intravenous and subcutaneous drips. He was able to die at home.

I miss Richard and still think of him often. I got used to talking to him every day, and counted on those calls just as he could count on me answering the phone. I was his lifeline, and some days he was mine too - the oasis in our craziness; the affirmation that what we do matters.

* Contributed by Mary Smith-Healy, RN, CHPN

** The patient’s name has been changed to respect the family's privacy.

Day 23 (miles 1849-1921)

2009-10-06T08:00:00.007-04:00

Dr. Greg is riding 73 miles from Ponca City to Bartlesville, Oklahoma in memory of the following people:

Anna M.
Carolyn M.
Adelaide M.
Michael M.
Anna M.
John M.
Jeffrey M.
Dorothy M.
Frank M.
Ronald M.
Steven M.
Glen M.
Thomas M.
Leonard M.
Danny M.
Rosetta M.
Sally M.
Rick M.
Lizzie M.
Joe M.
Nadine M.
Richard M.
Gary M.
Todd M.
Aline M.
Jefferson M.
David M.
Sue M.
Arthur M.
Doris M.
Sidney M.
Mark M.
Randall M.
William M.
William M.
Jimmy M.
Nellie M.
Anna M.
Estella M.
Ana M.
Francine M.
Betty M.
Jose M.
Terry M.
Clara M.
Mary M.
Alejandro M.
Amber M.
Gloria M.
Alvin M.
Frederick M.
Violet M.
Kenneth M.
JoAnn M.
Charles M.
Elizabeth M.
Calvin M.
Olaf M.
Pham M.
Vickie M.
Barbara M.
Pamela M.
Charles M.
Eva M.
Robert M.
Percy M.
Robert M.
Christine M.
Kenneth M.
Lucille M.
Virble M.
Angeline M.
Rachel M.

Marie - On Listening

2009-10-05T08:59:00.000-04:00

I applied to the palliative care ICM group as a first-year medical student with a personal motive. My grandfather had been paralyzed by a stroke and bedridden for a few years, and I wanted to learn how to speak with people like him, as they were approaching their deaths. I suppose I was also curious to find out how I would handle and understand another person’s death. So, at the beginning of the year, I was introduced to Marie, a patient on hospice care with a complicated medical history that included epilepsy, mental retardation, HIV and renal failure.** Marie had no friends or family to aid in her care. And while I tried, as an eager First Year, to wrap my mind around understanding and solving – or at least improving – her medical and social problems, I soon realized that my role in our relationship was to take a different path.

I met her for the first time about a week into the semester, when we went to her hospice facility. We sat down at the dining room table to talk. She stuttered badly and it was extremely difficult for me to understand what she was saying at first. I found myself waiting, often for awkwardly long periods, while she would pause. When I gave her the chance, she always started talking again

As I continued to visit her every 2-3 weeks, our communication had a lot of ups and downs, cycling with the complications of her disease and the side effects of her many medications. Sometimes she said more, sometimes she said less. Sometimes we didn’t speak for an entire visit. Initially, I’d arrive with an agenda of what I wanted to ask her, but eventually I learned to wait for her to speak and guide the conversation.

Although I don’t think Marie ever learned my name, she would light up when I visited and stop whatever she was doing in order to talk to me. She would describe her seizures to me in her own words. She told me about her parents and her childhood. She shared her understanding of death: when people die, she explained, they get to see their parents again. I could tell it eased her mind to share her thoughts with me.

She died at the end of the year. Just days before, we located some estranged relatives who came to her memorial service. I wish I could have expressed to them what an influence their family member had had on me.

Marie taught me a lot about my role in healthcare. Medical school is daunting, and I’d worked up personal expectations of becoming some sort of hero and miracle worker. But my work with Marie taught me that sometimes “making a difference” in a person’s care has nothing to do with working wonders. It can have everything to do with braving awkward silences, and listening to a person no one else will listen to. And I’m ever grateful for this lesson.

* Contributed by Val Simianu, a fourth-year medical student at IUSM

** The patient’s name has been changed to respect her privacy.

Day 22 (miles 1777-1848)

2009-10-05T08:00:00.008-04:00

Today, Dr. Greg is riding 72 miles from Enid to Ponca City, Oklahoma in memory of the following people:

James M.
Charles M.
Jerry M.
Lucille M.
Robert M.
Lamont M.
Augustin M.
Rosa M.
David M.
Candice M.
Anna M.
Dorothy M.
Robin M.
Donald M.
Kathleen M.
Darvin M.
Clifford M.
Harry M.
Queenie M.
Shonna M.
Robert M.
Virgil M.
Gary M.
Mildred M.
Charles M.
Gregory M.
Verlis M.
Steven M.
Larry M.
Curtis M.
Scott M.
Martha M.
Rose M.
Lester M.
Freida M.
Joe M.
Dorian M.
Karan M.
Juanita M.
Eddie M.
Ernest M.
Annie M.
Gene M.
Mary M.
William M.
Elsie M.
Leslie M.
Octavia M.
Helen M.
Matalyn M.
John M.
Michael M.
Roscoe M.
Bobbie M.
Doris M.
Paula M.
Carol M.
Mary M.
Annie M.
Donna M.
Ladora M.
John M.
Creola M.
Patricia M.
Catherine M.
Lovia M.
Sandra M.
Patti M.
Sammie M.
Thelma M.
Tony M.
Sharon M.

Nature gives and then takes away

2009-10-04T23:51:00.003-04:00

The tailwinds that helped push us across New Mexico turned to fierce head winds the past two days in Oklahoma. Yesterday's 125 miles to Woodward, OK far exceeded our most difficult ride to date with 20-30 MPH headwinds the ENTIRE DAY! At least at home on an out and back course or a loop course, the winds will sometimes be favorable. That was not the case yesterday.

Today didn't start out much better with a light drizzle and then more persistent light rain dampened our morning and lead to the most serious crash of our trip. Wet pavement caused a rider to fall and injury his hip. The rain stopped in the afternoon but the head winds returned, only not as strong as yesterday. Even so, we had nearly 10 hours of riding to cover 117 miles. This was more than scheduled due to a wrong turn for three miles before we corrected our error.

More wind and rain is expected for tomorrow so our streak of good weather is officially over. Somehow, we have to make it across Oklahoma. Here is a photo from yesterday's ride.

Day 21 (miles 1665-1776)

2009-10-04T08:00:00.008-04:00

On Sunday, October 4th, Dr. Greg is riding 112 miles from Woodward to Enid, Oklahoma in memory of the following people:

Rosalie L.
Scott L.
David L.
Robert L.
Mary L.
Norrel L.
John L.
Kenneth L.
Helen L.
Lucinda L.
Linda L.
John L.
Beverly L.
Wilbur L.
Steven L.
Alma L.
Emily L.
Anthony L.
Betty L.
Max L.
Zontini L.
Robert L.
Shirley L.
Ella L.
Amanda L.
Richard L.
Geraldine L.
Wallace L.
Jing L.
Mary L.
John L.
Okkyong L.
William L.
Lynda L.
James L.
Russell L.
Bobby L.
Lori L.
Mary L.
Shelia L.
George L.
Leonard L.
Anna L.
Stephen L.
Jeffery L.
Maxine L.
Lawrence L.
Ivan L.
William L.
Margaret L.
Brenda L.
Victor L.
Deborah L.
Bonnie L.
Irmgard L.
Ronald L.
Paul L.
Romulo L.
Jimmy L.
Linda L.
Marlyn L.
Leon L.
Florence L.
George L.
Prince L.
Robert L.
Joseph L.
Rose L.
Willis M.
Dorothy M.
Betty M.
Julias M.
William M.
Joel M.
Wiley M.
Ruth M.
Margie M.
Larry M.
Helen M.
Charles M.
Sherman M.
Jacqelyn M.
Sterling M.
Abelardo M.
Virgil M.
Larry M.
Ina M.
Patti M.
June M.
Marsha M.
Morgan M.
Rochelle M.
Carol M.
Robert M.
Judith M.
Penny M.
Richard M.
Anna M.
Tonya M.
Therese M.
Gene M.
Phyllis M.
Jennetta M.
Fausto M.
Dillard M.
Tony M.
Wanda M.
Dorothy M.
Beverly M.
Bernard M.
Norman M.
Father M.

Day 20 (miles 1540-1664)

2009-10-03T08:00:00.009-04:00

Dr. Greg is riding 125 miles from Guymon to Woodward, Oklahoma in memory of the following people:

Sandra J.
Ramon J.
Mary J.
Adrian K.
Yoon K.
Karen K.
Mark K.
Robert K.
Michael K.
Geraldine K.
Steven K.
John K.
Rosie K.
Kenneth K.
Marla K.
Dorothy K.
Ancle K.
William K.
Paul K.
Moses K.
Arthur K.
Howard K.
Donald K.
James K.
Viola K.
James K.
James K.
Lydia K.
Thomas K.
Stephen K.
Austin K.
James K.
Fred K.
Zahir K.
Shadow K.
Donna K.
Alice K.
Nadine K.
Lustine K.
J.C. K.
Carlene K.
Kevin K.
Annie K.
Robert K.
Eliza K.
Sheila K.
Walter K.
Nathan K.
Willie K.
Johnnie K.
Andrew K.
Jack K.
Harry K.
Dean K.
Marie K.
Willie K.
Dorothy K.
Fred K.
Edward K.
Joe K.
Eugene K.
Sylvia K.
Richard K.
Anna K.
Robert K.
Fern K.
Carmenia K.
Ada K.
Shirley K.
Nancy L.
Clarence L.
Paul L.
Jay L.
Carolyn L.
Naomi L.
Jane L.
Martin L.
Thomas L.
Joseph L.
Evia L.
Gina L.
James L.
Letha L.
Dorothy L.
Jack L.
Felix L.
Mark L.
Leonard L.
Karen L.
Ruth L.
Martha L.
Georgia L.
Betty L.
Oren L.
Jack L.
Daik L.
Leander L.
Philip L.
Debra L.
Laura L.
Earl L.
Cecilio L.
Joan L.
James L.
Mary L.
Irving L.
Maebelle L.
Stanley L.
Milton L.
Robert L.
Albert L.
Josephine L.
Leona L.
Lucas L.
James L.
John L.
Debra L.
Susie L.
Dale L.
Pearline L.
Charles L.
Stephen L.
Allen L.
Kassandra L.
Robert L.
Linda L.

J.C. - On Our Own Terms

2009-10-02T23:59:00.010-04:00

Mr. J.C. was quite a character. He first came to see me when he was relatively healthy even though he had metastatic prostate cancer. I was his fourth doctor; he had his VA doctor, another non-VA primary care doctor, his cancer doctor, and then he had me. He sought me out because he had seen me on the Bill Moyers’ PBS television special on end of life care, “On Our Own Terms: Moyers on Dying”. Mr. J.C. decided that he wanted to have me as his doctor – just in case.

In 1995, our Palliative Care Program at Wishard was just getting started. We had gotten a grant from the Open Society Institute’s Project on Death in America to describe the waterfront of what it’s like to be poor and dying. We did interviews and focus groups with patients, family members, nurses, hospice workers, residents, staff doctors, and even funeral home directors. From these interviews and group discussions, we tried to figure out the challenges of what it is like to be poor and dying. This grant allowed us to make recommendations to Wishard on how to improve end of life care and, over time, our experiences developed into the Wishard Palliative Care Program.

Moyers’ staff had heard about our work, and came to Indianapolis because they wanted to get as full a picture as possible about death in America. They didn’t want to leave out the struggles of the dying poor. So, Bill Moyers put a segment about our palliative care program into the second program in his series. Mr. J.C. saw that Bill Moyers’ special, and he sought me out.

Mr. J.C. wanted a palliative care doctor in his corner for when the chemo and the hormonal therapy wouldn’t work any more. He wanted to live as much as anybody, but he knew that one day he would die. When he began to decline, he wanted to make sure that I was around. He especially wanted me to come and see him at home. So, when he was too weak to leave his house, after he had fallen and bruised himself, I came to see him at home. Our relationship lasted for more than two years.

I have two pictures of Mr. J.C., the photo above was taken at my office during one of his early visits. This photo was taken at his home, where he stands with his wife on one side and his daughter on the other. I'm certain that this is his last photograph. I'm very grateful for the lessons that he taught me about early palliative care interventions. I'm also thankful that he wanted me to share his story and photos. I'm riding a mile tomorrow in his memory.

Day 19 (miles 1433-1539)

2009-10-02T08:00:00.005-04:00

Today, Dr. Greg is riding 107 miles from Clayton, New Mexico to Guymon, Oklahoma in memory of the following people:

Silas J.
Verdell J.
Lucy J.
Barbara J.
Willie J.
Roger J.
Cheryl J.
Judith J.
William J.
Deborah J.
Eleanor J.
Evelyn J.
Martha J.
Earl J.
Ausberry J.
Illeana J.
Arline J.
Charles J.
Clemie J.
Daniel J.
Larry J.
Mary J.
Virginia J.
Carol J.
Charlie J.
Henry J.
Johnnie J.
Lula J..
Norval J.
Patricia J.
Thelma J.
Samuel J.
Emily J.
Joe J.
Bettye J.
Barbara J.
Ernest J.
Cardell J.
Lena J.
Marcella J.
Ethel J.
James J.
Ramsey J.
Robert J.
John J.
Ronald J.
Branson J.
Helen J.
Alva J.
Elizabeth J.
Larry J.
Leroy J.
Mary J.
Waneta J.
Danny J.
Horacetine J.
Barbara J.
Mendola J.
Evelyn J.
Sandra J.
Dale J.
Keith J.
Gloria J.
Charles J.
Rodney J.
Willie J.
Ruth J.
Milton J.
Billy J.
David J.
Henry J.
Lucille J.
Oliver J.
Wallace J.
Willie J.
Frances J.
Shirley J.
Selenor J.
Lee J.
Catherine J.
Delbert J.
Shirley J.
Marcia J.
Anita J.
Ann J.
Bobbie J.
Elbert J.
Juanita J.
Julia J.
Laura J.
Nakomis J.
Harold J.
James J.
Sandra J.
Lelar J.
Linda J.
Juanita J.
Luther J.
Anthony J.
Harriet J.
Bruce J.
Doris J.
Kenneth J.
Velma J.
Gale J.
Ronald J.
Julia J.

Beth: On Faith and Love

2009-10-02T07:58:00.001-04:00

We met Beth during an in-patient consult five years ago.** She was suffering acutely from the pain associated with colon cancer, but her physical suffering and terminal diagnosis didn’t deflate the power of the joy, love, and faith that guided her life. She decided to “marry” the man she loved during her last months, and we hosted an unofficial ceremony in the Progressive Intensive Care Unit. The ceremony couldn’t be legal because marriage would have affected her medical insurance, and we conducted it right beside her bed because she was too weak to rise, but these details didn’t diminish the joy packed into that small hospital room. Beth’s seventeen-year-old daughter and I helped her put on a new pair of mint green pajamas, and their combined families squeezed into the room. They took lots of pictures, they exchanged traditional vows, and then we had cake and punch. Their faces were all smiles and joy.

Beth and Tom shared a remarkably strong faith in God. Tom was caring for her at home with hospice, and from the beginning, I encouraged them to call me whenever they needed me to stop by. They responded that they wouldn’t need to call: they knew God would send me at the right moments. And somehow, I did manage to stop by when she needed me. Tom had taken family medical leave from work, and he learned how to set up and monitor her feeding tubes, so he could spend as much time with her as possible. She died in her own home with her husband by her side.

Tom asked me to perform her funeral and told me that she’d called me her angel, because I always visited when she needed me. When we reached the cemetery, I learned that she was being buried with her married name. Beth was loved and knew how to love.

*Contributed by spiritual advisor Karen Estle

** The names of the patient and her husband have been changed to respect their privacy.

A tale of two rides

2009-10-01T22:18:00.006-04:00

Two very similar days of riding to get us to Clayton, New Mexico today. Yesterday morning after leaving Taos, we climbed through the Carson National Forest for nearly 30 miles. Then we had another climb with a chilly and rainy descent through the beautiful Cimmaron Canyon State Forest. After lunch, things warmed up and we had a smooth, straight and swift ride aided by strong tail winds to quickly arrive in Raton.

This morning, we again started a cold day climbing through the Sugarite Canyon State Park. Despite the effort to climb, it was hard to warm up. We rode across the Johnson Mesa before descending onto the high plains that will take us into Oklahoma tomorrow. Again, after lunch today, we had a fast, flat and wind-swept ride into Clayton. We covered the final 30 miles in about one hour!

We have our coldest start tomorrow mornning, below freezing but we hope for another tail wind and a quick warm-up. Tomorrow's ride is about 106 miles, then 125 miles on Saturday and 111 miles on Sunday to get us more than half way across Oklahoma. We're getting very close to the half-way point of the ride and hope to post more patient stories regularly.

Day 18 (miles 1340-1432)

2009-10-01T07:40:00.002-04:00

Dr. Greg is riding 93 miles from Raton to Clayton, New Mexico in memory of the following people:

Rosalyn H.
Dorothy H.
Douglas H.
Vickie H.
Hilda H.
Nathaniel H.
Pam H.
Helen H.
Lenora H.
Coeany H.
Kenneth H.
Lois H.
Chester H.
Penny H.
Lawrence H.
Loretta H.
Norman H.
Lawrence H.
Dorothy H.
Tony H.
Hubert H.
Daniel H.
Robert H.
James H.
Philamenia H.
Rosa H.
Audrey H.
Gerald H.
Emma H.
James H.
Philimena H.
Janet H.
Audrey H.
Vernon H.
Stephanie H.
Allen H.
Gertha H.
Sharron H.
Colleen H.
Arnsby H.
William H.
Lucille H.
Barbara H.
Brett H.
Bessie H.
Annie H.
Mary H.
Charles H.
Clarence H.
Odessia H.
Gertrude H.
Gregory H.
Margaret H.
Erma H.
Ollie H.t
David H.
Cynthia H.
Anthony H.
Larry H.
Joe H.
Mildred H.
Karin I.
Betty I.
Jack I.
Charles I.
Clifford J.
Judith J.
Leona J.
Raymond J.
Essie J.
Edna J.
Robert J.
Bennie J.
Betty J.
Esther J.
Mary J.
Richard J.
Myrtle J.
Thomas J.
Sharon J.
Beverly J.
Ronnie J.
Robert J.
Ira James
Dorothy J.
Gregory J.
Elnora J.
Fran J.
John J.
Clorine J.
Robert J.
Margaret J.
Willie J.

Day 17 (miles 1246-1339)

2009-09-30T08:00:00.012-04:00

Dr. Greg is riding 94 miles from Taos to Raton, New Mexico in memory of the following people:

James H.
Melvin H.
Frank H.
Bertha H.
Robert H.
Betty H.
Frances H.
Tracy H.
Julia H.
Dermont H.
Kevin H.
Marian H.
David H.
Ida H.
Michael H.
Gloria H.
Nancy H.
Jack H.
Shirley H.
Billy H.
Priscilla H.
Robert H.
Jesse H.
Deborah H.
Alvin H.
Fannie H.
Geraldine H.
Clara H.
Ronald H.
Gladys H.
Teresa H.
Raymond H.
Bret H.
William H.
Roger H.
Sharon H.
Jorge H.
Jorge H.
Jerry H.
Ernest H.
Jana H.
Mark H.
Arthur H.
Norvell H.
Nicholas H.
Bridgett H.
Rose H.
Alice H.
Betty H.
Owen H.
Michael H.
Orville H.
Martha H.
Willie H.
Violet H.
George H.
Wilma H.
Anna H.
James H.
Rickie H.
Haurlis H.
Marjorie H.
William H.
Martha H.
Donald H.
William H.
James H.
Perry H.
Juan H.
Norma H.
Etta H.
Beverly H.
Thomas H.
June H.
Ralph H.
Alma H.
Debra H.
Wanda H.
Blane H.
Marie H.
Ruth H.
Ralph H.
Eric Hoffman
Evelyn Hoffman
Gordon H.
William Hoffman
Anthony H.
Margaret H.
Lillian H.
Lillian H.
James H.
Dovie H.
Joseph H.
Douglas H.
Kenny H.
Adam H.
Dixie H.

Speed Wobbles

2009-09-29T22:58:00.005-04:00

A few quick tidbits from the road at the end of our second rest day since the ride started on September 14th. We are now in Taos, New Mexico, a small, beautiful and artsy town in the northern mountains. We all had a good day of rest and we begin riding again tomorrow starting with a 15 mile climb to the Cimmaron Canyon State Park and then a great descent out of the Rockies. Our total distance tomorrow will be around 94 miles with about 7100 feet of climbing but 7400 feet of descending! The last 30 miles tomorrow will be along the Santa Fe Trail into Raton, NM.

Now, for those of you who don't know about "speed wobbles" I hope that you never experience them. On a relatively short day from Durango to Pagosa Springs, we crossed two mountain passes. When we got to the top of the first pass, I made the decision to leave the shoulder and take to the road for a fast descent. There was very little traffic and the shoulder wasn't very smooth. As I was in a tuck position to gain speed and cut the wind, my speed was approaching 50 MPH. I've NEVER been on a bicycle going that fast. I had to keep reminding myself to breathe.

As I was tearing down the side of this mountain, my bike began to WOBBLE so much that I could barely hang on. I thought that I had a flat tire or broken spoke sending my wheel out of line. I did everything that I could to try and slow down enough so that when I crashed, it would only result in a serious injury as opposed to a consult for the Palliative Care team! Somehow I managed to slow down and stop without crashing. When my riding companion, Nadia, finally caught up to me, she could see that I was visibly shaken...and physically shaking. The tires and spokes were OK. I didn't know what had happened. Was I shaking so much from fear that I caused the bike to shake or did the bike actually shake?

It was only later that my roommate, Mike "Smash Mouth" Hobin told me that he has heard of this happening to other riders who descend at high speeds. Then at breakfast, Chris Sacca said "Speed Wobble" as if it was as common as a flat tire. One of our guides, Eric Berkas, agreed that the bike was OK and said that to overcome the speed wobble, you either have to go faster or slower. He suggested I go slower or grip the bike frame tight between my legs as I descend. Are you nuts? Grip the bike frame between my legs so that I can go faster! I've wondered for days now why I would trust my life to some carbon fiber and rubber!

I'd trust my life to Wishard's Palliative Care team and any of the fantastic doctors, nurses and staff who work there. But not to a bike!

Wikipedia reference at:

Matthew: A Parents' Reflection on Unforgettable Care

2009-09-29T16:46:00.001-04:00

Our family’s experience with palliative care happened ten years before the Wishard Palliative Care program was even developed. Our son Matthew was diagnosed with severe aplastic anemia (total bone marrow failure) in December of 1984, when he was nineteen years old. None of us in the family were bone marrow matches, and he’d twice failed alternative therapies. We were told that he would die, and Matthew’s first hematologist gently explained to us that medicine sometimes becomes about caring rather than curing. We have, of course, many stories from those eighteen months our son spent in and out of the hospital, but we most want to share a story about Matthew’s last resident physician and the unforgettable care he provided for the whole family. Dr. Mike exemplified the power and importance of the kind of service the Palliative Care program gives to patients and their families.

A year and a half after Matthew’s diagnosis, in spite of persistent precarious counts and serial life-threatening infections, he still managed, in his extremely compromised condition, to ride his bike through the hospital corridors and sometimes even in our own neighborhood. But by the end of May, it had become plainly evident that he was going to succumb to the current fungal infection. We’d all come to rely on Dr. Mike, his first-year resident physician. Dr. Mike had been consistently honest with Matthew, answering his young patient’s most direct questions and helping him understand his end-of-life options, but somehow not extinguishing his hope. He was affectionate and supportive of the whole family, without ever being patronizing or overly sentimental. But on the first of June, just when Matthew’s death was imminent, Dr. Mike was supposed to rotate out of Hematology. So he made a special petition to be permitted to stay with our son until the end. His attending physician granted the request.

Matthew died in mid-June, and Dr. Mike was right there with us. He had a young child of his own, so it couldn't have been easy for him to balance his emotions and be such an excellent and compassionate caregiver. Our family will never forget his kindness, and the way that he went out of his way to stay with us until the end, and we know that it made a difference to Matthew.

Submitted by Sally and Manny Debono.

Breakfast in Taos

2009-09-29T16:02:00.003-04:00

A chance to eat and relax during Tuesday's rest day.

Day 16 (Rest Day)

2009-09-29T08:00:00.006-04:00

Dr. Greg is resting today in Taos, New Mexico.

Day 15 (miles 1106-1245)

2009-09-28T08:00:00.007-04:00

Dr. Greg is riding 140 miles from Pagosa Springs, Colorado to Taos, New Mexico in memory of the following people:

Lillie G.
Dorothy G.
Sedalia G.
Sarah G.
James G.
Frank G.
Robert G.
Bro G.
Anthony G.
Twyla G.
Mattie G.
Anita G.
Lillie G.
Hayes G.
Billy G.
Anthony G.
Roberta G.
John G.
Darlene G.
Johnnella G.
Antonia G.
Allen G.
Noel G.
Albert G.
Michael G.
John H.
Robert H.
Edward H.
James H.
John H.
Sam H.
Jackie H.
James H.
Lois H.
Rickie H.
Agnes H.
Ida H.
Margaret H.
Woodrow H.
Fern H.
Pamela H.
Idella H.
Jessie H.
Jerry H.
Henrietta H.
Sharon H.
Robert H.
Samuel H.
John H.
Kenneth H.
Carrie H.
Ralph H.
Sherry H.
Virginia H.
Jeffrey H.
Jessie H.
Loretta H.
LaRee H.
Eugene H.
Johnnie H.
Dana H.
Roxie H.
Carl H.
Frank H.
Betty H.
Betty H.
Mattie H.
Thomas H.
Mary H.
Shirley H.
Viola H.
Almon H.
Cynthia H.
Katherine H.
James H.
Steve H.
Lois H.
Mrytle H.
Barbara H.
Derek H.
Frank H.
Ezekiel H.
Thaddeus H.
Bruce H.
Robert H.
Juanita H.
J. H.
Vera H.
Vera H.
Paul H.
Patricia H.
Louis H.
Claude H.
Stephen H.
Shirley H.
Shirley H.
Andrew H.
Donald H.
Lula H.
Annetta H.
Eureka H.
Marilyn H.
Loretta H.
Annie H.
Chester H.
Jim H.
Francis H.
Karen H.
Sandra H.
Ida H.
Robert H.
Thelma H.
James H.
Eleanor H.
William H.
Julia H.
Zachary H.
Johnita H.
Ronald H.
Kenneth H.
Jarvis H.
Sylvia H.
Michael H.
Jack H.
Benny H.
Minnie H.
Albert H.
Kenneth H.
Elma H.
Michael H.
Henry H.
Doris H.
Anthony H.
Lawrence H.
Glenn H.
Lula H.
Charles H.
Everdean H.
Elsie H.
Louis H.

Colorado to New Mexico

2009-09-27T23:55:00.004-04:00

After two beautiful "rolling recovery rides" the past two days, we head out early tomorrow for our most difficult ride to date: 140 miles and 11,000 feet of ascent that takes us from scenic Pagosa Springs, Colorado to Taos, New Mexico. The past two years, the riders were met with hail on the highest mountain pass (11,000 feet) about 80 miles into the ride. We are expecting much better weather tomorrow.

Here is a photo from today that doesn't begin to show the beauty of the Durango area in the fall of the year.

Day 14 (miles 1046-1105)

2009-09-27T08:00:00.009-04:00

Dr. Greg is riding 60 miles today from Durango to Pagosa Springs, Colorado in memory of the following people:

Betty G.
Sharon G.
Dorinna G.
Wallace G.
Mark G.
Nathaniel G.
Johnetta G.
Gary G.
Sandra G.
Barbara G.
Walter G.
Alfredia G.
Harry G.
Linda G.
Grace G.
Mary G.
Pete G.
Michael G.
Joann G.
Barbara G.
Xiomara G.
Cipriana G.
Charles G.
Laura G.
Otha G.
Robert G.
Bessie G.
Lillie G.
Felix G.
Gregory G.
Janie G.
Bertrand Gramelspacher
Claude Gramelspacher
Eugene Gramelspacher
John Gramelspacher
Kenneth Gramelspacher
Marie Gramelspacher
Robert Gramelspacher
Robert G.
Nancy G.
Daisy G.
Kenneth G.
Leonard G.
Ivajean G.
Robert G.
Louis G.
Phillip G.
Myra G.
Jerry G.
Raymond G.
Carolyn G.
John G.
Rex G.
Lorene G.
Helma G.
Floyd G.
Paul G.
Robert G.
Susan G.
Benjamin G.
Frank G.
George G.
Julia Green
Shirley G.
David G.

Day 13 (miles 1003-1045)

2009-09-26T08:00:00.006-04:00

Dr. Greg is riding 43 miles from Cortez to Durango, Colorado in memory of the following people:

Larry G.
Ann G.
Doris G.
Norberta G.
Damon G.
Verdell G.
Wilbert G.
Leola G.
Pamela G.
Katherine G.
Ron G.
Les G.
Mary G.
Lawrence G.
David G.
Mable G.
Christopher G.
Charles G.
Marsha G.
Ruth G.
Lori G.
Roy G.
Stephanie G.
Christella G.
Paul G.
Shirley G.
Dessie G.
Delores G.
Jewel G.
Doris G.
George G.
Gloria G.
Donna G.
John G.
Dorothy G.
Frank G.
Robert Griffin
Mary G.
Mary G.
J.C. G.
Emma G.
Barbara G.
Lupe G.

Frank: A Legacy of Love

2009-09-25T14:10:00.005-04:00

Frank was only 24 when he came to Wishard, a quadriplegic after a car accident.** Unable to speak, he would summon our attention and communicate simple messages with clicks of his tongue or by mouthing words. From the beginning, it was apparent how much love was in his life: his mother visited him daily and wouldn’t hear of taking a day off to relieve the stress showing in her tired eyes. She cherished every moment she could spend with him. Frank’s girlfriend and their two young children also visited often. The kids – a two-year-old boy and a three-year-old girl – would crawl all over in him in bed and give him sips of water and kisses. Frank couldn’t speak, but these visits brought smiles and tears to his eyes, as he longed to be able to hold and caress the children again.

He was in a lot of pain both psychologically and physically. He suffered from “phantom limb” pains and had two cardiac arrests. His memory began to flicker and fail, and he decided that he didn’t want to prolong a limited, immobile life on a ventilator. We had a long consultation and talked about his children, his mother, his faith, and the life he’d wanted to live. We supported him when he decided that he would stop ventilator support and allow himself to die. We helped him tie up loose ends, and helped explain everything to his mother. Many of us on the team grew close to him during this time. When he died, about ten of us from Wishard attended the funeral at the church he’d attended throughout his life. The service was full of young people who’d been inspired by Frank, and his childhood pastor gave a powerful tribute to a man whose life was so full of love.

I wrote several poems inspired by Frank, and I feel it’s appropriate to end this reflection about the end of his life with a line about the love that lives on in his two children:

His baby girl and his only son.

They are told daddy is going to heaven.

When they see a plane up in the sky,

To blow kisses and send them to daddy.

*Contributed by spiritual advisor Karen Estle

**The patient’s name has been changed to respect his privacy.

Day 12 (miles 897-1002)

2009-09-25T08:00:00.008-04:00

Dr. Greg is riding 106 miles from Mexican Hat, Utah to Cortez, Colorado in memory of the following people:

David E.
Robert E.
Damien Eversman
Reana E.
Norma E.
Estelle E.
Lurine E.
Roger F.
Walter F.
Marty F.
Janet F.
Curtis F.
Katherine F.
Jerald F.
Marilyn F.
Ruby F.
Sallie F.
Ray F.
Addie F.
Philip F.
Isabelle F.
Ted F.
Robert F.
Irene F.
Alford F.
James F.
James F.
Henry F.
Thomas F.
John F.
Wallace F.
Darrell F.
Ethel F.
Doris F.
Jeffrey F.
John F.
Phyllis F.
Juanita F.
James F.
Willard F.
Alvin F.
Larry Fleck
Tanya F.
Beverly F.
James F.
Frances F.
Benjamin F.
Michael F.
Barbara F.
Lewis F.
Olga F.
Gerald F.
Nellie F.
Michael F.
Dennis F.
Betty F.
Eunice F.
Preston F.
James F.
Ravanna F.
Mary F.
James F.
Julie F.
James F.
Daphne F.
Barbara F.
Beatrice F.
Timothy F.
James F.
Joseph F.
Rose F.
Louise F.
Donald F.
William F.
Lisa F.
Alma F.
Marsha F.
Samuel F.
Ila F.
Quaita F.
Cage F.
Arnold F.
Chillie F.
Meredith F.
Walter F.
Helen F.
Luther F.
Lawarence F.
Daniel F.
Jared F.
Marvin F.
Mitchell F.
Karen F.
Jeffery F.
Herbert F.
Ernest F.
Russell F.
Patricia F.
James G.
Dave G.
Gustavia G.
Edna G.
Anita G.
Oliver G.
Mary G.
Mary G.
Norman G.
Ramona G.

Bob: Monument Valley and a Purple Heart

2009-09-24T23:42:00.008-04:00

After a long 117 mile day, we made it to Mexican Hat, Utah. The highlight of the ride was cycling through Monument Valley. I know that our patients and their families would share the awe-inspiring nature of these vistas. The first mile today was for Mr. Robert Donovan who was my patient for more than 10 years! My wife introduced me to Bob who was a good athelete, swimmer, bike rider and weight lifter. He was not only my patient but a good friend. I was humbled to be able to help care for him at home where he died on his terms--a rare gift. Bob reinforced for me the lessons of humility, humor and story-telling. I still miss him and I send his family, especially Pat and Mary, continued good wishes.

Despite knowing Bob for so long, he never told me about his Purple Heart. I only found out about that after he died. The same bravery that earned him the Purple Heart helped him down the home stretch. Here is a photo for Bob and all of the other persons remembered today.

Day 11 (miles 780-896)

2009-09-24T08:00:00.009-04:00

Today, Dr. Greg is riding 116 miles from Tuba City, Arizona to Mexican Hat, Utah in memory of the following people:

Robert Donovan
James D.
Anna D.
George D.
Carol D.
Ruth D.
Christopher D.
Earl D.
Edwina D.
Holly D.
Matthew Debono
William D.
Rosie D.
George D.
Gloria D.
Eva D.
Joseph D.
Mark D.
Clarence D.
James D.
Sam D.
Henrietta D.
Edward D.
Robert D.
Donnie D.
Floyd D.
Michael D.
Thelma D.
Claude D.
Anna D.
Rayfield D.
Rebecca D.
Glenda D.
Emma D.
Mercury D.
Ronald D.
Leroy D.
Gerna D.
Claude D.
Karl D.
Helen D.
Billy D.
Robert D.
Dorothy D.
Margaret D.
Louise D.
James D.
Odessa D.
Ray D.
Steven D.
Frankie D.
Donald D.
Yelyzaveta D.
Mark D.
Francis D.
Marline D.
Virgil D.
Janet D.
Audrey D.
Beatrice D.
Lillian E.
Kathlene E.
Marva E.
Toni E.
Reto E.
Martha E.
Earley E.
Jeffery Edmondson
Joyce E.
Marvin E.
Mary E.
Anna E.
Jerry E.
Lucy E.
Rickey E.
Barbara E.
Michael E.
Barbara E.
Joan E.
Mark E.
Charles E.
David E.
Linda E.
Kenneth E.
Mary E.
Cal E.
Margaret E.
Arthur E.
Martha E.
Leonard E.
Jimmie E.
Edith E.
Dathan E.
Larue E.
Lule E.
Eleanor E.
Jane E.
Ervin E.
Mae E.
Betty E.
James E.
Mattie E.
Bernadine E.
Joseph E.
Calvin E.
Alejandro E.
Edwin E.
Willie E.
Joseph E.
Vernon E.
Carol E.
Scott E.
Judith E.
Glenda E.
Richard E.
Ronald E.
Dora E.

Day six video of Dr. Greg and Mike Hobin

2009-09-23T15:27:00.003-04:00

Greg cheers for the Fighting Irish and avoids the animals with his friend Mike Hobin on day six. Watch Mike's video of the day below.

Day 10 (miles 687-779)

2009-09-23T08:00:00.007-04:00

Dr. Greg is riding 93 miles from the Grand Canyon to Tuba City, Arizona in memory of the following people:

Pamela
James
Ima
Charles
Betty
Michelle
Richard
Dorothy
David
Keith
Tommy
Christopher
Brian
Lowell
Hattie
Barbara
Eula
Lee
Therese
John
Maurice
John
Jerry
Thelma
Joseph
Darlene
Marian
Janice
Susan
Paul
Frank
Elsie
Phil
Willis
Delores
Judy
Eugene
Lucille
Ricky
Princella
Thomas
Dessie
Clarence
Deborah
Wallace
Tony
James
Josie
Matthew Debono
Bessie
Charles
Arginita
Irene
David
Joyce
Janie
Marian
Irene
Perry
Timothy
Cynthia
Steve
Betty
Harold
Angie
Eugene
James
Karen
Teresa
Carolyn
Mabel
Michael
Jaynelle
Blanche
Arthur
James
Edward
Stephan
Errol
Robert
Dubois
Annie
Thomas
William
James
Carol
Sue
Daphne
Irena
Carl
Rufus
Pearly
Sharon

Thank God for rest!

2009-09-22T22:37:00.006-04:00

What a wonderful day of rest at a magnificent place, the South Rim of the Grand Canyon. Some time to catch up on things, including talking with family. We are on the road again tomorrow with the low temperature tonight around 30 degrees. We'll have a cool start to our ride but will soon be warm as we pedal, mostly downhill, to Tuba City, Arizona.

On Availability

2009-09-22T15:51:00.013-04:00

Six years ago, I was a jaw-agape resident physician, watching incredulously as Dr. Gramelspacher handed a card with his pager number on it to a patient he had met just 40 minutes earlier. I then learned that all the members of the team - the nurse, the social worker, and the spiritual advisor – they all did the same thing. I guess it’s a little bit like the bygone time when doctors were the healers of a community, constantly accessible because their patients knew them personally and knew where they lived. These days you seldom hear about physicians willing to make themselves available to their patients at all times, except to the most affluent patients. But complications of terminal illness don’t have the courtesy to manifest on a 9-5 schedule.

Watching the team hand out their pager numbers reinforced my growing impression of palliative care as one of the few areas of medicine that truly lives up to the promise that patients and families come first. It’s a return to a vintage style of medicine.

* Contributed by Dr. Lyle Fettig

Sam: On Friendship and Laughter

2009-09-22T15:36:00.005-04:00

I will always wish that I could have known Sam “before.”** As a first-year medical student, I signed up for the “Death and Dying” strand of the Intro to Clinical Medicine course 5 years ago without much of an idea of what to expect. I only knew my patient would be near the end of his life, and that he had agreed to allow a medical student to come talk to him on a weekly basis about his experiences, his fears, and his disease. I remember walking up to my first patient’s home, only 2 blocks from my own childhood neighborhood, and feeling a bit surprised to find a family just like any other: a young, blond little boy, a beautiful young mother, a few other scattered friends and family. There were pictures all over the walls showing his two teenage daughters, who were off playing sports and learning to drive. Dr. Gramelspacher led me back through the lovely one level home with the easy confidence of a regular visitor, and I passed through a door into a well-lit room in the back of the house. There lay a man who could have been 30 or could have been 50, connected to machines and monitors and tubes and the like. He looked at me and smiled, a gentle, welcoming smile that would stay with me for years to come. He had ALS, or Lou Gehrig’s Disease, which sentences your healthy mind to watch the slow atrophy and paralysis of your body. I wish we could have met in the grocery store, or at a football game, but that was simply not the way of things. I met Sam that day because he was dying, and because he had volunteered his waning days to help me learn about being a physician. I thought I would learn about death, but instead I learned so much more about life: family, children, always being able to laugh at yourself, and most of all, I learned that sometimes I just need to be quiet and listen.

Sam communicated by using a device that translated movements of his left knee (one of the last limbs he could still command) into alphabet selections by a cursor on a computer; the choice of one letter at a time led to a list of options for words to select based on frequency of prior use, spelling, and sentence structure. He was text messaging, long before I ever was. Dr. G had explained that most of my visits would need to be longer than the other students’, and it was soon evident why: Sam generally needed 10-20 minutes to finish typing a story or joke (he told lots of stories and jokes, showing off his wonderful, dry wit), and our visits often lasted many hours. We developed an easy and comfortable routine, often centered around the Food Network (Sarah, his wife, theorized that he loved the Food Network because he missed eating, now that he got his nutrients through a surgically-placed tube into his stomach – a G tube). We would turn on Rachel Ray or Emeril, and talk – slowly – about everything from his sixteen year old daughter learning to drive, to discovering who your true friends are, to God, while the pauses of our slow conversation were filled with tempting recipes and shouts of “BAM! Kick it up a notch!” Sarah used to tease Sam about Rachel Ray, saying, “Sam, isn’t your girlfriend on?” He gave me great advice on priorities, on relationships, on boyfriends. Sam must have been a riot when he could command his own voice.

I wish I could say I still see Sam every week, but the frenzy of medical school and residency has intervened, and I confess that I lost touch. Once, however, as an intern in the ICU last winter, I got the great privilege of caring for him one more time. A fellow intern in the lounge mentioned that a 40-year-old gentleman with ALS was being admitted. “Is it Sam Kent?” I asked, my heart unexpectedly racing at the prospect of seeing my old friend. “That sounds right –” and before he could finish the sentence, I was out the door and down the hall, in my friend’s room, looking for the Food Network on that hospital TV. During that stay, I made it clear to the nursing staff that I was to be called any time, day or night, even if it was my day off. He didn’t have his communication device, so we conversed through a language of blinking, and somehow Sam still managed to get many laughs out of me.

Both he and Sarah were looking more tired after all these years. But I admire my friend so much for his fight to stay alive, to raise his son and daughters, now almost grown. I got the sense during this last meeting that Sam was ready to let go soon, to trust his strong faith to carry him home. I hope he carries with him the knowledge that IUSOM taught me how to practice medicine, but he and Dr. G’s program taught me how to be a physician.

*Contributed by Dr. Becky O’Bryan

** The patient’s name has been changed to respect his privacy.

Day 9 (Rest Day)

2009-09-22T08:00:00.002-04:00

Dr. Greg is enjoying his first rest day at the Grand Canyon.

"I decided now is the time to fulfill that promise"

2009-09-21T09:40:00.004-04:00

Dr. Greg's Ride to Remember is featured in the Indianapolis Star.

Day 8 (miles 582-686)

2009-09-21T08:00:00.007-04:00

Dr. Greg is riding 105 miles from Seligman, Arizona to the Grand Canyon in memory of the following people:

Joe C.
Margaret C.
Lillie C.
Eadie C.
Rodney C.
Charles C.
Everett C.
Larry C.
Geraldine C.
Ernest C.
Isa C.
Jerry C.
Verline C.
Delores C.
Elizabeth C.
William C.
Remona C.
Cassie C.
Mary C.
Kevin C.
Dishmond C.
Elizabeth C.
Billie C.
Keith C.
Sallie C.
Walter C.
Carl C.
Barbara C.
Evelyn C.
Fred C.
Minnie C.
William C.
Charles C.
Julie C.
Freely C.
Robert C.
Carlie C.
Juanita C.
David C.
Sarah C.
Juanita C.
Barbara C.
Blanche C.
Sallie C.
Juanita C.
Dorothy C.
Henry C.
Willie C.
Patrick C.
Alejandro C.
Thomas C.
Randall C.
Robert C.
Geraldine C.
Alpha C.
Vera C.
Richard C.
Naida C.
Robert C.
Robert C.
Larie C.
Anna C.
Robert C.
Thomas C.
Linda C.
Gloria C.
Beatrice C.
John C.
Shirley C.
Jarred C.
Ricky
Timothy
Rick
Jackie
David
Edward
Carrie
Welby
Sondra
Oliver
Merle
Thetis
Christopher
Anthony
Jessie
Mary
Thomas
Betty
Leroy
Mary
Sharon
Odre
Nicole
Oscar
Lawrence
Wayne
Willie
Rosie
Donnie
Henriettay
Jason
Miama
Robert
Geraldine
David

Day 7 (miles 498-581)

2009-09-20T08:00:00.008-04:00

Dr. Greg is riding 84 miles today from Kingman to Seligman, Arizona in memory of the following people:

Thena
Ernestine
Willie
Harry
Columbus
Phillip
William
Orlester
Celestia
Claudie
Isidro
George
Mark
Evelyn
Izora
Alice
Ernestine
Edward
Larry
Everett
Ben
Anita
John
Dobbin
Teresea
Airsa
James
Shirley
Evelyn
Sung
Mary
Prudy
John
Sharon
Lela
Carol
Donald
Melvin
Caroline
Betty
Sarah
Lawrence
Anna
Raymond
William
Harold
Norma
Danny
Janet
Martha
Michael
Lillian
Thomas
Mary
John
Harold
Vinus
Vincent
Sussie
Peter
Mildred
Juanita
Lydia
Fred
Phillip
Richard
Jessie
Dorothy
Charles
Minnie
Morris
Herbert
Jessie
Beverly
Virgil
Jason
Gwendolyn
Justin
Mamie
Ural
Ernest
Katie
Melvin

The Poor Will Remain Invisible

2009-09-20T06:32:00.007-04:00

Except for a sunburned lower lip and some back pain, my body is holding up OK. The difficulty is that we’re still in western Arizona with the entire state yet to climb and cross. However, riding a bike across the desert can focus one's attention or cause you to feel disheartened.

On Friday evening, I was very disheartened to learn that our hospital compliance office recommended that we ONLY post our patients first names with last initial on the blog UNLESS we have specific permission to use their full name. Since death certificates are a matter of public record, I do not think that we disclose "protected" health information simply by listing someone's name who has died. I DO believe that we honor the patient more fully and indicate to their family and friends that we haven’t forgotten by including a person’s first and last name--one name on each line. The decision to include first and last names was mine alone.

Due to the recommendation from my hospital, we will only list a patient's first name and last initial UNLESS we have specific permission to list the full name. However, for family members and friends who we are remembering, I will list the persons' full name. Examples would be the miles that I've ridden to remember Charlie Kirk and Myles Brand.

This change in our blog reminds me that most of our patients lived (and died) in obscurity, often with little support, compassion or encouragement. This change in the way we list the names will NOT change my commitment to ride one mile each day with a full memory of that one precious life.

Day 6 (miles 413-497)

2009-09-19T08:00:00.007-04:00

Today, Dr. Greg is riding 85 miles from Lake Havasu City to Kingman, Arizona in memory of the following people:

Jeffery
Estella
Mary
Fozien
Martha
Qumar
Herman
Teresa
Daisey
John
Linda
David
Eddie
Sherri
Maurice
Dwayne
Donlevy
Larry
Myra
Beth
James
Albert
Cindy
Carl
Roscoe
Blanche
James
Alberta
Diane
J.W.
Gertrude
Robert
William
Jettie
Earl
James
Lillie
Alice
James
James
Alice
Ethel
Paul
Lewis
Don
Martha
Jeanette
Rodrigo
Irene
Monroe
Hester
Lillian
James
Opal
Lydia
Earl
George
Jimmie
Floyd
Edith
Linda
Mary
Liza
Rosemary
Elease
Carol
James
Della Carter
Ellison
Maude
William
Icey
James
Mattie
Willie
Pearl
Burnett
Mackie
Virginia
Otherean
Robert
Daniel
Mattie
Susan
Tony

Day 5 (miles 368-412)

2009-09-18T08:00:00.007-04:00

Today, Dr. Greg is riding 45 miles from Parker to Lake Havasu City, Arizona in memory of the following people:

Myles Brand
Paul
Margaret
George
Marilyn
Juanita
James
Hilda
Margie
John
Edna
Richard
Marquis
Richard
Timothy
Oliver
William
Oliver
William
Robert
Willie
Lawrence
Emma
Norma
Sandra
Fannie
Nancy
Beverly
Tracy
Archie
Mattie
Alma
Lila
James
Wilson
Ella
William
Viola
Maryann
Barbara
John
Nettie
Evelyn
Gayle
Leroy
James

Day 4 Musings

2009-09-17T20:50:00.012-04:00

A beautiful desert morning greeted us in 29 Palms for the start of Day 4, a 111 mile ride to Parker, Arizona. Riding with Mike Ryan (Texas) and listening to fast-paced music, we made it 51 miles to our "lunch" stop by 9:30 AM. By the time we finished lunch, it was VERY warm, with a peak temperature of 104 degrees.

Luckily, we joined another 8 riders and continued to ride fast despite the harsh conditions, arriving at our hotel around 1:30 PM. This was certainly our most difficult day. It occurred to me more than once that people are NOT SUPPOSE TO RIDE bicycles across the desert! But we've now pedaled 370 miles across California and we only have 32 more days of riding and 2910 miles before we swim in the Atlantic Ocean. But I'm getting ahead of myself...

Day 4 (miles 257-367) to Arizona!

2009-09-17T08:00:00.010-04:00

Dr. Greg is riding 111 miles today from Twentynine Palms, California to Parker, Arizona in memory of the following people:

James
Karen
Sarah
Howard
Armour
James
Delia
Joanna
Charles
Dennis
Robert
Marilyn
Nancy
Billie
Ralph
Janice
Tanya
Stephen
Ronald
Lillie
Vernon
Loretta
Michael
Ann
Floyd
Linda
Roselyn
Willie
Leo
Robert
Classie
Pamela
Hugh
Wayne
William
William
Maxie
Myles
Susan
Charlene
Florence
Joseph
Sarah
Marilyn
Bryan
Don
James
Roger
Kevin
Frances
Anna
Debra
Claude
Herta
James
Arden
Annie
Myrtle
Lorene
Anna
Carolyn
Donna
Raymond
James
Virginia
Dale
Evelyn
Franklin
Tommie
Arthurine
Thelma
Alberta
Amie
Hattie
Catherine
Norma
Michael
Vivian
Edna
Albert
Magdalene
Magerlene
Willie
Gloria
Beatrice
Dixie
Cynthia
Nesela
Roger
Rebecca
Charles
Christine
Robert
Harry
Judy
James
Ethel
Eugene
Lloyd
Robert
James
Donnie
Robert
Nancy
Randall
Eddie
George
John
Alan
Gerald
Teacola
Billy

Day 3 (miles 167-256)

2009-09-16T08:00:00.010-04:00

Dr. Greg is riding 90 miles today from Victorville to Twentynine Palms, California in memory of the following people:

Ursula
Sara
Stephen
Harley
Don Baxter
Edward
Josie
Maurice
Kenneth
Myla
Rosie
Walter
Ras
Charlezetta
Norma
William
Elizabeth
Patricia
Glenn
Clara
Betty
Larry
Carla
Ella
Thomas
Mary
Katie
Loraine
James
Alverta
Martha
Jane
Mildred
John
Bryan
Rehova
Terry
Perry
Alberta
Terrence
Gary
Beatrice
Daniel
Barbara
Martha
Janet
Gregory
Emma
Johnny
Carla
Bill
Starr
Brenda
Edith
Celika
David
James
Dorothy
Marlene
Daisy
Thurman
Glenn
Paul
Jerry
Grace
Clara
Jackie
Stephen
Trudy
Kenneth
Nora
Dennis
Danny
Carl
Jesse
Karen
Bennie
John
Seilata
Vera
Otha
Minnie
Christopher Bobberschmidt
David Bobberschmidt
Deborah
Dorothy
John
Margaret
Dolly

Jeff - On Fierce Independence*

2009-09-16T05:00:00.006-04:00

I arrived at the boarding house on West Washington and stomped my feet on the wooden front porch, hoping not to track snow in and soak the carpet. On the drive over, the snow had been falling so densely it looked as if each car on the road was in its own private lane. The pungent, meaty scent of Jeff’s meal wafted into the hallway and greeted me before I entered his room.** I walked in and wasn’t surprised to see Colts memorabilia covering a full third of the 8 by 10 room: this South Carolina transplant had an affection for the team and his adopted city that I never could quite understand. He had come up for a NASCAR race and fallen in love, so he moved here with the intention of fixing up cars and becoming a part of the local racing scene. At the age of 38, though, pain had overtaken his life and brought him into contact with the local healthcare scene instead. I met him in the hospital when his pain was at its worst, a tumor on his sacrum torturing him like a stabbing knife. But he was still in a betting mood. When I told him that he had a year left, he countered that he had two. I told him I'd happily pay up if I were wrong.

After a struggle to make it to his door, Jeff greeted me at it by saying, “You can do a lot of things with a Crockpot. That's all I need.” He was stubbornly independent, and this fragrant pot-roast seemed to say to me and to his cancer, I told you so. He’d already spent two stints at the Lockefield Nursing and Rehabilitation Facility, and the restrictions on his free-spirited behaviors turned out to be a problem for both him and the nurses. He left the first time for a pay-by-the-week motel, despite our social worker’s offer to arrange something more reputable, and he’d only returned because a birthday six-pack had stricken him with Saturday Night Palsy.

For the moment, at least, he was free again, and as the snow continued to blanket the city, we flipped through pictures of him and his brother standing on the field at the RCA Dome. Linda, our social worker, had arranged this through "Never Too Late," a local organization that grants final wishes to the terminally ill. Looking at the pictures, I got a sense of how divergent the path he’d taken was from his brother’s. There was Jeff with his scruffy beard, cancer riddled frame, and Manning jersey, smiling beside his clean-cut and healthy brother wearing a leather jacket. ”Spread my ashes,” he said, “at the 50 yard line of the new stadium.” I wish we could grant all of our patients’ requests, and it's hard not to think of him every time I drive by the new monstrosity.

He returned for a third and final stint at Lockefield when the tumor had invaded his nerves so thoroughly that he was down to two functioning extremities. He died 13 months after our initial meeting and one month after he claimed victory in our bet. His mother and brother, who had wrestled with his troubled but free spirit for 40 years, landed at Indy International Airport just as his spirit escaped. I waited in the dark outside Lockefield’s entrance as they drove their rental car through the city, preparing to share our loss.

* Story Contributed by Dr. Lyle Fettig

** The patient’s name has been changed to respect his privacy.

Day 2 Valencia to Victorville, CA

2009-09-16T00:22:00.006-04:00

Cool and shady 20 mile climb this morning up the Bouquet Canyon Road thru the Angeles National Forest (extremely dry). Enjoyed roommate Mike Hobin's company for the entire day. The Texans went out early and fast, never to be seen again by me. You know what they say about Texas..."don't mess with them." That would also apply to our four fast Texas riders, Larry and Kelli, John and Joe.

Only one minor accident that planted Chris Sacca in a pile of sand on the side of the road but he was able to finish the day. Too sleepy now but let's see what 4 am might bring.

Day One Musings

2009-09-15T08:12:00.003-04:00

Butterflies at work trying to get packed and organized for the start in Santa Barbara. Being the last one out to the van and bikes didn't help. In an attempt to calm myself, I asked fellow rider, Katherine, if she had butterflies. She smiled and pointed to her bike seat and said "Do you mean like this?" On her bike seat, she had a small butterfly embedded in saddle.

The start through Santa Barbara and along the coast to Ventura was very nice except for the stretch on 101. We made it the 48 miles to lunch outside Santa Paula without problems, except for a few folks with flat tires. As Larry and Kelli predicted (they did this trip in 2007 and are back for another round), the paced picked up after lunch. The smooth road and the gentle up and down had something to do with it. Plus, we were all anticipating 3000 more feet of climbing.

The climbing never really materialized and we eased down California 126 into Valencia for high fives and fist pumps.

Day One is in the bag. Thirty-five riding days to go...

Day 2 (miles 77-166)

2009-09-15T08:00:00.015-04:00

Dr. Greg is riding 91 miles today from Valencia to Victorville, California in memory of the following people:

Charles Kirk
James A.
Derek A.
Edward A.
Lillie A.
Lover A.
Ruby A.
Kathleen A.
Demoine A.
Margaret A.
Lelia A.
Pettie A.
Harold A.
Charles A.
Martha A.
Jefferson A.
Joe A.
Esther A.
Paul A.
Andre A.
Woodrow A.
Jimmy A.
Willie A.
Geraldine A.
Alan A.
Freida A.
Charles A.
Dorothy A.
Thomas A.
Chloe A.
Chloe A.
Gurdev A.
Dorothy A.
Jerry A.
Tyrone A.
Retha A.
Malcolm A.
Mavis A.
Jacob A.
Daniel A.
Mens B.
Sheila B.
Brian B.
Bernice B.
Anna B.
Alfred B.
Augusta B.
Beverly B.
Bertha B.
Larry B.
Eunice B.
Theda B.
Arthur B.
Curtis B.
Lee B.
Margaret B.
Robert B.
James B.
Odell B.
Jack B.
Judith B.
Dianne B.
William B.
Juanita B.
Henry B.
Deborah B.
Betty B.
Virginia B.
Johnny B.
Lucille B.
Louvenia B.
Ida B.
Sarah B.
Ralph B.
Pamela B.
Robert B.
Darlene B.
Sara B.
Bernadett B.
Hazel B.
Mary B.
Hattie B.
Sally B.
Andrew B.
Laura B.
Helen B.
Geraldine B.
Theophilus B.
Corine B.

About the Ride

2009-09-15T01:32:00.008-04:00

Ten years ago, Wishard Hospital established a Palliative Care Program to provide comprehensive and compassionate care to every patient and family faced with life limiting conditions. To celebrate our 10th Anniversary and to memorialize more than 3000 patients who we have cared for, Dr. Greg Gramelspacher will attempt to ride his bicycle 3,280-miles across the United States. Dr. Greg’s Ride To Remember is a testament to the deep impressions made by the many patients whose lives have touched the staff of Wishard’s program, and to the core principles of Palliative Care.

Every person, regardless of financial and personal circumstances, deserves to spend his or her final days free of pain and distressing symptoms supported by a loving team of caregivers who are committed to non-abandonment. Each mile of Dr. Greg’s ride is dedicated to a patient or to someone’s loved one. Beginning September 14th, this website’s blog will share some of the most inspirational stories of these unforgettable patients and their families. Each story for the Ride To Remember testifies to the courage, love, and strength of those who have touched the lives of the Wishard Palliative Care team.

Palliative care is not about death and dying, but rather about life and living, helping each person enjoy the fullness of life until the last breathe is gone.

Day 1 (miles 1-76)

2009-09-14T05:00:00.001-04:00

On his first day, Dr. Greg is riding 76 miles from Santa Barbara, California to Valencia, California in memory of the following people:

Jerry
Levi
Derwood
Josie
Paul
James
Gaile
Grace
Thomas
Sanford
Corey
George
Easter
Marion
Norita
Charles
Dorothy
Stephen
Thomas
Chloe
Paul
Roy
Mahassen
Eduardo
Roslyn
Al-Jamu
James
Penny
Dennis
Darrick
Gerald
Leon
Willie
Theresa
Kevin
Leon
Joe
Mary
Randall
Jack
Marian
Roberta
Bernice
Robert
Terry
Imogene
Kenneth
Cosby
Robert
James
Thomas
Dolores
Lula
Marilyn
Roger
Roy
Sandra
Gordon
Loretta
John
Jack
Mary
Sophia
Charles
William
James
Jack
Mayme
Bert
Betty
Donald
Rebecca
Madonna
Littie
Patricia

Mr. Suri and his son - On Honoring Loss

2009-09-14T04:30:00.007-04:00

At Wishard, I was called to consult on a Shik patient with metastatic colon cancer, who couldn’t speak English. His oldest son, Perminder, would interpret for him, but Perminder posed challenges to the staff because he didn't seem to trust anyone. This is not uncommon among the poor, and especially among minority populations. And why should poor, minority patients trust a young, white, male physician, especially when they’ve been failed by the system in so many other ways?

Before ending up in Wishard, Mr. Suri’s son had taken him to a Sikh oncologist in town, and even to some Sikh healers in New York. Mr. Suri had undergone chemotherapy with significant side effects and not much benefit. Neither he or his son wanted more chemo. Mr. Suri was at peace and ready to die. But Perminder clearly wasn’t ready to let go of his father.

I asked Perminder if I could take their photographs, and was surprised that he said yes. There’s one picture that explains for me why Perminder insisted on more medical treatment for his father over the wishes of his father and despite the recommendations of the medical teams.

The patient’s young granddaughter is sitting next to him on the hospital bed playing with something. Mr. Suri, head down, is resigned to the fact that he will die soon. And then Perminder, very stern, looks straight at the camera. His left hand is on his father’s shoulder, holding onto his father…not willing or wanting to let him go.

During his last hospitalization, I was caring for Mr. Suri alone without any housestaff at Perminder’s request and because no one else wanted to deal with this "difficult" son. When Mr. Suri was very close to dying, Perminder entreated me to do something. He actually specifically asked me to give his father a blood transfusion. I took several deep breaths before I answered. The call was entirely up to me. I knew the man was dying and that a blood transfusion wouldn’t make any difference at all – except to his son. I order the blood transfusion. I did it for Perminder, who wasn’t ready to say goodbye to his father.

I gave the transfusion in order to honor this son’s love for his father. It didn’t made a difference for Mr. Suri but it strengthened my relationship with his son. He knew that he had a physician who was willing to meet him halfway, who could recognize how hard it is to say goodbye to your father.

I was a welcomed guest at Mr. Suri's funeral. Several months later, I saw Perminder at the hospital outside the cafeteria. A rare but big smile lit up his face when he saw me. Then he embraced me-a Shik man embracing a Western physician in the halls of Wishard Hospital.

No Greater Love (Al Sondej, Part 3)

2009-09-13T01:35:00.008-04:00

In the gospel of John (the Wisdom gospel), Jesus says that "the Good Shepherd lays down his life for his sheep" and somewhere else (that I can't recall), it says that a person can have no greater love than to lay down one's life for his friends. I'm not sure how much Al Sondej read the Bible but he did understand this commandment: to love your neighbor as yourself.

During college and graduate school, Al supported himself by work as a volunteer fireman. The paid room and board provided a stable living arrangement so that he could attend school. The job was usually safe and boring. However, some days were filled with excitement and risk.

I lost track of Al after he left for graduate school in Maryland. It was only several years later that I learned that he had died in an apartment fire. Apparently, he re-entered a burning building thinking that a child was still trapped inside. Al couldn't find the child but his heroic act resulted in a severe injury. Al Sondej died several weeks later.

If Al could have chosen a way to die, it would be in this way, trying to save the life of a child.

Posthumously, the University of Notre Dame presented his family with the Dr. Tom Dooley Award for selfless service to humankind.

Dr. Greg on WTHR about Health Care Reform

2009-09-11T10:34:00.002-04:00

Dr. Greg was featured on WTHR News on 9/10. Watch the story here.

Outside the dining hall (Al Sondej, Part 2)

2009-09-07T07:44:00.008-04:00

So one day, I stopped to say hello to Al Sondej. I awkwardly introduced myself to this intimidating man and more than 5 hours later, we were still talking....about very idealistic things. Al wanted to change the world. He wanted, more than anything, to feed the world. He understood, but couldn't accept, the fact that thousands of people were dying every hour due to hunger and malnutrition. (This is still true 35 years later). Al's bottom line: we are all children of God and if we would simply conserve and share , there would be plenty of food, energy, water and other precious resources to go around.

We argued a lot. Everything Al owned could fit in a small backpack. He didn't own a belt because he didn't need it to hold up his pants (they were too small for him). He had one coat, one worn-out sweater and one pair of sneakers. Generally, this large man ate one meal a day consisting of 12-24 "pizza muffins." He never lost an argument to me because he would wear me out. He wouldn't STOP arguing until I capitulated.

He was a strong, beautiful man who died too young.

Dr. Greg discusses his Ride to Remember

2009-09-02T15:26:00.004-04:00