A Change in Altitude

           

‘Regret has to be useless or it’s not really regret.’
 ~Simone de Beauvoir

Rescuers did not find my uncle’s body.
But they found his axe at an icy altitude
impossible to navigate without one.


A little higher up, they found my uncle
’s sleeping bag at an altitude
unsurvivable without one.


You likely have a pen in purse or pocket.
Take it out and write a list of all
you need at your present altitude.


Next, change altitudes. Now, make another list:
the two biggest regrets of your life.
Take your time. Get it right. Because

here is all you need to know about need:
That list of regrets—cross one off.
You are going to need that space later.
~Jessica Goodfellow, “Unreachable” from Whiteout

I’ve known people who lost their lives while hiking/climbing in the mountains or due to some other tragedy – the cascade of decisions leading to their death are sources of regret for all who mourn them, even decades later. Somehow regret is a difficult feeling to let go;
we cling to it as if it is somehow an essential part of us.

It is easy for me to come up with a long list of regrets in my life. They seem to grow like weeds – useless, unplanned, unwanted and prolific, threatening to take over any good fruit being produced.

Few of us volunteer to share openly about our current guilt or shame unless we are sitting in a therapy group, a confessional booth, or AA. Instead it gives us permission to beat ourselves up, going over and over in our minds how we could have done things differently.

As a physician, I heard about such heart-ache in my clinical encounters – a patient will regret an impulsive sexual encounter that turned out badly, or drinking and drugging too much, or regret an ongoing conflict with a family member, or wish they had decided to get that vaccine before becoming ill with a potentially preventable infection.

Our list of regrets can be endless and life-destroying.

I understand the pain of regret as I too am a flawed and fractured person with an eight-decade history of things done and left undone, words said and unsaid. Even if I think I can somehow manage to cross a regret off my own list – perhaps I apologized and was granted forgiveness, or I tried to make right what I’d messed up — I still know a new regret will occupy its place before long.

I can’t simply fix my own regret list.

No matter what altitude we’re at — down in the pits in the lowest of the low, or up in the highest imaginable, I have come to realize that forgiveness is only possible through a knowledge of God Himself.
He came to walk beside us in our low spots and our high spots, no matter where we find ourselves. His work on earth has crossed off our regrets and mistakes and wiped us clean of them.

He did this because He understood our desperate need;
thanks to His sacrifice and love, our heart-aches are left at the Cross.

A Knock on the Door of Your Life

When a great moment knocks on the door of your life,
it is often no louder than the beating of your heart,
and it is very easy to miss it.
~Boris Pasternak

‘Is there anybody there?’ said the Traveller,   
Knocking on the moonlit door;
And his horse in the silence champed the grasses   
Of the forest’s ferny floor:
And a bird flew up out of the turret,   
Above the Traveller’s head:
And he smote upon the door again a second time;  
‘Is there anybody there?’ he said.
But no one descended to the Traveller;   
No head from the leaf-fringed sill
Leaned over and looked into his grey eyes,   
Where he stood perplexed and still.
But only a host of phantom listeners   
That dwelt in the lone house then
Stood listening in the quiet of the moonlight   
To that voice from the world of men:
Stood thronging the faint moonbeams on the dark stair,   
That goes down to the empty hall,
Hearkening in an air stirred and shaken   
By the lonely Traveller’s call.
And he felt in his heart their strangeness,   
Their stillness answering his cry,
While his horse moved, cropping the dark turf,   
’Neath the starred and leafy sky;
For he suddenly smote on the door, even   
Louder, and lifted his head:—
‘Tell them I came, and no one answered,   
That I kept my word,’ he said.
Never the least stir made the listeners,   
Though every word he spake
Fell echoing through the shadowiness of the still house   
From the one man left awake:
Ay, they heard his foot upon the stirrup,   
And the sound of iron on stone,
And how the silence surged softly backward,   
When the plunging hoofs were gone.

~Walter De La Mare “The Listeners”

Years ago, a young woman I’d been treating for depression for several weeks in my clinic called unexpectedly on a Friday afternoon and canceled an upcoming appointment for the following Monday and did not reschedule.

The receptionist sent me a message as was our policy for patients who “cancel and do not reschedule.” It gave me a bad feeling that she was turning her back on her treatment plan and I was uneasy about the upcoming weekend without knowing what was going on with her.

I could have just put on my coat and headed home at the end of that long Friday after a very stressful work week and even more stressful year. I was discouraged about many aspects of my clinic work load and my after-hours responsibilities only seemed to get heavier. I was frustrated at how ineffectively I was communicating to administrative supervisors about the need for change. 

I was ready to quit and walk away.

Even so, in a moment of clarity about my role and commitment to those I was responsible for, I called my patient to find out how she was doing. She didn’t answer her phone.

I mulled over my options. Protocol was to call the police to go to her address for a “well-being” check. I looked up her apartment address and decided instead to drive the few blocks to get there.

As I approached her door, I could hear someone moving around in her apartment, but she ignored my knocks and my voice and when I tried to open the door, it was locked.

So I stayed right there, talking to her through the door for about 15 minutes, letting her know I wasn’t leaving until she opened up the door. I finally told her she could decide to open the door or I would call 911 and ask the police to come to make sure she was okay. She then unlocked the door, tears streaming down her face. She had been drinking heavily, with liquor bottles strewn around on the floor. She admitted an intent to overdose on aspirin and vodka. The vodka was already consumed but the unopened aspirin bottle was in her hand.

I was the last person she expected to see at her door.

Miraculously, the inpatient mental health unit at the local hospital had an open bed. I told my patient that we could save time and hassle by heading over there together right then and there, and avoid the emergency room chaos and delay, and the possibility of an involuntary detainment.

She agreed to come with me and be admitted voluntarily for stabilization. When I went to the hospital to see ger the next day, she greeted me with a hug and thanked me for not giving up on her when she had given up on herself.

In sobriety, her eyes were brighter and she was more hopeful. She never expected anyone to care enough to come knock on her door when she was at her lowest point. It was the start of her climb out of her pain and depression.

Four years later, a small card arrived in my clinic mailbox on another most challenging work day from an unfamiliar address two thousand miles away. The name looked vaguely familiar to me but when I opened and read the contents, this time it became the knock on the door to get my attention, to focus the beating of my heart on what was most important – not the stresses of my work place — and it was my turn to let tears flow:

“Dear Doctor,

I am not sure if you will remember me considering you see a number of patients daily; however, I am a patient whose life you changed in the most positive way. I never truly THANKED YOU for listening to me and hearing my silent words of grief and hearing my cries for help. If it had not been for you, had you not knocked on my door, I would not be writing this letter to you today. I don’t know exactly what to say to the person who saved me from hurting myself fatally. You were a stranger in my life, but a dear friend in my time of need. THANK YOU, for everything that you did for me. You have a permanent place in my heart, you have given my spirit hope, you have reminded me that a life is worth living. Thank you, thank you, thank you! Sincerely, L_____”

Somehow I had the sense that I needed to go knock on her door because I was keeping my word to take care of her at her lowest point. I had the stubbornness to stay put until she responded, and most of all, I’m appreciative for her gracious note letting me know it made a difference.

When I needed it the most, she made a difference for me that kept me on the job for another twenty years.

With her letter, she knocked, oh so gently, on my own locked door. I opened it, amazed that someone cared enough to let me know I kept my word.

How to Clear the Fog

~Lustravit lampade terras~
(He has illumined the world with a lamp)
The weather and my mood have little connection.
I have my foggy and my fine days within me;
my prosperity or misfortune has little to do with the matter.
– Blaise Pascal from “Miscellaneous Writings”

Tired and hungry, late in the day, impelled
to leave the house and search for what
might lift me back to what I had fallen away from,
I stood by the shore waiting.
I had walked in the silent woods:
the trees withdrew into their secrets.
Dusk was smoothing breadths of silk
over the lake, watery amethyst fading to gray.
Ducks were clustered in sleeping companies
afloat on their element as I was not
on mine. I turned homeward, unsatisfied.
But after a few steps, I paused, impelled again
to linger, to look North before nightfall—the expanse
of calm, of calming water, last wafts
of rose in the few high clouds.
And was rewarded:
the heron, unseen for weeks, came flying
widewinged toward me, settled
just offshore on his post,
took up his vigil.
                               If you ask
why this cleared a fog from my spirit,
I have no answer.

~Denise Levertov “A Reward” from Evening Train

photo by Josh Scholten
photo by Josh Scholten

Flee for a while from your tasks,
hide yourself for a little space from the turmoil of your thoughts.
Come, cast aside your burdensome cares,
and put aside your laborious  pursuits.
For a little while give your time to God,
and rest in him for a little while.
Enter into the inner chamber of your mind,
shut out all things save God
and whatever may aid you in seeking God;
and having barred the door of your chamber, seek him.
~Anselm of Canterbury: The Major Works

And so you have a life that you are living only now,
now and now and now,
gone before you can speak of it,
and you must be thankful for living day by day,
moment by moment …
a life in the breath and pulse and living light of the present…

~Wendell Berry from Hannah Coulter

photo by Josh Scholten

There were long days during my doctoring years
when I would be near tears,
physically spent, too fried
to keep listening, problem solving, comforting.

I needed to feel something other than needed.
I needed neediness myself — 
a sorry place to be
for a physician and healer.

Of course it had happened before, many times:
middle of the night mothering a vomiting child,
middle of the night mothering a frail mother,
middle of the night reassuring a frightened patient,
middle of the night worried about the state of the world.

Yet morning always comes because God has never left,
maybe not bright and shining and wondrous,
maybe still hidden behind a fog,
maybe not hidden at all
but waiting inside my muddled thoughts –

I found if I gently closed the door to all
that is not God,
I would find Him looking for me
and all would become clear.

Text by George Matheson:
O Love that will not let me go,
I rest my weary soul in thee;
I give thee back the life I owe,
That in thy ocean depths its flow
May richer, fuller be.

O Joy that seeks me through pain,
I cannot close my heart to thee;
I trace the rainbow through the rain,
And feel the promise is not vain,
That morn shall tearless be.

When the dawn
O’er hill and dale
Throws her bright veil,
Oh, think of me!

When the laugh
With silver sound
Goes echoing round,
Oh, think of me!

When the rain
With starry showers
Fills all the flowers,
Oh, think of me!

When the wind
Sweeps along,
Loud and strong,
Oh, think of me!

When the earth
Sleeping sound
Swings round and round,
Oh, think of me!

When the night
With solemn eyes
Looks from the skies,
Oh, think of me!”

-Frances Anne Kemble

Plowing Deep for Love

image
image
Photo by Joel DeWaard

It’s the immemorial feelings
I like the best: hunger, thirst,
their satisfaction; work-weariness,
earned rest; the falling again
from loneliness to love;
the green growth the mind takes
from the pastures in March;
the gayety in the stride 
of a good team of Belgian mares
that seems to shudder from me
through all my ancestry.
~Wendell Berry “Goods”

photo by Joel De Waard
photo by Joel De Waard

The plow has savaged this sweet field
Misshapen clods of earth kicked up
Rocks and twisted roots exposed to view
Last year’s growth demolished by the blade.

I have plowed my life this way
Turned over a whole history
Looking for the roots of what went wrong
Until my face is ravaged, furrowed, scarred.

Enough. The job is done.
Whatever’s been uprooted, let it be
Seedbed for the growing that’s to come.
I plowed to unearth last year’s reasons—

The farmer plows to plant a greening season.
~Parker Palmer “Harrowing”

photo by Joel De Waard
photo by Joel De Waard

It’s not likely anyone would say I didn’t work hard enough.

After all, I come from a long line of human work-horses
who knew it takes sweat and tears, and sometimes bleeding.

Even so, all those years
I know I could have plowed more deeply than I did.

I could have thrown myself more fully
into the pull on the tugs,
shared the load more effectively,
shouldered the yoke with greater enthusiasm,
bent my neck down low with unbroken determination.

You could say somewhere
I lost the gayety in my stride,
and you would be right —
toward the end, I was trudging through the furrow,
bruised from turning up too many submerged rocks,
bumping into immoveable tree stumps,
tripping on hidden roots,
stuck in the deep mud
of long and lonely post-midnight hours.

You might even say the knowledge of a job well-done
lay at a depth my plow could ever reach.

I had seen others die in the harness,
never able to rest easy.

A few years ago I knew
the time had come
to shrug off the yoke,
shake off the bridle and bit,
shudder free of the harness.

On this side of the ground,
I find myself wondering and wandering,
the blinkers no longer impeding my vision,
feeling the morning sun on my unyoked withers.

Yet when I see an untilled field,
something in me even now
still tries to hold on to the plow —

photo by Joel De Waard
photo by Joel De Waard
photo by Joel De Waard

You Just 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 was 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~

On those clinic days when I would wash out
a plug of wax from a deaf ear and miraculously restore hearing
or remove a painful thorn in a festering 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 would cling to that crooked flower
of healing and forgiveness I was handed
over fifty years ago, sharing
its sacred sweetness with another.

I was given these tools for a reason,
and try to still use them.

You just never know.

What I’m Still Learning…

I’ve learned that no matter what happens, or how bad it seems today, life does go on, and it will be better tomorrow.

I’ve learned that you can tell a lot about a person by the way he/she handles these three things: a rainy day, lost luggage, and tangled Christmas tree lights.


I’ve learned that regardless of your relationship with your parents, you’ll miss them when they’re gone from your life.


I’ve learned that making a ‘living’ is not the same thing as making a ‘life.’


I’ve learned that life sometimes gives you a second chance.


I’ve learned that you shouldn’t go through life with a catcher’s mitt on both hands; you need to be able to throw something back.


I’ve learned that whenever I decide something with an open heart, I usually make the right decision.


I’ve learned that even when I have pains, I don’t have to be one.


I’ve learned that every day you should reach out and touch someone. People love a warm hug, or just a friendly pat on the back.


I’ve learned that I still have a lot to learn.


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

…think of all the things you’ve learned over the years—
the hard and the holy,
the mysteries that will always remain mysterious,
the clean edges of truth,
the soft edges of every kindness given or received,
the way trouble and wonder will continue to show up, sometimes leaving us beached and breathless with uncontainable joy or unutterable sorrow.
I think of all the times I was knocked to my knees by a beautiful and brilliant flash of the completely obvious.

~Carrie Newcomer from A Gathering of Spirits

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”

Five years ago today, I wrapped up 45 years of uninterrupted medical training and doctoring.

Even while bearing three children and going through a few surgeries myself, I was not away from patient care for more than twenty consecutive days at any one time. This was primarily out of my concern that, even after a few weeks, I would forget all that I’d ever known.

Indeed, half of what I learned in medical school and residency nearly fifty years ago has evolved, thanks to new discoveries and clarifying research. I worried if I actually stepped away from doctoring for an extended time, then return to see patients again, I would be masquerading as a physician rather than be the real thing.

I couldn’t fathom a day when I could actually investigate a medical dilemma by typing a few words in a search engine on a computer screen. Instead, I researched through opening my encyclopedic collection of reference textbooks along with huge notebooks of “Scientific American Updates,” a monthly process of throwing out old articles to be replaced by newly discovered data. That is how I kept learning before the computer replaced books and pen and paper…

If being truly honest, even now, those who spend their professional lives providing medical care to others always share this concern: if a patient only knew how much we don’t know and will never know, despite everything we DO know, there would really be no trust left for us at all.

With so much rapidly changing medical information at everyone’s fingertips and computer screens, who needs a trained physician when there are so many other resources – many sketchy and opportunistic – for seeking health care advice?

Yet, I am convinced most patients really do want doctors to share the best information they have available at any point in time rather than rely on the latest internet algorithm and so-called “experts.”

I know over forty years of clinical experience gave me an eye and an ear for the subtle signs and symptoms that no googled website or AI app or virtual doc-in-the-box can discern: the avoidance of eye contact, the tremble of the lip as they spoke, the barely palpable rash, the hardly discernible extra heart sound, the fullness over an ovary, the slight squeak in a lung base. These are things I was privileged to see and hear, about which I made decisions together with my patients. 

The work I did over four decades was a reflection of a continual learning process; out of my natural caution, I was honest when I didn’t know what the diagnosis was, nor the best treatment, but committed to doing my best to find out.

Continual learning – what I was trained to do for thousands of days and many more thousands of patients during my professional life, while passing a comprehensive certification examination every few years to prove my study and changing fund of knowledge.

Since retiring, the help I offer no longer means writing a prescription for a medication, or performing a minor surgery. I have to simply offer up me for what it’s worth, without a stethoscope.

Now I aim to be the best mom and grandma and friend I can be.
I can press my hand into another’s, hug when needed, smile and listen and nod and sometimes weep when someone has something they need to say. No advanced degree or certification required.

Someday, hopefully not too soon, I will die happy knowing I chose this with my life: still learning and still caring.

A Delicate Sadness of Dusk

The talkative guest has gone,
and we sit in the yard
saying nothing. The slender moon
comes over the peak of the barn.

The air is damp, and dense
with the scent of honeysuckle. . . .
The last clever story has been told
and answered with laughter.

With my sleeping self I met
my obligations, but now I am aware
of the silence, and your affection,
and the delicate sadness of dusk.
~Jane Kenyon, “The Visit” from Collected Poems

From morning suns and evening dews
At first thy little being came:
If nothing once, you nothing lose,
For when you die you are the same;
The space between, is but an hour,
The frail duration of a flower.
~Philip Freneau from “The Wild Honey Suckle”

It sprang up wild along the chain link fence—thick,
with glorious white
and yellow summer blooms, and green tips that we
pinched and pulled for one
perfect drop of gold honey. But Dad hated
it—hated its lack
of rows and containment, its disorder. Each
year, he dug, bulldozed,
and set fire to those determined vines. But each
year, they just grew back
stronger. Maybe that’s why I felt the urge to
plant it that one day
in May, when cancer stepped onto my front porch
and rang the doorbell,
loose matches spilling out of its ugly fists.
~Karla Morton “Honeysuckle” from Accidental Origami: New and Selected Works

Some things are very dear to me–
Such things as flowers bathed by rain
Or patterns traced upon the sea
Or crocuses where snow has lain . . .
The iridescence of a gem,
The moon’s cool opalescent light,
Azaleas and the scent of them,
And honeysuckles in the night.
And many sounds are also dear–
Like winds that sing among the trees
Or crickets calling from the weir
Or Negroes humming melodies.
But dearer far than all surmise
Are sudden tear-drops in your eyes
~Gwendolyn Bennett— Sonnet 2

I am an easy cryer. It takes very little to tip me over the edge: a hymn, a poem, simply witnessing a child’s joy.

Suddenly my eyes fill up.

I blame this on my paternal grandmother who was in tears much of the time while visiting our family, crying happy, crying sad, crying frustrated and angry tears, crying desperate tears after being diagnosed with metastatic pancreatic cancer. I think of her often as she was the age I am now, grateful I too have not been visited with such dire news.

My greatest trigger to weep myself is watching someone else tear up.
I think my grandmother left behind some powerful empathy genes and I will honor that when I visit her grave this weekend to lay flowers.

I needed to desensitize my response to others’ tears to be effective as a physician/healer. Witnessing tears in the exam room is a normal part of the job: patients are anxious, ill, in pain or just need to decompress in safety. I learned early on to be unobtrusive and not interrupt, letting the flow of tears be part of how the patient was trying to communicate their distress. It was a struggle when my inclination was to cry right along with them.

But I needed to remain the rock in the room, solid and steady. I could understand their tears as yet another symptom of a clinical presentation, allowing me to observe without being clouded by my own emotional response.

Sometimes that worked. Sometimes not. At times overwhelmed myself, I wept at births, I wept at deaths, I wept at the sharing of bad news.

Now retired and liberated from the exam room, I freely and regularly weep at the state of the world, or when I read of disaster and tragedy, and especially when I witness intentional harm and cruelty in others. I’m no longer a stone, but more like an over-filled sponge being squeezed – everything builds up until I can hold it no more.

Reading headlines in the news is sometimes more than I can bear.
I cry myself dry.

And that is okay, thanks to Grandma. Once emptied out, I can be filled again by so much that is good and precious and beautiful in this life – a sad and delicate dusk, the promising light of dawn, the persistence of the wild honeysuckles, the raindrops on colorful blooms, the resonance of a heartfelt spiritual, the love of my husband, children, grandchildren and friends.

Now those are worth weeping over.

The Lines Went Flat…

First of all, we’ve been using the wrong word all these years. It means without rhythm. The only arrhythmia is asystole, I tell my students. That’s the flat line accompanied by the clang of alarms in all the television dramas. There’s not much you can do about it; the patient is dead and usually stays dead. The correct word to describe all the ways a heart can dance and die is dysrhythmia, which means a disordered rhythm. There’s the soldiered march of ventricular tachycardia or the pirouette twirl of Torsades. Ventricular fibrillation simply quivers on the monitor. When these rhythms occur, the patient is pulseless and sometimes you give magnesium, usually shock, and always pump their chest to the beat of whatever song lives in your head. Once I was speaking with a man who stopped in the middle of a word, and I watched the rhythm on the monitor change. When I didn’t feel a pulse, I started CPR, and then we placed the paddles on his chest and shouted, Clear, just like in the movies. And it worked. He opened his eyes and looked at me and said, I don’t feel good. And I said, It’s okay, I’m going to get you better and smoothed the fair from his forehead, but then the alarms blared and the V tach returned, and we did it all over again—the drugs and compressions and shocks, and his eyes opened one more time and he mouthed I’m scared around the tube I’d placed in his throat, and I said, I’m here with you. But that was the last time he said anything. We didn’t stop for thirty minutes or more. He’d waved to his family when the medics loaded him into the ambulance with just a little chest pain, so they were shocked when I entered the small consult room to tell them he had died. His teenage son collapsed and landed on his knees and punched the ground and said, But we were fighting, and I think the last thing I said was I hate you.

All I’m trying to say is that it’s really important to use the right words.
~Rachel Mallalieu “A Brief History of Arrhythmia” from the journal PEMBROKE MAGAZINE

If you break
break going out not in.
How you live your life I don’t care
but I’ll sell my arms for you,
hold your secrets for ever.

If I speak of death
which you fear now, greatly,
it is without answers,
except that each
one we know is
in our blood.
Don’t recall graves.
Memory is permanent.

~Michael Ondaatje from “To a Sad Daughter”

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
shook
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

Like many other medical professionals who have worked in the trenches of frontline healthcare, I too am fascinated by the emergency room streaming drama “The Pitt.”

At first, I couldn’t watch without feeling I too should be working at the bedside alongside the ER team, trying my best to do the task assigned to me, responding to each new instruction, grateful when things go as hoped, crushed when nothing helps and the patient is lost.

The Pitt is the newest addition to the canon of medical dramas and feels like the real thing. All the technology is there, the medical terminology and procedures are real, in addition to the fraught interaction of professionals under stress. Most of all, it feels real because it shows patients and their families trying to cope with the worst day of their lives.

And medical miracles do happen, on TV and in real life.

Recently, a church friend was rescued in a drowning event, was unconscious on a ventilator for nearly a week, with much uncertainty about how much damage his brain had endured while under water. Several weeks later, he is now home, dealing with some memory gaps and muscle weakness, but improving strength daily.

Last week, I had the privilege of meeting a middle-aged pastor who was saved a few weeks ago when his heart stopped in his sleep. His wife started CPR, paramedics shocked his heart in the field more than once, he was stabilized in the ER, unconscious on a ventilator, cooled down to a lower body temperature to preserve his brain function.

His care team, along with family and friends, watched and waited and prayed, uncertain what would be the rest of his story.

When he was warmed up 24 hours later, he woke up, able to breathe on his own. Other than no memory for those brief hours of unconsciousness, he is still himself – living with a new awareness of his vulnerability and an immense gratitude, now with an implanted defibrillator in his chest.

The right words after being brought back from the dead?
The right words when we never know if they will be the last words we utter or the last we will ever hear?

I know what they would be for me. I carry them in my heart…

Lit From Within

For God, who said, “Let light shine out of darkness,” has shone in our hearts to give the light of the knowledge of the glory of God in the face of Jesus Christ.
2 Corinthians 4:6

there must take place that struggle
no human presumes to picture:
living, dying, descending to rescue the just
from shadow, were lesser travails
than this: to break
through earth and stone of the faithless world
back to the cold sepulchre, tearstained
stifling shroud; to break from them
back into breath and heartbeat, and walk
the world again, closed into days and weeks again,
wounds of His anguish open, and Spirit
streaming through every cell of flesh
so that if mortal sight could bear
to perceive it, it would be seen
His mortal flesh was lit from within, now,
and aching for home. He must return,
first, in Divine patience, and know
hunger again, and give
to humble friends the joy
of giving Him food—fish and a honeycomb.

~Denise Levertov from “Ikon: The Harrowing of Hell”

People are like stained-glass windows.  They sparkle and shine when the sun is out, but when the darkness sets in, their true beauty is revealed only if there is a light from within.
~ Elisabeth Kübler-Ross

Christ forced open a door that has been locked since the death of the first man. He has met, fought and beaten the king of death. Everything is different because he has done so.
~C.S. Lewis from Miracles

In my clinical work over four decades, I met people living with dark times. It is rare for a patient to come to clinic because all is well. 

They come because they are beaten down, struggling to keep going, running out of fuel, hungry for calm as they are blown about by the storms of life.

It was my challenge to stoke and feed the inner light hidden deep within each person, fighting back the darkness as I sorted out how to mend their unwellness.

I’m reminded Christ came back from the harrowing darkness of hell to be joyfully met by His disciples, who fed His hunger. Then He cooked breakfast for them, forever offering Himself as sanctuary from the darkness He had known.

So too, we are fed, bathing in His glow.

Lyrics
Jesus Christ, inner light,
let not our own darkness conquer us.
Jesus Christ, inner light,
enable us to welcome your love.
Jesus Christ, in our search for you,
Bring us into the warmth of your light.
Jesus Christ, inner light,
enable us to welcome your love.

Lyrics:
Through love to light!
Oh, wonderful the way
That leads from darkness to the perfect day!
From darkness and from sorrow of the night
To morning that comes singing o’er the sea.
Through love to light!
Through light, O God, to thee,
Who art the love of love, the eternal light of light!

Bring to Light the Mystery: Foot Washing

sculpture by Max Greiner

Being thorough, I remove a holey sock
to view a diabetic man’s filthy feet.
I use the time to complete our talk
of what drove him to live on the street
as I wonder how any of this can help.

While he tells me more of his medical past,
I run warm water into a stainless bowl.
I immerse both his feet and begin to ask
myself what good it does for this poor soul
to allow himself to undergo this ablution.

Silently I sluice the water between his toes
and soap the crusty callous at his heel.
I marvel at his arch and notice how closely
it fits my palm. I know he can feel
this proximity too. He shuts his eyes.

Months of useless layers peel away,
revealing layers useless weeks ago.
Removing the tough brown hide of yesterday
yields clean pink skin, but we both know
this ritual will be useless days from now.

Still, this moment may withstand time’s test,
teaching us each lessons unknown before.
I learn the medicine of selflessness.
He learns what medicine is really for–
the hope that basin, soap and touch can bear.
~Robert Fawcett “Washing Feet”

Jesus washing the feet of his disciples by Finnish artist Albert Gustaf Edelfelt

What e’er the soul has felt or suffered long,
Oh, heart! this one thing should not be forgot:
Christ washed the feet of Judas.
~George Marion McClellan
from “The Feet of Judas” in The Book of American Negro Poetry 1922

Ford Maddox Brown — Washing Peter’s Feet

As an aide in a rest home caring for the crippled feet of the elderly,
as a medical student in an inner city hospital seeing the homeless whose socks had to be peeled off carefully to avoid pulling off gangrenous toes, as a doctor working with the down and out detox patients from the streets who had no access to soap and water for weeks,

I’ve washed feet as part of my job.

People always protest,
just as Peter did when Jesus started to wash his feet.
We never believe our feet,
those homely gnarled bunioned claw-toed calloused parts of us,
deserve that attention, and certainly not love.

We are ashamed to have someone care about them, care for them, when we don’t care enough on our own.

I have never washed the feet of someone about to betray me,
leading me to my death.

I have never had my feet washed by someone
who understood my heart needed cleansing even more than my feet, who loved me that much.

Until now.

This one thing should not be forgot:
Kneeling, He wears the humility and towels of a servant as His only raiments. He gently cups our heels in His palms, washes and dries our soles and arches and toes, but our hearts are held, still beating, in His loving hands.