Barbaro's Hoof Prints

Yesterday was what would have been Barbaro's fifth birthday and his hoof prints were everywhere. A year ago, I was at Delaware Park marveling at the 600 plus Fans of Barbaro who showed up in full force to celebrate their hero's life. Yesterday they continued his legacy in a different but equally inspiring way.

In an all-out effort to "unstick" the two anti-slaughter bills that are being held up in committee by Senator Larry Craig, the Fans of Barbaro unleashed a phone campaign on the Senator's office urging him to release S 311 from the hold he has placed on it. I have no idea how many phone calls were made to the Senator's office, but woe be it to anyone who incurs the wrath of the Fans of Barbaro. I suspect their phone campaign may set a few records for the number of phone calls to one Senator in one day and I sincerely hope their efforts pay off. It may be that they have to continue this all out phone blitz for a few days in a row to make sure the Senator knows they are not going away.

And then there was a nice mention in Blood Horse about the Michael Matz-trained Derby entry, Visionaire and of course the inevitable comparison to you-know-who. "I was very happy with what he [Barbaro] did and what he accomplished and I hope I have the same feeling this Saturday," Matz told Deidre Bair. "I'm glad to be back, that's for sure. Anytime you're here it's a nice situation."

To top it off, the Lexington Courier-Journal reported that the $1 million bonus Yum! Brands offered last year to the Derby winner if he beat the 6 1/2 length winning margin of Barbaro in 2006, will not be repeated this year. "The offfer--called the Yumfecta--drew lukewarm reactions from previous victors who questioned whether any jockey should push a horse that was clearly going to win," reports Gregory Hall.

So Barbaro's "sublime" second largest margin of victory in the Derby stands on its own and is recognized for what it was--a supreme effort that will be hard to beat, bonus or not. And so should the accomplishments of all those who carry on his legacy.

I can't think of better ways to commemorate the day he was born than to continue what he stood for.

The Mating Game

Woe be to those who buy a race horse with the strict intention of making money. First they learn about food bills. Horses need to eat regardless of whether or not they are racing and with grain prices keeping pace with gasoline, well, it gets expensive fairly quickly. Then they learn about farrier bills. Horses need their feet tended to by professional farriers every six weeks. If they are racing and changing shoes for different surfaces, it can be more often.

Then they learn about dental bills. Horses need their teeth filed down routinely to accommodate their bits. And then there are the seemingly endless vet bills. Pampered thoroughbreds are routinely tested and treated for every possible symptom. Not to mention the insurance bills, training bills, shipping costs, race entry fees, licensing fees. You get the picture. It all adds up pretty quickly.

And woe be to those who figure they can earn it all back when the horse gets to the breeding shed. Because, as the owner of the very expensive War Emblem learned the hard way, there are no guarantees. As The New York Times reported on Monday, "In nearly five years of contact with hundreds of mares, War Emblem, now 9, [and purchased for $17 million by a Japanese owner] has managed to mate with only 70 of them, which is half of most stallions' yearly output. He has not produced a live foal since 2006..." Ouch and double ouch. "By conservative estimates, he [the owner] has lost as much as $55 million in stud fees," writes Joe Drape.

To frustrate the Japanese owner, Shadai Stallion Station, even more, the 26 horses that War Emblem has managed to sire, have, according to Drape, "become terrific racehorses, capturing six stakes races and putting their reluctant father near the top of Japan's leading sire list." Which may say more about the status of Japanese horse racing than War Emblem's lack of procreation, but nonetheless is a point of continued angst for all those associated with the 2002 Kentucky Derby winner.

So heads up all ye horse hedge fund creators (see my previous post on Big Brown, one of the horses running in this year's Kentucky Derby), there is no such thing as a sure thing in horse racing, on or off the track. A dud at stud can win the Kentucky Derby and a non-stakes winner can sire a Triple Crown contender.

As they say, hold those bets and don't tear up any tickets, just yet. War Emblem may regain interest in the opposite sex or then again, he may not. As I've said before, horses are not commodities and those that treat them as such may never recoup their investments. There is a reason it is called the sport of kings.....

Cause and Effect

As I learned in my bioethics class this semester, there are numerous approaches to the study of medicine, one of which is the narrative method. This literature-based approach is slowly becoming more popular as more and more physicians are trained to truly listen to the patent's story, not just his/her symptoms. As many patient narratives indicate, when narrative medicine comes face to face with evidence-based medicine (the prevalent school of thought), the result is often frustrating for the patient and the doctor, especially if the case does not fit into a neat paradigm of previous cases. Clearly there needs to be a happy medium that combines the casuistry model based on information gleaned from previous cases and the narrative method based on the individual patient's story. All of which actually brings me to the story of Dancing Forever, a horse that brings narrative medicine to life.

Dancing Forever is the son of Dancinginmydreams and he recently won the $200,000 Grade II Fifth Third Elkhorn Stakes at Keeneland, an event his trainer called "a miracle." Dancinginmydreams, you see, spent thirteen months at Penn's New Bolton Center, recuperating from five surgeries on the hind pastern bone that she shattered while running in the Frizette Stakes in New York eight years ago. According to an article in the Lexington Herald-Leader, trainer Shug McGaughey recalled that the surgeon at the track told him the horse's hind leg "looked as if a shotgun shell had been shot into the bone." And yet, the horse's owner asked, "Can we get her to New Bolton without being cruel?"

Off she went to New Bolton, hooked up to intravenous tubes, her leg stabilized in a brace, where Dr. Richardson put her leg back together again in five different surgeries. She healed for thirteen months, during which time, Barbaro's trainer, Michael Matz, would often go to New Bolton and check on her because he was close by. He phoned his reports to McGaughey. And when she left New Bolton for a nearby farm in Georgetown to continue her rehabilitation, Dr. Richardson and many others shed a few tears because they had grown so attached to her.

Dancing Forever was born five years ago and is Dancinginmydreams' first foal and the only one racing to date. Dancing Forever is a late bloomer and, according to McGaughey, "only turned the corner last year, at age four." He also prefers long distances such as 1 1/4 miles and 1/12 miles, but no one is complaining. To his owners, Dancing Forever is simply a miracle horse and the fact that he is racing at all is just icing on the cake.

So to those naysayers who questioned Dr. Richardson's ability to put Barbaro's leg back together again, there was indeed, medical precedence for him to try. The injury to Dancinginmydreams was not identical to Barbaro's injury but it was equally life-threatening and she survived, walked out of New Bolton and produced a graded stakes winner. Her story is as compelling as Barbaro's but many don't know about it simply because she did not win the Kentucky Derby or break down live on national television before an estimated viewing audience of four million people.

So using an evidence-based medical approach, there was every reason to try and save Barbaro. There was scientific evidence to suggest that his leg could be surgically repaired. It is the narrative approach, however, that, pardon the pun, gives the story legs and keeps it running long after the medical science has become a case on which to base future life and death decisions for other horses.

Of course, there is also the financial aspect and both Dancinginmydreams and Barbaro belonged to owners who could afford to spare no expense to save their horses. But without their willingness to try, we would never know if it could be done. And the irony, of course, is that even great men of science are moved, in the end, by the stories that give meaning to their work.

Young Frankenstein

We had an absolutely wonderful day yesterday--a continuation of my daughter's never ending 21st birthday (which was last week but who's counting...). We went to New York City, had a wonderful lunch at a sushi place recommended by one of my son's friends and then saw Young Frankenstein, the new Mel Brooks show on Broadway.

The show is classic Mel Brooks--hardly brain food but truly fun. The staging was phenomenal and the cast included some big names: Megan Mullally of Will & Grace fame, Sutton Foster who won a Tony for her role in Thoroughly Modern Millie and Roger Bart as Dr. Frankenstein. If you saw The Producers, Bart was the original Carmen Ghia. All of us thought the second act was better than the first and in fact, was what made the show, including a wonderful rendition of Putting on the Ritz that was very clever.

An equine point of interest. If you have seen the movie, you know that the housekeeper in Dr. Frankenstein's castle is named Frau Blucher and every time she says her name, the two horses (one named Black and the other named Andecker) whinny. Leave it to my son to note that Blucher is German for glue--hence the horse's concern. The horses, by the way, are priceless in the hay wagon scene. By the way, I have seen Mel Brooks on more than one occasion in the paddock at Saratoga and I know he loves horses.

I am always struck by the talent and energy it must take for these performers to pull this off day in and day out. I can't imagine how they do two performances on Wednesday and Saturdays but if you love what you do, it shows.

Four stars out of five on the Feldman review scale and guaranteed to make you smile.

Life with Sammy

It has now been a week and a day since Sammy arrived and we are settling in. Phoebe and Amos are adjusting, albeit slowly and Amos has actually turned into his prime babysitter. He spends a lot of time herding Sammy who has figured out that his role in this game is to lie down and roll over. Amos feels like he finally has someone to boss around and amazingly his limping has basically stopped. Today when I soaked his feet, he pulled them out as if to say, "OK--we're done now." Who knew?

Phoebe, on the other hand, is not thrilled--actually that's putting it nicely. She is miffed. There are times when she refuses to come inside if the puppy is anywhere near the door and then there are times when she refuses to go outside if he is bounding around. Today we did a little planting and she did rally when it was watering time (the hose is her absolute favorite thing except for food) and now she is curled up at my feet, her usual position when I work, but most of the time she has her nose out of joint. This may not improve--this may just be Queen Phoebe exerting her dominance over all of us.

As for Sammy, well he has grown and now lumbers around like a polar bear. He also has managed to make a place for himself in the hierarchy without stepping on too many literal and figurative toes. What can I say? His mellow disposition makes him a perfect third dog--he truly gets it--and he is smart, good and a charmer. He's figured out the house breaking rules pretty quickly and he sleeps through the night on his own enormous Orvis bed surrounded by a bevy of toys that he gathers together. He is hard to resist.

We did discover that the pet food he was on, Nutro, has been recalled which is very interesting since he never really liked it. We are switching him slowly to the brand inhaled by the other two and he seems to like that better. If you feed your pets Nutro you might want to take a look at this and contact your vet.

Otherwise, we're smitten. There is truly nothing like a puppy to make your heart sing.

There's No Crying in Medicine or is There?

When Dean Richardson, Barbaro's doctor, had difficulty keeping his composure when he spoke about Barbaro in the immediate aftermath (and actually sometimes even now) of the horse's death, did that make you feel any differently toward him as a professional? In other words, when a doctor cries either in front of a patient or, as Richardson did, when speaking about the patient, does this help or hurt his/her professional image?

It is an interesting question and one we have been pondering a bit in my class this semester. On Tuesday, Barron H. Lerner, M. D., a professor of medicine and public health at Columbia Medical Center and a fairly well-known scholar in the bioethics world, tackled the subject in The New York Times in an article entitled, "At Bedside, Stay Stoic or Display Emotions?"

As Lerner explains, the recent trend for doctors to display any type of emotion is a sharp departure from the centuries old stoic, detached stance practiced by most doctors of a certain age. The detachment, which often feels cold and uncaring to the patient, is, of course, a defense mechanism to guard against physician burnout. The theory is that avoiding emotional attachment to patients and their cases prolongs one's medical career.

As legions of patient illness narratives have documented, the cold bedside manner does little to improve patient morale. Not that every patient wants their doctor to hold their hands; more that every patient wants to know that there is a person in that white coat, not just a practitioner. Now, according to Lerner, most medical schools teach "physician-patient relationships and breaking bad news" (scary to think they actually have to teach compassion) but the real question still remains where to draw the boundaries.

In my class, the consensus, even among the med students, is that there is a time and a place to be emotional and it may not be at the patient's bedside. Many spoke of the need to keep their emotions in check until they could find a quiet place to cry, usually in the bathroom or even the broom closet. Lerner seems to be on the same page. "Whether because of my personality or my being a man, I, too, have never cried in front of a patient," he writes.

Which is probably a shame. I would argue that the danger of physician burnout caused by emotional attachment to one's patients, is equal to the danger of mental burnout caused by too much detachment from one's patients. The strain of keeping all those emotions in check has got to be as dangerous to one's health, physical and emotional, as letting it all hang out. There is still an aura of healer that we wish to associate with those who practice the profession and if we see them cry, this may mean they are not omnipotent or infallible as we would like to believe, especially about our own personal conditions. But not giving them permission to be human is doing those same practitioners more harm than good.

So, my guess is that Richardson cried for a lot of reasons--not the least of which was because he lost a patient he truly cared about--and that, in the end, it was good for his emotional health. My other guess is that we give our veterinarians a lot more leeway with regard to displaying their emotions than we give our human docs and that is not necessarily a good thing. Certainly each doctor has to do what is right for him/her and certainly all cases are different, but I don't think I would ever think less of a professional if I saw him/her shedding a tear.

Leveling the Racing Surface

It seems as if the use of synthetic racing surfaces has thrown all the Derby handicappers into a bit of a quandary. They simply do not know how to accurately compare races from synthetic tracks to those on dirt or turf and all of their "systems" have gone out the window. The New York Times reported yesterday that the guru of all handicappers, Andrew Beyer, has admitted that his speed figures (previously the gold standard by which many handicappers make their bets) are "next to worthless in the synthetic era."

To complicate matters further, there is no uniformity among synthetic surfaces. A Polytrack races differently than one made of Tapeta or Cushion and not even those well versed in workout fractions can seem to come up with a formula to level the playing fields. All of which led the New York Times to ponder whether or not we are in the "throes" of another "significant" change in horse racing (the triumph of the tote board, the invention of the starting gate and the acceptance of simulcasting being the three most recent ones).

To be sure, surface is a huge deal but not all dirt tracks are the same, just as turf differs from course to course. I'm more inclined to agree with Eric Banks who wrote (in the NY Times) that this new complaint is just a variation on the old problem of how to figure out how to compare horses who compete on different surfaces at different tracks.

Barbaro could run on anything--grass, dirt and even slop--and so could Secretariat. I hate to sound like a spoil sport but it seems like synthetic surfaces have just added another variable to the numerous ones that already exist in horse racing. Change is never easy and it usually involves adjustments (just like adding a third puppy to a very settled two dog household!) but eventually it all works out. The time may come when synthetic surfaces become the norm and then the handicappers will be moaning about how to calculate training sessions on dirt into their "full-proof" systems.

If you had it all figured out, it wouldn't be a horse race, and that, in the end, is what makes the sport interesting. If anything, the synthetic surface variable should make the sport more appealing to those who bet by hunch because who is to say they are any less knowledgeable than the pundits who admit they don't know how to compare apples to grapes. Especially sour ones.