Fixing Eyes on the Unseen – Footsore

Mo sheasamh ort lá na choise tinne…
(You are the place where I stand on the day when my feet are sore…)
~Irish saying translated by poet and theologian Pádraig Ó Tuama

I’ve been foot sore the last few days, most likely from trying in vain to pull my feet out of some boot-sucking mud in the barnyard while pushing a heavy wheelbarrow. With each painful step I now take, I am reminded how dependent I am on strong legs and feet to carry me through the pathways of life.

I have stumbled into holes, picked my way carefully over sharp rocks, scrambled up steep climbs and pulled my way through the muddiest mire.

Yes, of course I’ve had sore feet before:
blisters and callouses, tendonitis and fasciitis, bruised toes and stressed arches. When every step I take points out my failures and frailty, I begin to beg for a soft landing with each stride.

But more than comfort, I seek a stable place of trust to put my feet, to stand firm even when standing feels impossible.

Lord, be my landing place when I hurt and pull me out when I get stuck up to my ankles. May your gentle road rise to meet my sore feet.

This year’s Lenten theme:
So we fix our eyes not on what is seen, but on what is unseen, since what is seen is temporary, but what is unseen is eternal.
2 Corinthians 4: 18

Take this fainted heart
Take these tainted hands
Wash me in Your love
Come like grace again

Even when my strength is lost
I’ll praise You
Even when I have no song
I’ll praise You
Even when it’s hard to find the words
Louder then I’ll sing Your praise
I will only sing Your praise

Take this mountain weight
Take these ocean tears
Hold me through the trial
Come like hope again

Even when the fight seems lost
I’ll praise You
Even when it hurts like hell
I’ll praise You
Even when it makes no sense to sing
Louder then I’ll sing Your praise, oh-ooh
I will only sing Your praise, oh-ooh

I will only sing Your praise, oh, God
I will only sing Your praise
I will only sing Your praise

And my heart burns only for You
You are all, You are all I want
And my soul waits only for You
And I will sing ’til the morning has come

Lord my heart burns only for You
You are all, You are all I want
And my soul waits only for You
And I will sing ’til the miracle comes, yeah

I will only sing Your praise
I will only sing Your praise, ooh-oh, oh
I will only sing Your praise

Even when the morning comes
I’ll praise You
Even when the fight is won
I’ll praise You
Even when my time on earth is done
Louder then I’ll sing your praise
I will only sing Your praise
~Joel Houston

Fixing Eyes on the Unseen – A Hard Gift to Keep

To pull the metal splinter from my palm
my father recited a story in a low voice.
I watched his lovely face and not the blade.
Before the story ended, he’d removed
the iron sliver I thought I’d die from.

I can’t remember the tale,
but hear his voice still, a well
of dark water, a prayer.
And I recall his hands,
two measures of tenderness
he laid against my face,
the flames of discipline
he raised above my head.

Had you entered that afternoon
you would have thought you saw a man
planting something in a boy’s palm,
a silver tear, a tiny flame.
Had you followed that boy
you would have arrived here,
where I bend over my wife’s right hand.

Look how I shave her thumbnail down
so carefully she feels no pain.
Watch as I lift the splinter out.
I was seven when my father
took my hand like this,
and I did not hold that shard
between my fingers and think,
Metal that will bury me,
christen it Little Assassin,
Ore Going Deep for My Heart.

And I did not lift up my wound and cry,
Death visited here!
I did what a child does
when he’s given something to keep.
I kissed my father.
~Li-Young Lee, “The Gift” from Rose

I did, without ever wanting to, remove my child’s splinter, lance a boil, immobilize a broken arm, pull together sliced skin, clean many dirty wounds. It felt like I crossed the line between mommy and doctor.  But someone had to do it, and a four hour wait in the emergency room didn’t seem warranted.

My own children learned to cope with hurt made worse by someone they trusted to be comforter. I dealt with inflicting pain, temporary though it may be, to flesh that arose from my flesh. It hurt as much as if it were my own wound needing cleansing, not theirs.

And so, in the similar way, our wounds are His – He is constantly feeling our pain as He performs healing surgeries in our lives, not because He wants to but because He must, to save us from our own self-destruction. Too often we yell and kick and protest in our distress, making it all that much more difficult for both of us.

If only we can come to acknowledge His intervention is our salvage:
our tears to flow in relief, not anguish,
we cling to His protection rather than pushing Him away,
we kiss Him in gratitude as we are restored again and yet again.

This year’s Lenten theme:
So we fix our eyes not on what is seen, but on what is unseen, since what is seen is temporary, but what is unseen is eternal.
2 Corinthians 4: 18

Fixing Eyes on the Unseen – Wounds to be Healed

The earth invalid, dropsied, bruised, wheeled
Out in the sun,
After frightful operation.
She lies back, wounds undressed to the sun,
To be healed,
Sheltered from the sneapy chill creeping North wind,
Leans back, eyes closed, exhausted, smiling
Into the sun. Perhaps dozing a little.
While we sit, and smile, and wait, and know
She is not going to die. 
~Ted Hughes from ” A March Morning Unlike Others” from Ted Hughes. Collected Poems

March. I am beginning
to anticipate a thaw. Early mornings
the earth, old unbeliever, is still crusted with frost
where the moles have nosed up their
cold castings, and the ground cover
in shadow under the cedars hasn’t softened
for months, fogs layering their slow, complicated ice
around foliage and stem
night by night,

but as the light lengthens, preacher
of good news, evangelizing leaves and branches,
his large gestures beckon green
out of gray. Pinpricks of coral bursting
from the cotoneasters. A single bee
finding the white heather. Eager lemon-yellow
aconites glowing, low to the ground like
little uplifted faces. A crocus shooting up
a purple hand here, there, as I stand
on my doorstep, my own face drinking in heat
and light like a bud welcoming resurrection,
and my hand up, too, ready to sign on
for conversion.

~Luci Shaw “Revival” from What the Light Was Like.

Spring is emerging slowly this year from an exceptionally haggard and droopy winter. All growing things are a month behind the usual budding blooming schedule when, like the old “Wizard of Oz” movie, the landscape will suddenly turn from monochrome to technicolor, the soundtrack from forlorn to glorious birdsong.

Yearning for spring to commence, I tap my foot impatiently as if owed a timely seasonal transformation from dormant to verdant.  We all have been waiting for the Physician’s announcement that this patient survived some intricate life-changing procedure: “I’m happy to say the Earth is alive after all and restored, wounded but healing, breathing on her own but too sedated for a visit just yet.”

I wait impatiently to celebrate her healing, yet I know Creation is very much alive- this temporary home of ours. No invalid this patient.
She lives, she breathes, she thrives,
she will bloom and sing with everything she’s got
and soon, so will I.

This year’s Lenten theme:
So we fix our eyes not on what is seen, but on what is unseen, since what is seen is temporary, but what is unseen is eternal.
2 Corinthians 4: 18

Fixing Eyes on the Unseen: The Eyes of My Regret

Always at dusk, the same tearless experience,
The same dragging of feet up the same well-worn path
To the same well-worn rock;
The same crimson or gold dropping away of the sun
The same tints—rose, saffron, violet, lavender, grey
Meeting, mingling, mixing mistily;
Before me the same blue black cedar rising jaggedly to a point;
Over it, the same slow unlidding of twin stars,
Two eyes, unfathomable, soul-searing,
Watching, watching—watching me;
The same two eyes that draw me forth, against my will dusk after dusk;
The same two eyes that keep me sitting late into the night, chin on knees
Keep me there lonely, rigid, tearless, numbly miserable,
       —The eyes of my Regret.

~Angelina Weld Grimké “The Eyes of My Regret”

How granular they feel—grief and regret, arriving, as they do,
in the sharp particularities of distress. Inserting themselves—
cunning, intricate, subversive—into our discourse.

In the long night, grievances seem to multiply. Old dreams
mingling with new. Disappointment and regret bludgeon
the soul, your best imaginings bruised, your hopes ragged.

Yet wait, watch. From the skylight the room is filling with
soft early sun, slowly sifting its light on the bed, on your head,
a shower of fine particles. How welcome. And how reliable.

~Luci Shaw “Sorrow”

It’s now been a interminably long three years: millions of people sickened by a virus that could kill within days or simply be spread by those unwitting and asymptomatic. We’ve lived through shut down of businesses and schools, hospitals and clinics being overwhelmed, and hoarding behavior resulting in shortages of products addressing basic needs.

Now that I can look back with a bit more perspective, I know my first reaction was fear for myself and those I love. My words flew out too quickly, my anxiety mixed with frustration and anger, my tears spilling too easily. Like so many others, my work life forever changed.

I ended up lying awake many nights with regrets, wondering if I should be doing more than just telemedicine from home, yet wanting to hide myself and my M.D. degree under a rock until the unending viral scourge blew over.

Yet amazingly, miracles of grace in many places:
generous people full of courage made a difference in small and large ways all around the world. Some took enormous personal risks to take care of strangers and loved ones. Some worked endless hours and when they came home, they remained isolated to avoid infecting their families.

Such grace happens when hardship is confronted head on by the brilliant light of sacrifice. I am deeply grateful to those who have worked tirelessly providing care and compassion to the ill. Their work is never done.

We know, in His humanity, Jesus wept, in frustration, in worry for His people, in grief.
His tears still light the sky with a promise of salvation as He assures He won’t leave us alone in darkness – our regret dissipates with the dawn.

This year’s Barnstorming Lenten theme is taken from 2 Corinthians 4: 18:
So we fix our eyes not on what is seen, but on what is unseen, since what is seen is temporary, but what is unseen is eternal.

Breaking the Lock

And yes it is necessary to admit
walking in the forest
the heart is a lock

it has inviolable chambers
like the woods, fallen trees
that block

access to the river
snowdrops surprising its edges
moss crystalline with frost

What I thought I wanted what I have tried to be
was the slender instrument that opened

a key: presence moving deeper into the forest
that releases the birds from the trees
and sends them   ascends them
to sky   by definition

but now there is nothing left to be solved like a riddle

this time the lock must be broken
what’s left has to be seized

because God only loves the strong thief
I mean the man who breaks his heart for God
~Jennifer Grotz, “Locked” from Window Left Open

All my life I wanted to be an effective key, unlocking life’s mysteries and opening up the world to those who are hopeless, stifled and trapped. Doctor training gave me a few locksmith tools. I found my patients taught me far more about their pain and suffering than my professors did.

Yet profound mysteries remain: some illnesses are rare or unique enough to defy diagnosis, some just don’t respond to available tools, while illnesses as well understood and treatable as depression or COVID infection still kill and incapacitate with abandon. The keys I may have accumulated don’t fit every lock. They don’t necessarily open the doors to freedom from fear or worry.

At times I feel aimless, wondering what tools I still have and if I remember how to use them. Simple knowledge is only one key, while brute force – breaking and entering – may be necessary to break the hardest lock of all – access to the troubled heart and soul.

God wants in, to pick up our broken pieces and put us back together. He doesn’t need a key to enter what He Himself has built from scratch. He owns the place.


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Still Here, Giving Warmth Before Going Cold Again

When I was sick with a head cold, my head
full of pressure, my father would soak a washcloth
in hot water, then ball it up, ring it out. He would
open it above my head, then place it against
my face like a second skin, the light around me
disappearing entirely except through the spaces
between the stitching. I would inhale the steam
in that darkness, hearing his voice on the other side,
otherwise almost devoid of any other bodily sense
but the warmth and depth of his voice, as if
I had already died and was on the other side
of life waiting for the sickness to lift, but I wasn’t.
I was still on this earth, the washcloth going cold
on my face, my body still sick, and my father still
there when I opened my eyes, as he always was,
there to give me warmth before going cold again.

~William Fargason “Elegy with Steam”

A common clinic conversation this time of year:

I’ve been really miserable with a cold for three days, and as my COVID test is negative, I need that 5 day Z-pack antibiotic to get better faster.

It really can be miserable suffering from cold symptoms. Ninety eight percent of the time these symptoms are due to a viral infection and since your rapid RSV and influenza nasal swab tests are also negative today, your illness should resolve over the next few days without you needing a prescription medication.

But I can’t breathe and I can’t sleep.

You can use salt water rinses and a few days of decongestant nose spray to ease the congestion.

But my face feels like there is a blown up balloon inside.

Try applying a warm towel to your face – the heat will help improve circulation in your sinuses and ease your discomfort. When it cools off, warm it up again – basically rinse and repeat.

And I’m feverish and having sweats at night.

Your temp today is 99.2 so not a concern. You can use ibuprofen or acetominophen to help the feverish feeling.

But my snot is green.

That’s not unusual with viral upper respiratory infections and not necessarily an indicator of a bacterial infection.

And my teeth are starting to hurt and my ears are popping.

Let me know if that is not resolving over the next few days.

But I’m starting to cough.

Your lungs are clear today so it is likely from post nasal drainage irritating your upper airway. Best way to help that is to breathe steam to keep your bronchial tubes moist, push fluids and prop up with an extra pillow.

But sometimes I cough to the point of gagging. Isn’t whooping cough going around?

Your illness doesn’t fit the typical timeline for pertussis.  You can consider using an over the counter cough suppressant if needed.

But I always end up needing antibiotics. This is just like my regular sinus infection thing I get every year.

There’s plenty of evidence antibiotics can do more harm than good, eliminating healthy bacteria in your gut.  They really aren’t indicated at this point in your illness and could have nasty side effects.

But I always get better faster with antibiotics. Doctors always give me antibiotics.

Studies show that two weeks later there is no significant difference in symptoms between those treated with antibiotics and those who did self-care without them.

But I have a really hard week coming up and my whole family is sick and I won’t be able to rest.

This could be your body’s way of saying that you need to take the time you need to recover – is there someone who can help pick up the load your carry?

But I just waited an hour to see you.

I really am sorry about the wait; we’re seeing a lot of sick people with so much viral illness going around and needing to test to rule out COVID and influenza.

But I paid a $20 co-pay today for this visit.

We’re very appreciative of you paying so promptly on the day of service.

But I can go down the street to the urgent care clinic or do one of those telehealth doctor visits and for $210 they will write me an antibiotic prescription without making me feel guilty for asking.

I wouldn’t recommend taking unnecessary medication that can lead to bacterial resistance, side effects and allergic reactions. I truly believe you can be spared the expense, inconvenience and potential risk of taking something you don’t really need.

So that’s it?  Salt water rinses, warm towels on my face and just wait it out?  That’s all you can offer?

Let me know if your symptoms are unresolved or worsening over the next few days.

So you spent all that time in school just to tell people they don’t need medicine?

I believe I can help most people heal themselves with self-care at home. I try to educate my patients about when they do need medicine and then facilitate appropriate treatment. Also, I want to thank you for wearing your mask today to reduce the chance of transmitting your virus to those around you.

I’m going to go find a real doctor who will actually listen to me and give me what I need.

It certainly is a choice you can make. A real doctor vows to first do no harm while always listening to what you think, what your physical examination shows, then takes into account what evidence-based clinical data says is the best and safest course of action. I realize you want something other than what I’m offering you today. If you are feeling worse over the next few days or develop new symptoms, please let me know so we can reevaluate how best to treat you.

I’ll bet you’ll tell me next you want me to get one of those COVID vaccines too, won’t you?

Actually, I prefer you be feeling a bit better before you receive both the COVID and influenza vaccines. That would offer extra immunity protection for you through the next few months. Shall we schedule you for a time for your vaccination updates next week? Remember, I’m still here if you need to review your options again…


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We Couldn’t Do Anything

Yesterday our children, playing
in a tree, watched as the tiniest bird
fell from above them,
where it belonged,
to land below them,
where it did not.
The dog, animal and eager,
stepped on the bird, then
lowered his head. Our daughter
screamed, hauled him back,
then cupped her trembling hands
around the trembling bird,
Its one wing stretched and bent.
Our son ran inside, obedient
to our daughter’s instructions.
I was in the shower, useless.
You found a shoebox, sheltered the bird,
helped our children find leaves and twigs,
perched the box in the tree. At supper,
we prayed for the bird while its mother
visited the shoebox,
her beak full. She fretted
and fluttered. She couldn’t do anything,
and we couldn’t do anything,
and after supper, we found the trowel.
Dust to dust,
I said.
O how I longed to gather you,
you said, as a mother hen gathers
her young beneath her wings.
Our son pushed a stick into the soft earth.
Our daughter told him not to push too far.

~Shea Tuttle “After reading our daughter’s poem” from Image Journal

Hope is the thing with feathers
That perches in the soul,
And sings the tune without the words,
And never stops at all,

And sweetest in the gale is heard;
And sore must be the storm
That could abash the little bird
That kept so many warm.

I’ve heard it in the chillest land,
And on the strangest sea;
Yet, never, in extremity,
It asked a crumb of me.

~Emily Dickinson

I have known the helplessness of watching life ebb away from a living creature and not be able to do a thing to change what is happening.

As a teenage nurse aide in a rest home for the elderly, I saw much of dying over those years before going to medical school – some deaths were anticipated and some unexpected. What was most apparent to me in that setting is that my primary role was to be a caring witness and comforter. I could not change what was happening but I could be there, not leaving my patients to die alone. I hoped that I was useful in some way.

Later, when I worked as a physician in a hospital, there were certainly things we would do to respond to a sudden cardiac event, and it was very dramatic to see someone’s pulse restored and stabilized due to our intervention. But more often than not, what we could do wouldn’t change the reality – dying still happened and we were gathered to witness the end. We often left the bedside feeling useless.

Now I have grandchildren who are learning about death through observing the natural cycles of animals living and dying on our farm. They discover a dead bird or vole on the ground; they were aware one of our elderly horses recently died. They are aware our beloved farm dogs are aging and so are grandma and grandpa.

Children naturally ask “why?” and we do our best to explain there is always hope and comfort, even when physical bodies are dust in the ground, marked by a stick or stone or only a memory.

It is “Hope” that sings alive within us, even when we’re naked and featherless, even if we fall far from the nest we were born to. We are caught and safe under our Savior’s wings for the rest of eternity, never to be “just dust” again.


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Naming Your Hopelessness

Instead of depression,
try calling it hibernation.
Imagine the darkness is a cave
in which you will be nurtured
by doing absolutely nothing.
Hibernating animals don’t even dream.
It’s okay if you can’t imagine
Spring. Sleep through the alarm
of the world. Name your hopelessness
a quiet hollow, a place you go
to heal, a den you dug,
Sweetheart, instead
of a grave.
~Andrea Gibson “Instead of Depression” from You Better Be Lightning

We didn’t say fireflies
but lightning bugs.
We didn’t say carousel
but merry-go-round.
Not seesaw,
not lollipop,
We didn’t say pasta, but
spaghetti, macaroni, noodles:
the three kinds.
We didn’t get angry:
we got mad.
And we never felt depressed
dismayed, disappointed
disheartened, discouraged
disillusioned or anything,
even unhappy:
just sad.
~Sally Fisher “Where I Come From”  from Good Question.

…if you could distinguish finer meanings within “Awesome” (happy, content, thrilled, relaxed, joyful, hopeful, inspired, prideful, adoring, grateful, blissful.. .), and fifty shades of “Crappy” (angry, aggravated, alarmed, spiteful, grumpy, remorseful, gloomy, mortified, uneasy, dread-ridden, resentful, afraid, envious, woeful, melancholy.. .), your brain would have many more options for predicting, categorizing, and perceiving emotion, providing you with the tools for more flexible and functional responses.
~Lisa Feldman Barrett from How Emotions Are Made: The Secret Life of the Brain

Our own experience with loneliness, depression, and fear can become a gift for others, especially when we have received good care. As long as our wounds are open and bleeding, we scare others away. But after someone has carefully tended to our wounds, they no longer frighten us or others….
We have to trust that our own bandaged wounds will allow us to listen to others with our whole being. That is healing.
— Henri Nouwen from Bread for the Journey

If there is anything I came to understand over the decades I served as a primary care physician, it is that every person experiences painful emotions that make them miserable, making it even more difficult to share with others. Sometimes those feelings build up such pressure that they leak out of our cells as physical symptoms: headaches, muscle tightness, stomach upset, hypertension. Other times they are so overwhelming we can no longer function in a day to day way – described clinically as rage, panic, mood disorder, depression, self-destructive, suicidal.

Somehow we’ve lost permission to be sad.
Just sad. Sometimes unbearably, hopelessly sad.
Sadness happens to us all, some longer than others, some worse than others, some deeper than others. What makes sadness more real and more manageable is if we can say it out loud — whatever ‘sad’ means to us on a given day and if we describe our feelings in detail, explaining to others who can understand because they’ve been there too, then they can listen and help.

Painful emotions don’t always need a “fix” in the short term, particularly chemical, but that is why I was usually consulted. Alcohol, marijuana and other self-administered drugs tend to be the temporary anesthesia that people seek to stop feeling anything at all but it can erupt even stronger later.

Sometimes an overwhelming feeling just needs an outlet so it no longer is locked up, unspoken and silent, threatening to leak out in ways that tear us up and pull us apart.

Sometimes we need a healing respite/hibernation, with permission to sleep through the world’s alarms for a time. At times, medical management with antidepressants can be incredibly helpful along with talk therapy.

It helps to find words to express how things felt before this sadness, where you are now in the midst of it and where you wish you could be rather than being swallowed by sorrow. Healing takes time and like anything else that is broken, it hurts as it repairs. Armed with that self-knowledge and some gentle compassion, tomorrow and the next day and the next might feel a little less hopeless and overwhelming.


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When the Lines Went Flat

I was still a kid
interning at State
he reminisces late in the meal—
It was a young red-headed woman
looked like my sister
when the lines went flat
I fell apart
like a car with a broken axle
Went to the head surgeon
a fatherly man
Boy, he said, you got to fill a graveyard
before you know this business
and you just did row one, plot one.
~Alicia Suskin Ostriker, “The Surgeon” from The Book of Seventy

As a physician-in-training in the late 1970’s, I rotated among a variety of inner city public hospitals, learning clinical skills on patients who were grateful to have someone, anyone, care enough to take care of them. There were plenty of homeless street people who needed to be deloused before the “real” doctors would touch them, and there were the alcoholic diabetics whose gangrenous toes would self-amputate as I removed stinking socks. There were people with gun shot wounds and stabbings who had police officers posted at their doors and rape victims who were beaten and poisoned into submission and silence. Someone needed to touch them with compassion when their need was greatest.

As a 25 year old idealistic and naive student, I truly believed I could make a difference in the 6 weeks I spent in any particular hospital rotation. That proved far too grandiose and unrealistic, yet there were times I did make a difference, sometimes not so positive, in the few minutes I spent with a patient. As part of the training process, mistakes were inevitable. Lungs collapsed when putting in central lines, medications administered caused anaphylactic shock, pain and bleeding caused by spinal taps–each error creates a memory that never will allow such a mistake to occur again. It is the price of training a new doctor and the patient always–always– pays the price.

I was finishing my last on-call night on my obstetrical rotation at a large military hospital that served an army base. The hospital, built during WWII was a series of far flung one story bunker buildings connected by miles of hallways–if one part were bombed, the rest of the hospital could still function. The wing that contained the delivery rooms was factory medicine at its finest: a large ward of 20 beds for laboring and 5 delivery rooms which were often busy all at once, at all hours.  Some laboring mothers were married girls in their mid-teens whose husbands were stationed in the northwest, transplanting their young wives thousands of miles from their families and support systems. Their bittersweet labors haunted me: children delivering babies they had no idea how to begin to parent.

I had delivered 99 babies during my 6 week rotation. My supervising residents and the nurses on shift had kept me busy on that last day trying to get me to the *100th* delivery as a point of pride and bragging rights; I had already followed and delivered 4 women that night and had fallen exhausted into bed in the on call-room at 3 AM with no women currently in labor, hoping for two hours of sleep before getting up for morning rounds. Whether I reached the elusive *100* was immaterial to me at that moment.

I was shaken awake at 4:30 AM by a nurse saying I was needed right away. An 18 year old woman had arrived in labor only 30 minutes before and though it was her first baby, she was already pushing and ready to deliver. My 100th had arrived. The delivery room lights were blinding; I was barely coherent when I greeted this almost-mother and father as she pushed, with the baby’s head crowning. The nurses were bustling about doing all the preparation for the delivery:  setting up the heat lamps over the bassinet, getting the specimen pan for the placenta, readying suture materials for the episiotomy.

I noticed there were no actual doctors in the room so asked where the resident on call was.

What? Still in bed? Time to get him up! Delivery was imminent.

I knew the drill. Gown up, gloves on, sit between her propped up legs, stretch the vulva around the crowning head, thinning and stretching it with massaging fingers to try to avoid tears. I injected anesthetic into the perineum and with scissors cut the episiotomy to allow more room, a truly unnecessary but, at the time, standard procedure in all too many deliveries. Amniotic fluid and blood dribbled out then splashed on my shoes and the sweet salty smell permeated everything. I was concentrating so hard on doing every step correctly, I didn’t think to notice whether the baby’s heart beat had been monitored with the doppler, or whether a resident had come into the room yet or not. The head crowned, and as I sucked out the baby’s mouth, I thought its face color looked dusky, so checked quickly for a cord around the neck, thinking it may be tight and compromising. No cord found, so the next push brought the baby out into my lap. Bluish purple, floppy, and not responding. I quickly clamped and cut the cord and rubbed the baby vigorously with a towel.

Nothing, no response, no movement, no breath. Nothing.  I rubbed harder.

A nurse swept in and grabbed the baby and ran over to the pediatric heat lamp and bed and started resuscitation.

Chaos ensued. The mother and father began to panic and cry, the pediatric and obstetrical residents came running, hair askew, eyes still sleepy, but suddenly shocked awake with the sight of a blue floppy baby.

I sat stunned, immobilized by what had just happened in the previous five minutes. I tried to review in my foggy mind what had gone wrong and realized at no time had I heard this baby’s heart beat from the time I entered the room. The nurses started answering questions fired at me by the residents, and no one could remember listening to the baby after the first check when they had arrived in active pushing labor some 30 minutes earlier. The heart beat was fine then, and because things happened so quickly, it had not been checked again. It was not an excuse, and it was not acceptable. It was a terrible terrible error. This baby had died sometime in the previous half hour. It was not apparent why until the placenta delivered in a rush of blood and it was obvious it had partially abrupted–prematurely separated from the uterine wall so the circulation to the baby had been compromised. Potentially, with continuous fetal monitoring, this would have been detected and the baby delivered in an emergency C section in time. Or perhaps not. The pediatric resident worked for another 20 minutes on the little lifeless baby.

The parents held each other, sobbing, while I sewed up the episiotomy. I had no idea what to say,  mortified and helpless as a witness and perpetrator of such agony. I tried saying I was so sorry, so sad they lost their baby, felt so badly we had not known sooner. There was nothing that could possibly comfort them or relieve their horrible loss or the freshness of their raw grief.

And of course, there were no words of comfort for my own anguish.

Later, in another room, my supervising resident made me practice intubating the limp little body so I’d know how to do it on something other than a mannequin. I couldn’t see the vocal cords through my tears but did what I was told, as I always did.

I cried in the bathroom, a sad exhausted selfish weeping. Instead of achieving that “perfect” 100, I learned something far more important: without constant vigilance, and even with it,  tragedy intervenes in life unexpectedly without regard to age or status or wishes or desires. I went on as a family physician to deliver a few hundred babies during my career,  never forgetting the baby that might have had a chance, if only born at a hospital with adequately trained well rested staff without a med student trying to reach a meaningless goal.

This baby would now be in his 40’s, likely with children of his own, his parents now proud and loving grandparents.

I wonder if I’ll meet him again — this little soul only a few minutes away from a full life — if I’m ever forgiven enough to share a piece of heaven with humanity’s millions of unborn babies who, through intention or negligence, never had opportunity to draw a breath.

Then, just maybe then, forgiveness will feel real and grace will flood the terrible void where, not for the first time nor the last, my guilt overwhelmed what innocence I had left.


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Thanks to Blowing Snow

May the wind always be in her hair
May the sky always be wide with hope above her
And may all the hills be an exhilaration
the trials but a trail,
all the stones but stairs to God.

May she be bread and feed many with her life and her laughter
May she be thread and mend brokenness and knit hearts…
~Ann Voskamp from “A Prayer for a Daughter”

Nate and Ben and brand new baby Lea
Daddy and Lea
Mommy and Lea

“I have noticed,” she said slowly, “that time does not really exist for mothers, with regard to their children. It does not matter greatly how old the child is – in the blink of an eye, the mother can see the child again as she was when she was born, when she learned to walk, as she was at any age — at any time, even when the child is fully grown….”
~Diana Gabaldon from Voyager

Just checking to see if she is real…

Your rolling and stretching had grown quieter that stormy winter night
thirty years ago, but still no labor came as it should.
Already a week overdue post-Christmas,
you clung to amnion and womb, not yet ready.
Then as the wind blew more wicked
and snow flew sideways, landing in piling drifts,
the roads became more impassable, nearly impossible to traverse.

So your dad and I tried,
concerned about your stillness and my advanced age,
worried about being stranded on the farm far from town.
When a neighbor came to stay with your brothers overnight,
we headed down the road
and our car got stuck in a snowpile in the deep darkness,
our tires spinning, whining against the snow.
Another neighbor’s earth mover dug us out to freedom.

You floated silent and still, knowing your time was not yet.

Creeping slowly through the dark night blizzard,
we arrived to the warm glow of the hospital,
your heartbeat checked out steady, all seemed fine.

I slept not at all.

The morning’s sun glistened off sculptured snow as
your heart ominously slowed.
You and I were jostled, turned, oxygenated, but nothing changed.
You beat even more slowly,
threatening to let go your tenuous grip on life.

The nurses’ eyes told me we had trouble.
The doctor, grim faced, announced
delivery must happen quickly,
taking you now, hoping we were not too late.
I was rolled, numbed, stunned,
clasping your father’s hand, closing my eyes,
not wanting to see the bustle around me,
trying not to hear the shouted orders,
the tension in the voices,
the quiet at the moment of opening
when it was unknown what would be found.

And then you cried. A hearty healthy husky cry,
a welcomed song of life uninterrupted.
Perturbed and disturbed from the warmth of womb,
to the cold shock of a bright lit operating room,
your first vocal solo brought applause
from the surrounding audience who admired your purplish pink skin,
your shock of damp red hair, your blue eyes squeezed tight,
then blinking open, wondering and wondrous,
emerging and saved from a storm within and without.

You were brought wrapped for me to see and touch
before you were whisked away to be checked over thoroughly,
your father trailing behind the parade to the nursery.
I closed my eyes, swirling in a brain blizzard of what-ifs.

If no snow storm had come,
you would have fallen asleep forever within my womb,
no longer nurtured by my aging and failing placenta,
cut off from what you needed to stay alive.
There would have been only our soft weeping,
knowing what could have been if we had only known,
if God had provided a sign to go for help.

So you were saved by a providential storm
and dug out from a drift:
I celebrate when I hear your voice singing-
your students love you as their teacher and mentor,
you are a thread born to knit and mend hearts,
all because of a night of blowing snow.

My annual retelling of the most remarkable day of my life thirty years ago today when our daughter Eleanor (“Lea”) Sarah Gibson was born, hale and hearty because the good Lord sent a wind and snow storm to blow us into the hospital in time to save her. She is now married to her true love Brian–another gift sent from the Lord; we know you will be awesome parents when your turn comes!