Tanglewood by Trike – 2011

It was a special treat to be able to enjoy a nice 400 mile motorcycle trip along with a memorable concert at Tanglewood. The ride from the lakehouse in Pennsylvania to Lenox, Massachusetts took us on interstate highways initially but then mostly on state and county backroads in the state of New York and then on numerous back roads to Massachusetts, through West Stockbridge and into Berkshire County to Lenox, the summer home of the Boston Symphony Orchestra.

The BSO weekend concert included one of the world’s foremost concert pianists, Emanuel Ax, performing one of my favorites, Mozart’s Piano Concerto No. 22 in E-flat, K.482, written in Vienna in 1785 when the young composer was writing many new concertos for performances featuring himself as soloist. I have been listening to Emanuel Ax for decades but this is the first time I had seen him in a live performance. He was amazing. Performing the “too many notes” of Mozart seemed like a joy to him as it was to us.

Lionel Bringuier, assistant conductor of the Los Angeles Philharmonic Orchestra, who made his BSO and Tanglewood debut in this program, was also amazing. It was great to see that there are young conductors coming up through the ranks. His energy was exciting for all.

The first concert at Tanglewood was in 1936 and since then a substantial organization and support structure has grown up around the beautiful facility. The capacity is 24,000. Not sure how many were there on Sunday but thousands for sure. Although the main gate was closed to cars when we arrived the police happily motioned us in. Most big events are very courteous to motorcyclists. They save some choice parking areas that are not big enough for cars but are perfect for bikes (or trikes). There were thousands of cars, but just two trikes!

Most people bring wagons with their folded chairs and tables and dinner. Some make quite an elaborate evening out of the free seats on the lawn and embellish their wines and dinners with candles and even candelabras. Nothing that fancy, but we had a great dinner at the Dakota Steak House in Pittsfield.

On the way back we headed across the Hudson River via the Rip Van Winkle Bridge and then up route 385 to Coxackie where we met with our daughter and grandchildren at the Blue Water Bistro. After a delightful lunch, we headed down route 209 along the historic Delaware and Hudson Canal and then back to the Lake. We dodged a few thunderstorms but did not get too wet. We look forward now to another trike trip to Bethel Woods. Stay tuned.

Tags: boston pops, boston symphony orchestra, bso, dakota, delaware and hudson, hudson, hudson river, james taylor, john williams, keith lockhart, kingston, lenox, motorcycle, mozart, pittsfield, route 209, smetana, stockbridge, tanglewood, tchaikovsky, trike, woodstock, yo-yo ma

How to Live When You Have to Die

Yesterday was a beautiful day in the Northeast. I started out the day with a drive to Manhattan to have breakfast with a dozen physicians and healthcare executives. We had a discussion with Dr. Atul Gawande (2010), Staff Writer for the New Yorker and author of “The Checklist Manifesto”. I will keep the autographed copy of the book on my office bookshelves but I will read it on the Kindle this week. Dr. Gawande made a few comments about healthcare and then opened up for Q&A. Most of the questions and answers centered on the high cost of healthcare and how to best reduce the duplication of efforts and medical errors. This is the focus of his new book and will be the subject of postings here to come.

After the breakfast discussion we headed for the packed SVA Theatre at the New Yorker Festival to hear Dr. Gawande’s talk called “How to Live When You Have to Die”. This is a tough subject. Dr. Gawande cited figures about the staggering cost of healthcare that is expended in the final days of life for millions of people. Even though paliative care can result in living longer, there is an unstoppable momentum to do something. Our impulse is to try anything and everything to preserve life of a loved one when at times this approach results in a nearly unbearable quality of life and significant trauma to family members when the end eventually comes. Hospice is often shunned out of fear of the implications but the result of hospice care is usually more comfort, less suffering for the terminally ill, and less trauma for family members later.

Dr. Gawande believes that the challenge is that doctors often don’t always tell the truth about the prognosis for a person and family members do not want to discuss end of life. He suggested that what is needed is what he called a “breakpoint discussion” with the terminally ill centered around four simple principles. First is an honest assessment of the condition and prognosis. Second is to ask about what fears the person has. Third is to ask about their goals — what do they want for themselves and for their families? Finally is the question of what tradeoffs is the person willing to make — for example, what degree of pain and suffering versus comfort? At the end of his one-hour talk, Dr. Gawande entertained questions. There were many and also many supportive comments about his thesis. At the very end, a young woman walked to the aisle microphone and talked about what it was like to lose her husband to cancer six months ago. She described how they had discussions very much along the lines Dr. Gawande had outlined. She praised the approach but brought the audience to tears.

Atul Gawande is an excellent communicator and is writing about some of the toughest issues in healthcare. I look forward to reading his three books (Better, Complications, and The Checklist Manifesto).

On a brighter note — actually many notes — was an evening performance of the Ridgefield Symphony Orchestra back home in Connecticut. Guest pianist Gayle Martin Henry performed Tchaikovsky’s Piano Concerto No. 1. It was brilliant. The orchestra was in rare form as it played Schubert’s unfinished Symphony No. 8 and Prokofiev’s Classical Symphony.

Tags: checklist manifesto, end of life, gawande, Healthcare, tchaikovsky