Christian’s Journey: The Final Chapter

We speed down the pavement towards Grand Canyon National Park. In a few hours this road will be jammed for miles, but right now it’s empty. The trees stand motionless in our headlights and the air rushes into the car through the open windows and back out into the night. There is a young buck on the side of the road, and his presence only accentuates the stillness of the scenery. We pass the empty ranger station, the closed visitor center, and continue driving to the rim of the canyon. Clouds cover the stars like a nightshade, and only the moon penetrates the veil—it is dark.

Daniel edges our car into an empty lot, and he shuts the engine off. It is 4:30 am, one hour until sunrise. I unstrap my boots and feel an ache from my feet to my neck. We put the seats back as far as they will go, and roll up the windows so only a thin volume of night air can rush in with the chilly breeze. I think my red sweatshirt is buried at the bottom of my duffel bag of clothes, and I churn up the t-shirts and jeans to find it. I wedge it between me and the passenger door—the cotton is soft against my head. One deep exhale is enough to calm my body, and I drift off into an exhausted sleep.

***

The next morning I woke up for the first time in months. But that was strange, because you can’t wake up if you haven’t been sleeping, and I hadn’t slept, really slept, until that night. It was the first time in at least eight weeks that stomach cramps hadn’t kept me up. I felt relaxed—I smiled.

 And that was the end, the end of the knives in the stomach. At first I was nervous, because I thought that they would surely return as suddenly as they had departed. But I kept sleeping through the nights, and smiling a wide, grateful smile when my alarm woke me up the next morning. My stomach cramps during the day waned and eventually disappeared into memory. My skin began to heal, and with time, the red blisters faded into mere scars.

My junior year gave way to summer, and then senior year flew by. It was hard to see the days as anything but a pleasure, when I could throw my head up high and take deep breaths of Nebraska air. At graduation time, my spirit was as high as it has ever been, blossoming with the trees and the flowers and the promise of another chapter come fall, when I would move to Providence and start my freshman year at Brown.

Two years later, I took another deep breath in my driveway, my lungs filling with fresh prairie air, before pulling out of the driveway towards The Badlands, Hot Springs, and three months of whatever lies beyond.

***

Fifty minutes pass, and the alarm ends my sleep with a clean ring—I am awake before it can ring twice. The fatigue is set deep into my bones, but a last shot of adrenaline rouses my mind to clarity. The windows are down, and I roll them up before stepping out into the empty lot. It is still cool, and I slip on flip-flops so loose gravel won’t stick to my icy feet.

I leave everything in the car and amble towards the sidewalk. The path edges me away from the pavement and towards the rim of the canyon. Although the sun has not yet risen, the trees and the rocks are bathed in a faint light. I reach the lookout spot, with a clear view over the canyon. There are a few others around, huddled in groups of two or three. I sit on a boulder just above the official lookout spot for a better perspective.

Vertical cliffs form the canyon walls. These walls are not smooth, they are craggy edges with creases folding inwards and spires that jut out at different heights. The canyon is cut deep into the ground, and two Turkey Vultures descend in slow spirals towards its base. Here, the Colorado River twists up and down through the canyon and to the west.

I am staring blankly into the sky when the eastern wall lights up. The sun’s top ascends above the rim and its rays hit my eyes. The canyon comes alive through light and shadow—each jutting piece of rock grabs the sun and sends a long piece of night behind it. The sky is white clouds and pink streaks, and the canyon is bright orange. No grain is out of place, and the Colorado River runs through it all, now reflecting a deep red.

But even in this vision, my mind is drawn back to the nighttime drive. I think of the wind whipping my arms, the red taillights in the distance, and my foot endlessly pressing the gas. I feel tired, and it’s hard not to wish for the sleep I didn’t get.

I wait for the sun to stop, to hang on the rim of the canyon, and to give me the time to absorb it all. But with each passing second it rises further, and I can hear the footsteps of more tourists arriving at the lookout point. Soon they are coming in a constant stream, and I turn back towards the parking lot, walking against the grain of the crowd.

Just before I disappear into the trees, I stop and twist my body back for one last look. A bird in the distance catches my attention. It is a vibrant purple shadow set against the sun.

I see it flap its wings with vigor as it climbs into the sky. It reaches the streaks of pink and purple and dances among the clouds. Warm currents lift it higher and higher. It angles its tiny body to the left and glides in lazy circles through the heavens.

Then it stops flapping. I watch the bird’s beak turn down, and its body dives towards the canyon bed. Like a streak of lightning it cuts through the canyon, from the sky to the rock to the river.

I stand there on a boulder and crane my neck to see—the bird falls into the shadows of the red rocks. Just before the canyon floor, it pulls its beak even to the ground.

There is a moment of silence. I feel the breeze on my face, and see the golden sun shining down on the pastel clouds and the green forest of the rim and down the sheer cliff faces where the river has tread day and night for those ten million years.

And the bird begins to flap its wings, ascending slowly, once more.

Harnessing the power of data

AHRQ Issue Brief Colletti QuoteImproveCareNow is being highlighted by the Agency for Healthcare Research and Quality (AHRQ). AHRQ previously provided funding to help create enhancements of the ImproveCareNow registry, including automated population management, pre-visit planning, Quality Improvement performance and data quality reports. The efforts of physicians, improvers, parents and patients are also highlighted. Continue reading

Christian’s Journey: Part 4

It’s 3:00am, and we’re at a gas station ninety miles outside of the park. We’ve been up for twenty-two hours, and been on the road for sixteen of them. I pull out of the station and on to the open road. We roll the windows down and open the sunroof. The air hits my arms and my body shivers at the cold. I stick my left hand out the window and open my palm to the night—it keeps me awake. Continue reading