FORBIDDEN TRAIL

"Let go... let go" I huff down the long decline into the Wissahickon for a rehabilitation run.

 Slowing to a jog as I cross an old stone bridge over the creek, I turn onto Forbidden Drive, a wide gravel path that courses the seven mile length of the Philadelphia park.

"Breathe... breathe" I now chant, encouraging the lungs to open to rifampin and isoniazid with each footfall through the dense forest of a July evening.

__________

Internship year had been tumultuous, peaking fast with thirteen new doctors eager to save the people of lower North Philly. Just as quickly we descended into the resentments and accusations of the chronically stressed and sleep deprived. Why didn't you treat that midnight high blood pressure? You left that admission for me? You left the ER early and I had to run that code!

I survived by focusing on the patients as people while trying to leave them at the hospital, a tactic that worked until one of those people's problem came home in the apex of my right lung. This was the mid-eighties when the tide of sexual and intravenous excess was receding into an ebb of immunodeficiency diseases. The new great masquerader, AIDS, was unleashing the old, tuberculosis. It could have been the young woman with a gunshot to the abdomen under a full moon. I had helped to compress her bleeding wound until the surgeon arrived. Or maybe it was that heroin addict in isolation with liver failure and respiratory distress. We talked football, our former sport, until he coughed himself to sleep. Regardless of source I had it, and irregardless of anti-mycobacterials I would always have the possibility of reactivation from that granuloma now showing up on a chest x-ray. A saving grace of sorts was knowing how one would probably die when the time came. Another was a long healing run in the Wissahickon.

__________

I emerge from the green tunnel of foliage after five miles and hit the pavement back out of the steep valley.

"Ninety-eight, ninety-nine, one hundred" I chant, breaking the long hill into doable intervals until making it over the rim.

And that's how it will be for the duration - of treatment, of residency, of practice and teaching, of first and last child - doable intervals until an old friend carries me home.