Lean on Me

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Thanks to changes in laws mandating reasonable accommodation of mental illness disabilities, we are seeing a boom in requests from our patients for documentation to keep emotional support animals with them in on and off campus housing, classes, public transportation and other public places.   Patients desire an animal support to lean on through their stress.  Within the past year, the population of dogs has exploded on the University campus where I serve as medical director — dogs leashed and (usually) obediently following their student, faculty and staff owners to classes, meals, and back home to the dorm.  As a relatively outdoorsy, green and tolerant northwest University campus, the presence of animals on campus has yet to seem like a big deal, but as the numbers inevitably increase due to 25% of the college student population nationwide currently carrying a mental health diagnosis, it soon will be a big deal as individuals insist on exercising their civil rights along with their dogs.

And it isn’t always dogs.  There are cats, along with the occasional pocketed rat, hamster, guinea pig, flying squirrel, and ferret not to mention emotional support pot bellied pigs, tarantulas, ducks and geese.  And at least one snake.

Yes, a snake.

As a physician farmer concerned with stewardship of the patients I treat and the land and animals I care for, I’m emotionally caught and ethically bound in this new trend.  The law compels clinicians to write the requested documentation to avoid accusations of potential discrimination, yet I’m more concerned for the rights of the animals themselves.   I’ve loved, owned and cared for animals most of my sixty years and certainly missed my pets during the thirteen years I was in college, medical school, residency and doing inner city work (my tropical fish and goldfish notwithstanding).  I neither had the time, the money, the space nor the inclination to keep an animal on a schedule and in an environment that I myself could barely tolerate, as stressed as I was.   That is not stopping the distressed college student of today from demanding they be able to keep their animals with them in their stress-mess.

As a clinician, I’d much prefer writing fewer pharmaceutical prescriptions and help individuals find non-medicinal ways to address their distress.   I’d like to see my patients develop coping skills to deal with the trouble that comes their way without falling apart, and the resilience to pick themselves up when they have been knocked down and feel broken.   I’d like to see them develop the inner strength that comes with maturity and experience and knowing that “this too will pass.”  I’d like individuals to see themselves as part of a diverse community and not a lone ranger of one, understanding that their actions have a ripple effect on those living, working, eating, riding and studying around them. Perhaps corporate work places, schools and universities should host a collaborative animal center with rotating dogs and cats from the local animal shelter, so those who wish to may have time with animals on their breaks without impacting others who aren’t animal fans, or with potentially life threatening animal dander allergies.

I didn’t go through medical training to write a prescription for a living breathing creature perceived by the law as a “treatment” rather than a profound responsibility that owners must take on for the lifetime of the animal.   The animal is not disposable like a bottle of pills (or a human therapist) when no longer needed and needs a commitment from its owner beyond a time of high personal stress.

Pardon me now while I go take care of my dogs, my cats, and my horses and yes, my goldfish.  They lean on me.

 

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A Blessing of Balance

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On the day when
The weight deadens
On your shoulders
And you stumble,
May the clay dance
To balance you.

And when your eyes
Freeze behind
The grey window
And the ghost of loss
Gets into you,
May a flock of colours,
Indigo, red, green
And azure blue,
Come to awaken in you
A meadow of delight.

When the canvas frays
In the currach of thought
And a stain of ocean
Blackens beneath you,
May there come across the waters
A path of yellow moonlight
To bring you safely home.
~John O’Donohue from “Beannacht”

photo by Josh Scholten
photo by Josh Scholten

I figure I was born unbalanced in one way or another.  I was the kid who couldn’t manage roller skating out of fear of falling, clinging to the rail rather than risk being ground-bound yet again.  My one and only cross country skiing experience was actually cross-country sitting more than gliding.  I still freeze in place when trying to walk over an icy surface or down a steep incline — my brain just can’t help my body navigate anything other than a straight flat pathway.

It isn’t just physical balance that is a challenge for me.  As a child, and still at times in my later years, my feelings can be intense and immobilizing too,  every disappointment becoming tragedy and every happy moment so joyous I cling to it fiercely, fearing it could fade.

A blessing of balance is ideal: ground that dances to steady me when I stumble, a palette of rainbow colors to overwhelm gray emotions when I’m struggling,  a lighted pathway if the going gets dark.   I’ve given up the idea of skating or skiing, but just maybe I can ride and glide through the waves of life without getting seasick.

A Recipe For Good Medicine

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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

Most days in clinic we see tears, lots of them.  We keep boxes of tissues strategically placed in the exam and consult rooms,  as well as the waiting room.  Life can seem overwhelming, fear and worry proliferate unchecked and floodgates spillover occurs when just one more thing happens — maybe a failed test, a fight with a family member, a lingering fatigue that just might be some dread disease.

We underestimate how therapeutic a good cry can be, almost as helpful as deep and heart felt laughter.  Stress and tension is dissipated, endorphins are released, muscles relax.  Holding back tears, like trying not to laugh (think Mary Tyler Moore at Chuckles the Clown’s funeral service) is hard work and cab only make things worse.

So I hand out kleenex like candy and tell my patients to just let it go and flow.  I’m an easy crier myself, and will cry at the drop of a hat with very little provocation — a certain hymn in church, a beautiful word picture, a poignant memory, or sometimes in exhaustion and frustration.  Tears are a visible tangible connection with what is happening to us and around us and to others.   They can be more honest than what we say and do.

When the weeping wanes,   I always recommend a good night’s sleep.

And chocolate.

Good medicine without a pharmacist.

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Embarking on a Voyage

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new year’s eve-
in the echo of fog horns
another voyage starts
–  Keiko Izawa

I grew up on a small farm located about two miles from a bay in Puget Sound.  When I awoke in the morning, I knew it was foggy outside even before looking out my bedroom window.  The fog horns located on coastal buildings and bobbing buoys scattered throughout the inlet would echo mournful moans and groans to warn freighter ships away from the rocky or muddy shallows.   The resonant lowing of the horns carried miles over the surrounding landscape due to countless water particles in the fog transmitting sound waves so effectively.  The louder the foghorn moan heard on our farm, the thicker the mist in the air.  The horn voices would make me unspeakably sad for reasons I could never articulate.

Embarking on a voyage in blinding foggy conditions, like starting the second month of a new year,  portends both potential adventure and risk.  Of course I’d prefer to see exactly where I am headed, carefully navigating with precise information and expert knowledge,  eventually winding up exactly at my intended destination.

The reality is that the future can be a murky mess.

We cannot see what lies ahead: we navigate by our wits, by our best guess, but particularly by listening for the low-throated warnings coming from the rocky shores and shallows of those who have gone ahead of us.

I am still too easily lost in the fog of my fears of the unknown – disconnected, afloat and circling aimlessly, searching for a touch point of purpose and direction.  The isolation I sometimes feel may be my own self-absorbed state of mind, sucking me in deep until I’m soaked, dripping and shivering from the smothering gray.   If only I might trust the fog horn voices, I could charge into the future undaunted, knowing there are others out there in the pea soup prepared to come alongside me as together we await the sun’s dissipation of the fog.

Now, almost sixty years into the voyage,  I recognize the fog does eventually clear so the journey continues on.

Even so, I will keep listening for the resonant voices of wisdom from shore, and raise my voice to join in, not to echo the moans and groans of my  misty childhood mornings,  but to confidently sing an anthem of hope and promise.

 

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Expecting Catastrophe

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photo by Nate Gibson
photo by Nate Gibson

(originally published in Country Magazine in 2007)

Chores at our farm are rarely routine since our batch of four male kittens were born 6 months ago. They were delivered unceremoniously in the corner of one of the horse stalls by their young mother whose spontaneous adoption we accepted a mere four weeks before, not realizing we were accepting five kitties, not just one.

They were born under a Haflinger’s nose, and amazingly survived the ordeal and managed to stay safe until the next day when we came in to clean and discovered them nicely warmed near a nice fresh pile of poop. What a birthing spot this mama had chosen. Thankfully Haflingers are tolerant about sharing their space as long as you don’t ask for a share of their food too…

We moved them and mama to a safer spot in the barn, away from big Haflinger feet, and they thrived, getting more adventuresome by the week, until they are now in full adolescent glory, mock fighting with each other, scrambling up and down the hay bales, using the shavings as their personal litter box, doing rodent patrol, and most of all, strolling along the shelves that line the stalls, breathing in the Haflinger smell, and rubbing their fur up against Haflinger noses through the wire. They are best of friends with these ponies in the light of day, as after all they were born right in a Haflinger bed.

But at night it’s another story. Each evening as I come out to do chores after returning home from work, it is pitch dark and the Haflingers, out in their winter paddocks, must walk with me one by one back to their box stalls for the night. Only this is now far more of an adventure thanks to four cats who glory in stealth attacks in the dark, like mountain lions in the shadows, waiting for their prey to pass by.

These rascals are two gray tabbies, one black and one gray, all four perfectly suited to be camouflaged in the northwest dim misty fall evenings along a barely lit pathway between paddocks and barn. They flatten themselves tight on the ground, just inches from where our feet will pass, and suddenly, they spring into the air as we approach, just looking for a reaction from either the horse or myself. It never fails to unnerve me, as I’m always anticipating and fearing the horse’s response to a surprise cat attack. Interestingly, the Haflingers, used to kitten antics all night long in the barn, are completely bored by the whole show, but when the tension from me as I tighten on the lead rope comes through to them, their head goes up and they sense there must be something to fear. Then the dancing on the lead rope begins, only because I’m the one with the fear transmitted like an electric current to the Haflinger. We do this four times along the path to the barn as four kittens lay in wait, one after another, just to torment me. By the end of bringing in eight horses, I’m done in by my own case of nerves.

You’d think I’d learn to stop fearing, and start laughing at these pranksters. They are hilarious in their hiding places, their attempts to “guard” the barn door from intruders, their occasional miscalculations that land them right in front of a hoof about to hit the ground. Why I haven’t had at least one squished kitten by now is beyond my comprehension. Yet they survive to torment me and delight me yet another night. I cuddle them after the horses are all put away, flopping them on their backs in my arms, and tickling their tummies and scolding them for their contribution to my increasing gray hair.

I’m a slow learner. These are like so many of my little daily fears, which seem to hide, blended in to the surroundings of my daily life, ready to spring at me without warning, looking like much bigger scarier things than they really are. I’m a highly skilled catastrophizer in the best of circumstances, and if I have a kitten sized worry, it becomes a mountain lion sized melodrama in no time. Only because I allow it to become so.

Stepping back, taking a deep breath, if I learn to laugh at the small stuff, then it won’t become a “cat”astrophe, now will it? If I can grab those fears, turn them over on their back and tickle their tummies until they purr, then I’m the one enjoying a good time.

I’ll try that the next time I feel that old familiar sensation of “what if?” making my muscles tense and my step quicken. I just might tolerate that walk in the dark a little better, whether it is the scary plane flight, the worry over a loved one’s health, the state of the economy, where the next terrorist will strike, or the uncertainty of what tomorrow might bring.

I’ll know that behind that mountain lion is a soft loving purring fur ball, granting me relief from the mundane, for which I’m extremely grateful. Life is always an adventure, even if it is just a stroll down a barn lane in the dark wondering what might come at me next on the path.

photo by Nate Gibson
photo by Nate Gibson

 

A Desolate Reflection

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It is a blustery and soaking start to the University’s academic year:  we enter autumn with no little trepidation…

 

Enter autumn as you would
a closing door.  Quickly,
cautiously.  Look for something inside
that promises color, but be wary
of its cast–a desolate reflection,
an indelible tint.
~Pamela Steed Hill from “September Pitch”

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Don’t Be Afraid

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To acknowledge the significance of this day and the events of 13 years ago:

The grace of God means something like:
Here is your life.
You might never have been, but you are,
because the party wouldn’t have been complete without you.
Here is the world.
Beautiful and terrible things will happen.
Don’t be afraid.
I am with you.
~Frederick Buechner
in Wishful Thinking and later in Beyond Words

 

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Those Who Water Flowers

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Thank God that there are solid folk
Who water flowers and roll the lawn,
And sit and sew and talk and smoke,
And snore all through the summer dawn.
Who pass untroubled nights and days
Full-fed and sleepily content,
Rejoicing in each other’s praise,
Respectable and innocent.
Who feel the things that all men feel,
And think in well-worn grooves of thought,
Whose honest spirits never reel
Before man’s mystery, overwrought.
~C. S. Lewis from “In Praise of Solid People”
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Listening to Lent — Often Enters Fear

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When amidst the storm I’m shaken
wearied by the wind and waves
Lord within me faith awaken
Jesus hear me call your name.

Not to take away the turmoil
Not to change the tempest tide
But to keep a constant vigil
Hold me through the sleepless night.

Chorus:

Be my rock, my steady love
Your grace, my all
For ’tis enough
Often enters fear so subtle
Weakening where once was love.
For despair trade hope eternal

For doubt exchange only trust

When my faith is firmly planted
Rooted in salvation’s hill
No deceiver, neither tempter can
collapse what Christ has built.
~Allie LaPointe

 

As He entered His final week
He knew His turmoil
could not be taken away
The awful tide could not be turned.

So He walked on in hope and trust
Away from fear and doubt and despair,
And now He shows me
What faith and grace can build.

It is enough.
Always enough.
Enough forever
and evermore.