A Prescription for Maggots

You can’t say you haven’t been warned: there are creepy crawlies in this post

Things I will never like:
1. Drying off with a cold, damp towel.
2. The feeling of seaweed wrapping around my legs.
3. Anything that was popular in the 70’s.
4. Licorice, yam, or raisins.
5. That high-pitched screech that babies make.
6. Writhing maggots.
~Bill Watterson from It’s A Magical World: A Calvin and Hobbes Collection

A fly maggot photo from a recent Atlantic article on maggot therapy found here

A few weeks ago, I had a bit of home-made potato corn chowder left over that I added to our compost bin in our barnyard. It isn’t often that much animal protein makes its way into the bin so when I checked on the compost a few days later, I was amazed to see it teeming with fly maggots in the midst of their Thanksgiving feast. Ordinarily pictures and videos of maggots would not find their way to this blog. People might be looking at this blog while eating their breakfast or lunch and writhing maggots are not something you are expecting to see. My apologies in advance and now is the time to delete delete delete.

Therefore: a trigger warning. Don’t scroll down further if you would rather avoid seeing (and hearing) creepy crawly things.

My first medical exposure to maggots came while examining the leg and foot wounds of the homeless folks I helped care for when training in an inner city emergency room. Peeling off old ragged stockings and socks would often reveal more than dirty feet – in fact, the maggots may have been somewhat beneficial in those cases yet we were quick to dispose of them.

Maggots are, in fact, fascinating creatures with potential therapeutic value, notwithstanding their gross-out factor. This week in a brief Atlantic article found here, there is a summary of a recent study in France comparing typical surgical debridement of venous ulcers of the skin with maggot therapy. Maggots were faster in cleaning the wounds but didn’t enhance eventual healing any more than traditional surgical care. There wasn’t a difference in the discomfort level as long as the patient didn’t know which therapy was being used. For those who had been randomly assigned to maggot therapy in one study, an astounding 89% said they would opt for the insects over surgeons if faced with needing wound care in the future.

I’m not sure what that says about surgeons, but it is a great compliment to maggot larvae!

Here is a formal cross-referenced evidence-based summary from UptoDate.com about wound treatment with biologic methods:

Biologic — An additional method of wound debridement uses the larvae of the Australian sheep blow fly (Lucilia [Phaenicia] cuprina) or green bottle fly (Lucilia [Phaenicia] sericata, Medical Maggots) [42,43]. Maggot therapy can be used as a bridge between debridement procedures, or for debridement of chronic wounds when surgical debridement is not available or cannot be performed [44]. Maggot therapy may also reduce the duration of antibiotic therapy in some patients [16].

Maggot therapy has been used in the treatment of pressure ulcers [45,46], chronic venous ulceration [47-50], diabetic ulcers [42,51], and other acute and chronic wounds [52]. The larvae secrete proteolytic enzymes that liquefy necrotic tissue, which is subsequently ingested while leaving healthy tissue intact. Basic and clinical research suggests that maggot therapy has additional benefits, including antimicrobial action and stimulation of wound healing [43,47,53,54]. However, randomized trials have not found consistent reductions in the time to wound healing compared with standard wound therapy (eg, debridement, hydrogel, moist dressings) [55,56]. Maggot therapy appears to be at least equivalent to hydrogel in terms of cost [56,57].

Dressing changes include the application of a perimeter dressing and a cover dressing of mesh (chiffon) that helps direct the larvae into the wound and limits their migration (movie 1). Larvae are generally changed every 48 to 72 hours. One study that evaluated maggot therapy in chronic venous wounds found no advantage to continuing maggot therapy beyond one week [48]. Patients were randomly assigned to maggot therapy (n = 58) or conventional treatment (n = 61). The difference in the slough percentage was significantly increased in the maggot therapy group compared with the control groups at day 8 (67 versus 55 percent), but not at 15 or 30 days.

The larvae can also be applied within a prefabricated “biobag”, commercially available outside the United States, that facilitates application and dressing change [58-61]. Randomized trials comparing “free range” with “biobag”-contained larvae in the debridement of wounds have not been performed.

A main disadvantage of maggot therapy relates to negative perceptions about its use by patients and staff. One concern among patients is the possibility that the larvae can escape the dressing, although this rarely occurs. Although one study identified that approximately 50 percent of patients indicated they would prefer conventional wound therapy over maggot therapy, 89 percent of the patients randomly assigned to maggot therapy said they would undergo larval treatment again [62]. Perceived pain or discomfort with the dressings associated with maggot therapy may limit its use in approximately 20 percent of patients.

Biobag of maggots on a wound from http://www.uptodate.com

The STARZ show Outlander (a show and series of books by scientist Diana Gabaldon I thoroughly enjoy) used real maggots in the fifth season of the show when in 18th century America, wife (and surgeon) Claire successfully treats her husband Jamie’s snakebite wound with the larvae. Actress Caitriona Balfe describes her co-starring maggots in this brief video:

image from Starz – Outlander Season 5 Episode 9
image from Starz – Outlander Season 5 Episode 9

So there are still things to learn about medical therapies we used in the past which have been sidelined or forgotten in our push for modern treatment modalities. The days of leeches and maggots may not be over after all.

And now for video, complete with little maggotty sound effects — scroll down

Maggots in our compost bin – enjoying corn and potato chowder leftovers

A new book from Barnstorming is available to order here

(no maggot pictures in this book, I promise!)

Cure for Every Hurt

hankerchief tree (Ireland)
Baby Barn Owlet hiding in the rocks and grass
River carp (2-3 feet long) in Higashi-Kurume, Tokyo

Gardens are also good places
to sulk. You pass beds of
spiky voodoo lilies   
and trip over the roots   
of a sweet gum tree,   
in search of medieval   
plants whose leaves,   
when they drop off   
turn into birds
if they fall on land,
and colored carp if they   
plop into water.

Suddenly the archetypal   
human desire for peace   
with every other species   
wells up in you. The lion   
and the lamb cuddling up.
The snake and the snail, kissing.
Even the prick of the thistle,   
queen of the weeds, revives   
your secret belief
in perpetual spring,
your faith that for every hurt   
there is a leaf to cure it.

~Amy Gerstler “Perpetual Spring” from Bitter Angel

photo by Tomomi Gibson

We all want to fix what ails us: that was the point of my many years of medical training and over 40 years “practicing” that art. We want to know there is a cure for every hurt, an answer for every question, a resolution to every mystery, or peace for every conflict.

And there is. It just isn’t always on our timeline, nor is it always the answer we expect, nor the conflict magically dissolved. The mystery shall remain mystery until every tear is dried, as we stand before the Face of our Holy God who both loves and judges our hearts.

Sometimes this life hurts – a lot – but I believe in the perpetual Spring and Resurrection that guarantees our complete healing.

Soli Deo Gloria

A new book available to order https://barnstorming.blog/new-book-available-almanac-of-quiet-days/from Barnstorming and poet Lois Edstrom!

Waiting in Wilderness: God Will See Us Through

My Lord, my Lord,
Long have I cried out to Thee
In the heat of the sun,
The cool of the moon,
My screams searched the heavens for Thee.
My God,
When my blanket was nothing but dew,
Rags and bones
Were all I owned,
I chanted Your name
Just like Job.

Father, Father,
My life give I gladly to Thee
Deep rivers ahead
High mountains above
My soul wants only Your love
But fears gather round like wolves in the dark.
Have You forgotten my name?
O Lord, come to Your child.
O Lord, forget me not.

You said to lean on Your arm
And I’m leaning
You said to trust in Your love
And I’m trusting
You said to call on Your name
And I’m calling
I’m stepping out on Your word.

Into the alleys
Into the byways
Into the streets
And the roads
And the highways
Past rumor mongers
And midnight ramblers
Past the liars and the cheaters and the gamblers.
On Your word
On Your word.
On the wonderful word of the Son of God.
I’m stepping out on Your word.

~Maya Angelou from “Just Like Job”

Once again — and again and again — bullets have been fired out of evil intent by disturbed and hate-filled men, striking down people who look (and are) just like us. 

Weeping never needs translation or interpretation, no matter what color cheeks they moisten.

Distrust and fear continue to impact us daily, settling like a shroud over the most routine activities – going to school, going grocery shopping, going to church. It isn’t just a virus that threatens us; it is being targeted in someone’s gun sight.

In order to even walk out the door in the morning, we must fall back on what we are told, each and every day, in 365 different verses in God’s Word itself:

Fear not.

Do not be overwhelmed with evil but overcome evil with good.

We shall overcome despite evil and our fear of each other.

The goal of this life is to live for others, to live in such a way that death cannot erase the meaning and significance of a life.  We are called to give up our selfish agendas in order to consider the dignity of others and their greater good. We are called to keep weapons out of the hands of those who would use them to harm themselves or others, which means better screening, longer waiting periods, improved tracking of ownership.

It is crystal clear from Christ’s example as we observe His journey to the cross over the next week: we are to cherish life, all lives, born and unborn, even unto death. Christ forgave those who hated and murdered Him.

Our only defense against the evil we witness is God’s offense. Only God can lead us to Tolkien’s “where everything sad will come untrue”, where we shall live in peace, walk hand in hand, no longer alone, no longer afraid, no longer shedding tears of grief and sorrow, but tears of relief and joy.

We shall all be free. We shall overcome because God does.

We shall overcome

We shall live in peace

We’ll walk hand in hand

We shall all be free

We are not afraid

We are not alone

God will see us through

We shall overcome

Oh, deep in my heart
I do believe
We shall overcome some day

The ultimate weakness of violence is that it is a descending spiral
begetting the very thing it seeks to destroy.
Instead of diminishing evil, it multiplies it.
Through violence you may murder the liar,
but you cannot murder the lie, nor establish the truth.
Through violence you may murder the hater,
but you do not murder hate.
In fact, violence merely increases hate.
So it goes.
Returning violence for violence multiplies violence,
adding deeper darkness to a night already devoid of stars.
Darkness cannot drive out darkness:
only light can do that.
Hate cannot drive out hate: only love can do that.
Hate multiplies hate,
violence multiplies violence,
and toughness multiplies toughness
in a descending spiral of destruction….
The chain reaction of evil —
hate begetting hate,
wars producing more wars —
must be broken,
or we shall be plunged
into the dark abyss of annihilation.
~Dr. Martin Luther King, Jr. from Strength to Love

Turning Darkness Into Light: Promise of a New Dawn

…Christmas will come once again.
The great transformation will once again happen.
God would have it so.
Out of the waiting, hoping, longing world,
a world will come in which the promise is given.
All crying will be stilled.
No tears shall flow.
No lonely sorrow shall afflict us anymore, or threaten.
~Dietrich Bonhoeffer in a sermon to a church in Havana, Cuba December 21, 1930

when
this blessing comes,
take its hand.
Get up.
Set out on the road
you cannot see.

This is the night
when you can trust
that any direction
you go,
you will be walking
toward the dawn.
— Jan Richardson (author of Circle of Grace)

“Gandalf! I thought you were dead! But then I thought I was dead! Is everything sad going to come untrue?”
~J.R.R. Tolkien from The Lord of the Rings when Samwise Gamgee wakes to find his friends all around him

“The answer is yes. And the answer of the Bible is yes. If the resurrection is true, then the answer is yes. Everything sad is going to come untrue.”
~Pastor Tim Keller’s response in a sermon given in an ecumenical prayer service memorial in Lower Manhattan on the fifth anniversary of Sept. 11.

In our minds, we want to rewind and replay the events of a tragedy in a way that would prevent it from happening in the first place.   We want to bring the dead and injured back to health again.  The pandemic virus fizzles out on its own, the devastating earthquake becomes a mere tremor, the flooding tsunami is only one foot, not thirty feet tall, the terrorist hijackers are prevented from ever boarding a plane, the shooter changes his mind at the last minute, lays down his arms, disables his booby trap bombs and calls someone for help with his distress and anger.

We want so badly for it all to be untrue, especially the events of this year.  The bitter reality of horrendous suffering and sadness daily all over the earth is too much for us to absorb.   We plead for relief, beg for a better day.

Our minds may play mental tricks like this, but God does not play tricks.  He knows and feels what we do.  He too wants to see it rewound and replayed differently.  He has known grief and sadness, He has wept, He has suffered, He too died.  And because of this, because of a God who came to dwell with us, was broken, died and then rose again whole and holy, we are assured, in His time, everything sad is going to come untrue.

Our tears will be dried, our grief turned to joy, our pain nonexistent, not even a memory.  It will be a new day, a better day–as it is written, trustworthy and true.

May it come.

Quickly.

He will wipe away every tear from their eyes, and death shall be no more, neither shall there be mourning, nor crying, nor pain anymore, for the former things have passed away. And he who was seated on the throne said, “Behold, I am making all things new.” Also he said, “Write this down, for these words are trustworthy and true.  Revelation 21: 4-5

Did You Cry?

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

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

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

Look how I shave her thumbnail down
so carefully she feels no pain.
Watch as I lift the splinter out.
I was seven when my father
took my hand like this,
and I did not hold that shard
between my fingers and think,
Metal that will bury me,
christen it Little Assassin,
Ore Going Deep for My Heart.
And I did not lift up my wound and cry,
Death visited here!
I did what a child does
when he’s given something to keep.
I kissed my father.
~Li-Young Lee, “The Gift”

Your father enters the poem
early,
storying past
the metal splinter
in your palm.

I set your paternity
—and the poem—
aside,
to reach back for my mother
and try to remember

what kind of day it was
when I played by the barn
where, it is said,
my own father raised pigs
(I do not remember this).

And what kind of day it was
when I found the barn,
door open,
silent

and tried to pluck silver lines
from silver webs
long-left,
then tendered my hand
on noiseless silvered wood

until my palms
were rife with the evidence
of my trying,

and mother
spent the night
with a silver tweezer,
counting as she went…
ninety-eight
ninety-nine
one hundred—

a ritual for my
tears.

And now I wonder,
Li-Young—did you cry,
and who was in the story,
and how many times
have you counted it since,
to forget,
and to remember.

~L. L. Barkat, “Li-Young Lee’s Splinter” from  Love, Etc.

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

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

Our wounds are His – He is constantly feeling our pain as He performs healing surgeries in our lives, not because He wants to but because He must, to save us from our own destruction.

Too often we yell and kick and protest in our distress, wanting it our way, not His way, making it all that much more difficult for both of us.

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

This Doctor is Open For Business

yinandyang

 

pinksunset52019

 

Astonishing material and revelation appear in our lives all the time.
Let it be.
Unto us, so much is given.
We just have to be open for business.

~Anne Lamott from Help Thanks Wow: Three Essential Prayers

 

pinksunset520181

 

ticklethemoon

 

scar

 

I have the privilege to work in a profession where astonishment and revelation awaits me behind each exam room door.

In a typical clinic day, I open that door up to thirty plus times, close it behind me and settle in for the ten or fifteen minutes I’m allocated per patient.  I need to peel through the layers of each person quickly to find the core of truth about who they are and why they’ve come to clinic that day.

Sometimes what I’m looking for is right on the surface: in their tears, in their pain, in their fears.  Most of the time, it is buried deep, often beneath a scar I must search to find. I need to wade through the rashes and sore throats and coughs and headaches and discouragement to find it.

Once in awhile, I actually do something tangible to help right then and there — sew up a cut, lance a boil, splint a fracture, restore hearing by removing a plug of wax from an ear canal.

Often I find myself giving permission to a patient to be sick — to take time to renew, rest and trust their bodies to know what is best for a time.

Sometimes, I am the coach pushing them to stop living sick — to stop hiding from life’s challenges, to stretch even when it hurts, to get out of bed even when not rested, to quit giving in to symptoms that are to be overcome rather than become overwhelming.

Always I’m looking for an opening to say something a patient might think about after they leave my clinic — how they can make different choices, how they can be bolder and braver in their self care, how they can intervene within their own finite timeline to prevent illness, how every day is just one thread in the larger tapestry of their lifespan.

Each morning I rise early to get work done at home before I actually arrive at my desk at work, trying to avoid feeling unprepared and inadequate to the volume of tasks heaped upon each day.   I know I will be stretched beyond my capacity, challenged by the unfamiliar, the unexpected and will be stressed by obstacles thrown in my way.  I know I will be held responsible for things I have little to do with, simply because I’m the one who often acts as decision-maker.

It is always tempting to go back to bed and hide.

Instead of hiding,  I go to work as the exam room doors need to be opened and the layers peeled away.  I understand the worry, the fear and the pain because I have lived it too.   I know the limitations of a body that wants to consume more than it needs, to sleep rather than go for a walk, to sit rather than stand.

Even now in my seventh decade of life,  I am continually learning how to let it be, even if it is scary.  It is a gift perhaps I can share.

No matter what waits behind the exam room door,  it will be astonishing to me.

I’m grateful to be open for business.  The Doctor is In.

 

bleedingheartsclose

 

rosedepth

 

 

We Will Weep and Know Why

septleaves4

 

sunset10117

~to a young child~

Márgarét, áre you gríeving
Over Goldengrove unleaving?
Leáves like the things of man, you
With your fresh thoughts care for, can you?
Ah! ás the heart grows older
It will come to such sights colder
By and by, nor spare a sigh
Though worlds of wanwood leafmeal lie;
And yet you wíll weep and know why.
Now no matter, child, the name:
Sórrow’s spríngs áre the same.
Nor mouth had, no nor mind, expressed
What heart heard of, ghost guessed:
It ís the blight man was born for,
It is Margaret you mourn for.
~Gerard Manley Hopkins “Spring and Fall”
septleaves
This morning we weep and know why.
It is not simply the sorrowful loss
of the perfection of spring and childhood
giving way to the dying of the fall,
the last gasp coloring of leaves and skies.It is the loss of innocence, of sense of reverence for life,
this blight man was born for,
this bleeding out for no reason.

What must drive one man’s selfish rage, loneliness and despair to compel him to deprive innocent others of their blood and life?

What unexplained evil overtakes one heart that he seeks to stop the beating hearts of others before his own is stopped?


When will there ever be safe havens again in society?
Not schools, not churches, not hospitals, not concerts, not any place people gather.

This is a day for lament, for tears, and for prayers to God that we cry out and bleed out the spiritual sickness that is infecting us all.
madronajoint
moonrise10117
sunsetbarnlight

Take My Waking Slow

morning823171

I wake to sleep, and take my waking slow.   
I feel my fate in what I cannot fear.   
I learn by going where I have to go.
We think by feeling. What is there to know?   
I hear my being dance from ear to ear.  
I wake to sleep, and take my waking slow.
Of those so close beside me, which are you?   
God bless the Ground!   I shall walk softly there,   
And learn by going where I have to go.
Light takes the Tree; but who can tell us how?   
The lowly worm climbs up a winding stair;   
I wake to sleep, and take my waking slow.
Great Nature has another thing to do   
To you and me; so take the lively air,   
And, lovely, learn by going where to go.
This shaking keeps me steady. I should know.   
What falls away is always. And is near.   
I wake to sleep, and take my waking slow.   
I learn by going where I have to go.
~Theodore Roetke “TheWaking”

 

sunrise818172

tennant20171

 

In my rush to get from there to here
I missed some things.  The solitary song
of the chickadee; the play of winter light
on kitchen walls; the smell of fresh-raked leaves;
the summer days of childhood, stretched slow
from dawn to dusk, no need to know the date
or time, only the sound of a silver swung bell
to call me in for supper.

Could I re-learn to navigate by phases
of the moon, the ebb and flow of tides,
the rhodies budding out today before
the fall’s first snow?  Could I re-learn
to take my waking slow?
~Ted McMahon, M.D. “Slow Season”

 

sunset817

eveningrun

I took an unscheduled landing while wheelbarrowing hay to our horses in the field yesterday morning.

In my rush to get from there to here I missed some things.

I stumbled on uneven ground and fell hard, badly injuring my elbow.  Finishing chores afterward was a challenge and a necessity, wrapping my broken wing up tight in my jacket, doing what was needed before my husband came home to take me to the ER where good people who know me took great care of me.

Of those so close beside me, which are you?   
God bless the Ground!   I shall walk softly there,   
And learn by going where I have to go.

Even though no bones were broken, it was dislocated, so my elbow (and I) needed to be put back together.  The miracle of “conscious sedation” IV medication let my body “think” I was awake – I was surrounded by a swirling round of voices telling me to take deep breaths and constantly reassuring me–while the ER doctor and nurse put traction on my arm and shoulder, then twisting and turning my elbow back into proper position with a “clunk”.  I was blissfully unaware of the tugging and torque, paying attention only to the swirling sounds in my head, then waking slow to find my arm splinted and wrapped from mid-humerus to fingers — all fixed but now typing is also slow.

This shaking keeps me steady. I should know.   
What falls away is always. And is near.   
I’m walking more carefully now, paying attention to exactly where my feet land and what is around me.
The ground is near yet still can be a hard and abrupt landing;
I celebrate the good clinicians who put broken people back together again.
Great Nature has another thing to do   
To you and me; so take the lively air,   
And, lovely, learn by going where to go.
tammingasunset

 

 

Dusted

dustybee

beeweed

 

“Bees do have a smell, you know,
and if they don’t they should,
for their feet are dusted with spices from a million flowers.”

― Ray Bradbury, Dandelion Wine

 

beeblu

bee

 

I admire the honey bee as pollinator and pollen gatherer simultaneously, facilitating new fruit from the blossom as well as taking away that which will become sweet honey tasting of the spicy essence of the flower touched.

As a physician, I can only hope to be as transformative in the work I do every day.  I carry with me tens of thousands of patients I’ve seen over thirty five years of medical practice.  There is no way I can touch another human being without keeping some small part of them with me – perhaps a memory of an open wound or the residual scar it left behind, a word of sorrow or gratitude, a grimace, a tear or a smile.

Each patient is a flower visited, some still in bud, some in full bloom, some seed pods ready to burst, some spent and wilting and ready to fall away.  Each patient carries a spicy vitality, even in their illness and dying, that is unforgettable and still clings to me. Each patient changes me, the doctor, readying me for the next patient by teaching me a gentler approach, a clearer explanation, a slower leave-taking.  Each patient becomes part of my story, adding to my skill as a healer, and is never to be forgotten.

It has been my privilege to be thoroughly dusted by those I’ve loved and cared for.  I want to carry that on to create something wonderful that reflects the spice of living.

Nothing could smell or taste as sweet.

 

beechestnut

cornbee

beebye

wwubusybees

Music Against the Hard Edges

galena

 

waterfalljasper1

 

In all the woods that day I was
the only living thing
fretful, exhausted, or unsure.
Giant fir and spruce and cedar trees
that had stood their ground
three hundred years
stretched in sunlight calmly
unimpressed by whatever
it was that held me
hunched and tense above the stream,
biting my nails, calculating all
my impossibilities.
Nor did the water pause
to reflect or enter into
my considerations.
It found its way
over and around a crowd
of rocks in easy flourishes,
in laughing evasions and
shifts in direction.
Nothing could slow it down for long.
It even made a little song
out of all the things
that got in its way,
a music against the hard edges
of whatever might interrupt its going.
~John Brehm “Passage”

 

waterfall

 

It may be that when we no longer know what to do
we have come to our real work,

and that when we no longer know which way to go
we have come to our real journey.

The mind that is not baffled is not employed.

The impeded stream is the one that sings.
~Wendell Berry “The Real Work”

 

mejierwaterfall

 

Who among us knows with certainty each morning
what we are meant to do that day
or where we are to go?
Or do we make our best guess by
putting one foot ahead of the other
until the day is done and it is time to rest.

For me, I wake baffled each day
that I am allowed
to eavesdrop on heartbeats,
touch tender bellies,
sew up broken skin,
listen to tearful stories
of those no longer wish to live
and those who never want to let go of life.

I wake humbled with commitment
to keep going even when too tired,
to offer care even when rejected.
to keep trying even if impeded.

It is only then I learn that
daily obstacles slow
but cannot stop
the offer of help,
the gift of caring,
the flow of time given freely
which overflows its banks with
uncertain certainty:
my real work and journey
through life.

May I wade in deep~
listening~
ready to raise my voice
for those who hurt
and sing along.

 

poliswaterfall2