Sometimes, one just needs a layover day. Canoe campers will be familiar with the layover day. It is a non-travel day in the trip plan. It is a day that serves any number of purposes--a rest and relaxation day to recover from the rigors the preceding days of paddle and portage--a chance to string a line and dry out sleeping bags and tents packed either in the rain or simply endowed with several nights' heavy dew--fishing, swimming, or both--a more leisurely pace in making supper and performing other camp chores--repairing a piece of equipment--an afternoon nap--reading--catching up on one's trip log-- and yes, enjoying more than one day's allotment of trail mix. It may even become a travel day, if the crew is behind schedule and needs to make up time and distance. The layover day may be determined by the weather and taken when high winds prevent venturing forth. The crew may decide to travel in light rain on a scheduled layover day, thereby saving the layover day for when there is a break in the weather.

Today is my layover day. I spent the past two days making firewood for the 2014 maple syrup season. They were two long days. Monday I quit at 6:00PM; yesterday I quit at 5:00PM. Rather than push on, I decided that a layover day was called for. This morning I got the oil changed in the pick-up and made a periodically compulsory trip to Walmart for somethings which I simply can't live without. Since then the lawn has been mowed and the chainsaw sharpened. It is too bad there is not a Brewers' game this afternoon. I could have caught the end of it while napping in the recliner.

I have a daylong commitment tomorrow. I will be back making firewood on Friday and Saturday, weather permitting. The weather may have me considering another layover day this trip.

I have taken a few minutes to review my 2013 postings. It is accurate to say that I was preoccupied with the maple syrup season during March, April, and early May. It is not that I haven't been thinking about anything since the close of the syrup season; it is just that I haven't been successful in putting together a blog entry. Syrup making is really a year-a-round activity. This time of the year I am thinking of the need to replenish the woodpile. Rick and I walked the farm yesterday and discussed some ways to tackle this task. It is very wet in the woods, so vehicle access in most areas will be off limits for now. We leave enough marks on the natural environment; deep ruts don't have to be one of them at least with respect to our syrup making venture. The chain saw hasn't been sitting idle. I bucked up a couple of understoried balsams in the yard that had succumbed to the lack of sunlight and had given up their ghosts in tree terms. They are now stacked next to a friend's firepit where they will create ambiance for guests.

In January I enrolled in an e-course with UW-Superior titled "Healthcare in the Second Half of Life." The course addressed a number of topics applicable to the age 60 and older crowd and in many ways, applicable to anyone, who has anything to do with these same folks. My motivations for the course were self-interest and a continuing education requirement. The course was scheduled to end May 31st, but a few things have lingered on. It involved a lot more time than expected. A few of the topics were much more engaging than expected, in particular, the issue of healthcare planning within the context of chronic illness and life-threatening conditions. I learned how conflicted we are as a society on this issue and how the individual healthcare consumer is clearly outmatched by healthcare professionals and healthcare institutions as one attempts to exercise a degree of autonomy in the selection of treatment options when the best possible outcome is so limited and the risk of serious and detrimental consequences is so high. It appears that having one's documents in order, including powers of attorney of medical care, advance directives, living wills, or physician orders for life sustaining treatment (POLST), is not sufficient. One can expect that it will take considerable assertiveness on the part of the consumer patient with the added support of a strong willed advocate to insure that the desires laid out in such documents are followed.

The Medical Society of Wisconsin is piloting a program entitled Honoring Choices-Wisconsin, which encourages physicians and patients to have a discussion about the patient's individual preferences for end of life care and to make appropriate plans and arrangements. As this program is implemented, I am fully expecting a bit of an uproar. My hope is that all parties concerned can participate in a reasonable conversation and set aside hyperbole and volatile vocabulary. We need to find common ground rather than highlight and concretize differences.

For my part, I am also conflicted on where to make my own stand.  I know that I am not comfortable with a dictatorial overriding moral principle of survival at all costs--however one may compute those costs--personal, emotional, the capacity for independent and autonomous function, financial, and social. The past three years have also shown me that this issue needs to be resolved before implementation is imminent. It is not a task to be attempted coincidentally within the highly charged atmosphere of emergency medicine. I also know from experience that the longer a crisis or chronic condition lingers on, both patient and family simply want it to be over--one way or another. This too may not be the best rationale--in whole or in part--in support of a decision.