A pathologist’s reflections.

Forget Doc Brown and Marty McFly’s DeLorean. I’ve got my music, my very own time machine.

For example, yesterday I was heading east on Lake-Cook Road, trying to be on time for a serious pickleball match. Little Red Corvette, the Prince hit song from the early 1980s came on the radio and suddenly I forgot about slams and dinks and was transported back in time. As the chorus played on, I envisioned myself parking my old Chevy in the dark, winding four-story garage next to Evanston Hospital. I was in the last year of my pathology residency in suburban Chicago and the sounds of Prince were everywhere.

That four-year residency program was the best part of my medical education. Following the intense years of medical school, the residency consisted of four laid-back years in the hospital laboratory learning anatomic (autopsies, diagnosing disease in biopsy specimens, surgical specimens, and pap smears) and clinical (chemistry, hematology, microbiology, etc.) pathology.

Although I learned the basics of my professional skills at Evanston, my memories yesterday were not of pathology, but about the people I spent those four years with, the ones who trained me and the others who trained with me.

Most prominent was Hartmann Frederici, a South American native of German descent. He was chairman of the department and was known for his strict Prussian demeanor. We clashed over autopsy coverage but I did my best to show him the respect he craved.

I am sure you have met people who can never say no, and wind up so overworked that the report they promised to review, or the recommendation they swore they would write end up buried under a pile of other papers and promises. That describes Tom Victor, who led the Anatomic Pathology teaching core. Good-hearted and caring he was in a perpetual state of frenzy. Dermatopathology was his passion; much of what I know came from his teaching.

Tom’s hard work was matched by the efforts of the ever-caffeinated Mike Kaufman, continuously checking his watch to avoid being late for his next gig, and Miriam Christ, Mike’s serene counterpoint and crackerjack diagnostician. Their contrasting styles gave the department balance.

Arlen Brodin, a general pathologist and a fierce proponent of Occam’s Razor, was the titular head of the residency program. His instruction to me “to look at that slide until you know it is prostate cancer” paid off in my ultimate career in urologic pathology. Sharon “Holy Guacamole” Bugaj and Serpa Schwartz, a petite Scandanavian pathologist who said little but always knew the answer to a tough breast biopsy question, pitched in from their perch at Glenbrook Hospital.

The pathologists and scientists who trained us in clinical pathology had varied reputations. Volker Dube, who ran the blood bank, was renowned among the residents for taking a pair of scissors and literally cutting up our autopsy reports. That was years before the phrase “cut and paste” entered our vocabulary. Our young chemist, Lem Bowie, was the only black man in the department. In his research lab, I analyzed red blood cell membranes, looking for a cure for sickle cell anemia. Sadly, Lem passed away from colon cancer, another disease over-represented in young black men.

Den mother to the residents was Eileen Randall, our microbiologist. Randy taught us to recognize every pathogenic bacterium and every deadly fungus. She held study sessions for us in her north suburban home, feeding and teaching us in her backyard. She was looking forward to retiring and moving into a woodsy cabin, but like Lem Bowie, succumbed to colon cancer before she could follow her dream. The entire department mourned her, and I vowed I would choose to retire too soon rather than too late. Two years ago I followed through on that promise to myself.

I trained with more than a dozen fellow residents while at Evanston. We were a friendly and cooperative bunch, celebrating Toxic Taco Tuesdays and Thursday afternoon tea, all while sharing questions for future Board exams and preparing for anticipated careers. Bob, Mike, Candy, and many others were supportive comrades, while George’s gift for gab was essential in making “a long story longer.” I didn’t foresee George being the first pathologist I would hire when I created the UroPartners Laboratory more than 20 years later.

Such wonderful memories. For time travel, I’ll take a little red Corvette over a souped-up DeLorean any day!

Last weekend Barb and I were at the Cadillac Palace Theater for our first show in this season’s Broadway in Chicago subscription. We had 5th-row center seats for Back to the Future, the musical based on the iconic 1985 movie. The show is high energy and the performances top-notch, but the show-stopper is Doc Brown’s souped-up DeLorean time machine.

She roars onto the stage and flies high above it while jetting Marty McFly from 1985 to 1955 and back again. Whether plutonium-powered or lightning bolt-activated she screams to 88 mph and booms across the decades. The audience loves her.

But the time-traveling DeLorean is not the car most on my mind. A few weeks ago I wrote about my struggle in deciding how to replace my aging and cranky Audi sedan. Like Marty McFly, I was shuttling back and forth, but for me, the decision was whether to buy another sedan or my first SUV. You may recall I landed on something neither fish nor fowl, an Audi A6 Allroad, a throwback to station wagons of the ’60s popular on the West Coast.

Then Barb saw one on the street and reported “That car is ugly. And weird. You cannot buy that car.” So we canceled the order and reviewed our notes. We considered our wants, needs, and finances. I am here to report that two Saturdays ago I joined SUV Nation.

We bought the most basic level of an upscale brand SUV with a few thousand miles on the odometer to help control the cost. Black-on-black, it is stylish and shiny.

Driving the SUV has been an even bigger adjustment than moving to a new house seven years ago. I must get used to the higher cabin, the “tight” ride, and the powerful engine. It’s wider than my old Audi, making it a tight fit in the garage. Then there is the sticker shock of filling the fuel tank with 20 gallons of premium gasoline. Where are plutonium-powered cars when you need them?

Despite the drawbacks, I enjoy my new ride. And having an SUV has already proved worthwhile. Over the weekend Barb and Laury were going furniture shopping for Laury’s remodeled home. It’s a good thing I came along. Two large pieces of art that never would have fit in a sedan (or a weird station wagon) slid easily into the SUV’s rear compartment. I’m sure that huge capacity will also be useful when hauling bikes, golf clubs, or both.

It’s not a DeLorean. It won’t take me back in time, but I am sure it will help us make many future memories.

Finding the Meaning in Retirement

The first time I remember the switch flipping was during my Freshman Honors Algebra class in high school. Most of my classmates had studied algebra in 8th grade and were already proficient manipulators of operations, equations, and variables. I was encountering these concepts for the first time and I was struggling. I asked my uncle Poldi, an engineer, for assistance, and worked with him for an hour in his dining room.

And suddenly, I got it. I don’t know if Poldi was responsible, but a switch in my head clicked on; algebra came into focus, enough for me to raise my grade from a D to a B+ in a mere ten weeks.

That’s how I operate. Malcolm Gladwell has his 10,000 hours until mastery rule, but that’s not how I progress. Things don’t come to me gradually, they come to me in a rush, all at once—as if a finger is pushing a button deep in my frontal lobe.

Prostate pathology came to me the same way. Suddenly I had the utmost confidence that I could diagnose prostate cancer. That confidence never failed me.

I never know when to expect a click. They have come in the middle of a college physics exam and the fourth frame of a bowling line. A month ago it happened on a pickleball court—though admittedly a new paddle helped flip the switch.

Clicking never happened in tennis; I never had a sudden surge in my skills and never gained mastery. I fear I am headed for the same sad outcome in golf but I have no way of foretelling if on some glorious, sunshiny day, the grip and the swing and the follow-through will all come together and I can say “I got this.”

There is one more thing I am still waiting to get, waiting for a click. It is more of an abstract, metaphysical one. I have been retired for almost two years. When asked how I like my current circumstances, I always truthfully respond in the positive. I retired at the right time with the right motivation. Yet I still await the light to turn on to understand what retirement means and what is it for.

Yes, I keep busy with golf and pickleball. I read and I write. I have a pathology-related consulting gig and participate in a generous smorgasbord of volunteer activities. Barb and I do some traveling and babysit as needed.

But so far those activities don’t give me the answer to the purpose of my retirement or how I can make it meaningful. The web offers advice (find your passion, set goals, etc), workbooks are available, and workshops too. Although it seems like a lot of work, maybe I will travel down that route. Or maybe I’ll wait for something to click, just like high school algebra. It’s the rest of my life and this time I want straight A’s.

I am neither a TV news addict nor a history buff. My television time is spent mostly viewing family dramedies and Brian Cranston serials, whilst my reading tastes run strongly to Cold War spy novels and “unreliable narrator” fiction popularized in the last decade by Gone Girl.

I have stepped out of my comfort zone. For the past two weeks, I have been reading (technically, I have been listening to Will Patton read) The Demon of Unrest, Erik Larson’s description of the run-up to the Civil War. And for the last three nights, I have been glued to cable news watching each speaker, performer, and talking head at the Democratic National Convention.

I suspect I am not the first, and will not be the last, to comment on the parallels between the two events—the war that tore our country apart, and the upcoming election that is having a similar polarizing effect on the American character and soul.

Larson takes us inside the diaries, notes, military orders, and personal letters of a wide array of people in describing the tenor of the nation in the months leading to President Abraham Lincoln’s inauguration and the firing of the first volley at First Sumter.

Congress’s certification of the Electoral College vote, concern about assassination attempts, and investigations of conspiracies all played a role in bringing us to war. The South’s dependence on the sin of slavery probably made conflict nearly inevitable, but hyperbole, misdirection, fear, and poor communication guaranteed it.

In our world of everything, everywhere, all at once, many of those pressure points are once again present. I am not forecasting a Civil War. Unlike the Blue vs. Gray, I don’t think we are rushing to a Blue vs. Red armed conflict. But I do fear for the future of our country.

I’ll listen to more of The Demon of Unrest in the car today. I will be glued to MSNBC tonight. I will work hard to support my candidates. And though not a religious man I will pray that “this government of the people, by the people, for the people, shall not perish from the earth.”

My bad!

Greetings readers,

For those of you who were trying to contact me via the email address in my previous post, I apologize. My email address was missing a letter. Comments can always be made directly here on Substack or sent to me at:

lesrraffblogger@myyahoo.com

In the previous post, I was missing the 2nd “r” in raff.

Shout out to MK for alerting me to the possible error. And thanks to all for being loyal readers! Keep those cards and letters coming in (now that they can get here!)

Les Raff

I sometimes miss the simple life.

Growing up in Rogers Park I frequently accompanied my mother on an important mission. As we walked through the neighborhood, I was trusted to carry a small rectangular piece of stiff white cardboard. The card was not a postcard or an invitation. It was a bill, our monthly chit from Commonwealth Edison, the city’s sole electricity provider.

Mom and I were not out to pay the bill. Like all of our family payments, that duty was handled by my dad, a meticulous bookkeeper who was never late meeting a financial obligation. The journey Mom and I were on was to a neighborhood hardware store, where we could present the bill in exchange for 10 light bulbs.

The bulbs were “free”; their cost was likely built into our monthly bill. At the store, we could choose from any of the available bulbs. And what was available? We had a choice of 60, 75, or 100-watt incandescent light bulbs. Standard light bulb shape, standard light bulb size, standard light bulb base. They were a perfect fit for every fixture of our apartment.

I remembered the lightbulb task this morning while standing in Aisle 1 of the Home Depot store in Northbrook. I was there because a 60-watt incandescent light bulb, one of the three bulbs in the ceiling fixture of our home office, had burned out. My goal at the store was to find equivalent LED replacements for all three bulbs.

Through more than 7 years of service, the incandescent bulb had projected a warm yellow glow through the glass base of the fixture. That’s what I was looking for as I studied about 400 shelf-feet of bulbs at the Home Depot. They were virtually all LEDs but beyond that, the variations and choices were uncountable and unimaginable.

There were long bulbs, short bulbs, round ones and square ones. Candelabra bases, standard bases, and something in between. Bright white, soft white, daylight, and plain white. There were even smart bulbs that changed colors with your mood, your music, or your appetite. Overwhelmed, I chose some daylight bulbs, assuming they would project light with a soft, sunny, slightly yellow appeal.

I was wrong. The new bulbs filled the home office with an unpleasant, glary, harsh, white light. Twenty minutes later I was back at Home Depot exchanging those bulbs and grilling the store clerk on the best bulb for my needs. We chose soft white bulbs and the soft yellowish-white light is just what I like while I sit at my desk typing this post.

We have traveled a long way since those Rogers Park days in the 1960s. Technology has gifted us a wonderful assortment of energy-efficient, environmentally friendly, and cosmetically stylish light sources. But sometimes, in our quest for progress, we lose sight of the small, simple treasures that once illuminated our lives—like a walk with Mom and a bag of light bulbs.

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Hello friends—this is the first time I have used Substack to distribute a blog. I am still trying to figure the site out. Please let me know if you have received this by emailing me at lesrrafblogger@myyahoo.com

Commetns are always appreciated!