“It is good to have an end to journey toward; but it is the journey that matters, in the end.” – Ernest Hemingway (1899-1961)
Editor-In-Chief, Chester “Trip” Buckenmaier III, MD, COL (ret.), MC, USA
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.
I am compelled to warn my reading audience that while I have nothing against powerboaters personally, I harbor an irrational disdain for powerboats. It is something akin to the inbred antipathy between internal medicine and surgical sides of the medical house. So, if you are a particularly thin-skinned powerboater, perhaps this editorial is worthy of a hard pass. I will be making some unflattering comments and generalizations with no sound basis beyond my opinion (damn, I do love editorialization). I also admit my observations likely represent only a tiny slice of the powerboating community. Then again, as Mark Twain reminds us: “Nothing so needs reforming as other people’s habits.” Stink-pot drivers (thanks, Dad, good one), you have been warned.
Imagine, if you will, the serene joy of harnessing the wind to drive your ocean craft across the seas with a delightful song of rushing water under the hull. Dolphins often seek your vessel out to play in your gentle bow wave. Few human activities offer such sublime enjoyment with so little impact on the environment or your fellow man. Then consider, this mellow setting is ripped asunder. Nothing, and I mean nothing, will destroy nautical harmony faster than when an outrageously huge power yacht passes perilously close (why? Because they can), thrashing the waves into submission with thundering diesel engines belching smoke as the ocean is mechanically cleaved into a damaging wake. To add insult to injury, the helmsman of this seagoing menace has purposely or unwittingly (not sure which is worse) turned their malodorous mechanical sea beast towards your sailing vessel for physical confirmation of their horsepower as their wake violently rocks your innocent sailboat. This all-too-common occurrence serves only to confirm in the sailor’s mind that the intelligence needed to operate a powerboat requires little more mental acuity beyond the ability to write a check that clears.
Too harsh? It is, but boy, that felt good. I will also sheepishly admit that for every &^%# powerboater that pulls the stunt above, 10 others will pass responsibly and, in some cases, even slow down and be responsible for their wake (bless you). Notwithstanding my general aversion to the species, in truth, I generally end my emotional rants against stink-pots by feeling sorry for the poor buggers.
There is no argument that powerboats get there faster. These are the appropriate vessels if that is your particular goal and joy. Indeed, as a cruising sailor, a destination is essential to any cruise plan. As Hemmingway so aptly points out, however, the journey is the meat of the matter. Pam and I have visited some fantastic destinations. Still, the most memorable portions of our trip were during our slow sailing. Twenty to 30 dolphins playing in our bow wave, steering around a right whale resting on the water surface and refused to budge, witnessing one of Elon Musk’s Starlink rockets go up 20 miles off the Cape Canaveral coast at night, and the stars, stars, stars, are just some of the things that seen the ocean, unhurriedly, offers. How much of the ocean’s wonders are just passed by (or torn asunder) in the roaring and fuming diesel rush to ‘get there.’ I distinctly remember one power monster pitched up high in RPM glee, leaving a trail of disturbed bottom while we were sailing in the shallow and environmentally fragile Florida Keys. It’s likely not cool for the bottom sea critters. Make no mistake, our boat has twin engines. I am not above switching to the ‘iron genoa’ when weather conditions necessitate arrival sooner rather than later. As a sailboat, though, we usually travel slower even with the engines on. For Shavasana, traveling under power is the exception and is never the rule.
I have consumed an inordinate amount of editorial space (sorry, Brenda) developing this idea because it reminds me so much of modern medical practice. The incessant demand for patient throughput, seen as the primary marker of medical quality and efficiency by clinical ‘bean-counters’, has ruined the doctor-patient relationship. The clinical schedule forces otherwise decent clinicians to power through their patient loads, cleaving their way through the sick and injured with superficial half answers to their medical questions. To make matters worse, medical consumers often have to wait hours for their brief bounce with the clinician. The encounter is usually so fast and pugnacious that the hapless patient is left more confused and uncomfortable about their condition than when they arrived.
Only later in my career did I learn to resist throughput pressure in favor of more quality (and time-consuming) interactions with my patients. When I slowed my role, I enjoyed my work more and had far better relationships with the folks in my care. One of the most common medical laments I hear from folks in my retirement is the shocking speed and lack of understanding in their interactions with healthcare today. Speed and throughput may appear pleasing on medical financial spreadsheets, but this is not good medicine.
I wish, earlier in my career, some old and crusty fart in the medical profession, like me, would have reminded me that the journey with patients is the most fulfilling aspect of medical practice. The quality of time one spends on one’s medical charges is far more critical than the speed or volume with which they are seen. Always remember power-docs, you are responsible for your wake and just imagine what you are likely missing. I recommend the sailor’s approach to ocean voyaging and medicine.
