The Union of Your Spirits

{Prompt: What was your wedding like?}

The Beginning

The best part of my wedding was in its beginning.

I’m not kidding when I say that.

Of course, there was relief that the ceremony had begun, after weeks of planning.

And I was encouraged that our union would really take place, after sitting with my brother in the back of the church… isolated from the wedding party… waiting for the seats to fill.

But the beginning of our wedding was also a beautiful experience. I saw Dianne walking down the aisle, towards the altar (and me), with a radiant smile. She looked unbelievable to me, in a lovely, lacy white wedding dress that nearly matched the glow of happiness in her face.

Everything after that moment… the processional… the ceremony… the reception… pales by comparison.

The beginning of the wedding also featured two pieces of beautiful music — two pieces that we had not only requested, but insisted upon.

One piece was “The Wedding Song” (There is Love) by Noel Paul Stookey (a member of the band Peter, Paul, and Mary). The lyrics made reference to Matthew 18:20, a verse that I knew well from my inculcation in the Methodist church.

Here is a portion:

“The union of your spirits here has caused Him to remain; For whenever two or more of you are gathered in His name… There is love….”

That song was played before the processional began — a beautiful mixture of Stookey’s resonant voice and layered arpeggios on guitar. I felt the tingle of goose bumps listening to the music and the lyrics — a blessing on our union, me and Dianne.

The Wedding Song

The other song was Schubert’s Ave Maria — a traditional and religious song set to a classical melody. This piece was sung from the balcony by Dianne’s brother, Maurice, while we waited together at the front of the church. It was a prelude to the wedding sacrament. I feel sure that Dianne was as moved by her brother’s falsetto voice, singing the Ave Maria, as I was moved by The Wedding Song, before.

Those two ethereal songs, Dianne’s angelic walk down the aisle, and our reunion at the altar are priceless memories.

I should stop here. I really should.

But then you would never understand my dealings with the Greek mafia, my camaraderie with the belly dancer, or my loathing of Bette Midler.

The Greek Orthodox Church

When I first met Father George Rados, I thought he might be a part of the Greek or Middle Eastern mafia. He wore a big pair of partially shaded glasses, a big gold cross on his chest, and a clerical collar. His mouth said, “Nice to meet you”, but his eyes said, “Don’t get too comfortable.””

We met with Father George to discuss our plans for marriage, and, as it turns out, my plans to join the Greek Orthodox Church! We met with Father George at the Saints Peter and Paul Antiochian Orthodox Church — the church for Dianne and her family. According to Father George (…and who was I to contradict him), there could be no wedding of a Greek Orthodox woman to a Protestant man.

For a moment, I thought that the wedding was off.

But Father George graciously offered a practical solution. I would simply have to join the Greek Orthodox church, pledging my allegiance.

Father George with Steve & Dianne Gallup

Back in 1991, I had been busy studying medicine and public health, and I was not particularly well acquainted with the history of the Greek Orthodox Church. I knew practically nothing about “her mystical vision of God and His Kingdom… the beauty of her worship… the purity of her Christian faith, and… her continuity with the past.” I was woefully uninformed about the “Great Schism” or the subtleties of Orthodox worship.*

Fortunately, Father George gave us both a primer on the tenets of the faith — one of the oldest denominations of Christianity on Earth. For those of you who are less familiar, the service is composed of long passages of Divine Liturgy, Litany, and Sacraments. There is Communion at every service. I learned later that the part in which the congregation typically responds, “Lord, have mercy,” or “Grant this, O Lord,” is called the Litany. It is a petition for divine intervention.

The Greek Orthodox service can be a comforting ritual. The services are always sung or chanted, often in a language other than English, according to the needs of the congregation. According to a church website, “Although Orthodox Services can very often be elaborate, solemn, and lengthy, they express a deep and pervasive sense of joy.” I had seen this for myself on a few occasions, before our meeting with Father George.

The Ceremony

With our religious affiliations sorted out, we scheduled our wedding to be held at Saint Katherines Greek Orthodox Church, in Falls Church, Virginia. I had never been there before, but when I saw it, I was happily surprised. As Saint Katherine’s website itself says, “The rich color, distinctive iconography and beauty of the interior of an Orthodox Church generally are in sharp contrast to the simplicity which one finds in many… Protestant churches.”

Humor me a moment, as I describe it for you.

As you walk into the nave, your eyes are instinctively drawn to look up at the circular dome, with its muted painting of Jesus, surrounded by an array of stained glass windows, light shining in all directions, illuminating an outer circle of saints and apostles. These heavenly beings are further encircled by finely painted scenes from the life of Jesus, which in turn are lit from below by dozens of panels of stained glass where the dome meets the ceiling.

St. Katharine’s Greek Orthodox Church

Below the dome are the church nave and the Altar. The church nave holds wooden pews for the congregation; and the church altar holds the Iconostasion, an ornate wooden screen decorated with a panel of icons. The Iconostasion separates the altar from the sanctuary, where the processional cross and the censer are kept, until needed for the service.

During a normal service, when the priests and the acolytes enter, and when they leave, they make their way through the congregation with the censer swinging puffs of incense from side to side, while the priest issues blessings upon the faithful.

In our wedding, the usual procession of priests and acolytes, at the beginning, was replaced by a procession of mothers and fathers, bride’s maids and ushers, and finally (and best of all), by the bride herself.

After “The Wedding Song” and the Ave Maria, the service began in earnest.

And it went on… for quite a while.

The vows were taken care of right off the bat, but they weren’t the kind of vows you see in a soap opera wedding. We never actually said, “I do”, and I don’t think we were addressing each other, or looking deep into each other’s eyes. The vows were promises to God and the Church, addressed to Father George and the congregation, and the response each time was, “I will”, or “We will”. It was just a little disappointing.

That was just the beginning.

There was an exchange of rings, which went by in a flash, and then Father George told us with a wink, “Now we go for a little walk.”

From the altar table he took a pair of crowns, attached one to the other by a band of gilded ribbon. He put them over our heads, and he said some religious words, swapping them back and forth, like a magician with some golden hoops, about to perform a magic trick.

Then he placed them on our heads — a crown of gold, precariously perched on each of our brows. And then the five of us (Father George, Me and Dianne, the bride’s maid, Kelly, and my best man, Mike) went for a “little walk” around the middle of the altar, circling once or twice or three times… Dianne and I balancing our crowns… and holding candles… before that portion of the ritual concluded.

(Placement of the “Stefana” (crowns) during the ceremony)

The service wasn’t nearly finished.

We also performed a sacrament of communion, sharing a common cup, before the service was completed.

And then came the photo session.

Planning the Wedding

If you ever plan a wedding, give yourself some down time before the photo session. Even five minutes would be enough.

Our photo session was held right after our wedding service, and by then I had already been on an emotional roller coaster.

I had locked my keys in my car. I had been sitting in isolation near the church’s rear entrance. I had been elated by the processional, and deflated by the (unfamiliar) vows. I had exchanged rings, circled the altar in a golden crown, and completed my first Greek Orthodox communion. Now I was expected to smile for about a hundred photographs.

Of course, I was happy to oblige, and I was happy to be married, but I was ready for a break, and there were a lot of photos to smile for.

Photos with each member of the wedding party. Photos with each parent’s family, and extended family. Photos with everybody.

Let me fill you in.

Our wedding party included five bridesmaids and five ushers. Most of them were friends or family of the bride. My brother — my best man — was the sole exception. Dianne had three female cousins, her sister, and her best friend for bridesmaids; and she had an uncle, male cousin, brother, and college friend for ushers. Another cousin was the flower girl.

Dianne has a lot of relatives.

And they were all invited.

We knew going into the planning of the wedding that they must all be invited. This was the first wedding in the Shihadi family. And it was the time that her father’s generosity (at other weddings) would finally be rewarded.

We were certainly able to include our own friends and family as guests, but there was never any question that the ceremony would take place in DC. And everyone known to Dianne’s parents would be invited. It was a concession. But it was well worth it.

In most respects, our wedding plans were unimpeded. Dianne could choose her own wedding dress. We could choose the bakery for our wedding cake. We could choose the outfits for the wedding party. We could choose the flowers and table decorations. We could choose the photographer and videographer. We could choose our DJ (more on him later). And we could choose the invitations themselves. If anything, there were too many choices to be made. (It was almost as bad as all the choices we had to make for our home addition, years later, when we even had to decide where to put the light switches.)

Our Wedding Invitation

The first thing we did, was open a bank account. Mr. Shihadi “helped” us set it up. We all went to the strip mall together to sign the paperwork.

“Why do we need another bank account?” I asked Dianne. (We each had separate accounts already.)

“Because these are Arabs,” she whispered back. “They’re going to be giving us money!”

That’s about the time when Dianne began giving me a tutorial on Arabic custom and her relations. She tutored me on the names of her aunts and uncles, cousins, and their spouses. She taught me how they would say “Congratulations” (“Mabruk”), and how I should say “Thank You” (“Shukran”).

So when we entered the Knights of Columbus dining hall in Arlington, Virginia, for our reception, there was a nice big decorated gift box at the entrance, with a slot at the top for monetary gifts. (Those gifts paid for our French Renaissance style bedroom suite, including the tripartite mirror, which we later purchased from the Furnitureland showroom in High Point, North Carolina.)

I said “Shukran” repeatedly, leaning over to kiss each aunt and female cousin on their cheek, and I did my best to greet them by name, as they filed into the hall for the celebration.

The Reception

There were dozens of tables in the reception hall. Almost all of them were filled with Arabic friends and family. One or two tables contained the extended Gallup family, such as it was. And one or two tables contained a contingent of friends from Chapel Hill (where we were living at the time) and elsewhere.

We sat down for dinner at a table at the front of the room, for a few moments of relative comfort. But the respite was very brief. A performative kiss was given each time the audience started to ding their wine glasses.

And there was a big surprise.

What we didn’t know was that Dianne’s father had hired a belly dancer to perform at the reception. What he didn’t know was that she was a blond-haired American — not an Arabic dancer as he had assumed. We were both embarrassed — I by the unexpected, sensuously gyrating dancer, and Mr. Shihadi by her unexpected ethnicity.

But the belly dancer was an unabashed and sensational performer. She started to dance for the entire hall, showing enough grace and skill to convince anyone that she was legit, Arabic or not.

Then she came up to the wedding party table to give a personal dance for the groom! I wanted to crawl under a rug. But there was no way to hide.

I would have preferred to be anywhere else, but I got up the gumption to get on my feet and give my finest imitation of an Arabic man dancing with a belly dancer, as if it was the most natural thing to do in the world. It must have been hysterical.

Dianne and I with our belly dancer.

When she was done with her dance with me, the belly dancer was encouraged to dance with Mr. Shihadi, the instigator of this whole charade. So Mr. Shihadi got up, with her persuasion, and he did a little Arabic shuffle across the dance floor.

Mr. Shihadi and the belly dancer at our wedding reception.

I didn’t enjoy it at the time, but in a way, I was happy to have that belly dancer at our wedding. It made our wedding impossible to forget. That’s for sure. But it also made me feel a little bit less like a fish out of water. In a way, we were both trying to fit into the Arabic culture. She was embracing an Arabic dance, and I was embracing an extended family of Arab descent.

After the belly dancer left the reception, we finished our dinner, and we visited each table of wedding guests, one by one. Then we sliced our cake and served dessert. Then the Arabic band played some music for the traditional Palestinian dance; the Debka… three steps to the right, turn, hop, skip, repeat.

When the Arabic band and the dinner were done, our DJ took over the festivities, starting with a dance for the bride and groom. We danced to the song “Beautiful” by Gordon Lightfoot.

Then there was a Mother-Son and Father-Daughter dance, which we did to Shower the People, by James Taylor.

Then there was an insane mixture of music ranging from songs we requested to the Chicken Dance and the Electric Slide. Lots of semi-inebriated celebrants took to the floor.

Every now and then a ballad would be played, allowing for folks to slow down and catch their breath. The Wind Beneath My Wings came on and we joined the crowd to slow dance around the dance floor.

Then, a little bit later, it came on again. I thought, “That’s strange. Why is he playing it again?”.

Then it came on again… and again… and again. It seemed like it was the default tune for any pause in the rotation of songs.

I started to cringe each time the song began: “It must have been cold there in my shadow…” I started to hate the DJ, and Bette Midler, with each refrain of “Did you ever know that you’re my hero…”

I’ll never know what possessed the DJ to play Bette Midler over and over again. I mean, after all, it’s about a woman that dies when she’s still young. It’s maudlin. It’s saccharine. It was just too much.

If you ever have a wedding or an event with recorded music or a master of ceremonies, choose your DJ like your life depends upon it. They can either make the party swing, or they can make it a real drag. Maybe we should have stuck with the Arabic folk music instead.

At the end of the night, the music came to an end, we said our goodbyes; we got into our white Acura Integra, decorated by a white water-soluble marker — “Just Married” — and we headed to a hotel suite for our first night of wedded bliss.

The bliss was getting a full night of sleep, and then getting to sleep in late. We got some rest and recovery before we headed out of town for the rest of our Honeymoon.

A Union of Spirits

Our wedding was literally a wedding of cultures, equally influenced by American traditions and Palestinian customs. We had heartfelt folk music by Noel Paul Stookey, rapturous classical music by Schubert, and the Byzantine chant of the Greek Orthodox Church.

We had ululation, affirmation, undulation, and celebration— Palestinian expressions of joy… Greek Orthodox vows of commitment… gyrations of Arabic dance… and the festivities of a marital union.

A wedding is heavily planned and choreographed, fraught with anxiety and emotion. It can seem like the longest day of your life, but when thoughtfully done, there are moments that resonate with each of the participants. There is something for everyone.

In the words of my favorite song, “…whenever two or more of you are gathered in His name, there is love.”

…there is Love.

Dianne and her father - June 23, 1991.

Footnotes:

*“While Christianity in the West developed in lands which knew the legal and moral philosophy of Ancient Rome, Eastern Christianity developed in lands which knew the Semitic and Hellenistic cultures. While the West was concerned with the Passion of Christ and the sin of man, the East emphasized the Resurrection of Christ and the deification of man. While the West leaned toward a legalistic view of religion, the East espoused a more mystical theology. Since the Early Church was not monolithic, the two great traditions existed together for more than a thousand years until the Great Schism divided the Church. Today, Roman Catholics and Protestants are heirs to the Western tradition, and the Orthodox are heirs to the Eastern tradition.”

*https://www.saint-katherines.org/about-orthodoxy/

Wearing White

{Prompt: What did you wear when younger that mortifies you now?}

Fashion

I guess I’ve been around long enough to talk about the embarrassing fashion trends of the past, but it’s kind of hard not to love the way we embraced of psychedelic fashion in the 70s or the Hip Hop culture of the 80s.

And I was there, wearing striped, plaid, or swirling patterns in the 70s along with my classmates at elementary school.

And later, wearing long tube socks and baseball shirts with record album artwork in the mid-70s.

And even later, wearing muscle pants and tank tops during the Jane Fonda inspired aerobics movement in the early 80s. Or Cosby sweaters and pleated pants in the mid 80s.

There is a beautiful school picture of 9 or 10 year-old me in 1969 or 1970, wearing a beige, orange, and brown striped shirt, with long pointed collars, that could only have been worn when hippies were fighting for peace and love.

And I’m wearing a light brown home-made vest — only one of many hand-sewn articles of clothing fashioned from a pattern by my mom.

I’m standing in front of a pile of books and an apple, with a library themed back-drop. I actually love the picture, but having the apple there kind of irks me. As if I was that 1950s era kid that would bring an apple for the teacher. Yuck!

4th or 5th grade school photo.

Another photo, in the 70s shows a sproutly young adult wearing tube socks and short shorts — possibly on the way to the basketball court, or just back from a game. Other photos, in the 80s, show glimpses of a young man in muscle pants (I had at least three pairs) or wearing a colorful rugby shirt (I had many).

(Me and Mike in 1980s fashion: Baseball shirts (Kansas & Willie Nelson), Short shorts, Adidas shoes, and high tube socks)

I don’t find any of those photos to be mortifying. Actually, I’m a little proud of those times when I embraced the fashion trends with such abandon. It’s when I was fully immersed in a time, in pop culture, that those crazy styles were captured on film.

Why should I be ashamed of being ‘hip’… or ‘groovy’… or ‘cool’… or even ‘bodacious’ (even though I was really none of those things)? It’s when you aren’t thinking about the camera; when the oddest clothes seem like a natural choice, that you are living in the moment… living your best life.

Wearing muscle pants for MS150 ride, circa 1990.

Uniforms

The clothes I find to be the most embarrassing were the ones that you might consider to be a ‘costume’, or a ‘uniform’. My khaki boy scout uniform would seem too goody-two-shoes today (but I sure loved those merit badges and the metal belt clips).

My baseball uniform always felt like it belonged on someone else. I wore the mid-length sleeves and pin-stripe pants of the baseball outfit, but I sure didn’t deserve them. Of all the sports that I played, I was most ill prepared for baseball.

And my marching band uniform comes closest to being an embarrassment to anything I’ve ever worn. It featured a felt cavalier hat (spray-painted black), high waisted dress pants, and a gold satin cumberbund.

Or maybe I just felt embarrassed to be there. Imagine a skinny teenager, with oily hair, wispy facial hair, and zits, dressed in costume, with a pair of cymbals. Who really likes the way they look at age 15, when they’re lanky and awkward? I know I didn’t.

Broughton marching band costume - not as bad as I thought.

The White Lab Jacket

However, the worst — the most abhorrent uniform, to my thinking, is the short, waist-length white lab coat. That’s right. The short white lab jacket is the worst.

Although a doctor’s white jacket might seem like a sign of competence — nay, of prestige — to an outside observer, it is nothing of the sort, particularly to those who work in the hospital setting.

To be clear, lab coats come in varying lengths, which when worn according to the protocol of a teaching hospital, range from waist length (for medical students), to hip length (for residents), to knee length (for attendings). And the length of your jacket is a clear indication of your abilities.

The short, “introductory” lab coat of the medical student, is the hardest to stomach — the hardest to wear. It’s pretty clear, to the student, at this point in their apprenticeship, that the lab coat is undeserved, and more of a warning to the trained medical staff that surround you. If you’re a nurse on a ward, and an aspiring doctor in a waist length lab coat comes by; you probably already know more about medicine than their academically saturated brain has yet absorbed.

And if a resident in a hip length coat gives a medical order, it still wouldn’t be wrong to regard it with suspicion. Medical specialists, called “attendings”, enjoy the status of a full length uniform, coat tails draping to their knees — every bit as elegant as a full length tuxedo.

(2010 Publicity photo for Village Family Practice)

Sidenote: Non-physicians also wear lab coats; and if you, in fact, are working in a lab, then you are a credit to the scientific profession, and you deserve applause, but if you wear a white coat in the service of some pseudoscientific or medically-adjacent profession, then you should be tarred and feathered.

Not only the length, but also the quality of the white lab coat changes over time. In the beginning, it is of low quality. Only the most rudimentary of stitching, coarse fabric, and a universal fit.

It is only adorned with the references and gear that can be stuffed in the pockets. Usually the small upper left hand pocket contains a pen and a pen light, and sometimes a list of phone numbers, or a small plastic-card-reference of lab values or advanced CPR protocols. The “Intern Pocket Survival Guide” might fit in the small pocket, and “The Sanford Guide to Antimicrobial Therapy” might fit, also.

The lower right pocket would contain your more comprehensive on-call guides, such as the “Oxford American Handbook of Clinical Diagnosis” or the “Little, Brown Spiral Manual of Problem-Oriented Medical Diagnosis”. The lower left hand pocket usually held a clinical rotation-specific guide to the most common medical conditions for that specialty. It could be swapped out… a pocket guide to psychiatry… or obstetrics… or pediatrics… or surgery… depending upon the need.

Once the pockets were balanced with medical books and plastic algorithm cards, the stethoscope or the dictaphone could be added in any space that remained. Over time, the stethoscope invariably was relocated to wrap around the neck of the doctor in training, partly to make more room in the pockets below, but also to give the illusion of medical capability and readiness.

As the jacket grows in length it also becomes embroidered, first with the doctor’s name, then with the name and specialty, or with the name and the practice. The longer the white blazer, the more buttons are required — each button added as if it was a badge of experience or a medal of honor.

The longer jackets require slits in the sides, so that one can stand with one’s hands, passing through the jacket seams, into the pants pockets beneath. It is the height of posing, for a doctor to stand with one hand in a pocket, while leaning with the other arm against a display monitor of patient’s vitals.

These long, flowing knee-length jackets add the same action hero panache as a flowing cape, or a black trench coat from The Matrix.

When I completed residency, I wore long white jackets, with sturdy inseams, and a properly tailored fit, for almost 30 years. I no longer had the apprehension and the anxiety of an intern in a short white lab jacket.

I assembled a collection of button shirts and silk ties. I had respectable beige polyester pants and maroon leather Rockport shoes. I pretty fully exemplified the appearance and demeanor of a board certified family physician.

If there were fashion trends in the last 30 years, I most certainly missed them. I was committed to a doctorly “look” that reflected my feelings of integrity and empathy.

But when I retired, I left the fashion and accessories of the medical profession behind.

I began wearing the most outrageous outfit so far…

for cycling…

skin tight Lycra.

But that’s another story.

(Trying to reach the top of Grandfather Mountain in 2014.)

(On the way to Mount Mitchell, a few years later.)

A Zen State of Mindfulness

{Prompt: Did you have any pets growing up?}

In my lifetime, I’ve had four cats and four dogs. The cats were all short-hairs: Pit-a-Pat, Charlie, Salinger, and Orion. As far as I know, Pit-a-Pat and Charlie were there when I was born. Cats were just a part of the family.

Salinger and Orion, however, were all mine. Salinger’s name obviously comes from J. D. Salinger, who certainly deserves to be honored with a naming. His name also rolls off the tongue, so it seemed like a good choice.

Salinger and me - circa 1989.

Salinger liked to live outside, probably a good idea when I was away at the hospital, doing rotations in medical school. Once I came home and a neighbor saw me with Salinger, and asked if that was my cat. It turns out that Salinger had made other friends in the apartment complex. He had been getting handouts from half the tenants.

Salinger, in his element.

Salinger was my cat when I met Dianne, and he was a little bit of a wildcat. Dianne tried to pet him and play with him, but he loved to scratch and bite so much, that he was risky to play with. That was less of a problem with Orion, who was adopted as a kitten.

Orion came into my life later, when we had a family — Dianne, two girls, and a dog (more on her later). Orion’s full name is D’artagnan Orion Gallup — “DOG”. Get it? That name was the result of a group family effort. And it should serve as a cautionary tale. Never outsource a long-lasting naming decision to other people—no matter how much you love them.

His real name — the one I prefer — is ‘Orion’, a particularly genius nod to the Siamese cat in the first Men in Black movie. In Men in Black, it is ‘Orion’ who carries the whole of the Orion galaxy affixed to his cat collar. (He’s the ‘MacGuffin’ of the whole movie.) In real life, Orion mostly responds to ‘Kitty’, although, now, being mostly deaf, he only responds to exaggerated hand-gestures and his infrared perception of perfectly heated sleeping concavities (i.e. laps).

Jasmine and Samantha cuddling young Orion.

Now, on to the dogs. (I love cats; but let’s face it… they don’t really need human interaction.) My dogs were named Lindy, Scooby, Snickers, and Maggie.

I had a hand in picking out each of these dogs from the time they were pups—meaning three exciting trips to the animal shelter, where seemingly life-and-death decisions were made. Taking only one puppy felt like leaving the rest in a state of peril — at risk of being “put down.” Even on the last trip, to the Collie breeder in Kenansville, we had to choose between one of the two females, all very likely to be adopted. Maggie was picked, on the spur of the moment, in large part because she had an easy-to-identify spot on her tail. If not for that black spot, another dog might be ‘Maggie’ right now.

Lindy’s story

My father and I picked up Lindy at the SPCA in South Raleigh, and she was named for a residential street (Linden Street) that we passed by on the way home. She was believed to be part beagle and part fox terrier.

Lindy and me - circa 1979.

She was a great source of solace following my father’s death, and she was a wonderful dog. She naturally became immortalized in cyberspace, as her name served as my primary computer password, for years and years.

Lindy, beside an incandescent lamp. 

Although I helped pick Lindy from the shelter, she ended up living with my Mom when I went to the School of Science and Math, and then to college. I didn’t see much of Lindy in her later years.

Lindy and Mom - circa 1979.

Snickers’ story

Snickers was a beautiful puppy, with the Merle colored markings of an Australian Shepherd, and the black and brown color of a Snickers bar, from whence she got her name. She had the energy of a herding dog — often nipping at our heels — and much was required to burn off that excess mischievousness.

Snickers was our dog when we were both working full-time — me, at Garner Family Practice, and Dianne, at Duke Clinical Research Institute. While Dianne and I were working, we often sent Snicker to “Doggie Day Care” to make her a little less rambunctious. Unfortunately, in her youth, Snickers suffered fractures to both of her front legs, when she leapt after a tennis ball, and over an embankment, onto the asphalt parking lot below. Although she recovered from the injury, after surgery at the NC State Vet School, she was a little more temperamental than our other dogs until the day she died.

Samantha and Jasmine wrangling Snickers.

Scooby’s story

Scooby is the dog that I remember most fondly. She was adopted by Dianne and me around the time we were engaged. It may be cliché, but she was our first baby. We picked her from a skittering litter of puppies — from a playpen at the animal shelter north of downtown Chapel Hill.

At this time, Dianne was living in an apartment complex in Carrboro with her roommate, Barb, and her roommate’s huge, cuddly part-Malamute dog, named Otis. So… Scooby came back to a two-bedroom apartment to live with Dianne, Barb, and Otis, with frequent visits by me and my cat, Salinger. There was no shortage of play and affection during her puppyhood!

Scooby was a “Collie mix”, but she was mostly white and tan in coloring, and a bit taller than a true collie or border collie. However, like a well-trained herder, she liked to go about 15 feet ahead of us on a walk, then turn sideways and look back to check on our progress. It was quite normal for her to keep tabs on our whereabouts, wherever we were.

She traveled with us from Chapel Hill to Pittsburgh, where I bitterly remember taking her for rather short, brisk walks in the winter, down an unevenly paved alleyway near our back door, left onto a side street, and then back to our house on the corner of Beechwood and Wilkins. This walk was particularly unpleasant — nay, impossible — on the day we had a snowstorm that left 24 inches of snow. On top of everything else, this walk was often in the dark, before or after a shift at the hospital where I was working more than full-time, during residency.

But her life wasn’t too bad — too housebound. We sometimes took her to Frick Park, where in the pre-internet days, we somehow heard of an unleashed doggy play-time in the park. (Some of our first dog parent friends were a neurologist and her husband, who owned a playful Dalmatian.) This play time was our first introduction to group dog play, and to the unique — sometimes eccentric — character of various pet owners.

It’s kind of amazing that the dogs were allowed to play unleashed and unfenced in a section of the park. It gives you an idea of just how expansive Frick Park must be, to allow a whole section to be dedicated to free dog play. There must have been a lot of people who had to rethink their walking path, when they saw all the dogs frolicking on the hillside.

Scooby followed us to Columbia, South Carolina, where our most common walk was around the pan-flat streets of our suburban neighborhood. It was on the outskirts of town, about a mile from Fort Jackson, where it wasn’t unusual to here the sounds of artillery exercises.

We also would go for a walk at Sesquicentennial Park, where the sandhills of the Carolinas can only support the growth of the aptly named Scrub pine. (I don’t think any pine tree is particularly majestic; but the scrub pine is distinctly unmajestic in comparison to the Longleaf pine or the Loblolly pine.)

Scooby was the unwilling nanny for our twin girls when they were born in 1994, and she must have given me many a forlorn look while I was feeding sugar water to Jasmine, or changing the position of the “Bili-blankets” on both of our early arrivals.

From Columbia, we moved to Sanford, in North Carolina, and an aging Scooby frequently joined us when we went to play volleyball on the sand courts at OT Sloan Park. And then to Cary where we played on the broad, grassy field at Lake Crabtree County Park, near RDU. Jasmine and Samantha were often nearby, in a shared, teal-and-baby-blue playpen. I don’t really know how we got through a game without interruption, but somehow it worked. More than likely there were interruptions, but if there were, our volleyball friends never seemed upset. Those were good times.

Not long before Scooby passed away, I decided to take her with me on a trip to the Outer Banks. I think we went from lighthouse to lighthouse (Currituck, Bodie, Hatteras, and Ocracoke), getting some nice photographs, and basically spending some time together to enjoy the smell of the salt water on the ocean breezes, and the feel of the sand beneath our feet and our paws.

She had to be euthanized shortly after that, and thankfully she died in our company, surrounded by her loving family. As she was quietly sleeping, from a sedative, the veterinarian gave us the room. I pushed the final dose of medicine, and as she stopped breathing, I lost my composure, and I felt hot tears rolling down my cheeks.

Dianne and I remembered the excitement we had when we picked her out during college, years before, when we were still young and foolish. In contrast, by the time that Scooby died, we had full-time jobs, children, and responsibilities. We had gone through the hardest years of our parenthood. And we had been through the wringer with medical concerns (including major surgery). We had grown up so much during Scooby’s lifetime that she was hard to let go. We’ll never forget the magic of the “Scooby years”.

Little Scooby in her pink collar — keeping a close eye on me.

Maggie’s story

If we hadn’t chosen Scooby at the pound years before, we might not have chosen Maggie years later. When I retired, in 2019, I made a list of the things that I might do with my time, and after six or more years without a pet, I thought retirement might be the perfect time to give a dog the proper amount of devotion — walking, training, and playing with them all day.

Dianne and I debated the merits of various medium-sized dog breeds, and given our experience with the “collie mix” we had before, we decided to see what a full breed collie had to offer. I think it’s fair to say that Maggie exceeded our expectations, being the most affectionate, obedient, athletic, and beautiful dog we’ve ever had.

The only downside is that everyone of a certain age has a story about a collie that they knew as a youngster. And they want to tell you about it!

She is the smartest dog, no doubt — so smart that we often have to figure out who is playing mind games with whom. Are we training her, or is she training us? I’m sure it’s a little of both… but, you know what… I’m Ok with that.

Maggie’s story isn’t done, and our story isn’t done, either. She hasn’t seen us through the kind of trials and tribulations that our other pets have. She hasn’t suffered from an injury or absence or neglect. Perhaps you could say she is pampered — living the life of Reilly, so to speak — but that’s probably for the best.

After a while, the challenges… the vicissitudes of life can be exhausting. After a while you just want to sit down on the side of a chair and rub the really soft curly fur behind your dog’s ears, or laugh at her expression when she does a head tilt of bewilderment (like when your wife is screaming at the Washington Redskins defense), or just reach a Zen state of mindfulness as you and your dog walk along a wandering path, a path into the woods, filled with tall loblolly pines.

Steve and a young Maggie at a brewery in Durham.

All About Me: A Timeline

{From Graduate to Practitioner}

This little timeline was created while I wrote my story Love at First Spike. I thought it might become a prelude to the story, illustrating how chaotic life was for me around the time that I went to UNC (and met Dianne). However, that became part of the problem—it was all about me, when the story was meant to be all about my future wife, Dianne.

So I removed this background information from the love story, where it had no proper place, even as a sidebar or an appendix. Instead I put it here for those of you who might be interested in my meanderings after graduation from NC State with a degree in Zoology, a degree which prepared me for little else but to apply for a more advanced degree. You’ll see that my wanderings took me all over tarnation, mostly as a resident or a transient in someone else’s house or apartment (or on-call bed). Somehow I emerged as a respectable, employable young man in a noble profession. Maybe someday I’ll write about it all.

Ripon (Summer 1986)

After graduating from NCSU, I go on a work exchange program to work at Lightwater Valley Amusement Park — preparing English lads and lasses for borderline dangerous rides, drinking dark malty ale in pubs, eating at kebab and fish ‘n’ chip stands, and living in Ripon, North Yorkshire, in England. I hitchhike through the Yorkshire Dales, the Lake District, and Scotland, before traveling from Edinburgh to Paris, and then Amsterdam for a flight home.

Raleigh (Fall 1986 - Winter 1987)

I return home to Raleigh, but live in an apartment with Srini Iyengar and his wife and stepdaughter. (Srini is my best friend from Alexander Dorm at NC State, and he has married while I was away.) My mom has sold our house on Wayland Drive, and moved to Stanley, Virginia, to take care of her parents. My brother is busy attending the NC State College of Veterinary Medicine. I work in the deli department of the Harris Teeter in Glenwood Village, while completing my application to medical school. Later I move to a room that I rent on Daisy Street, which provides greater privacy.

Raleigh (Summer 1987)

I am (surprisingly) hired to work as a pool manager at Biltmore Pool in Raleigh, while I’m on waiting lists for three medical schools (Duke, U. Va., and Emory) but I haven’t been accepted by any of them at the time of my fifth NCSSM reunion (July of 1987). Things are not going according to plan, and I feel like a bit of a failure, for an alumnus of the first class of such a prestigious school.

Durham (1987-1988)

I breathe a sigh of relief when I am accepted by Duke University Medical School, and begin the first year of basic science classes that include Anatomy, Physiology, Pathology, and Pharmacology. Most of my time is spent taking notes in a dark auditorium. Everyone is smart and ambitious. My love life is nonexistent. I am living with two other male students (who I never see) in a house near Morreene Road in Durham, within biking distance of the hospitals.

Durham (1988-1989)

After frighteningly brief instruction in how to perform a complete physical exam and create a differential diagnosis, we are let loose on the wards in our second year. Clinical rotations include Internal Medicine (at the Durham VA), Surgery (holding retractors), OB-GYN (cervical checks and no sleep), Psychiatry & Child Psychiatry (with oppositional-defiant adolescents), Family Medicine, and Pediatrics (subjecting me to repeated URIs.). My brother was diagnosed with manic depression during this year, and I also go to therapy, myself. It is a year of caffeine-fueled hospital rounds at an inhuman pace, learning to give the perfect nutshell patient presentation on rounds, after pre-rounding at 5 or 6 in the morning, going to bed well after midnight, after completing exhaustively researched medical notes in the patient chart that no one ever reads, and being under constant stress.

Chapel Hill (1989–1990)

I opt to apply for the dual MD/MPH program, so that I can spend the year at UNC instead of at Duke. It’s a little bit like going on a Study Abroad program, leaving Durham for a sabbatical in Chapel Hill. I almost instantly regret the decision because we are writing paper after academic paper, and doing team projects where my independent spirit is quashed. But there are good things too. I enjoy the focus on healthcare policy and implementation. I enjoy Chapel Hill and Carrboro. I have time for volleyball and a life, and I meet people, who find me both interesting and even attractive. I am living with my cat, Salinger, in a room on McAuley Street, only a block from Rosenau Hall. I also spend some time working at Vine Vet on Franklin Street as a vet/kennel assistant.

Tempe (Summer 1990)

I go to Arizona State University in Tempe, Arizona, to work on my Maternal and Child Health Master’s paper with a preceptor, who is researching the primary prevention of childhood psychopathology. My paper, on the history of research on the psychological vulnerability of children who have lost a parent, is little more than a summary regurgitation of the research that has been done to date. Both my UNC advisor and I agree that it is unacceptable. My master’s degree is still incomplete. On the plus side, I have spent the summer listening to NPR for the first time, because it was constantly playing overhead at the house of the room I was renting in Tempe.

Durham (Fall 1990)

I must complete a semester of basic sciences at Duke, before resuming clinical rotations. I take a class in Medical History, which is an apprenticeship deep in the bowels of the Searle Center basement, where rare and dusty books are gathered under the purview of a crusty modern day monk with a penchant for primary sources. Another class, on Epidemiology, gives me firsthand experience with clinical research using modern technology (computers) to perform secondary analyses of data using SAS. Although I have a private room in west Durham to keep my stuff, mostly I’m driving back and forth to Carrboro, to see Dianne during this time.

Durham (1991)

I take my senior-year clinical rotations which include Cardiology, Gastroenterology, Emergency Medicine, and more Family Medicine rotations, but my memories of these rotations are hazy. Somehow I got married in Falls Church, Virginia, in the middle of the year, and in the middle of rotations. I move in with Dianne (and Scooby) in a duplex in Woodcroft, in south Durham — a real home, at last! Somehow I graduate from Duke University Medical School in December, 1991.

Durham (Spring 1992)

I have roughly six months of gloriously free time to complete my master’s paper (second attempt), for the department of Maternal and Child Health at the UNC School of Public Health. It is a paper on the potential benefit of secondary analysis of emergency room data. I don’t remember anything else, but my Epidemiology course at Duke laid the foundation for the topic, and helped me close the deal. My paper is approved, and I am granted a master’s degree. Dianne also graduates with a master’s degree in Biostatistics.

Pittsburgh (1992-1993)

At the medical residency match in June, I am offered a spot in the Transitional Year residency at Montefiore Hospital in Pittsburgh, Pennsylvania. Dianne also finds a job at the Biostatistics Department of the University of Pittsburgh. We are awestruck as we drive through the Fort Pitt Tunnel, below Mount Washington, and over the Monongahela River toward the lights of downtown Pittsburgh. We move into the middle floor of a three-story house on Beechwood Boulevard in the Shadyside neighborhood, near Squirrel Hill and Frick Park. A year later we are moving again, but we have fond memories of our year in Pittsburgh.

Columbia (1993-1995)

After interviews in Pittsburgh, PA; Worcester, MA; and Albuquerque, NM, I fail to match to any of the residency programs—mostly due to my indecision on whether to pursue a career in emergency medicine or family practice. Ultimately, I accept an offer to join the family practice residency at Richland Memorial Hospital in Columbia, South Carolina (where my mother was born and raised), and we move back to the South. We are living so close to Fort Jackson that we can hear the artillery exercises. In 1994, we discover that we are having twins on an early ultrasound. They are delivered in November, and our lives are changed forever. Six months later, we are moving back to North Carolina with two toddlers. I begin my career in Family Medicine at Sanford Medical Group, while Dianne works first for UNC and then for Duke at the Duke Clinical Research Institute (DCRI).

Love at First Spike

{Prompt: What was your first impression of Dianne?}

Dianne and I have been married since 1991. Still, even now, from time to time, we will meet someone at a party (or a dinner party) who will ask, “So… how did you meet?”

Dianne will light up with excitement because the story of how we met is one of her favorites, and it involves her all-time favorite activity, volleyball. It even has a sort of tagline, which is the first line of the story — “It was Love at First Spike”.

Before I tell the story, let me tell you what is pretty self-evident when we’re both in the room. Simply this. There is a slight discrepancy between her height and mine. I am 6 feet tall, and Dianne is about 5 feet 4. I can almost touch the top of a volleyball net while standing flat footed, while she can barely reach the top of the net when jumping. (Sorry, but it’s true.)

After all, she’s a setter. Her job is to move laterally — scrambling all over the court to track down errant passes, and lob them up in a perfect arc (with zero spin) to the waiting hitters.

My job is to move vertically — jumping high above the net (I wish), and spiking the perfect set down into the other court—preferably leaving a dent in the parquet floor and blockers, weeping in anguish.

Now back to our story. It goes something like this, as Dianne tells it. (Once more. From the top.)

“So… how did you meet?”

“Well…” Dianne says, “…I know Steve has heard this a lot, but…” glancing at me, “…It was love at first spike!”

(Pause for effect, while laughing.)

“See, we were both at UNC…”

“UNC-Chapel Hill,” I clarify, helpfully. “At the School of Public Health…”

“We both went to a volleyball game at the gym…”

“A pick-up game. At Fetzer Gym. It’s the student gym on campus…” I interject.

“We had never seen each other before…”

“Well, that’s not completely true…” I feel that I really must object.

“Well, I had never seen him before.” Dianne says while giving me a cautionary look to hold my tongue. So I stop interrupting.

“So… anyway… we were playing volleyball. I’m on one side of the net, and Steve is on the other side. I hit the ball, and Steve tries to block it. It glances off of his fingers and goes out of bounds. Ha!”

“Next time, the ball came to him, and he tried to spike it on me. [Eye roll, meaning “Can you believe the nerve!”]

“Well, I jump up and put my hands up to block, even though my hands are barely over the net. And he hits the ball down — right into my hands! And the ball popped back over the net and landed at his feet. Aha!”

“Love at first spike.”

“We started going out, and we’ve been together ever since. Thirty-something years.”

This is where the story ends, and we start doing the math in our heads, trying to figure out how long we’ve been married.

Dianne and I with a Volleyball - circa 1989

It’s a pretty good “meet-cute” version of our introduction to one another, on and off the court. First as adversaries, and then as teammates. If a rom-com movie is ever made, please use it. And for the most part that’s what really happened, although, to be fair, we played for several hours and I had a few good plays of my own. Some of the retellings—of serves, spikes, digs, and dinks—had to be sacrificed for the sake of brevity and amusement.

In essence, although I played decently well in my own right — well enough to show promise — Dianne outwitted me and outplayed me at the net — not just once, but twice — and she did a little victory dance right in front of me each time, which kind of made me fall in love with her.

My First Impressions

But it wasn’t really the first time I had seen Dianne. I had noticed Dianne several times before, at the UNC School of Public Health, where her department (Biostatistics) and my department (Maternal & Child Health) shared space on the third floor of Rosenau Hall.

I noticed her because:

A) she was (and is) beautiful,

B) she was not from “round these-here parts”, and

C) she was a dynamic bundle of energy and activity.

Dianne Shihadi - circa 1990

I had even learned her name - “Dianne Shihadi” - from the posted page of class photos on the bulletin board for the department of Biostatistics. But I had never met her until we met on the court in that legendary game.

A mutual friend introduced us either before or after the game, and we got to know each other a bit for the very first time. Not much later, we went out to “pepper” the volleyball on a grassy field at West Point on the Eno, a park in Durham.

We hit it off and saw each other with our friends, or at “the Trailer” where Dianne was often working after classes. It wasn’t long before we had our first date at an Italian restaurant near the Weaver Street Market in downtown Carrboro. So we kept spending time together — playing volleyball at Fetzer Gym, or going out for dinner at Pepper’s Pizza, on Franklin Street, or meeting up at her apartment at Ramsgate, in Carrboro.

I already knew that Dianne was dynamic, athletic, and competitive. I came to find out that she was also outspoken, unfiltered, and honest. She left an impression on everyone she met, and it was usually a good impression. She was hard to forget. She always said what she meant, but said it in a spirit of good humor and goodwill. She just said things without thinking twice.

Over time, I also came to find that she was caring and loving. She cared about her friends at school; her family in Maryland (cousins and all); her roommate, Barbara; Barb’s dog, Otis; me and even my cat, Salinger (the little psycho).

Before you knew it, we were spending all of our time together, and I began to see how impetuous she could be. I half-jokingly asked if she had any interest in riding in a 150 mile charity bicycle ride in New Bern — the MS150 — and she agreed! That is another story, for another time.

Two impetuous cyclists— Dianne Shihadi & Steve Gallup

I once returned from a road trip to Miami (with my brother) to find her hair completely permed (nearly as tight as the Orphan Annie on Broadway). I barely got over the shock of her new perm before she gave me a long, dramatic hug, saying she was so happy to see me, and she was lucky to be alive. On her way to see her family, she had spun out on Interstate 95 in Richmond, passing out in the process, yet waking up unscathed. She had had a near-death experience. I didn’t know what to say. I was thinking, “What have you done to your hair?”

Barbara (Baldwin) and Dianne (Shihadi) - college roomies

She had another experience driving back to Chapel Hill, in her Acura Integra, along Highway 52 near Pilot Mountain (returning from a volleyball tournament). She was given a speeding ticket for driving more than 15 miles over the speed limit. (That Acura was a bit of a magnet for attention and trouble, with its race-car design and its spoiler.)

She was complaining to me about having to make an in-person appearance at the Surry County courthouse. Little bells went off in my head that this could be more serious than she imagined, so I offered to ride up to Surry County with her.

I’m not doing the story justice, but to make a long story short, at the courthouse she had come to an unwritten agreement with the prosecutor to plead “nolo contendere,” (and put off punitive action), but the court was so busy that some of the cases were sent to another courtroom with a different prosecutor. He refused to accept the plea, saying that 15 mph over was just “too fast… way too fast.” And consequently, they yanked her license… on the spot.

I think that’s the first time I saw a bit of the righteous anger, lurking beneath the surface of her gentle exterior. She went on a bit of a rant — at the injustice — outside the courtroom, but ultimately complied with the laws against reckless driving, and turned over her license… for the next 6 months! Fortunately, I was on hand to “save the day,” and give her a ride home (probably my first time driving her Integra) so it was a lucky day for me.

Getting Engaged

Within a few months, we were so close, and so in love, that I asked her to marry me. But she didn’t say yes right away. At least in this regard, she was not too impulsive. She waited a few weeks before she agreed to my proposal, and then, still, with some trepidation.

I didn’t know why she was so hesitant at first. But it became apparent after an ill-fated call with her father, when she tried to make plans to go back up to Maryland for a visit (a chance for me to ask him for his daughter’s hand in marriage, and his blessing). Mr. Shihadi asked why she was coming home. And she equivocated. And then he insisted on a reason. It seemed that she had to admit that we were not only dating, but also talking about marriage. I would judge that the rest of the call went rather badly, as she recounted the altercation to me in tears. The problem, essentially, was that I was not Middle Eastern.

Of course, our marriage was eventually approved. Dianne says that he changed his tune a little when he found that I was going to be a doctor. I had always intended to ask Dianne’s father for her hand in marriage, as traditional and misogynistic as that might be, but I never really got the chance to do it properly. In fact, the whole process of our engagement was a bit of a mess.

One of our engagement photos

Aside from some family drama, our time in Chapel Hill (and Carrboro) was really magical. We were going to graduate school, which was admittedly hard, but we had so much fun at Dianne’s apartment in Ramsgate that the hard times were mostly forgotten.

We enjoyed Pepper’s Pizza and Ben & Jerry’s on Franklin Street. We walked around the UNC campus to places like the Pit and the Old Well. We went to a basketball game and a few concerts. (Mia Hamm and Kristine Lilly were winning multiple women’s soccer championships, at the time, but I think we only ever saw one women’s soccer game.)

We went to the SPCA on North Columbia Street to look at puppies and came home with an adorable blonde Collie mix that Dianne named “Scooby”. Little Scooby and gigantic Otis (a Malamute mix) became close friends and playmates. And Scooby was such a good dog that she inspired us later to go out and get a purebred rough-haired Collie that we named “Maggie”.

Steve & Dianne with Scooby (and Dianne’s Integra)

From Romance to Reality

But all good things must come to an end, and before we were married (June 1991), I had to return to my life as a medical student and complete my medical degree at Duke University.

One night I didn’t come home, and Dianne couldn’t figure out where I was. She must have called and I explained that when I said that I was going to be “on call”, that meant that I would actually be spending the night in the on-call room in the hospital, praying for a little bit of sleep between high-pitched beeping from my pager. (I had to carry a pager on my belt for about the next 10 years — before the advent of cell phones.)

Another time, before we were married and while I was still at Duke, I returned to Ramsgate to find Dianne lying on her couch, in the living room barely able to sit up. She was weak and sick. I knew that she had been dealing with a GI illness, but then she told me that there had also been some GI bleeding. She was dehydrated and anemic.

She had been to the UNC student clinic several times, for the usual diagnostic tests for an acute condition, but that night we went over to the N.C. Memorial Hospital Emergency Department where more extensive testing gave us new insights. X-rays of the colon showed the quintessential “lead pipe” sign of ulcerative colitis (UC). I saw it myself.

Subsequent treatment for ulcerative colitis resulted in a remission. But that was just the beginning of our odyssey in living with inflammatory bowel disease. (Although a biopsy confirmed ulcerative colitis, we later came to learn that she had Crohn’s disease, or a hybrid of the Crohn’s and Colitis.)

The story of Dianne’s life with Crohn’s disease has the makings of an epic, and it’s too long and gruesome to tell over cocktails, so I don’t think it will ever make it into a Hollywood rom-com. The real story is how she has survived the ordeal, persevering to have a full career in clinical research, raise twin daughters who still join us for family meals, and go on globe-trotting adventures with me, even after I played so badly as a beach volleyball doubles partner so early in our marriage.

We went on to play many games of volleyball together. We were teammates, fighting for that elusive championship T-shirt, in the Sanford (or Cary) city league, and fighting over who should receive or pass the ball in pick-up sand volleyball games.

I love you Dianne, but that last ball was yours, not mine. :)

 A candid moment - circa 1990 (T.C. Pate’s house?).

The Life Aquatic

{Prompt: What was your best boss like? What did you learn from them?}

The Telemetry Ward

In 1994, I was a family practice resident on a cardiology rotation at Richland Memorial Hospital, in Columbia, South Carolina. I was getting paid to care for unassigned patients in a teaching hospital while increasing my exposure to and familiarity with different medical problems—cardiology problems in this instance.

A few weeks into the rotation, the cardiology team was doing rounds on the telemetry floor — a floor where every patient was wearing a heart monitor for one reason or another, and the heart monitor readings and waveforms were displayed in real time at the nurses’ station.

The attending cardiologist, who had been assigned to lead the inpatient cardiology team (and be on-call with them for the month) decided to hold rounds at the nurses’ station, in the midst of those telemetry monitor displays, with the residents (including me) and the medical students.

Rather than marching from room to room, we were sitting at one end of the hall, behind the station counters, looking out on bare tile floors and sterile vinyl walls, lined by pastel-colored handrails and door trim. The smell of disinfectant and the muted sound of EKG monitors surrounded us.

I was preparing to provide my update on a young patient, who had been admitted for suspected endocarditis, but I was distracted by the heartbeats… her heartbeats… that were displayed on one of the telemetry monitors right beside me.

There were many premature ventricular contractions (PVCs), but that wasn’t unusual. It was more disturbing to see fairly frequent runs of ventricular tachycardia (V Tach) — four or five beats at first, but then, even longer runs.

…And the time her heart stayed in a normal sinus rhythm was dwindling.

…And there were pauses between the runs and between the sinus rhythm that were even more frightening.

I felt a knot in the pit of my stomach — a sinking feeling as I was thinking, “$#!t, that’s not good.”

I wasn’t worried about my case presentation anymore. That was the least of my worries. I was worried for my patient’s mortality.

“Dr. Roberts. Would you look at this?”

PVCs… sinus pauses… V Tach scrolling across the screen.

“What’s up?” We look at the monitor together.

Longer pauses… erratic waveforms… ventricular fibrillation scrolling by.

“My patient…”

A period of asystole.

“She’s in asystole.”

We look at each other. A beat. A moment of hesitation.

He says, “What are you waiting for?”

“…GO!”

So I ran off down the hall. As I ran by, I yelled for the nurse to call a “Code Blue” — a code for cardiac arrest.

I ran into my patient’s room and gave her a precordial thump.

I started CPR. At least, I think I started CPR. I think I entered a fugue state in which adrenal took over and secondary processes (like my memory) were overwhelmed.

At some point, a crash cart was brought into the room.

At some point a bag valve respirator was used to give rescue breathing.

At some point, chest compressions might have been administered.

Perhaps none of those things occurred, and her heart beat spontaneously returned. The point is that I was spurred into action by my supervisor’s directive, but my actions were wildly chaotic and poorly executed… and still, somehow, the patient survived.

My First Red Cross CPR Course

I first took CPR ten years before the incident on the telemetry ward — in 1984. I had to take it to become a lifeguard. But even before taking CPR, I had taken Advanced Lifesaving, at NC State University. I took it in 1983 as a sophomore, probably to prepare myself for a better job — better than a morning paper route or fast food work.

Since I successfully passed the lifesaving course, I applied for a summer job with the Raleigh Department of Parks and Recreation, and I was hired to work as a lifeguard at the outdoor pool at Pullen Park. (Sidebar: Now, that pool has been filled in, and there is an open space next to the carousel for small events and gatherings. I went to a community drum circle event there in 2024.)

As part of the job, we were required to take the American Red Cross class in Adult and Pediatric CPR. The course was taught to the group of us — incoming lifeguards for the City of Raleigh. We had our first introductions to Resuscitation Annie, and our first introduction to the adrenaline rush that occurs when you are called to perform, in public, those skills that you’ve been reading about and have memorized for the occasion.

We also went through the more specific drills required for resuscitation of a drowning victim, and the skills required to manage a patient with a broken neck (such as might occur from diving into the shallow end of the pool).

That’s probably the first time I met my upcoming “boss”, my supervisor, Terri Stroupe. She was the Parks and Rec employee — a Pool Manager for Pullen Park Pool — who was giving the instruction that was specific to being a lifeguard. She taught us everything we needed to know to put these lifesaving measures into action.

Terri Stroupe (standing, on the right).

She went through the process of how to give resuscitation breathing to the drowning victim… while still in the water, if necessary.

She taught us how to move an unresponsive victim from the water to the side of the pool, and then from the side of the pool to the concrete surface—things that are not easily done with an unconscious person.

She taught us how to move the trauma victim from the surface to a backboard, while cradling and restricting the neck from even the slightest movement, until the head and neck could be strapped in between two bright orange cushions and stabilized for the arrival of the paramedics.

We also learned to use the “Jaw Thrust–Chin Lift” maneuver (for CPR), instead of the standard “Head Tilt” maneuver, in any case of suspected neck trauma, to keep a bad situation from getting worse.

Working at Pullen Park Pool

Terri was young, nearly as young as I was — only a few years older than me, at best. She loved to swim, and she was usually wearing her navy blue City of Raleigh lifeguarding swimsuit. Sometimes she was wearing khakis and a City of Raleigh short-sleeved golf shirt with the Parks and Recreation logo.

Even though she was young, she was confident. She seemed so sure of the procedures, and so in-charge of the proceedings, that later, when the pools opened and she took on the role of pool manager (instead of instructor), her oversight and management seemed like a natural progression.

She supervised not only the vital roles we had to fulfill (like lifesaving), but also the mundane roles: enforcing the safety rules, patrolling the locker rooms for trouble, collecting entry fees, and maintaining the pH balance and chlorination of the pool water.

Teri was friendly and approachable. The job under her tutelage was so chill and interactive, it was easy to relax. As lifeguards, we sat and watched the social dynamics of school-age kids at play, younger children learning to swim, or parents blowing bubbles to their babies.

The “Baby Pool.” (Benches for “Spectators” in background.)

We spent the hours sitting in an elevated chair looking for trouble, shaded by an umbrella, spinning the lifeguard whistle on its lanyard, first clockwise, then counterclockwise — back and forth as the minutes ticked away.

Or we walked around the perimeter, looking out into the pool for any signs of potential mishap, or back around the edges of the pool deck for any transgression of the rules.

“Shallow End” of Pullen pool (“Deep End” beyond the bar).

Or we took a break and got to relax inside the cool shelter of the pool offices, chatting with the pool receptionist and cashier, or chatting with the manager… chatting with Terri.

The only downside of working at Pullen, at that time, was the incessant jangle of recorded music playing (at full volume) from the Carousel, only 50 feet away.

“Deep End” of Pullen. Locker Rooms & Carousel in background.

It was an otherwise idyllic summer job. Even the merry-go-round’s music can be remembered with humor. But we didn’t just sit around. We did save people. I never did put notches on my whistle, but I’m sure I kept at least five people from requiring the CPR that I had learned to perform. And no one had to be strapped onto a body board.

On one occasion I was walking the perimeter, and I had stopped to chat with Terri about nothing in particular. We saw an older boy who was trying to swim from the edge of the pool to the metal bar in the middle. (Yes… a metal bar. Almost any pool these days would use a row of buoys instead, but at that time, a fixed metal bar, painted bright red, served to separate the deep end from the shallow end of the pool.)

But this boy was in the deep end, and he was not a good swimmer. He was making very slow progress. His arms were low in the water. He was taking big gulps of air whenever he raised his head to breath. He looked like he might not make it to the other side.

I pointed out the boy to Terri and asked if she thought maybe he needed some help. With a nod from her and her agreement, I took off my whistle and dove into the water. It took me only a second or two to reach him near the middle of the pool. As I slowed to offer him help, I kept a distance of three feet, as we had learned (to be sure to avoid any onslaught from a swimmer who might panic).

I think he was happy to see me. He was more than willing to accept a helping hand, and without any fanfare or commotion, I gave him a little support as we made our way back to the side. No need for rescue breathing or CPR.

Our pool was quite busy that summer. We saved a number of swimmers, who came to enjoy the cool water, but were not able to swim, or unable to swim and breathe above the water at the same time.

On one occasion, a big kid jumped off the diving board and tried to make his way back to the side of the pool, while still underwater — swimming in a long underwater arc. That wasn’t too unusual, but this time the kid got disoriented and didn’t reach the side before he ran out of breath. He really couldn’t swim, so when he ran out of breath, he tried to come to the surface. From his ineffective movements — his splashing and reaching for air — it became obvious that he would have to be rescued.

We had already been watching him closely, so it only took a moment for the lifeguard at the chair beside the diving boards to grab the long aluminum hook and extend it out from the edge for the boy to grab. He was pulled back to the side with no need for CPR, but he was not allowed back on the diving boards or in the deep end. But that was the least of his worries. He was more upset and mortified about having to be rescued in front of his friends.

On another occasion, on a very busy day — maybe even the Fourth of July — a smaller child got into water that was literally over her head. She must have been about 3 foot 6, because her head was below water that was exactly 4 feet deep. She was bouncing up and down, every few seconds, off of the pool bottom, to come up for air.

She was only a foot from the pool’s edge (a kind of blind spot for a lifeguard, because, normally, we are looking toward the middle of the pool, away from the edge). I consider it a miracle that I noticed her at all because there was no spectacle —no frenzy or evidence of panic. She was simply hopping up and down, trying to get a sip of air, and stay alive.

All I did was reach out and pull her to the side. I guess we found her parents to make sure she would stay in a safer area. Maybe we offered to sign her up for swimming lessons. It was probably the most anticlimactic save you could think of. But life-threatening conditions can be harder to spot than you might imagine.

A view of the iconic “Island” in Pullen Park pool on a busy day.

Working at Optimist Pool

There was virtually no danger of a drowning at Optimist Pool. At Pullen Park Pool there were many who waded in, or jumped in, not knowing how to swim, or swim well. In contrast, I feel sure that everyone at Optimist Pool, which was located in a wealthier part of Raleigh, knew how to swim, and swim well.

“Master’s” swimmers (Working or retired adult senior citizens) got up early in the morning to swim laps at Optimist. Swim teams from the nearby high schools trained at this Olympic-sized pool. And there was no playing, or virtually none, at Optimist. There certainly was no horseplay. Rules were rigidly enforced.

Optimist Pool had a “bubble” — an inflatable plastic dome, which allowed it to remain open all year-round. Optimist Pool is where I went when Pullen Park closed for the season. I was taking shifts in the morning, while taking my college classes in the afternoon. Not every morning, mind you. I was only working part-time. Nevertheless, I spent a number of mornings in the fall of 1984, trying to get up at some god-awful time, drive across town (from my NCSU dorm to North Raleigh), and open up the pool for all those early morning swimmers.

A picture of Optimist Pool with its modern “bubble”.

This job was no fun. There was usually only one or two lifeguards on duty in the Fall and Winter at Optimist. There wasn’t much opportunity for socializing. The job required some cleaning of the locker rooms — moldy and rank. The floating lane lines had to be unrolled and pulled across the pool. That meant that you had to get wet to pull the lines across, with no summer sunshine to dry you off. And the need for attentiveness was virtually nil, as everyone could swim. This was not the dream job that I had enjoyed for the summer.

Terri was no longer my boss, and I had no camaraderie with my new boss… whatsoever. Honestly, I don’t even remember who he or she was. I wonder if I even saw them in person more than once or twice.

The first time I slept through my alarm to get up and drive to work, I got a rather terse reprimand.

The second time I slept through my alarm, I woke up about a half hour later, looking at the clock with consternation. I dressed in a terrible hurry and drove to Optimist as quickly as possible, cursing my plight all the way down the Beltline and up North Hills Drive. As I arrived to open the doors, the elderly clientele looked on with silent disapproval.

The third time I slept through my alarm, I was unceremoniously fired.

Honestly, I was thankful. No more frigid drives across town in the dark to cater to Raleigh’s needful swimming elite. That was my thinking.

I figured that was the end of my career in aquatics.

Study at Home and Study Abroad

I wasn’t too concerned about my water safety career. I was deep into my sophomore and junior years at NC State in a pre-med degree, taking courses that included biochemistry, genetics, physiology, microbiology, and histology. I packed 1984 with tough classes filled with Zoology degree requirements because I was planning to go off on an international student exchange. There, I would take nothing but electives — pass/fail courses of little consequence. And I was certainly not planning to work while I was away. In 1985, from March to November, I attended Flinders University in Adelaide, South Australia.

When I returned, I completed my degree, and I received my diploma, but while I was technically still a student, in the summer of 1986, I went overseas again, on a work exchange program. I took a summer job at Lightwater Valley amusement park in North Yorkshire, in England. I didn’t think twice about applying for an overseas job, since it gave me another chance to travel the world.

When I returned to Raleigh from an exchange program, for the second time, I still had a year in purgatory. I couldn’t go straight into medical school, because I had been unable to take the Medical College Admission Test (MCAT), a prerequisite for all medical school applications in the US. The MCAT wasn’t given in Australia, during my study abroad, so I opted to take it a year later and postpone my entry to medical school. Consequently, I needed to take a job for the year between my college degree and medical school.

I still wasn’t ready to apply for a lifeguarding position. I didn’t know if I even could, after the black mark of my dismissal. And besides, the summer season of 1986 had already passed at the amusement park in England, so I took a job as an assistant in the deli department of the local Harris Teeter, where one of my friends was working.

Working at Harris Teeter gave me a greater appreciation for the range of exotic cheeses and cold cuts, and for the vagaries of customer service, but it also gave me a loathing for the smell of a deep fryer (which I was assigned to clean) and a deeper respect for the dangers of a rotary slicer (which sliced my pinky).

When the time came again for applications for summer lifeguarding positions with Raleigh Parks and Recreation, I was willing to give it another try. Maybe they had forgotten, or would forgive, my history of habitual tardiness.

Working at Biltmore Pool

Well, guess who had become the Raleigh Parks & Rec aquatics supervisor — the one hiring the lifeguards for the summer? None other than my former boss at Pullen, Terri Stroupe.

My chances of getting a lifeguarding gig seemed decidedly improved.

The conversation at the time of hiring went something like this:

Terri - “Hey Steve, it’s nice to see you again.”

Me (optimistically) - “Hi Terri, I’m looking forward to working as a lifeguard again.”

Terri - “Yeah… Listen, I’ve got this opening at Biltmore Hills pool… for a pool manager. I think it would be a good job for you. What do you think?”

Me (befuddled) - “Pool manager?”

Terri - “Yep. Pool manager. You’re older than the other lifeguards. I think you should be the manager.”

Me (confused because she knows I got fired, right?) - “Biltmore Hills?”

Terri - “Yep. Biltmore Hills is a pool over in south Raleigh, off of Rock Quarry Road.”

Me (optimistically) - “Um, okay, I can do that.”

Terri knew I was anxious, maybe even out of my depth. But she was moving up the career ladder, and it seemed like she was taking me with her. More importantly, she needed to find warm bodies to staff and to manage eight or nine public swimming pools across the city. She knew me, and she trusted me. She was willing to give me a second chance.

So she trained me for the job — a crash course in business management. I learned to schedule personnel, enforce office policies, manage cash intake and bank deposits, take care of pool security, create a pleasant work environment, deal with the public, and maintain water quality. Basically, she gave me, and all the new pool managers, a lesson in leadership and accountability.

And things went surprisingly well. The lifeguarding staff was satisfied and responsive. The chemical balance in the water never strayed. Life-saving measures were not required. (In fact, Biltmore Hills was a piece of cake compared to the pandemonium of Pullen Park.)

We organized a swim team for the members of the community. I even had time to swim laps between my essential management duties.

The only difficulty was navigating through downtown Raleigh during rush hour. And on one occasion, we had to call the police to investigate some locker room thefts.

But, as it turns out, I was a pretty good pool manager.

On the whole, my career in aquatics went well, and it could have been an ongoing career. But after three months on the waitlists of the medical schools of Emory, University of Virginia, and Duke, I was finally accepted to the Duke University School of Medicine.

I had to give notice to Terri and the Raleigh Parks and Recreation department, and turn my attention to an even broader expanse of life-saving endeavors.

Life and Death

Working as a medical doctor (or doctor in training), is more like an apprenticeship, and the supervising physicians are changing every month or every rotation (two months). There is relatively little continuity.

Learning medical skills is a process of study, observation, and performance. The mantra of medical school is “See one, do one, teach one.” Although occasionally there is time for true preparation and instruction in the performance of skills and procedures, it is frighteningly rare. I shudder to think of the rather painful lack of skill (or at least lack of patient preparation) with which I placed a number of nasogastric (NG) tubes during my medical residency.

A lot of medical skill came from learning on the job. Sometimes we had to do things that we weren’t sure we could do. Sometimes we just had to do our best, and hope that our best would gradually improve. Sometimes the attending had to say, “Go!” to prompt us into action.

My endocarditis patient ultimately died of her illness. She died after I left the cardiology rotation. Her condition was too grave… her heart too badly damaged… to sustain her.

I did everything I could to aid in her diagnosis… to facilitate her treatment… to extend her time on Earth. I must have done at least six separate blood draws for blood culture testing — an attempt to identify a treatable infection. I studied the treatment options — medical and surgical — that might be beneficial, and I tried to find a solution for a no win situation. I spent time with my patient and her parents, as a liaison with the medical team, and I tried to be a comfort to the patient and family on a professional and a personal level.

Her death was one of the hardest I had to accept in my entire career— a life full of promise, cut short. The futility of our efforts seemed so great. Her death at such a young age seemed so tragic.

And unfortunately that’s the nature of medical practice: trying to fight off death and disease, even though you know that both are inevitable; trying to mix effective therapy, objectivity and productivity, while maintaining compassion and preserving your humanity.

Epilogue - My Medical Career

After residency, I took a job at a group practice called Sanford Medical Group. I built up my proficiency in treating all the conditions seen in a family practice.

Then I worked at a group practice called Garner Family Physicians. I became confident in my diagnostic and therapeutic skills. Ultimately, I left in the hope of having more time to see each patient and provide them with personalized care.

I opened a practice called Village Family Practice of Holly Springs, where I became “self-employed”, working as my own boss… as an entrepreneur. Working without a safety net — making your own decisions and facing the consequences — is the most enlightening work of all.

I paid myself less than I made even as a resident, and I worked harder and longer by working as both the physician and the office manager. I learned a ton about running a business when I had no boss or mentor at all. And I was happy to do all that because of the independence and the feeling of accomplishment.

I took one more job, as the physician and medical director of the UNC Family Practice of Fuquay Varina before I retired. And during that last job, I finally provided some mentorship and guidance for the mid-level providers under my direction.

I think I saved a few lives in the course of my profession. I think I diagnosed a few significant medical conditions. I think I made life—and sometimes death— a little easier for a few patients.

I had a lot of encouragement along the way. Many physicians passed along their knowledge and their experience. Many doctors inspired me to take action — to put my heart into the practice of medicine.

But even before I got into medical school, when I wasn’t sure if I even would get into medical school, at least one person had confidence that I had some life-saving ability and leadership potential, and that was Terri Stroupe. She took a chance and she gave me a second chance.

Teri’s radiant smile (off the clock).