How You Made Them Feel

I’ve learned that even
when I have pains, I don’t have to be one …
I’ve learned that people will forget what you said,
people will forget what you did,
but people will never forget how you made them feel.
~Maya Angelou
on her 70th birthday, citing a quote from Carl Buehner

I learned from my mother how to love
the living, to have plenty of vases on hand
in case you have to rush to the hospital
with peonies cut from the lawn, black ants
still stuck to the buds. I learned to save jars
large enough to hold fruit salad for a whole
grieving household, to cube home-canned pears
and peaches, to slice through maroon grape skins
and flick out the sexual seeds with a knife point.
I learned to attend viewings even if I didn’t know

the deceased, to press the moist hands

of the living, to look in their eyes and offer
sympathy, as though I understood loss even then.
I learned that whatever we say means nothing,

what anyone will remember is that we came.
I learned to believe I had the power to ease
awful pains materially like an angel.
Like a doctor, I learned to create

from another’s suffering my own usefulness, and once
you know how to do this, you can never refuse.
To every house you enter, you must offer

healing: a chocolate cake you baked yourself,
the blessing of your voice, your chaste touch.
~Julie Kasdorf– “What I Learned from my Mother”

Usually a mom knows best about these things — how to love others when and how they need it and how to ease pain, not become one.  We don’t always get it right though, and dads can do it better.

Showing up with food is always a good thing but it is the showing up part that is the real food;  bringing along a cake is simply the icing.

This is a good reminder that as a doctor,
my usefulness has tended to depend on another’s suffering.
No illness, no misery, no symptoms and I’m out of a job.
I can only hope that someday that might be the case.
What a world it would be, especially as now suffering is universal.

And then I can still be a mom and grandmom
even if there is no more doctor work to be done:
….if I’d known it could help, I’d have baked a cake and shown up with it…

You Never Know

What shall I say, because talk I must?
That I have found a cure
for the sick?
I have found no cure
for the sick

but this crooked flower
which only to look upon
all men
are cured. This
is that flower
for which all men
sing secretly their hymns
of praise! This
is that sacred
flower!
~William Carlos Williams from “The Yellow Flower”

The nail of each big toe was the horn of a goat.  Thick as a thumb and curved, it projected down over the tip of the toe to the underside.  With each step, the nail would scrape painfully against the ground and be pressed into his flesh.  There was dried blood on each big toe. 

It took an hour to do each big toe.  The nails were too thick even for my nail cutters.  They had to be chewed away little by little, then flattened out with the rasp, washed each toe, dried him off, and put his shoes and socks back on.  He stood up and took a few steps, like someone who is testing the fit of a new pair of shoes. 

“How is it?”

“It don’t hurt,” he said, and gave me a smile that I shall keep in my safety deposit box at the bank until the day I die.

I never go to the library on Wednesday afternoon without my nail clippers in my briefcase.
You just never know.

~Richard Selzer from “Toenails” from Letters to a Young Doctor

I know for a while again
the health of self-forgetfulness,
looking out at the sky through
a notch in the valleyside,
the black woods wintry on
the hills, small clouds at sunset
passing across. And I know
that this is one of the thresholds
between Earth and Heaven,
from which even I may step
forth and be free.
– Wendell Berry from “Sabbath Poems”

Whenever I lose perspective about what I’m trained to do
and who I am meant to serve,
when I wallow in the mud of self-importance
rather than in the health of self-forgetfulness~

I wash out a plug of wax from a deaf ear
and restore hearing
or remove a painful thorn in a thumb
or clip someone’s crippling toenails
so they can step forth in freedom
or I simply sit still as someone
cries out their heart’s pain.

I cling to the crooked flower
of healing and forgiveness I was handed
over forty years ago in order to share
its sacred sweetness.

I’ve been given these tools for a reason
so need to continue to use them.

You just never know.

Giving Life or Draining It

In every encounter we either give life or drain it. There is no neutral exchange. We enhance human dignity or we diminish it. The success or failure of a given day is measured by the quality of our interest and compassion toward those around us.
~Brennan Manning
from Abba’s Child: The Cry of the Heart for Intimate Belonging

Forty years ago this week I graduated with an M.D. degree from the University of Washington and began a lifetime of trying to be life-giving rather than life-draining to others.

There have been times when I’ve failed miserably, my interest waning and my compassion fatigued.

But like tracing the path of a spiral from inside to outside, I continue to try to reach farther and encompass more with each step I take in the time I have left, remembering the dignity of each person I meet and being worthy of their time and trust.

May this young woman who embarked so enthusiastically on the physician journey so many decades ago never forget, after so much seasoning, what it took to get there and what it means to continue to be worthy.

Known and Unknown

As a fond mother, when the day is o’er,
   Leads by the hand her little child to bed,
   Half willing, half reluctant to be led,
   And leave his broken playthings on the floor,
Still gazing at them through the open door,
   Nor wholly reassured and comforted
   By promises of others in their stead,
   Which, though more splendid, may not please him more;
So Nature deals with us, and takes away
   Our playthings one by one, and by the hand
   Leads us to rest so gently, that we go
Scarce knowing if we wish to go or stay,
   Being too full of sleep to understand
   How far the unknown transcends the what we know.
~Henry Wadsworth Longfellow “Nature”

I remember being reluctant to go to bed as a child; I could miss something important that the adults waited to do until after I was asleep, or I wasn’t sure that I wanted to turn myself over to my dreams.

I had a period of time when I was in third grade (during the Cuban missile crisis) when I really was terrified to go to sleep, and ended up reading comic books during the night hours, trying to keep myself distracted from whatever fears I harbored. My mother, frantic for sleep herself during this worrisome time, consulted my pediatrician who prescribed orange juice with a tablespoon of brandy – for me, not for her. She was outraged at the thought, being a teetotaler, so bought no brandy for me (or for herself). I eventually got over my sleep issues, but not my worried heart.

The unknown is always more frightening than the known, and the older I got, the more I learned during 24 years of formal education and training, the more I realized I didn’t know. There would be no end to it. Even though I still spend several hours a week reading for required and non-required continuing medical education, I don’t crack the surface of everything that is news in my profession. There is a whole lot that I need to un-learn because it is now proven that it is no longer valid as it originally was over four decades of medical practice.

During the last three months of COVID-19, it is like drinking from several firehoses at once, as data on this previously unknown virus comes piecemeal from countless sources: the studies are rushed and sample sizes are small, conclusions are tentative, often barely peer-reviewed and sometimes disproven the next week by another study. What was considered “fact” a month ago may no longer be so.

So I know I must settle into the reality that there will always be plenty of unknowns, particularly as I reluctantly let go of life’s playthings one by one.

The unknown will always transcend the known on this side of the veil so I appreciate that I am gently led, in faith, to that long-awaited sleep that was so elusive before.

The Clarity of Light

On the day when
The weight deadens
On your shoulders
And you stumble,
May the clay dance
To balance you.

And when your eyes
Freeze behind

The gray window
And the ghost of loss
Gets in to you,
May a flock of colors,
Indigo, red, green
And azure blue,
Come to awaken in you
A meadow of delight.

When the canvas frays
in the currach of thought
and a stain of ocean
blackens beneath you,
may there come across the waters
a path of yellow moonlight
to bring you safely home.

May the nourishment of the earth be yours,
may the clarity of light be yours,
may the fluency of the ocean be yours,
may the protection of the ancestors be yours.

And so may a slow
wind work these words
of love around you,
an invisible cloak
to mind your life.

~John O’Donohue “Beannacht”

So many of us grieve the loss of the way things were
and the loss of the people we loved.

There seems no light at all in the world,
only heaviness of burden, of clouds and sickness.

May God bring back the lightness to our days,
the color back to the gray,
the clarity of purpose throughout generations.

May God be real to us now, cleansing us
from our doubts, our frustrations,
our anger and our impatience
with one another
and with Him.

May God love us
in the midst of our weeping,
cloaked in His Word and His arms.

Flat Affect

I used to think the land
had something to say to us,
back when wildflowers
would come right up to your hand
as if they were tame.

Sooner or later, I thought,
the wind would begin to make sense
if I listened hard
and took notes religiously.
That was spring.

Now I’m not so sure:
the cloudless sky has a flat affect
and the fields plowed down after harvest
seem so expressionless,
keeping their own counsel.

This afternoon, nut tree leaves
blow across them
as if autumn had written us a long letter,
changed its mind,
and tore it into little scraps.
~Don Thompson October

photo by Nate Gibson
photo by Nate Gibson

We’re in a time of seasonal abundance but our emotions are spent from containment through lock-down, shelter-in, social distancing, zoom-in and zoom-out.

As I meet with my patients via a televisit, I try to read their faces and find that along with the flatness of our screens, our emotions are flat too. My usual gentle humor to lighten things up becomes pointless – it is hard to elicit smiles these days. On the other hand, there no longer is a need for abundant tissues for tearful conversations because no one will weep on screen. There may be a hint of emotion in a catch in a voice, but I have yet to see anyone actually cry in two months of telehealth conversations. That would be too vulnerable – somehow being on camera suggests we need to put the actor-mask on, be expression-less, strong and invulnerable. And somehow my patient knows I can’t reach out as I would in an exam room, literally and verbally, to reassure them I’m present and listening. I’m not really present on a screen even though I’m listening.

And while out in society, we must literally hide ourselves behind a mask that conceals our smiles as well as our grim-faced frowns.

So our social and clinical interactions are as flat as the screens they play out on.

We need some unchecked tears about now, as well as endless belly laughs. Perhaps there will be a reawakening to the range of emotions we have taken for granted before finding ourselves in this time of restraint and restriction.

As we reintegrate and reunite, slowly, carefully and compassionately, let us re-experience in 3-D what we have been missing in our virtual meetings: tears that accompany joyous reunion as well as the lament of all we’re lost during this time.

Please pass the tissues.

So Much Better

How much better it is
to carry wood to the fire
than to moan about your life.
How much better
to throw the garbage
onto the compost, or to pin the clean
sheet on the line,
With a gray-brown wooden clothes pin.
~Jane Kenyon “The Clothespin”

I get easily overwhelmed with everything that needs to get done:
a full day of telehealth computer visits with patients from home but all the usual household and farm tasks waiting for me –grass to mow, flower beds to weed, garden to plant, fences to fix, manure to haul, animals to brush out — the list is endless and there are never enough hours in the day.  

So of course, I moan and whine and write about it.

Or I can set to work, tackling one thing at a time.  A simple task is accomplished, and then another, like hanging clothes on the line: this one is done, and now this one, pinned and hanging to freshen, renewed, in the spring breezes.

At the end of the day, I pull them down, bury my face in them and breathe deeply, knowing how much better I am than before I began.

So much better.

Blooming Impossibly

There are days we live
as if death were nowhere
in the background; from joy
to joy to joy, from wing to wing,
from blossom to blossom to
impossible blossom, to sweet impossible blossom.

~Li-Young Lee, last stanza of “From Blossoms” from Rose.

… it seemed as if the tiniest seed of belief had finally flowered in me, or, more accurately, as if I had happened upon some rare flower deep in the desert and had known, though I was just then discovering it, that it had been blooming impossibly year after parched year in me, surviving all the seasons of my unbelief.
~Christian Wiman from My Bright Abyss

To live as if
death were nowhere in the background:
that is impossible right now
when death is in every headline
and everyone knows someone
who has been lost to the virus.

Yet, to still emerge and blossom,
despite the dryness and drought of pandemic~
this is Christ’s call to us.
 
We are not dying,
but alive in Him,
an amazing impossible flowering.

So I allow my eye to peer through
a dying time such as this,
needing a flotation device
and depth finder
as I’m likely to get lost,
sweeping and swooning
through the inner space
of life’s deep tunnels,
canyons and corners,
coming up for air and diving in again
to journey into exotic locales
draped in silken hues
~this fairy land on a stem~
to immerse and emerge
in the possibilities
of such an impossible blossom.

Spreading Infection

Good things as well as bad, you know, are caught by a kind of infection.

If you want to get warm you must stand near the fire:
if you want to be wet you must get into the water.
If you want joy, power, peace, eternal life,
you must get close to, or even into, the thing that has them. 

They are not a sort of prize which God could,
if He chose, just hand out to anyone.
They are a great fountain of energy and beauty

spurting up at the very centre of reality.
If you are close to it, the spray will wet you:

if you are not, you will remain dry.

Once a man is united to God, how could he not live forever?
Once a man is separated from God, what can he do but wither and die?

~C.S. Lewis- Mere Christianity

As society becomes more divided about how to manage continued COVID pandemic spread with new long-term medical complications among young and old — I wonder what is it that is truly infecting us aside from a tiny packet of RNA?

We are willing to believe almost anything without verification if it suits our previously held viewpoints; we can’t discern truth from fiction if it appears in a youtube video or a clickable headline.

The forces of evil are using a virus to divide and conquer good and well- meaning people who become infected without realizing it, spreading a contagion of suspicion, distrust and conspiracy theories.

Out of caution, as I’ve done for forty years inside the walls of my clinic, I now glove and mask outside the clinic to prevent me from inadvertently infecting others. Just as it has been during my whole professional career, taking those precautions doesn’t infringe on my rights nor does it harm me. It simply shows my careful consideration for others around me. Yet, more than ever, I am unwillingly exposed to the sad reality of this fallen fragile world through the angry words and deeds of others.

Instead, I want to be infected and contagious with the reality of God. I seek out the life-saving vaccination of God’s Word: eternal, unchanging and 100% effective.

If I’m to be contagious to others, let it be because I’m overwhelmed with the Spirit, not dangling helplessly by a mere thread in a pandemic spread of suspicion and distrust.

This Tranquil Dust

I like to live in the sound of water,
in the feel of mountain air. A sharp
reminder hits me: this world still is alive;
it stretches out there shivering toward its own
creation, and I’m part of it. Even my breathing
enters into the elaborate give-and-take,
this bowing to sun and moon, day or night,
winter, summer, storm, still—this tranquil
chaos that seems to be going somewhere.
This wilderness with a great peacefulness in it.
This motionless turmoil, this everything dance.

~William Stafford, “Time for Serenity, Anyone?” from Even in Quiet Places

We are, as breathed on dust, called into the service and company of another, called to do work other than our own. This creature, formed of dust, is entrusted with the garden, with all the animals, and with all living things. Our creatureliness binds us to the role of steward, friend, and companion of all other creatures who share our fragility.
~Walter Brueggemann from “Remember You Are Dust”

As a physician, I am reminded daily of the fragility of our bodies and minds, this breathed-on dust of us, especially now as a mere novel virus has immobilizes the world’s population.

As a farmer, I dwell compatibly with the dust I’m entrusted to steward.  I carry it around under my fingernails, on my boots, my skin smudged in unexpected ways and places as I go about my chores and tasks.  The dust of the barnyard wilderness clings to me, not wanting to let go of one of its own as I return indoors.  Sunbeams in our house swirl with released dust motes given new life through solar energy, each mote a source of fragile strength, tranquil beauty, complex simplicity.  Such joyful dust dance makes me reluctant to get out the dust rags and cleaning solutions.

As a child of the Creator, I am well aware of the cleansing needed in this grimy, desperately soiled world.  The dustiest parts of me lie far deeper than my shedding skin — the breathed-on dust that innervates, circulates and motivates me.

God sent His Son to be the dust rag I sorely need;  I cling to Him as He comes to clean house.