Teddy Roosevelt and the Menger Bar

The Menger Hotel in San Antonio dates back to 1859, just 13 years after Texas was admitted to the Union, and 23 years after the battle of the Alamo. With its three-story high vaulted Victorian lobby housing an intricately designed stained glass window overhead, its Corinthian columns and wrought iron railings, its fine antique settees and Colonial Room restaurant, the Menger still holds an old world charm. None of it is more striking than in the Menger Bar itself.

The bar was designed as an exact 19th century replica of the House of Lords Pub in London. It boasts an inlaid cherry wood ceiling, beveled mirrors from France and decorated glass cabinets. A brass rail runs along the base of the bar. To the right, mounted on a stanchion above, rests the head of a huge moose. Photographs of Teddy Roosevelt decorate the walls and the corridor that leads into the hotel itself. Unlike most drinking establishments these days, smoking is actually permitted in the bar. You can even enjoy a fine cigar from the selection on display below the bottles of liquor behind the bar.

It was here that Teddy Roosevelt began recruiting volunteers to serve in the American cavalry unit that fought in Cuba during the Spanish American war. Several photos capture his band of Rough Riders mounted on horseback or posing for a group shot at the top of San Juan Hill.

While seated at the bar with your feet resting on the fine brass rail and the smell of cigar smoke wafting up to your nostrils, you can’t help but think of T.R. and his band of men. The regiment was disbanded shortly after service in Cuba. Roosevelt went on to become President after the turn of the century. He viewed the presidency as a bully pulpit, from whence he chose to preach his philosophy to the American people. Here are a few excerpts from his finer speeches:

It is not the critic who counts: not the man who points out how the strong man stumbles or where the doer of deeds could have done better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood, who strives valiantly, who errs and comes up short again and again, because there is no effort without error or shortcoming, but who knows the great enthusiasms, the great devotions, who spends himself for a worthy cause; who, at the best, knows, in the end, the triumph of high achievement, and who, at the worst, if he fails, at least he fails while daring greatly, so that his place shall never be with those cold and timid souls who knew neither victory nor defeat. “Citizenship in a Republic,” Speech at the Sorbonne, Paris, April 23, 1910

There are good men and bad men of all nationalities, creeds and colors; and if this world of ours is ever to become what we hope some day it may become, it must be by the general recognition that the man’s heart and soul, the man’s worth and actions, determine his standing. Letter, Oyster Bay, NY, September 1, 1903

This country will not be a permanently good place for any of us to live in unless we make it a reasonably good place for all of us to live in. Chicago, IL, June 17, 1912

The President is merely the most important among a large number of public servants. He should be supported or opposed exactly to the degree which is warranted by his good conduct or bad conduct, his efficiency or inefficiency in rendering loyal, able, and disinterested service to the Nation as a whole. Therefore it is absolutely necessary that there should be full liberty to tell the truth about his acts, and this means that it is exactly necessary to blame him when he does wrong as to praise him when he does right. Any other attitude in an American citizen is both base and servile. To announce that there must be no criticism of the President, or that we are to stand by the President, right or wrong, is not only unpatriotic and servile, but is morally treasonable to the American public. Nothing but the truth should be spoken about him or any one else. But it is even more important to tell the truth, pleasant or unpleasant, about him than about any one else. “Roosevelt in the Kansas City Star”, 149, May 7, 1918

In his recent New York Times column A World of Difference, Bob Hebert writes: “We’re now in a ridiculous period in which politicians are concerned about appearing too well-spoken and too intellectual — elitist — as if mangling the language while downing a shot and slurping from a mug of beer were sure signs of fitness for high office.”

Maybe we need a man like T.R. these days too—a man who can lead us out of the morass in which we as a country find ourselves; a man who can once more instill in us as a nation the notion that we are capable of rising to the occasion at hand; a man who can goad us into believing in ourselves once again.

The closest thing to praying

There are many things to consider when you’re sitting at home recuperating from a broken hand and ankle. For instance, there are the leaves. Most of them are down now, forming a thick crunchy carpet in the yard. This year, despite the good fall weather, I won’t be able to do the leaves of course. You can’t rake and bag and heave sacks of leaves into a pickup truck with a cast on your right hand and leg.

At this point I can’t drive either. I can’t take a load of leaves to the local landfill, nor can I drive the six hours to Pennsylvania to visit my good friend and medical mentor one last time.

I emailed him earlier this month to tell him about my hiking accident and tedious recovery. Over the past three months through fits and starts he was struggling to recover from open heart surgery and a concomitant exacerbation of lymphoma. He replied to my extensive narrative with only two words: “Trade you.”

I was thinking about him earlier this week with every intention of writing him again when an e-mail from his son popped into my Inbox this morning. “My father was hospitalized again for spiking fevers. Those abated, but his mental confusion persists. Part of the problem may have been the heavy doses of medication used to sedate him. His mental state currently ranges from confusion to agitation, interspersed with moments of lucidity. They transferred him to hospice yesterday. No one knows how long he’ll last.”

You never know about these things. Although my friend could wax and wane over an undetermined period of time, my intuition tells me that he won’t last long.

Thirty years ago when I was a student and later an employee at the clinic where he worked, he and I became good friends. One of his hobbies was photography; another was flying. On his 30th birthday he invited me to go soaring with him. A small Cessna towed our sailplane up to 3000 feet before my mentor pulled the knob on the instrument panel, detaching the tow line from the nose of the glider, and we began our silent descent through the clouds. “It’s the closest thing I know to praying,” he told me as the air rushed over the long narrow wings just outside the cockpit.

Later he purchased his own airplane, a small Aeronca with conventional landing gear and tail wheel. He would take me up high above the local airport to do acrobatics in the bright blue autumn sky: inside loops, Cuban 8s, barrel rolls and spins.

He also taught me a lot of medicine. He, the established physician, working just a little bit ahead of me, the student. Together we saw the gamut of everything from office-based obstetrics, gynecology, pediatrics, psychiatry and adult medicine. He gave me a long leash on which to learn. I will always be thankful for the solid grounding in general medicine that I received under his tutelage.

Now he lies in a hospice bed faraway in another state, while I’m confined to the few rooms in my second story garret, relying on a set of crutches and a platform walker for support. Over the next several weeks one of us will heal; the other will take his place among those past practicing physicians who now belong to the ages.

Author to speak at Mason Hill caregivers’ conference

Author Brian T. Maurer is slated to speak at this fall’s Mason Hill caregivers’ conference in the Berkshire mountains of western Massachusetts on Saturday, November 01, 2008. Maurer will open his presentation with some remarks on brokenness and healing and hold a workshop for participants on storytelling as a medical art.

For further information on this one-day retreat click here.

Humane Medicine column debuts in JAAPA

Author Brian T. Maurer is pleased to announce the debut of the Humane Medicine section in the October 2008 issue of the Journal of the American Academy of Physician Assistants with the publication of his essay “The practice of medicine: moving beyond the science”.

JAAPA, the official journal of the American Academy of Physician Assistants, currently plans to run a series of articles relating to humane medical practice over the next year. Maurer will serve as section editor for Humane Medicine.

Sitting here in limbo

A fitful night: somehow I just couldn’t get comfortable. I suppose I should have taken a pill for pain, but I had little pain. Sleeping is difficult when you have to wrestle two heavy casts beneath the blankets.

Today the sky is overcast; it looks like rain. I might have guessed as much from yesterday’s high wispy cirrus clouds. Somehow today’s grey morning sky dulls my senses and fogs my outlook.

After breakfast I plug the CD that a musician friend brought me into my laptop and lean back in the overstuffed chair by the bed to listen. Otis Redding laments his lot while sitting on the dock of the bay; an unknown artist spins the sad tale of what happened that fateful night in Amanda’s Café in Sonora; and then suddenly Jerry Garcia’s raspy voice breaks in over the intertwined notes emanating from finger-plucked strings—

Sitting here in limbo, but I know it won’t be long.
Sitting here in limbo, like a bird without a song.

There are times when the mood of a recording artist’s voice dovetails with your own. There are times when the music and lyric of a song resonates with your soul. Perhaps it’s the weather outside; perhaps it’s the season of the year. Perhaps it’s the fact that two of my limbs are resting at my side, temporarily useless, as I sit here in limbo, a prisoner in my upstairs garret.

Sitting here in limbo, waiting for the dice to roll.
Sitting here in limbo, got some time to search my soul.

I sit and listen to the words, gently carried along by the music. I could have written these lyrics myself, so closely can I identify with them.

I don’t know where life will lead me, but I know where I’ve been.
I can’t say what life will show me, but I know what I’ve seen.

Just yesterday a friend e-mailed me the words of the philosopher Giambattista Vico: “One truly understands only what one creates.” Perhaps that is true. Yet today, listening to this song this morning, it seems as though I can understand the very depths of Jerry Stratton’s words completely.

Sitting here in limbo waiting for the tide to flow.
Sitting here in limbo knowing that I have to go.
Well they’re putting up resistance, but I know
that my faith will lead me on.

A view from the window

Today the morning sun defines the brilliant autumn colors of the foliage in our backyard. The remnants of my wife’s flower garden rest in muted shadows below the overhanging branches of the maple tree in the southwest corner. Earlier this morning you could see the burning fires of the tiny wild red roses perched in the white flower pot hanging amidst the gnarled grapevine runners by the back fence. Monet could have done them justice on canvas.

Last week I had a different view outside my window. Through parallel pine branches that bobbed in the morning breeze you could see the far mountains dressed in swaths of fall colors rising up from the far shore of the lake. The lake always mirrored the color of the sky. At first light the lake reflected the grayness overhead; later in the day you could see tiny ripples of puffy white cumulus clouds dancing among the commas of fall colors on the surface of the water. This was the view from my hospital bed on the second floor of the medical center in Saranac Lake.

The anesthesiologist who lived in that area told me that a pair of bald eagles had nested in a tall pine on the shores of the lake the previous spring. If I watched closely, he said, I might catch a glimpse of one of the parent birds hunting high in the air above the lake. Although I had no way of knowing if this were true or not, I had no reason to doubt his word.

The surgeon who put the fractured bones in my right leg and hand back together did not talk about the eagles or the lake. He merely described the surgical procedure known as open reduction pin fixation while I lay flat on my back in the hospital bed. He named the pieces of surgical hardware individually and explained where they would be placed to stabilize the fractures. Like a good mechanic, he practiced his trade well. I was very grateful for his expertise and skill.

But now, looking back with my mind’s eye from where I sit in a chair by the window of my second story bedroom back home—my right leg and arm in bulky casts—I suddenly realize that it was the anesthesiologist who was the poet.

“Notes from a Healer” — An Elephant in the Room

As seasoned clinicians, we’ve all dealt with situations that we’d rather forget. But the elephant in the room never forgets, and sometimes it’s difficult to ignore his presence. As the Dionne Warwick lyric goes: “there’s always something there to remind you.”

The latest installment of Notes from a HealerAn Elephant in the Room — is now online, newly published in the Yale Journal for Humanities in Medicine.

The Yale Journal for Humanities in Medicine is an online clearinghouse for manuscripts dealing with the humanities and medicine.