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.
…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.
“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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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.
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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I slip, grabbing twigs as I fall, assaulting an innocent hemlock— skinning my palms, arms, legs, landing muddy-bruised and sore, taken down by a path I thought kind— a familiar wooded walk hiding its ice beneath a sheath of old, dried leaves. ~Laura Foley, “Spring Treachery” from It’s This
“Tell us please, what treatment in an emergency is administered by ear?” ….I met his gaze and I did not blink. “Words of comfort,” I said. ~Abraham Verghese from Cutting for Stone
I was walking a kind and familiar path, part of my usual daily walk, not paying much attention when I stepped on what appeared a solid and trustworthy surface.
The danger was hidden from my eyes; I had no idea it would take me down, put me on my knees, render me helpless.
I believed I couldn’t be rendered helpless by something I trusted like the back of my hand … or the interior of my heart vessels.
But treacherous surfaces are almost anywhere we are least expecting. And so are the helpers, ready and able and willing.
When I lost my grip, I felt hands and voices lifting and supporting me, pulling me to safety, encouraging me with hope and refuge.
And so I’m here to share this, richly blessed by those coming along side me – still walking this path I love, despite its hidden and sometimes deadly, dangers.
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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.
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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“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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All the complicated details of the attiring and the disattiring are completed! A liquid moon moves gently among the long branches. Thus having prepared their buds against a sure winter the wise trees stand sleeping in the cold. ~William Carlos Williams “Winter Trees”
Winter – a quiet, still time for trees, a time for preparation for new attire, a time for root-stretching and branch-reaching.
Unless there are windstorms Unless there is frozen rain Unless there is heavy burden of snowfall
A tree might be taken unawares in the night, branches breaking like popping gunshots, as if innocent prey is hunted.
Remnants lie waiting on the ground, unaware of their brokenness, still budding, hopeful for yet another spring.
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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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I got out of bed on two strong legs. It might have been otherwise. I ate cereal, sweet milk, ripe, flawless peach. It might have been otherwise. I took the dog uphill to the birch wood. All morning I did the work I love. At noon I lay down with my mate. It might have been otherwise. We ate dinner together at a table with silver candlesticks. It might have been otherwise. I slept in a bed in a room with paintings on the walls, and planned another day just like this day. But one day, I know, it will be otherwise. ~Jane Kenyon “Otherwise”
…this has been a day of grace in the dead of winter, the hard knuckle of the year, a day that unwrapped itself like an unexpected gift, and the stars turn on, order themselves into the winter night. ~Barbara Crooker from “Ordinary Life” in Barbara Crooker: Selected Poems
…it’s easy to forget that the ordinary is just the extraordinary that’s happened over and over again. Sometimes the beauty of your life is apparent. Sometimes you have to go looking for it. And just because you have to look for it doesn’t mean it’s not there. God, grant me the grace of a normal day. ~Billy Coffey
…there is no such thing as a charmed life, not for any of us, no matter where we live or how mindfully we attend to the tasks at hand. But there are charmed moments, all the time, in every life and in every day, if we are only awake enough to experience them when they come and wise enough to appreciate them. ~Katrina Kenison from The Gift of an Ordinary Day
These dead of winter days are lengthening, slowly and surely. I’m thankful I’m retired now so I no longer I leave the farm in darkness to head to work in town, and return in darkness at the end of the workday. I’m able to do my barn chores at either end of the day as the sun is rising to chase away the moon, and later as the sun is chased away by starlight.
I tend to get complacent in my daily routines, confident in the knowledge that tomorrow will be very much like yesterday. The distinct blessings of an ordinary day are lost in the rush of moving forward to whatever comes next. Poet Jane Kenyon wrote her poem with the knowledge she was dying of leukemia, which meant each ordinary day was precious indeed.
The reality is there is nothing ordinary about the events of each day. It might have been otherwise and some day it will be otherwise. That is the hard knuckle of the days we are given, each a gift, each peaches and cream.
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