Chester Buckenmaier III, MD, COL (ret), MC, USA

It has been a particularly challenging few weeks for Team Buckenmaier. We recently pulled our floating home (a Lagoon 42 catamaran) for much-needed routine maintenance and bottom work at a local yacht yard. Our 3,000-plus miles in the Atlantic had taken their toll on the boat and its systems.

I have sworn this oath several times throughout my military career, as did my wife and first daughter. A framed print of the oath of office adorned our living room for years. Often, when asked what I did for a living by a new acquaintance, I will state that I spent a career protecting and defending the United States Constitution. It is an occupation my family has been involved in for generations. Except for my family, nothing has been more fundamentally important to my identity and sense of purpose. Defense of our Constitution is the most important endeavor I have performed to protect my family, posterity and my country.

I am tapping out this editorial on my 60th birthday in May. I prefer the annual and unavoidable nonevent—which is the date of my birth—to go by quietly and without too much hoopla. Family and friends have been asking if I feel any different at 60. I have responded that it seems no different from how I felt yesterday at 59. That is not to suggest I have not noticed the changes to my appearance associated with aging as I gaze in the mirror. I have no idea where all the gray hair is coming from (damned barber) or why less of it seems to be growing on my head but has sprouted with renewed aggressive vigor from my nose and ear canals (God does have a sense of humor).

My wife, Pam, and I have just completed a 413 nautical-mile sail from Key Biscayne, Florida, to Hilton Head, South Carolina, on our Lagoon 42 – Shavasana. It is our most extended passage so far and the furthest out in the Atlantic Ocean we have ventured. We are headed back north towards the Chesapeake Bay and had a weather window that allowed us to sail into the Gulf Stream and ride that fabled ocean river north. The two to three knots of push make for some incredible boat speed over the ground, and we were often logging 8 to 10 knots with stern winds and following seas. From a sailor’s perspective, that is fast. I imagine the powerboat enthusiasts shaking their heads and smiling at such pitiful velocities.

One of the best aspects of the sailing lifestyle is discovering new anchorages and meeting the local people. Recently, after a spectacular downwind sail with consistent 10-15 knot winds off the starboard quarter (what sailors mean by fair winds and following seas), we dropped our hook at Boot Key in Marathon, Florida. Marathon is home to The Turtle Hospital, a fascinating non-profit organization dedicated to the rescue, rehabilitation, and release of sea turtles. Sea turtles are Shavasana’s (our Lagoon 42 sailing catamaran) ‘spirit’ animal, and a graphic of five sea turtles graces our bows. Pam and I felt a visit to the Turtle Hospital a must. We were not disappointed and recommend a tour of this fascinating facility if you happen to be traveling the Florida Keys.

Theresa Tam serves as Canada’s Chief Public Health Officer. Like many public health officials during the COVID-19 pandemic, Dr. Tam was the focus of considerable criticism of her recommendations as the virus spread. Health officials worldwide tried to guide the public on responding to the virus based on few facts. At the time, the virus was new and barely understood. There was no vaccination and little science regarding the COVID-19 virus. Fortunately for all of us, much has improved regarding our understanding and treatment of COVID and other respiratory viruses.

New Year’s Eve 2023 was marked with sadness for my family as my mother-in-law, Susan “Sue” Timperley, passed. Leave it to Sue to pass with fireworks and parties in full swing. She was a vital force within our family, a calming influence on the males of our clan, an example for all and a tireless advocate for her grandchildren. Although she was just a slip of a woman, 5 feet tall and 100 pounds soaking wet, woe to anyone who would mistakenly assume her petite physical appearance belied weakness of character.

I was saddened to learn of the passing of first lady Rosalynn Carter. She and President Jimmy Carter were a leading political team during a particularly turbulent time in America. Although the Carter presidency was marred by the energy crisis of 1979 and the Iran hostage crisis, which likely limited Carter to one presidential term, the husband-wife team had a remarkable list of accomplishments during their four years at the White House. Carter made some difficult and unpopular decisions during his presidency. He pardoned all Vietnam War draft dodgers, returned the Panama Canal, established the Departments of Energy and Education and shepherded, arguably, the most significant talks regarding Middle East peace through the Camp David Accords.

As 2023 passes into history, I cannot suppress the feeling that I am on a perpetual rollercoaster ride, from which I cannot get off. The planet continues to warm, sea levels keep rising, frequent weather extremes, war in Ukraine and Israel, inflation, COVID, and so on. In the era of instant and constant media, one can be challenged to find a respite from the pressure of modern life. For many federal healthcare professionals, the barrage of world events is compounded by the everyday drama of patient care. Society recognizes the extraordinary daily challenges healthcare providers face, which explains our exulted status within the social fabric.

I have been enjoying the summer months (notwithstanding the heat we escaped by hiding out up north), and I hope my readers are doing the same. Sadly, some irritating and tragic medical events have interrupted my otherwise blissful season. The first issue involved my newly minted grandson, who required a routine ultrasound for a skin mass that was determined to be a benign cyst. This was and should have remained a “nothing burger” until my daughter called to tell us she had been hit with a $937 co-pay for the scan.

I am hunkered down at our family camp in Maine, avoiding the sweltering temperatures baking the country’s interior. The environmental demons we have created through our insatiable thirst for fossil fuel energy are exacting their vengeance on our abuse of mother nature. My family is, indeed, fortunate to have a rustic cabin refuge on the shores of a clean Maine lake. I revel in the fact that I often must ask what day it is and rarely know whether the former president has collected another indictment.

My mother is an educator, and I have observed her impact on countless lives. Most of my career as a physician has centered on the medical education of resident physicians. My second daughter has a master’s degree in education. Until recently, she was a second-grade teacher within an economically challenged area. My mother and daughter are the heroines in this editorial, since the resident student material I molded had already been appropriately shaped by teachers of children.

My wife Pam and I have developed a habit of listening to audiobooks while traveling the American continent in our RV (TimBuckTwoBlog.com). A particular favorite for both of us was “The Oregon Trail: A New American Journey” by Rinker Buck. The book details Rinker and his brother, Nick, following the historic Oregon Trail in a covered wagon drawn by three mules in modern America. A recurrent theme in the text was the value of “seeing America slowly” from the buckboard seat of a covered wagon as everyday Americans whipped by on ribbons of asphalt at highway speed.

I took a deep, cleansing breath and calmly explained to the Pentagon officer that pain was as complex and varied as human cancer. No one approach would solve the issue consistently for every patient without unwanted and occasionally severe consequences. Needless to say, this was not the answer these leaders were looking for. We all left the meeting disappointed.

When this editorial charms (or lands with a thud) on the masthead page of the May 2023 edition of US Medicine, Pam and I will be back on the road again. These past few months hanging out in Virginia during Pam’s recovery have been challenging for both of us. We are not used to being this static, physically or existentially. I have been writing extensively during this period, which necessitates a protracted amount of time on my bum (I do my best work with pressure on my brain). This has caused my long-term affair with lower back pain to flare up with a vengeance. I am certainly not alone in this painful condition. Researchers suggest that 8 in 10 Americans will experience back pain at some point in their lives. When I retired from the Army, I noted back pain as an issue during my exit physical review. In response, every corner of my body seemed to be scanned and/or X-rayed. The Army concluded I had the well-used spine of a fifty-something soldier. In short, like so many other humans, I have classic musculoskeletal lower back pain.