The wind, one brilliant day, called to my soul with an odor of jasmine.
“In return for the odor of my jasmine, I’d like all the odor of your roses.”
“I have no roses; all the flowers in my garden are dead.”
“Well then, I’ll take the withered petals and the yellowed leaves and the waters of the fountain.”
The wind left. And I wept. And I said to myself: “What have you done with the garden that was entrusted to you?” ~Antonio Machado “The Wind, One Brilliant Day” translated by Robert Bly
This garden bloomed with potential, entrusted to me for 32 years: the health and well-being of 16,000 students, most thriving and flourishing, some withering, their petals falling, a few have been lost altogether.
As the winds of time sweep away another group of graduates from my care, to be blown to places unknown, their beauty and fragrance gone from here.
I marvel at their growth, but also weary weep for those who left too soon, wondering if I failed to water them enough – or is it I who am parched in this garden with a thirst unceasing, my roots reaching deep into drought-stricken soil, ever so slowly drying out?
A new book from Barnstorming available for order here:
Nothing seems to please a fly so much as to be taken for a currant; and if it can be baked in a cake and palmed off on the unwary, it dies happy. ~Mark Twain
Today I will wrap up 45 years of uninterrupted training and doctoring. Most of that time, I have worried I’m like a fly hiding among the black currants hoping to eventually become part of the currant cake.
Maybe no one has noticed. These days we call it the “impostor” syndrome. Mark Twain knew all about currant cake and how easy it was for a fly to blend into its batter.
Even while bearing three children and going through a few surgeries myself, I’ve not been away from patients for more than twenty consecutive days at any one time. This is primarily out of my concern that, even after a few weeks, I would forget all that I’ve ever known. In fact, half of what I learned in medical school and residency over forty years ago has evolved, thanks to new discoveries and clarifying research. I worried if I were to actually to step 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. A mere fly among the currants palmed off on the unwary.
If being truly honest, 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.
Of course, some say, didn’t the COVID pandemic prove our ignorance? Physicians started at Ground Zero with a novel virus with unclear transmissibility and immense potential to wreak havoc on the human body … or cause no symptoms whatsoever. We had no collected data to base prevention or treatment decisions: would masks just protect others or would they only protect ourselves, or maybe they protect both? Could a common inexpensive anti-inflammatory/antimalarial drug be beneficial or would a parasitic wormer medication be somehow effective to fight the devastation of the virus?
Effective treatments are still being sought all these months later; others have been debated, studied and discarded as worthless.
Or would this pandemic finally resolve thanks to effective yet controversial public health mandates while rapidly distributing highly effective vaccines developed from many prior years of carefully performed research?
During the past 16 months, your next door neighbor, or the loudest tweet on Twitter proclaimed more expertise than the average medical professional and definitely had a stronger opinion. At least we doctors knew how much we didn’t know and how much was simply guess work based on experience, good intentions and hopeful prayer. Gradually, while lives were lost, including too many of our own, real data began to trickle in so decisions could be made with some evidence backing them. But even that data continues to evolve, day by day, as authentic medical evidence always does.
That doesn’t stop all the “quack” flies out there from climbing into the batter pretending to be currants. With so much rapidly changing medical information at everyone’s fingertips, who needs a trained physician when there are so many other resources – sketchy and opportunistic though they may be – for seeking health care advice?
Even so, I am convinced most patients really do care that doctors share the best information they have available at any point in time. None of us who are doctoring wants to be the “fly” in the batter of health care.
As I meet with my last patient today, I know over forty years of clinical experience has given me an eye and an ear for the subtle signs and symptoms that no googled website or internet doc-in-the-box can discern. The avoidance of eye contact, the tremble of the lip as they speak, 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 am privileged to see and hear and about which I make decisions together with my patients. What I’ve done over four decades has been no masquerade; out of my natural caution, I am not appearing to be someone I am not. This is what I was trained to do and have done 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 continued study and changing fund of knowledge.
The hidden fly in the currant bush of health care may be disguised enough that an unwary patient might gobble it down to their ultimate detriment. I know I’ve not been that doctor. I’ve been the real thing all these years for my patients, even if I’ve seemed a bit on the tart side at times, yet offering up just enough tang to be exactly what was needed in the moment and in the long term.
And someday, hopefully not too soon, I will die happy having done this with my life.
A new book from Barnstorming is available to order here:
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:
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
Here dies another day During which I have had eyes, ears, hands And the great world round me; And with tomorrow begins another. Why am I allowed two? ~G.K. Chesterton
Any number of times a day I ask a patient who is weary worn and sad: can tell me about your thoughts about ending your life?
Most days I’m amazed I’m allowed another day to continue to be present and listening. I pray as this day dies there will come yet another so I might help the weary worn and sad find gladness: they too are given the gift to live another day.
I heard the voice of Jesus say, “Come unto Me and rest; Lay down, thou weary one, lay down Thy head upon My breast.”
I came to Jesus as I was, Weary and worn and sad; I found in Him a resting place, And He has made me glad.
I heard the voice of Jesus say, “Behold, I freely give The living water; thirsty one, Stoop down, and drink, and live.” I came to Jesus, and I drank Of that life-giving stream; My thirst was quenched, my soul revived, And now I live in Him.
I heard the voice of Jesus say, “I am this dark world’s Light; Look unto Me, thy morn shall rise, And all thy day be bright.” I looked to Jesus, and I found In Him my Star, my Sun; And in that light of life I’ll walk, Till trav’ling days are done.
I heard the voice of Jesus say, “My Father’s house above Has many mansions; I’ve a place Prepared for you in love.” I trust in Jesus—in that house, According to His word, Redeemed by grace, my soul shall live Forever with the Lord. ~Horatius Bonar
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
~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”
I laughed in the morning’s eyes. I triumphed and I saddened with all weather, Heaven and I wept together, and its sweet tears were salt with mortal mine. Against the red throb of its sunset heart, I laid my own to beat And share commingling heat.
Rise, clasp my hand, and come. Halts by me that Footfall. Is my gloom, after all, Shade of His hand, outstretched caressingly? Ah, Fondest, Blindest, Weakest, I am He whom thou seekest. Thou dravest Love from thee who dravest Me. ~Francis Thompson from “The Hound of Heaven”
My days are filled with anxious and sad patients, one after another after another. They sit in front of their screen and I in front of mine, so close yet so far from each another – a wilderness of unexpressed emotions.
They struggle to hold back the flood from brimming eyes. Each moment, each breath, each heart beat overwhelmed by questions: How to take yet another painful breath of this sad life? must there be another breath? Must things go on like this in fear of what the next moment will bring?
The only thing more frightening than the unknown is the knowledge that the next moment will be just like the last or perhaps worse. There is no recognition of a moment just passed that can never be retrieved and relived. There is only fear of the next and the next so that now and now and now is lost forever.
Worry and sorrow and angst are more contagious than any viral pandemic. I mask up and wash my hands of it throughout the day. I wish there was a vaccine to protect us all from our unnamed fears in the wilderness.
I want to say to them and myself: Stop this moment in time. Stop and stop and stop. Stop expecting this feeling must be “fixed.” Stop wanting to be numb to all discomfort. Stop resenting the gift of each breath. Just stop. Instead, simply be in the now and now and now.
I want to say: this moment, foggy or fine, is yours alone, this moment of weeping and sharing and breath and pulse and light. Shout for joy in it. Celebrate it. Be thankful for tears that can flow over grateful lips and stop holding them back.
Stop me before I write, out of my own anxiety over you, yet another prescription you don’t really need.
Just be– and be blessed– in the now and now and now.
The thing is to love life, to love it even when you have no stomach for it and everything you’ve held dear crumbles like burnt paper in your hands, your throat filled with the silt of it. When grief sits with you, its tropical heat thickening the air, heavy as water more fit for gills than lungs; when grief weights you like your own flesh only more of it, an obesity of grief, you think, How can a body withstand this? Then you hold life like a face between your palms, a plain face, no charming smile, no violet eyes, and you say, yes, I will take you I will love you, again. ~Ellen Bass, “The Thing Is” from Mules of Love
There is so much grief these days so much loss of life so much weeping.
How can we withstand this? How can we know, now, when we are barely able to breathe that we might know – at some point – we might love life again?
At almost four in the afternoon, the wind picks up and sifts through the golden woods.
The tree trunks bronze and redden, branches on fire in the heavy sky that flickers
with the disappearing sun. I wonder what I owe the fading day, why I keep
my place at this dark desk by the window measuring the force of the wind, gauging
how long a certain cloud will hold that pink edge that even now has slipped into gray?
Quickly the lights are appearing, a lamp in every window and nests of stars
on the rooftops. Ladders lean against the hills and people climb, rung by rung, into the night. ~Joyce Sutphen “On the Shortest Days” from Modern Love & Other Myths.
While spending my day at my desk talking to faces on a screen, as I will today and every day, the names and stories and symptoms change every half hour. I sometimes glance up and out my window to the world beyond, concerned not to break eye contact.
I want to say: don’t you know this darkness surrounding you won’t last, while this day is fading you can turn on the light that you were given to find your way out of this.
I wonder if I owe it to you to tell you when I was young and afraid and away from home I didn’t believe the light was there either, or it wouldn’t turn on, or it burned out so I I felt swallowed by the darkness.
Then someone gave me a ladder to climb out and lit my light so I could see where I was going.
Here I am now, handing you a working light and a sturdy ladder and telling you how to use them.
You can hide nothing from God. The mask you wear before men will do you no good before Him. He wants to see you as you are, He wants to be gracious to you. You do not have to go on lying to yourself and your brothers, as if you were without sin; you can dare to be a sinner. ~Dietrich Bonhoeffer from Life Together
In your hands
The dog, the donkey, surely they know They are alive. Who would argue otherwise?
But now, after years of consideration, I am getting beyond that. What about the sunflowers? What about The tulips, and the pines?
Listen, all you have to do is start and There’ll be no stopping. What about mountains? What about water Slipping over rocks?
And speaking of stones, what about The little ones you can Hold in your hands, their heartbeats So secret, so hidden it may take years
When I myself go to the doctor, I am to trust I’m seeing someone who is meant to know me thoroughly enough that he or she will help me move out of illness into better health. This is how acceptance feels: trusting someone enough to come out of hiding.
As a physician myself, I am reminded by the amount of “noticing” I need to do in the course of my work. Each patient, and there are so many, deserves my full attention for the few minutes we are together. I start my clinical evaluation the minute we sit down together and I begin taking in all the complex verbal and non-verbal clues offered up, sometimes unwittingly, by another human being.
Now, during the COVID19 pandemic, my interactions with patients are all “virtual” so I don’t have the ability to observe as I usually do, so I need them to tell me outright what is going on in their lives, their minds and their hearts in spoken or written words. I can’t ‘see’ them, even on a screen, in the same way.
How might someone call out to me when their faces are hidden?
I can’t witness first hand the trembling hands, their sweatiness, the scars of self injury. Still, I am their audience and a witness to their struggle; even more, I must understand it in order to best assist them. My brain must rise to the occasion of taking in another person, accepting them for who they are, offering them the gift of compassion and simply be there for them, just them, right now.
God doesn’t struggle in His Holy work as I do in my clinical duties. He knows us thoroughly because He made us; He knows our thoughts before we put them into words. There is no point in staying hidden from Him.
He holds us, little pebbles that we are, in His Hand, and He discerns our secret heartbeats.
We, the hidden, are His.
This year’s Lenten theme for Barnstorming:
God sees us as we are, loves us as we are, and accepts us as we are. But by His grace, He does not leave us where we are. ~Tim Keller
I will search in the silence for your hiding place. In the quiet, Lord, I seek your face. Where can I discover the wellsprings of your love? Is my search and seeking in vain? How can I recover the beauty of your word? In the silence I call out your name. Where can I find shelter to shield me from the storm? To find comfort, though dark be the night? For I know that my welfare is ever in your sight. In the shadows I long for your light. Lead me in your footsteps along your ancient way. Let me walk in the love of the Lord. Your wisdom is my heart’s wealth, a blessing all our days. In the silence I long for Your world. ~Liam Lawton
…difficulties are magnified out of all proportion simply by fear and anxiety. From the moment we wake until we fall asleep we must commend other people wholly and unreservedly to God and leave them in his hands, and transform our anxiety for them into prayers on their behalf: With sorrow and with grief… God will not be distracted. ~Dietrich Bonhoeffer in Letters from Prison
.…you mustn’t be frightened … if a sadness rises in front of you, larger than any you have ever seen; if an anxiety, like light and cloud-shadows, moves over your hands and over everything you do. You must realize that something is happening to you, that life has not forgotten you, that it holds you in its hand and will not let you fall. Why do you want to shut out of your life any uneasiness, any misery, any depression, since after all you don’t know what work these conditions are doing inside you? ~Rainer Maria Rilke from Letters to a Young Poet
Every day I see young adult patients who are so consumed by anxiety they become immobilized in their ability to move forward through the midst of life’s inevitable obstacles and difficulties. They become so mired in their own overwhelming feelings, so distracted by their symptoms, they can’t sleep or eat or think clearly. They self-medicate, self-injure and self-hate. Being unable to nurture themselves or others, they wither like a young tree without roots deep enough to reach the vast reservoir that lies untapped beneath them.
In epidemic numbers, some decide to die, even before life really has fully begun for them.
I grieve for them in their distress, my heart breaks daily. My role is to help find healing solutions, whether it is counseling therapy, a break from academic and work pressures, or a medicine that may give some form of relief. Yet I know all too well the ultimate answer is not as simple as the right prescription.
We who are anxious must depend upon a Creator who does not suffer from attention deficit disorder and who is not distracted from His care for us even when we turn away in worry and sorrow. We magnify our difficult circumstances by staying so tightly into ourselves, unable to look beyond our own eyelashes. We are called to be transformed, to reach higher and deeper, through prayer, through service to others, through acknowledging there exists a power greater than ourselves.
So we are called to pray for ourselves and for others, and in doing so, we disable anxiety and fear as they meld into gratitude and grace.
No longer withering, we drink deeply of the well, finally able to thrive.
This year’s Lenten theme on Barnstorming:
God sees us as we are, loves us as we are, and accepts us as we are. But by His grace, He does not leave us where we are. ~Tim Keller
It feels like falling. It feels like rain. Like losing my balance Again and again. It once was so easy; Breathe in, breathe out. But at the foot of this mountain, I only see clouds.
I feel out of focus, Or at least indisposed As this strange weather pattern Inside me takes hold. Each brave step forward, I take three steps behind. It’s mind over matter – Matter over mind.
Slowly, then all at once. A single loose thread And it all comes undone.
Where there is light, A shadow appears. The cause and effect When life interferes. The same rule applies To goodness and grief; For in our great sorrow We learn what joy means.
I don’t want to fight, I don’t want to fight it. I don’t want to fight, I don’t want to fight it. I don’t want to fight, I don’t want to fight it. But I will learn to fight, I will learn to fight, ‘Til this pendulum finds equilibrium.
Slowly, then all at once. The dark clouds depart, And the damage is done. So pardon the dust While this all settles in. With a broken heart, Transformation begins. ~Ryan O’Neal – Sleeping at Last “Sorrow”
Wait, for now. Distrust everything, if you have to. But trust the hours. Haven’t they carried you everywhere, up to now? Personal events will become interesting again. Hair will become interesting. Pain will become interesting. Buds that open out of season will become lovely again. Second-hand gloves will become lovely again, their memories are what give them the need for other hands. And the desolation of lovers is the same: that enormous emptiness carved out of such tiny beings as we are asks to be filled; the need for the new love is faithfulness to the old.
Wait. Don’t go too early. You’re tired. But everyone’s tired. But no one is tired enough. Only wait a while and listen. Music of hair, Music of pain, music of looms weaving all our loves again. Be there to hear it, it will be the only time, most of all to hear, the flute of your whole existence, rehearsed by the sorrows, play itself into total exhaustion. ~Galway Kinnell “Wait”from A New Selected Poems
If everyone abandons you and even drives you away by force, then when you are left alone fall on the earth and kiss it, water it with your tears, and it will bring forth fruit even though no one has seen or heard you in your solitude. Believe to the end, even if all people went astray and you were left the only one faithful; bring your offering even then and praise God in your loneliness. ~Fyodor Dostoyevsky from The Brothers Karamazov
Suicide rates of teenagers in the United States have increased well over 30% since 2009. It is a national epidemic and tragedy.
Based on the anguish of the patients I see every day, one after another and another, over and over again I hear a too-easy contemplation of suicide, from “It would be easier if I were dead” or “no one cares if I live or die”, or “the world would be better off without me”, or “I’m not worthy to be here” to “that is my plan, it is my right and no one can stop me”.
Without us all pledging an oath to live life no matter what, willing to lay ourselves down for one another, to bridge the sorrow and lead the troubled to the light, there will be no slowing of this trend.
…when there is no loyalty to life, as stressful and messy as it can be, …when there is no honoring of the holiness of each created being as weak and frail and prone to helpless hopelessness as we are, …when there is no resistance to the buffeting winds of life~
please just wait a little longer, only a little longer: don’t go too early