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of possum hunts and compassion

Imagine having the compassion to change everything in your life because of love; because it would heal a family, because it was the right thing to do. Curtis Pugh gave up nights on the town, drag racing and following Frank Sinatra shows to marry a strong, kind, widow, with five children. Pauline lost her beleaguered first husband, and father of her children, as a victim of a liquor store robbery. I know what you are thinking, find me a young romantic who hasn’t fallen on the sword of good times for salvation of love. But how many freewheeling spirits give it all up to change not only their lives, but the lives of six others and generations to come? When Curtis married Pauline he didn’t just marry the love of his life, he became a father, a healer and savior.

Curtis Pugh traded the raucous life of a young man in exchange for the love of a whole family. When he married Pauline he also adopted her four daughters, and son. It wasn’t a happy ever ever tale, at least not at fist. The Pughs, despite hard work and love faced more hardship. Their son, Jerry, passed away from leukemia as a young man, before the age of 16. Pauline, no stranger to grief, with as Curts her compassionate bedrock, worked hard to raise the girls in a loving home.

He once told me a story about his ‘wild days’: “We’d drink a little and go out running in these old cars... they were tin back then and when we’d go ‘round a curve too fast and one or two of our cars would roll over...” You’ve never seen a smile like that, I promise. “We’d just get out, dust ourselves off and all together push ‘em back over!” Curtis had a chuckle which was infectious in the best possible way. It was hard not to laugh at the mental image. I heard Duane Eddy’s Rebel Rouser playing in my imagination and saw classic cars, men in white under shirts and work pants racing around dirt roads, laughing and carrying on. “... but that’s all over now, the day I married Paulie, I never wanted a drink again.”

And he didn’t. He spent the rest of his life impossibly devoted to Pauline and her girls. They had another daughter, Robin, 11 grand children, five great grand children, three great great grand children and an immeasurable impact of kindness and compassion on their world.

I didn’t know Curtis in his rebel rouser days. Fast forward a few years later, he and I would spend quality time possum hunting. At dusk, the two of us would stake out from the house, armed with only flashlights, prematurely boasting about what was to be the biggest possum hunt ever. We walked down the over-grown middle of the gravel drive so our shoes didn’t crunch on the rocks. We’d creep past the old red woodshed, resting on its side like it had been there long enough to be tired, our landmark for entering native possum territory. I don’t remember how many we ever caught. Light is a powerful weapon against possums just as night is the enemy of sleepy young scallywags. I don’t remember how those hunts ended, but I suspect it was with me on his shoulders fast asleep.

I don’t know a lot about sacrifice. Not granddad’s kind. Sacrifice is different than compromise. That’s not self depreciation or humility, its honesty. How many young men in my generation opt out their care free lives, into full time caring for others? Curtis Pugh made a choice in his life which has profoundly, profusely and positively affected four generations so far. I know the example he set will continue to be my golden standard of kindness and love for the rest of my life.

When I think about his choices, I wonder who saved whom...

Goodbye Grandaddy, you will always be one of the best men I’ve ever known.


I'm a Gopher!

I'm excited to share that starting in January 2011 I will be a Gopher! A university of Minnesota Gopher to be exact. I am starting an executive Masters of Hospital Administration program (MHA). Apparently, the first test involves seeing if I'm actually crazy enough to travel to the Twin Cities for a week in the middle of January. I am excited, nervous and a little stressed all at once (you'll be grateful to read that my online activity may decline for the next two years). The University of Minnesota program is well regarded- or at least it was until they accepted me. The executive MHA is a mix of on-campus and online work. I'll visit Minneapolis / St. Paul twice a year for two years. The rest of the coursework is done by podcast, online forums, video conference, etc. Pretty slick!

I chose UMN over a few other programs, one in particular with strong ties to many who are near and dear to me. It was not an easy choice.

With that bit of good news, if you see me standing around the snow covered streets of Richmond prepping for the winter onslaught that is Minnesota in January, wish me luck. Go Gophers!

Its all about .ME

google profile I am not a huge fan of the "personal brand" sentiments. Something about pushing yourself on people rubs me the wrong way. That said, I do really like the idea of controlling your own identity online. After all, if you don't own it, someone else will!

In the past I have used iWeb and .Mac to compile a list of all of my internet profiles. The challenge was remembering them all and keeping up with the static page. Google has recently introduced Profiles ( where you can claim your identity across the net. It appears that the more your tell it, the smarter it gets. Start with creating a profile and linking to your homepage or twitter account. Pretty soon google starts finding other sites on the net that appear to belong to you - facebook, flickr, vimeo, etc. Additionally, when someone searches for your name, your google profile will appear at the bottom of the search results. That means the likelyhood of someone finding the real you is much higher.

Not only is Google Profiles a great way to control your presence online, it is a powerful aggrigrator of our online selves. Take a look at mine - and you'll see what I mean. Things get even more fun when you use a vanity domain and point it to your profle. In my case, I have used NickDawson.ME which redirects to google profile. A profile and a .ME domain is an easy way to share your online contacts with anyone. Imagine creating a business card with nothing but your .ME address. "Want to reach me, here is a one stop shop".

Hopping around - post op day 5

back to workJust a quick update - five days after surgery, things are on the mend. I think it is safe to say that I underestimated the recovery from the ACL reconstruction and meniscus repair. Thursday, Friday and Saturday (days 1, 2, and 3) were spent in bed with little or no mobility. It was during physical therapy on Monday that things seemed to round the corner. While the joint has started to calm down, I have also gotten better on crutches. Perhaps its taking a few more risks in the form of a hop or two. I have been able to get back to the office and am returning to a somewhat normal schedule.

I consider myself a fairly well informed patient. A few weeks ago I wrote about the process of finding a surgeon. I attributed a good deal of that research to working in and being connected with the healthcare industry. I thought I had asked the right questions, made the right calls and done my homework. And frankly, for the decisions I had to make, I was well informed. However, I was not fully prepared for the recovery and post-op recovery.

Since then, I have rediscovered the Mayo Clinic's online health library. Mayo has made a name with its health library, licensing the content to other providers and sites (which is how I had first come across the site). It is a wonderful resource for anyone doing research on a health-related issue.

As the pain lessons, I am pushing through with physicial therapy. I am in good hands and expect to be walking again in a few weeks.

day 2 - let the rehab begin

Not a lot to report today except for some reduction in the pain. I have discovered that 'keeping in front of the pain' means taking the meds before you need them. As long as I set some reminders, then it seems to be much more manageable. Physical therapy - electro shock

Yesterday was my first dose of physical therapy. Given my limited understanding of whats to come, yesterday's PT was rather mild. The best part was getting the bulky dressings off. Besides just being able to flex and breath a bit, it means that the pad from the ice machine is closer to the joint and considerably more effective. We covered a few basic exercises including quad flexing, heal pushes and ankle pumps. Its remarkable how much you muscles atrophy in a short period of time - at this point I cannot lift my leg without help. Two weeks ago I was squatting 400lbs at the gym... pretty stark juxtaposition.

As the pain gets better and movement gets easier, I am looking forward to what the next 24 hours will bring. I've been cleared to bend my knee to 90 degrees which means I may be able to sit up and spend some time somewhere other than the bed.

On a sad note, I am bummed to be missing Susan's marathon this weekend. Be sure to follow her progress on twitter.

A leg up - one day after surgery

Recovery Room

Fans of the TV show Top Chef know that contestants are often admonished for not tasting their food before it goes to the diners. Sampling your wears is the tenet of any service industry. That said I would wager that most healthcare professionals have not volunteered to go under the knife just to see what its like (and who would fault them?). There are times however when some of us get a chance to experience our service from the patient perspective - yesterday was one of those times for me.

As a result of my ACL injury, yesterday I underwent a surgical procedure to start the road to recovery. I wrote about my decision to to return to Richmond verses having the surgery at a world-renown clinic. What I did not not mention, something that was a major factor for me, is that I work for a top notch health system with four hospitals in Richmond. As part of my role I am focused on our 'service excellence' initiative. Indeed it is something we empower all of our team members to lead; a path towards world class patient experiences. The goal is simple, in every move we make, every interaction, we seek to exceed every patient's expectation, every time. In practice it is not so easy a thing.

So what did I observe from my day as a patient? For starters I confirmed what I had hoped for, that we do have team members committed to first class treatment. We have some things to fine tune but overall there is no doubt that my decision to come home for care was the right one.

The procedure went well, or so I am told. Once inside, they found a considerable amount of damage beyond the ACL rupture. From the MRI, we had suspected a tear in the meniscus (a cushion of tissue that forms a cup between the thigh and leg bones. The surgical team found multiple rips in the meniscus and were fortunately able to repair them. That repair will hopefully save me from a knee replacement in the future but it comes with a price tag. To let the meniscus heal, I have to keep my weight off the knee for three weeks - crutches, blurg! The ACL repair is a very interesting procedure in itself. When they tear, anterior cruciate ligaments literally explode, leaving nothing behind. I had a choice, they could remove a portion of a ligament from elsewhere in my leg or use a donor ligament. For various reasons, I chose the donor tissue. In either case, the procedure is really a bone graft. Since ligaments cannot be directly attached to bones, the replacement ligament still as a portion of bone attached to either end, and that bone segment is grafted into the knee joint.

And the patient? I'm in a fair amount of pain and rather immobilized. But I have a wonderful care taker and will start physical therapy today which should help. I also want to say a very heartfelt thank you to friends and family who have checked in.

Throughout my convelesence, I will continue to update this site with notes and observations. In particular, I am looking forward into detailing the clinical procedure and the physician who performed the work. For those interested, check back soon! on your iPhone

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