Where You Go, I Will Go: The Lost Are Like This

I wake and feel the fell of dark, not day.
What
hours, O what black hours we have spent
This night! what sights you, heart, saw; ways you went!
And more
must, in yet longer light’s delay.

With witness I speak this. But where I say
Hours I mean years, mean life. And my lament
Is cries countless, cries like dead letters sent
To dearest him that lives
alas! away.

 I am gall, I am heartburn. God’s most deep decree
Bitter would have me taste: my taste was me;
Bones bu
ilt in me, flesh filled, blood brimmed the curse.

Selfyeast of spirit a dull dough sours. I see
The lost are like this, and their scourge to be
As I am
mine, their sweating selves; but worse.
~Gerard Manley Hopkins
“I wake and feel the fell of dark”

Surfacing to the street from a thirty two hour hospital shift usually means my eyes blink mole-like, adjusting to searing daylight after being too long in darkened windowless halls.  This particular January day is different.   As the doors open, I am immersed in a subdued gray Seattle afternoon, with horizontal rain soaking my scrubs.

Finally remembering where I had parked my car in pre-dawn dark the day before, I start the ignition, putting the windshield wipers on full speed.  I merge onto the freeway, pinching myself to stay awake long enough to reach my apartment and my pillow.

The freeway is a flowing river current of head and tail lights.  Semitrucks toss up tsunami waves cleared briefly by my wipers frantically whacking back and forth.

Just ahead in the lane to my right, a car catches my eye — it looks just like my Dad’s new Buick.  I blink to clear my eyes and my mind, switching lanes to get behind.  The license plate confirms it is indeed my Dad, oddly 100 miles from home in the middle of the week.  I smiled, realizing he and Mom have probably planned to surprise me by taking me out for dinner.

I decide to surprise them first, switching lanes to their left and accelerating up alongside.  As our cars travel side by side in the downpour,  I glance over to my right to see if I can catch my Dad’s eye through streaming side windows.  He is looking away to the right at that moment, obviously in conversation.  It is then I realize something is amiss.  When my Dad looks back at the road, he is smiling in a way I have never seen before.  There are arms wrapped around his neck and shoulder, and a woman’s auburn head is snuggled into his chest.

My mother’s hair is gray.

My initial confusion turns instantly to fury.  Despite the rivers of rain obscuring their view, I desperately want them to see me.  I think about honking,  I think about pulling in front of them so my father would know I have seen and I know.  I think about ramming them with my car so that we’d perish all, unrecognizable, in an explosive storm-soaked mangle.

At that moment, my father glances over at me and our eyes meet across the lanes.  His face is a mask of betrayal, bewilderment and then shock, and as he tenses, she straightens up and looks at me quizzically.

I can’t bear to look any longer.

I leave them behind, speeding beyond, splashing them with my wake.  Every breath burns my lungs and pierces my heart.  I can not distinguish whether the rivers obscuring my view are from my eyes or my windshield.

Somehow I made it home to my apartment, my heart still pounding in my ears.  The phone rings and remains unanswered.

I throw myself on my bed, bury my wet face in my pillow and pray for sleep without dreams,
without secrets,
without lies,
without the burden of knowing a truth
I alone now knew
and wished I didn’t..

Postscript:
I didn’t tell anyone what I saw that day. My father never asked.
He divorced my mother, and was remarried quickly,
my mother and two families shattered as a result.
Ten years later, his second wife died due to a relentless cancer, and he returned to my mother, asking her forgiveness and wanting to remarry. Within months, he too was diagnosed with cancer and Mom nursed him through his treatment, remission, recurrence and then hospice.

We became a family again, not the same as before,
yet put back together for good reason – forgiving and forgiven.

This year’s Lenten theme:

…where you go I will go…
Ruth 1:16

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Where You Go, I Will Go: I 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. An xray shows the wear and tear of arthritis changes in my somewhat twisted chest wall and spine.

I consider crookedness 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 medical monitoring 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 and dads 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 blessed by parents who did what their kids needed to thrive.

Without my realizing it, my mom constantly offered me her raincoat so I wouldn’t get wet. Meanwhile she was getting drenched. I never really understood.

Some of you walk this road, now and in the past, sometimes long miles with a family member, handing over your own raincoat when the storms of life overwhelm.

Your sacrifice and compassion are Jesus’ hands and feet made tangible. He walks along where we go, keeping us safe and dry for as long as it takes.

This year’s Lenten theme:

…where you go I will go…
Ruth 1:16

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Where You Go, I Will Go: Even in the Wilderness

To be commanded to love God at all, let alone in the wilderness ,
is like being commanded to be well when we are sick,
to sing for joy when we are dying of thirst,
to run when our legs are broken.
But this is the first and great commandment nonetheless.
Even in the wilderness-
especially in the wilderness –
you shall love him.   
~Frederick Buechner
from A Room Called Remember

The wilderness might be a distant peak far removed from anything or anyone, where there is bleak darkness.

The wilderness might be the darkest corner of the human heart we keep far away from anything and anyone. 

From my kitchen window on a clear day, I sometimes see a distant mountain wilderness, when the cloud cover moves away. 

During decades of perching on a round stool in clinic exam rooms,  I was given access to hearts lost in the wilderness many times every day.

Sometimes the commandment to love God seems impossible. We are too self-sufficient, too broken, too frightened, too wary to trust God with our love and devotion. 

Recognizing a diagnosis of wilderness of the heart is straight forward: despair, discouragement,disappointment, lack of gratitude, lack of hope. 

The treatment is to allow the healing power of the Father who sent His own Son to navigate the wilderness in our place.

He reaches for our bitter, wary, and broken hearts that beat within our bodies, to bring us home from the dark wilderness of our souls.

This year’s Lenten theme:

…where you go I will go…
Ruth 1:16

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Where You Go, I Will Go: Waiting To Be Filled

Oh! hush thee, my baby, the night is behind us,
And black are the waters that sparkled so green.
The moon, o’er the combers, looks downward to find us
At rest in the hollows that rustle between.
Where billow meets billow, there soft be thy pillow;
Ah, weary wee flipperling, curl at thy ease!
The storm shall not wake thee, nor shark overtake thee,
Asleep in the arms of the slow-swinging seas.
~Rudyard Kipling “Seal Lullaby”

For you created my inmost being;
    you knit me together in my mother’s womb.
14 I praise you because I am fearfully and wonderfully made;
    your works are wonderful,
    I know that full well.
15 My frame was not hidden from you
    when I was made in the secret place,
    when I was woven together in the depths of the earth.
16 Your eyes saw my unformed body;
    all the days ordained for me were written in your book
    before one of them came to be.
17 How precious to me are your thoughts,[a] God!
    How vast is the sum of them!
18 Were I to count them,
    they would outnumber the grains of sand—
    when I awake, I am still with you.

Psalm 139: 13-18

The call came in the middle of a busy night
as we worked on a floppy baby with high fever,
a croupy toddler whose breathing squeezed and squeaked,
a pale adolescent transfusing due to leukemia bleeding.

It was an anencephalic baby just born, unexpected, unwanted
in a hospital across town, and she needed a place to die.

Our team of three puzzled how to manage a baby without a brain–
simply put her in a room, swaddled, kept warm but alone?
Hydrate her with a dropper of water to moisten her mouth?
Offer her a taste of milk?

She arrived by ambulance, the somber attendants
leaving quickly, unnerved by her mewing cries.

I took the wrapped bundle and peeled away the layers
to find a plump full term baby, her hands gripping, arms waving
once freed;  just another newborn until I pulled off her stocking cap
and looked into an empty crater — only a brainstem lumped at the base.

No textbook pictures had prepared me
for the wholeness, the holiness of this living, breathing child.

Her forehead quit above the eyebrows with the entire skull missing,
tufts of soft brown hair fringed her perfect ears,
around the back of her neck.
Her eyelids puffy, squinting tight, seemingly too big
above a button nose and rosebud pink lips.

She squirmed under my fingers, her muscles strong, breaths coming steady despite no awareness of light or touch or noise.

Yet she cried in little whimpers, mouth working, seeking,
lips tentatively gripping my fingertip. A bottle warmed,
nipple offered, a tentative suck allowing tiny flow,
then, amazing,  a gurgling swallow.

Returning every two hours, more for me than for her, I picked her up
to smell the salty sweet scent of amnion still on her skin as she grew dusky.

Her breathing weakened, her muscles loosened, giving up her grip
on a world she would never see or hear or feel to behold
something far more glorious, as I gazed
into her emptiness, waiting to be filled.

(this poem has been published in Sarah Arthur‘s wonderful Lenten and Eastertide anthology Between Midnight and Dawn)

This year’s Lenten theme:

…where you go I will go…
Ruth 1:16

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Where You Go, I Will Go: The Mourning Bench

…we all suffer.
For we all prize and love;
and in this present existence of ours,
prizing and loving yield suffering.
Love in our world is suffering love.


Some do not suffer much, though,
for they do not love much.
Suffering is for the loving.
This, said Jesus, is the command of the Holy One:
“You shall love your neighbor as yourself.”
In commanding us to love, God invites us to suffer
.

Over there, you are of no help.
What I need to hear from you is that you recognize how painful it is.
I need to hear from you that you are with me in my desperation.


To comfort me, you have to come close.
Come sit beside me on my mourning bench.
~Nicholas Wolterstorff from Lament for a Son

I wondered if 7:30 AM was too early to call her. As a sleep-deprived fourth year medical student finishing a long night admitting patients in the hospital, I selfishly needed to hear her voice.

I wanted to know how Margy was doing with the latest round of chemotherapy for breast cancer; I knew she was not sleeping well these days. She was wearing a new halo brace—a metal contraption that wrapped around her head like a scaffolding to secure her degenerating cervical spine from collapsing from metastatic tumor growths in her bones.

She knew, we all knew, she was trying to buy more time from a life of rapidly diminishing days.

Each patient I had seen the previous 24 hours while working in the Emergency Room benefited from the interviewing skills Margy had taught each medical student in our class. She reminded us that each patient had an important story to tell, and no matter how pressured our time, we needed to ask questions that gave permission for that story to be told. As a former nun now married with two teenage children, Margy had become our de facto therapist at a time no medical school hired supportive counselors.

She insisted physicians-in-training remember the suffering soul thriving inside the broken body.

“Just let the patient know with certainty, through your eyes, your body language, your words, that you want to hear what they have to say. You can heal so much hurt simply by sitting beside them and caring enough to listen…”

After her diagnosis with stage 4 cancer, Margy herself became the broken vessel who needed the glue of a good listener. She continued to teach, often from her bed at home. I planned to visit her that day, maybe help out by cleaning her house, or take her for a drive as a diversion.

Her phone rang only once after I dialed her number. There was a long pause; I could hear a clearing of her throat. A deep dam of tears welled behind a muffled “Hello?”

“Margy?”

“Yes? Emily? ”

“Margy? What is it? What’s wrong?”

Her voice shattered like glass into fragments, strangling on words that struggled to form.

“Gordy’s gone, Emily. He’s gone. He’s gone forever…”

“What? What are you saying?”

“A policeman just left. He told us our boy is dead.”

I sat in stunned silence, listening to her sobs, completely unequipped to know how to respond.

None of this made sense. I knew her son was on college spring break, heading to Mexico for a missions trip.

“I’m here, what’s happened?”

“The doorbell rang about an hour ago. Larry got up to answer it. I heard him talking to someone downstairs, so I decided to try to get up and go see what was going on. There was a policeman sitting with Larry on the couch. I knew it had to be about Gordy.”

She paused and took in a shuddering breath.

“The group was driving through the night in California. He was asleep in the back of the camper. They think he was sleepwalking and walked right out of the back of the moving camper and was hit by another car.”

Silence.  A strangling choking silence.

“They’ll bring him home to me, won’t they? I need to know I can see my boy again. I need to tell him how much I love him.”

“They’ll bring him home to you, Margy.
I’m on my way to help you get ready…

God is not only the God of the sufferers
but the God who suffers. …
It is said of God that no one can behold his face and live.
I always thought this meant
that no one could see his splendor and live.
A friend said perhaps it meant
that no one could see his sorrow and live.
Or perhaps his sorrow is splendor. …
Instead of explaining our suffering, God shares it.

~Nicholas Wolterstorff from Lament for a Son

This year’s Lenten theme:

…where you go I will go…
Ruth 1:16

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Inviting Back the Killers of Yesteryear

Texas has been in the news as the origin of the most recent rubeola measles outbreak, continuing to spread with over 124 cases recorded and one child’s death.  This morning, travelers are informed they were exposed to measles earlier this month at LAX after an international flight brought an infected person to the U.S. Later today, there was a Seattle area case announced.

The potential exponential climb of more rubeola cases is anticipated over the next weeks due to the growing percentage of unvaccinated children due to the “anti-vaccine” movement.

Mr. Kennedy, our new HHS secretary, has a great deal to do with that change in vaccination rates, but I’m not writing about the politics of his views which are popular among a strident minority of citizens.

He does not speak or act in concert with the world’s public health scientists and experts. They have worked tirelessly for decades to develop safe life-saving preventive medical care that has significantly dropped infant and child mortality rates, as well as all-age hospitalizations and deaths from infectious diseases.

It started with the small pox vaccine, routine in the U.S. 175 years ago. It’s now been almost seventy years since effective vaccinations became standard for childhood killers like polio, measles, mumps and whooping cough. People my age and older had no choice but to suffer through childhood infectious diseases, given how quickly they spread through a non-immune community. 

Yes, most of us survived, harboring life-long natural immunity. A significant number did not survive or have suffered life-long complications from the effects of those diseases.

People living in privileged first world countries have forgotten the harsh reality of morbidity and mortality statistics, and too many turn their backs on vaccinations, considering them “too risky” for themselves and their children as these diseases become less common in a mostly vaccinated society. In contrast, millions of people without easy and affordable access to vaccines in third world countries have not forgotten the devastation of these infections. They gladly walk miles to get their children vaccinated to give them a better chance at a long life.

As most measles cases in the U.S. originate from overseas travel, it’s especially critical that Americans be vaccinated when traveling outside the U.S., even to Europe. Those who serve in third world countries and mission fields are particularly vulnerable, and I’ve found it interesting that previously unvaccinated Christians are usually more than willing to accept immunizations when they know the risk of exposure is high where medical care may be minimal.

As a society, we simply don’t think about immunizations in the same way as we did in the 1940s and 50s. When I received my first DPT vaccination at the age of 4 months, my mother wrote in my baby book: “Up most of the night with fever 104.5 degrees,  considered a good ‘take’ for the vaccine.”  She truly was relieved that it had made me so sick, as it meant that I would be safe if exposed to those common killer diseases. Now a febrile reaction like that might be considered grounds for a law suit. Our vaccines have vastly improved with ongoing research to improve their effectiveness and reduce their side effects.

When measles or mumps or pertussis outbreaks reemerge within our borders,  we act surprised when it becomes a major media event — but we shouldn’t be. Diseases that were nearly nonexistent a few years ago are occurring with greater frequency again in modern societies due to misguided and misinformed anti-vaccination campaigns.

As a college health physician, I helped enforce vaccination requirements for a public university. A week didn’t go by without my having a discussion with a prospective student (or more likely the student’s parent) about the necessity for our requirement for proof of mumps, measles, rubella vaccination immunity. 

I am accused of being a pawn (or, absurdly, a financial beneficiary??) of the pharmaceutical industry because I believe in undeniable evidence of the efficacy of modern vaccines to help keep a community free of infectious disease outbreaks that can kill healthy people. 

I helped coordinate a public health response at our university in 1995 when we had a rubeola outbreak of eleven confirmed cases over a three week period, necessitating the mass vaccinations of over 8000 students and staff over three days so our institution could safely remain open.  

Having experienced first hand what the effort and resources it takes to respond to a potentially lethal contagious disease outbreak, I am so discouraged it is now happening again and again, due to a “MAHA – Make America Healthy Again” misinformation campaign swallowed whole without questions by thousands of concerned parents.

These families are banking that everyone else will be vaccinated, which puts their own child at lower risk. The problem is: guess again.  There are too many deciding that they are the ones who can remain vaccine-free.

I don’t think any one of these parents would deny the life-saving miracle of injectable insulin for their child diagnosed with diabetes, nor would they fail to strap their child into a car seat for the rare but real possibility of a life-threatening collision on even the shortest car ride.

Vaccines are miracles and instruments of prevention too, but the rub is that we have to give them to healthy youngsters in order to keep them healthy.

I’m an old enough physician to have seen deaths from these diseases as well as the ravages of post-polio paralysis and post-polio syndrome, the sterility from mumps, and deafness from congenital rubella. My father nearly died from the mumps that I brought home from school when I was eight and he was in his early forties. My sister-in-law almost didn’t pull through when she was an infant and contracted pertussis. I’ve seen healthy people develop encephalitis and pneumonia from chicken pox. 

I’ve seen an otherwise healthy college student die of influenza within a week of getting ill despite everything modern medicine could offer him.

If only there were a shot for irrational fears and conspiratorial distrust.  When I’ve written about my stance on vaccinations over the years, I’m astonished at the vehemence of the angry responses coming from individuals who have no trust whatsoever in the advances of modern medicine to prevent the killers that have devastated mankind for centuries, but will spend resources on unproven prevention strategies.

Sure, I wish vaccines were perfect with no side effects and conferring 100% immunity — but as yet they aren’t.

I wish medications that are developed for treatment of a few of these illnesses were perfect but we can’t depend on a 100% guarantee of cure once sickened.

I wish our immune systems were perfectly able to respond to infectious diseases, but they too fail and people do die.

There will always be a new plague on the horizon – history has demonstrated that over and over with the appearance of COVID, HIV, SARS, Ebola or multidrug resistant tuberculosis, and now new strains of Avian flu are in our farmyards. There will be plenty to keep our immune systems at the ready because we don’t yet or may never have effective vaccines widely available for all diseases.

But there is simply no good reason to invite the old plagues back into our homes, our schools,  our blood streams, and onto our death certificates. They deserve to be merely a chapter in the history books as the killers of yesteryear, now wholly overcome by modern medicine.

It takes a united front against these killers to prevent them from leaping from the pages of history to once again wreak devastation upon us all.

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Talk Softly to Your Heart

The main thing is this– 
when you get up in the morning 
you must take your heart in your two hands. 
You must do this every morning. 
Then talk softly to your heart, don’t yell. 
Say anything but be respectful. 
Say–maybe say, Heart, little heart, 
beat softly but never forget your job, the blood. 
You can whisper also, Remember, remember. 
~Grace Paley from “The Art of Growing Older” in  Just As I Thought

Approaching seventy, she learns to live,
at last. She realizes she has not
accomplished half of what she struggled for,
that she surrendered too many battles
and seldom celebrated those she won.
Approaching seventy, she learns to live
without ambition: a calm lake face, not
a train bound for success and glory. For
the first time, she relaxes her hands on the
controls, leans back to watch the coming end.
Asked, she’d tell you her life is made out of
the things she didn’t do, as much as the
things she did do. Did she sing a love song?
Approaching seventy, she learns to live
without wanting much more than the light in
the catbird window seat where, watching the
voracious fist-sized tweets, she hums along.

~Marilyn Nelson “Bird Feeder” 

I’ve been learning in retirement to let go by relaxing my grip on the controls on the runaway train of ambition. This is a change for someone driven for decades to succeed in various professional and personal roles. 

I’m aware who I am is defined both by what I haven’t gotten done and what I managed to do. And now, at seventy years old, I hope I still have some time to explore some of those things I left undone.

Except I haven’t been as robust and healthy as I wish to be. For the past month, during very chilly weather and after a prolonged bout of bronchitis, I found I couldn’t tolerate the cold air outside or in the barn while I did daily chores. My chest strangely hurt.

I finally took myself to a cardiologist who was concerned with a number of risk factors in my family and my own history and arranged testing, which I flunked yesterday.

I ended up with two stents to open blockages in my main coronary artery, plus a night in the hospital. I spent the night thinking about blessings and what needs to happen in my life now:

Reflecting with gratitude on being alive by the grace of our Lord.
Holding my heart gently and treating it well.
Humming as I go. 
Just sitting when I wish but walking when I must.
Watching out the window for the real twitters and tweeters in this crazy noisy world.
Loving up those around me.

It’s sweet to remember why I’m here. I’ve been given a new chance to enjoy every moment.

So after a lifetime of getting mostly A’s, flunking isn’t always bad.

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Breaking Through

Walking in February
A warm day after a long freeze
On an old logging road
Below Sumas Mountain
Cut a walking stick of alder,
Looked down through clouds
On wet fields of the Nooksack—
And stepped on the ice
Of a frozen pool across the road.
It creaked
The white air under
Sprang away, long cracks
Shot out in the black,
My cleated mountain boots
Slipped on the hard slick
—like thin ice—the sudden
Feel of an old phrase made real—
Instant of frozen leaf,
Icewater, and staff in hand.
“Like walking on thin ice—”
I yelled back to a friend,
It broke and I dropped
Eight inches in
~Gary Snyder “Thin Ice”
from No Nature

Everyone is treading on thin ice right now, unsure where to go next.

The trouble with overheated action and rhetoric in the middle of winter is that we all end up at risk of breaking through, no matter where we try to tread.

When we allow ourselves to be put in such peril, when we hear the creak with each step as a warning, we deserve to be doused by the chilly waters beneath our feet.

Lord, have mercy on us as we call your name in our fear and distress.
Help us recognize the cracks forming with each step we take.

Put us on our knees before you and lead us to safety.
Only you know where we need to be rather than where we are.
You’ll be there to pull us out of the mess we’re in.

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Is There a Cure?

“Peasant women digging potatoes” Van Gogh 1885 Kröller-Müller Museum The Netherlands

“Do you know a cure for me?”
“Why yes,” he said, “I know a cure for everything. Salt water.”
“Salt water?” I asked him.
“Yes,” he said, “in one way or the other. Sweat, or tears, or the salt sea.”
~Isak Dinesen from Seven Gothic Tales

A good night sleep, or a ten minute bawl, or a pint of chocolate ice cream, or all three together, is good medicine.
~Ray Bradbury from Dandelion Wine

The woods are lovely, dark and deep,   
But I have promises to keep,   
And miles to go before I sleep,   
And miles to go before I sleep.
~Robert Frost from “Stopping by Woods on a Snowy Evening”

If there is anything I learned in 42 years of doctoring, it’s that physicians “practice” every day in the pursuit of getting it right. As much as MDs emphasize the science of what we do through “evidence-based” decision-making, there were still days when a fair amount of educated guessing and a gut feeling was based on past experience, along with my best hunch. 

Many patients don’t arrive with classic cookbook symptoms that fit the standardized diagnostic and treatment algorithms. The nuances of their stories require interpretation, discernment, and flexibility. A surprise once in awhile made me look at a patient in a new or unexpected way and taught me something I didn’t know before. It kept me coming back with more questions, to figure out the mystery and dig a little deeper.

I also learned that though much medical treatment comes through some intervention using surgical procedures, pills or injections, those aren’t the only options in our doctor bag.

A simple good night’s sleep can do wonders for what ails a mind and body, especially when we’ve kept our promises.

At times the most appropriate cure is simple salt water in all its forms – just feeling ocean waves lapping at our feet, or sweating it out with exertion, or feeling the flow of tears down our cheeks.

How many of us allow ourselves a good cry when we feel it welling up behind our eyes?  It could be a sentimental moment–a song that brings back bittersweet memories, a movie that touches just the right chord of feeling and connection. It may be a moment of frustration and anger when nothing seems to go right. It could be the pain of physical illness or injury or emotional turmoil. 

Or just maybe there is weeping when everything is absolutely perfect and there cannot be another moment just like it, so it is tough to let it go without our tears spilling over.

And lastly, aside from the obvious curative properties of salt water, the healing found in chocolate is unquestioned by this physician. It can fix most everything that ails a person – at least for an hour or so.

It doesn’t always take an M.D. degree to determine the best medicine. It just takes a degree in common sense.

Healing tools to consider when all else fails: 
sleep, weep, keep ( promises), and reap (chocolate!)

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Learning the Hard Way

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

We living creatures learn from the moment we take our first breath. We continue to learn until our last breath. With that lifetime of learning, one would think eventually we should find some semblance of wisdom.

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 and well-being.

Within a community, we want autonomy to do as we like, no matter what the science says. You’d think we’d know better, but as fallible human beings, we may impulsively make decisions about health issues. Is it evidence-based or simply an anecdotal story about what “worked” or “didn’t work” for someone else?

We’re facing at least four years of a new administration encouraging us all to “pee on the electric fence” and learn for ourselves rather than trust science. Careful research, years of observed experience, and plain common sense isn’t enough to trust public health and infectious disease experts to make wise recommendations about community and individual risk and prevention strategies.

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 potent learning curve for them to make important future decisions. They won’t try testing it again no matter how alluring thngs appear on the other side. Humans 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!) or annoyed at being told what I can and can’t do, or simply indulging in magical thinking, I find myself reaching for the greener grass. 

I suspect I’m not alone in my surprise when I’m jolted back to reality.

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. 

So we call peeing on an electric fence it “a teachable moment.”

Sadly, when we learn the hard way, it often ends up hurting everyone.

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