Never Got Wet

When the doctor suggested surgery
and a brace for all my youngest years,
my parents scrambled to take me
to massage therapy, deep tissue work,
osteopathy, and soon my crooked spine
unspooled a bit, I could breathe again,
and move more in a body unclouded
by pain. My mom would tell me to sing
songs to her the whole forty-five minute
drive to Middle Two Rock Road and forty-
five minutes back from physical therapy.
She’d say, even my voice sounded unfettered
by my spine afterward. So I sang and sang,
because I thought she liked it. I never
asked her what she gave up to drive me,
or how her day was before this chore. Today,
at her age, I was driving myself home from yet
another spine appointment, singing along
to some maudlin but solid song on the radio,
and I saw a mom take her raincoat off
and give it to her young daughter when
a storm took over the afternoon. My god,
I thought, my whole life I’ve been under her
raincoat thinking it was somehow a marvel
that I never got wet.
~Ada Limón “The Raincoat”

When I was 13, I grew too quickly. My spine developed a thoracic scoliosis (curvature) — after inspecting my back as I bent over to touch my toes, my pediatrician referred me to a pediatric orthopedic specialist an hour away from my home town.

The question was whether I would need to have a metal rod surgically placed along my spine to prevent it from more misalignment or whether I would need to wear a back brace like a turtle. The least intervention would be physical therapy to try to keep my back and abdominal muscles as strong as possible to limit the curvature.

Since my father didn’t have much flexibility in his work schedule, my mother had to drive me to the “big city” for my appointments – as a nervous driver, she did it only because she knew it was necessary to get the medical opinion needed. She asked me to read aloud to her from whatever book I was reading at the time – I don’t think she listened closely but I think she knew it would keep me occupied while she navigated traffic.

At first, we went every three months for new xrays. The orthopedist would draw on my bare back and on my spine xrays with a black marker, calculating my curves and angles with his protractor, watching for a trend of worsening as I grew taller. He reassured us that I hadn’t yet reached a critical level of deviation requiring more aggressive treatment.

Eventually my growth rate slowed down and the specialist dismissed me from further visits, wishing me well. He told me I would certainly be somewhat “crooked” for the rest of my life, and it would inevitably worsen in my later years. I continued to visit PT for regular visits; my mom would patiently wait in the car as I sweated my way through the regimen.

The orthopedist was right about the curvature of my aging spine. I am not only a couple inches shorter now, but my rib cage and chest wall is asymmetric affecting my ability to stand up totally straight. Just last week, I had an xray of my collar bones as even those joints have developed wear and tear changes. I consider being crooked a small price to pay for avoiding a serious surgery or a miserable brace as a teenager.

What I didn’t understand at the time was the commitment my mother made to make sure I got the care I needed, even if it meant great inconvenience in her life, even if she was awake at night worried about the outcome of the appointments, even if the financial burden was significant for my family. She, like so many parents with children with significant medical or psychological challenges, gave up her wants and wishes to make sure I received what I needed. As a kid, I just assumed that’s what a mom does. Later, as a mom myself, I realized it is what moms do, but often at significant personal cost. As a physician, I saw many young people whose parents couldn’t make the commitment to see they got the care they needed, and it showed.

I was one blessed by parents who did what their kids needed to thrive.

My mom constantly offered me her raincoat so I wouldn’t get wet. Meanwhile she was being drenched.

Thank you, Mom, for making sure I was covered by your love. I still am.

Original Barnstorming artwork note cards available as a gift to you with a $50 donation to support Barnstorming – information here

To Keep From Being Forgotten

I like to stroll the graveyard in the middle of town
With my friend Anne, though we seldom agree
On what an epitaph we happen to read implies.
I’m inclined to find the one-line gravestone,
Dr. Noah Vedder, M.D., as sadly comic.
If we can’t take our money into the dark,
I read it as saying, at least we can take our titles.
But Anne, whose sympathies are aroused
More quickly than mine, reads it more darkly
As confessional. Here is the man’s admission
That he saw himself as a better doctor
Than he was a friend, or father, or husband,
A better listener in his office than at home.

If his kin were responsible for the inscription,
Its terseness, I say, may suggest they were moved
More by duty than they were by love.
But for her, its terseness seems to imply
Their painful acknowledgment that no praise
Inscribed on the stone would keep their friend
From being forgotten soon after they would be.
And behind this truth she hears a protest:
If the world were fair, he wouldn’t be sentenced
To endless retirement but allowed to practice,
In a life beyond this one, the profession he loved.

What use would a doctor be, I ask, in a realm
Where bodies are laid aside? But for her the point is
That those who knew him were certain that if
Such a realm existed and a doctor were called for there,
He’d volunteer, glad to hold office hours
And glad after hours to visit patients
Too sick to leave home,
However modest the streets they lived on,
However winding and poorly lit.

~Carl Dennis “At the Graveyard with Anne”

Since my people are crushed, I am crushed;
    I mourn, and horror grips me.
 Is there no balm in Gilead?
    Is there no physician there?
Why then is there no healing
    for the wound of my people?

Jeremiah 8:21-22

We physicians can be an arrogant lot in our devotion to our profession above all else in our lives – I’ve known a few who wear their M.D. title full-time like a banner and shield to prove their expertise.

The only time the label M.D. is relevant is on a name tag in a clinical setting and often it doesn’t even make a difference there. We do what we can with what knowledge we possess from our training, as limited as it is. There is so much that we don’t know and don’t understand.

Even so, there are many altruistic physicians who give of themselves 24 hours a day for their lifetime. Some would gladly continue their healing efforts long after they have become dust, yet those skills are no longer needed. In heaven, all are already healed.

Our healing comes from beyond our expertise, from a balm that can never be prescribed. We have a Great Physician who never forgets us, even when we are crushed and mourning, when all seems hopeless with our wounds so incredibly deep.

We are not forgotten.

Every face is in you, every voice,
Every sorrow in you.
Every pity, every love,
Every memory, woven into fire.
Every breath is in you, every cry,
Every longing in you.

Every singing, every hope,
Every healing, woven into fire.
Every heart is in you,
Every tongue, every trembling in you,
Every blessing, every soul,
Every shining, woven into fire.
~Michael Dennis Browne

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Saved By a Snow Storm

“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

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”

Your rolling and stretching had grown quieter that stormy winter night
twenty nine 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.
So 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 loose 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,
and when your students love you as their teacher,
knowing you are a thread born to knit and mend hearts,
all because of blowing snow.

My annual retelling of the most remarkable day of my life when our daughter Eleanor (“Lea”) Sarah Gibson was born, hale and hearty because the good Lord sent a snow and wind storm to blow us into the hospital in time to save her. She is now married to her true love Brian who is another gift sent from the Lord; someday their hope for parenthood will come true for them as well.

Benign

“They’re benign,” the radiologist says,
pointing to specks on the x ray
that look like dust motes
stopped cold in their dance.
His words take my spine like flame.
I suddenly love
the radiologist, the nurse, my paper gown,
the vapid print on the dressing room wall.
I pull on my radiant clothes.
I step out into the Hanging Gardens, the Taj Mahal,
the Niagara Falls of the parking lot.

~Jo McDougall, “Mammogram” from In the Home of the Famous Dead: Collected Poems

Outside the house the wind is howling
and the trees are creaking horribly.
This is an old story
with its old beginning,
as I lay me down to sleep.
But when I wake up, sunlight
has taken over the room.
You have already made the coffee
and the radio brings us music
from a confident age. In the paper
bad news is set in distant places.
Whatever was bound to happen
in my story did not happen.
But I know there are rules that cannot be broken.
Perhaps a name was changed.
A small mistake. Perhaps
a woman I do not know
is facing the day with the heavy heart
that, by all rights, should have been mine.

~Lisel Mueller “In November”

It does not escape me,
especially on mammogram days~~

(although I wake every day knowing this):

an earthquake happened somewhere else,
a war left people homeless and lifeless,
a windstorm leveled a town,
a drunk driver destroyed a family,
a fire left a house in ashes,
a famine caused children to starve,
a flood ravaged a village,
a devastating diagnosis darkened
someone’s remaining days.

No mistake has been made,
yet I wake knowing this part of my story
has not yet visited me,
the heavy heart
that could have been mine
is spared again,
still beating,
still breaking,
still bleeding,
still believing
the radiance from this good news is real
and once again happened today.

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A book of beauty in words and photography, available to order here:

The Reddening Light

Near dusk, near a path, near a brook,
we stopped, I in disquiet and dismay
for the suffering of someone I loved,
the doe in her always incipient alarm.

All that moved was her pivoting ear
the reddening sun was shining through
transformed to a color I’d only seen
in a photo of a new child in a womb.

Nothing else stirred, not a leaf,
not the air, but she startled and bolted
away from me into the crackling brush.

The part of my pain which sometimes
releases me from it fled with her, the rest,
in the rake of the late light, stayed.
~C. K. Williams  “The Doe”
from The Singing

Oh little one
who was to have been born this week in June
thirty eight years ago~
so wanted
so anticipated
but lost too soon.

Gone as swiftly in a clot of red
as a doe disappearing soundlessly into a thicket:
so long ago it makes me question
if you were real,
until my heart clenches again at the memory.

But you were
and you are
and someday
I’ll know you when I see you
and curious about who I am,
you won’t flee this time,
but stay to find out.

A new book from Barnstorming is available to order here:

Absorbing the Shock

There are three kinds of men.
The ones that learn by reading.
The few who learn by observation. 
The rest of them have to pee on the electric fence for themselves.
~Will Rogers

Learning is a universal human experience from the moment we take our first breath.  It is never finished until the last breath is given up.  With a lifetime of learning, one would think eventually we should get it right.

But we don’t.  We tend to learn the hard way especially when it comes to matters having to do with our (or others’) health.

As physicians in training, we “see one, do one, teach one.”   That kind of approach doesn’t always go so well for the patient.   As patients, we like to eat, drink, and live how we wish, demanding what interventions we want only when we want them – this also doesn’t go so well for the patient.  You’d think we’d know better, but as fallible human beings, we may impulsively make decisions about our health without actually using our heads (is it evidence-based or simply an anecdotal story about what “worked” for someone else?).

The cows and horses on our farm need to touch an electric fence only once when reaching for greener grass on the other side.  That moment provides a sufficient learning curve for them to make an important decision.  They won’t try testing it again no matter how alluring the world appears on the other side.   Humans are smarter sentient beings who should learn as quickly as animals but unfortunately don’t.  I know all too well what a shock feels like and I want to avoid repeating that experience.  Even so, in unguarded careless moments of feeling invulnerable (it can’t happen to me!), and yearning to have what I don’t necessarily need,  I may find myself reaching for the greener grass (or another cookie) even though I know better.   I suspect I’m not alone in my surprise when I’m jolted back to reality when I continually indulge myself and climb on the scale to see the results.

Many great minds have worked out various theories of effective learning, but, great mind or not, Will Rogers confirms a common sense suspicion: an adverse experience, like a “bolt out of the blue,” can be a powerful teacher.  As clinicians, we call it “a teachable moment.”  None of us want to experience a teachable moment — none of us, and we resent it when someone points it out to us.

When physicians and patients learn the hard way, we need to come along aside one another rather than work at cross-purposes.

It just might help absorb the shock.

Turning Darkness into Light: Dust Made Manifest

Nobody in the hospital
Could tell the age 
Of the old woman who
Was called Susanna

Because she had no visitors
I would stop by to see her
But she was always sleeping

One day I was beside her
When she woke up
Opening small dark eyes
Of a surprising clearness

She looked at me and said
You want to know the truth?
I answered Yes

She said it’s something that 
My mother told me

There’s not a single inch
Of our whole body
That the Lord does not love

She then went back to sleep.
~Anne Porter  from “Susanna”

photo by Andrea Nipges

So many people lie in a hospital bed these days, all alone
and fearful, wondering what could happen next,
waiting for the tide to turn and move them back to the shore
or sweep them out into the arms of their Creator forever.

We tend to forget the love of the One who made us,
including our funny looking feet, our anxieties,
the crooked teeth, the wrinkles, the scars, the split ends —

We see only our imperfections and frailty
when our Creator sees dust made manifest
in His image.

He loves us even when we do not love ourselves,
as we hide our flaws and cover up our vulnerable nakedness.

He loves every inch
because we are His opus,
a masterpiece,
so He became one of us.

He knew exactly what He was doing
and even now,
in the midst of our loneliness,
He knows exactly what He is doing
with the dust that still swirls around us.

How is Your Life?

Today, when I could do nothing,
I saved an ant.

It must have come in with the morning paper,
still being delivered
to those who shelter in place.

A morning paper is still an essential service.

I am not an essential service.

I have coffee and books,
time,
a garden,
silence enough to fill cisterns.

It must have first walked
the morning paper, as if loosened ink
taking the shape of an ant.

Then across the laptop computer — warm —
then onto the back of a cushion.


Small black ant, alone,
crossing a navy cushion,
moving steadily because that is what it could do.

Set outside in the sun,
it could not have found again its nest.
What then did I save?


It did not move as if it was frightened,
even while walking my hand,
which moved it through swiftness and air.


Ant, alone, without companions,
whose ant-heart I could not fathom—
how is your life, I wanted to ask.


I lifted it, took it outside.

This first day when I could do nothing,
contribute nothing
beyond staying distant from my own kind,
I did this.

~Jane Hirschfield “Today When I Could Do Nothing”

Nine months into social distancing one from another, with COVID spreading wider and faster than ever, I feel helpless to be a helper without the virus becoming a potentially deadly attachment to my efforts.

So I look for little ways to try to make a difference, as inadequate as they seem. I can no serve meals after evening church service. I can’t visit vulnerable people in their homes so have to be satisfied with screen visits. I can’t go where I wish when I wish because, by definition of age and medical risk, I am one of the vulnerable too.

So I look for words to express that may bring you a smile or maybe a knowing tear. I look for images to share that remind you of something from your past experience. I look for ways to make sense of the senseless when there can be so much disagreement and anger and bitterness. I look for where our common ground exists: how can we deepen and broaden our connection to one another in this time of painful and empty separation?

I want to ask and I want to hear: how is your life?

When we feel we can do nothing, we can do this: rescuing one another from isolation and loneliness. It will be the most important thing we do today.

Please tell me how you are.

Caught in Our Own Careless Wreckage

I believed only air
stretched between the dogwood

and the barberry: another
thoughtless human assumption

sidetracking the best story
this furrow spider knew to spin.

And, trying to get the sticky
filament off my face, I must look,

to the neighbors, like someone
being attacked by his own nervous

system, a man conducting an orchestra
of bees. Or maybe it’s only the dance

of human history I’m reenacting:
caught in his own careless wreckage,

a man trying to extricate himself,
afraid to open his eyes.
~Jeff Worley from Lucky Talk

It was an uneasy feeling opening my eyes this morning, waking up to a world where the election results are still uncertain. We are suspended in a sticky web of our own making and will be for some time, dangling…

Twenty years ago, I woke up not feeling well after a long night of waiting for election results to come in. I thought it was from the tension of not knowing when the outcome would be finalized but no… It ended up being appendicitis that day — my 2000 post-election surgical solution to take my mind off Bush vs Gore. It worked. I simply ceased to care about anything but my own healing, my priorities clarified by post-op recovery.

I’m not looking to resort to that remedy today in Trump vs Biden. I’d like to keep myself out of the ER and the OR and just go about my clinic day as usual. Yet in the dance of human history we badly want to determine who our leaders will be in a clear-cut and clean-cut process, something this campaign season has lacked. So why we would expect clarity now?

Instead, we are covered in a sticky-wickety web, spread all over our faces, unwilling to open our eyes to the reality of our divisive messiness, and attacked by our own nervous systems.

Today, I will open my eyes, take a few deep breaths and I hope you will too. And tomorrow and the next day. And avoid radical surgery if we can.

Maybe the dance is something we can do together — coordinated, cooperative, choreographed, and united — rather than flailing about in our careless wreckage of human history.

Because You Matter to Me…

If I can stop one heart from breaking,
I shall not live in vain;
If I can ease one life the aching,
Or cool one pain,
Or help one fainting robin
Unto his nest again,
I shall not live in vain.
~Emily Dickinson

So if there is any encouragement in Christ,
any comfort from love,

any participation in the Spirit,
any affection and sympathy,
complete my joy by being of the same mind,
having the same love,
being in full accord and of one mind.
…. in humility count others more significant than yourselves.
Let each of you look not only to his own interests,
but also to the interests of others.
~Philippians 2: 1-4

Walk in a manner worthy of the calling
to which you have been called,
with all humility and gentleness,
with patience,
bearing with one another in love,
eager to maintain the unity of the Spirit in the bond of peace.
Ephesians 4: 1-3

By wearing a mask…

If I can stop one person from infection,
I shall not live in vain;
If I can ease another’s worry,
Though masking goes against the grain,
Or help a divided country be
Restored to health again,
I shall not live in vain.

I wear a mask because you matter to me…