Tag: commitment

The Fly in the Currant Cake

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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.

My ID photo from my first year of medical school 1976
45 years later…

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Leaning In

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Sometimes, in the middle of a crowded store on a Saturday
afternoon, my husband will rest his hand
on my neck, or on the soft flesh belted at my waist,
and pull me to him. I understand

his question: Why are we so fortunate
when all around us, friends are falling prey
to divorce and illness? It seems intemperate
to celebrate in a more conspicuous way

so we just stand there, leaning in
to one another, until that moment
of sheer blessedness dissolves and our skin,
which has been touching, cools and relents,

settling back into our separate skeletons
as we head toward Housewares to resume our errands.
~Sue Ellen Thompson, “Leaning In” from The Golden Hour

It never fails to amaze me that after nearly forty years of life together, even in the most mundane moments, I still feel that invisible connection to you no matter where we are. That connection is made visible and tangible in our children and now our grandchildren.

We are blessed to have found each other and to regularly remind ourselves of that. We were meant to be and everything good continues to flow from that.

Soli Deo gloria.

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Wing to Wing

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No speed of wind or water rushing by
But you have speed far greater. You can climb
Back up a stream of radiance to the sky,
And back through history up the stream of time.
And you were given this swiftness, not for haste
Nor chiefly that you may go where you will,
But in the rush of everything to waste,
That you may have the power of standing still-
Off any still or moving thing you say.
Two such as you with such a master speed
Cannot be parted nor be swept away
From one another once you are agreed
That life is only life forevermore
Together wing to wing and oar to oar
~Robert Frost “Master Speed”

All at once I saw what looked like a Martian spaceship whirling towards me in the air. It flashed borrowed light like a propeller. Its forward motion greatly outran its fall. As I watched, transfixed, it rose, just before it would have touched a thistle, and hovered pirouetting in one spot, then twirled on and finally came to rest. I found it in the grass; it was a maple key, a single winged seed from a pair. Hullo. I threw it into the wind and it flew off again, bristling with animate purpose, not like a thing dropped or windblown, pushed by the witless winds of convection currents hauling round the world’s rondure where they must, but like a creature muscled and vigorous, or a creature spread thin to that other wind, the wind of the spirit which bloweth where it listeth, lighting, and raising up, and easing down. O maple key, I thought, I must confess I thought, o welcome, cheers.

And the bell under my ribs rang a true note, a flourish as of blended horns, clarion, sweet, and making a long dim sense I will try at length to explain. Flung is too harsh a word for the rush of the world. Blown is more like it, but blown by a generous, unending breath. That breath never ceases to kindle, exuberant, abandoned; frayed splinters spatter in every direction and burgeon into flame. And now when I sway to a fitful wind, alone and listing, I will think, maple key. When I see a photograph of earth from space, the planet so startlingly painterly and hung, I will think, maple key. When I shake your hand or meet your eyes I will think, two maple keys. If I am a maple key falling, at least I can twirl.
~Annie Dillard from Pilgrim at Tinker Creek

(Happy birthday to Annie today — her 76th !)

I think a lot about wings — particularly when I’m sitting belted in a seat looking out at them bouncing in turbulence, marveling at how they keep hundreds of people and an entire aircraft miles above ground. 

Wings, no matter what they belong to, are marvelous structures that combine strength and lift and lightness and expanse and mobility, with the ability to rise up and ease back to earth.

And so ideally I am blown rather than flung through my fitful windy days,
rising and falling as those thin veined wings guide me,
twirling, swirling as I fall,
oh so slowly, to settle, planted.

A new book available with Barnstorming photos and poetry by Lois Edstrom:

Watching the Weather

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When it snows, he stands
at the back door or wanders
around the house to each
window in turn and
watches the weather
like a lover.

O farm boy,
I waited years
for you to look at me
that way. Now we’re old
enough to stop waiting
for random looks or touches
or words, so I find myself
watching you watching
the weather, and we wait
together to discover
whatever the sky might bring.
~Patricia Traxler “Weather Man”

My farm boy always looked at me that way,
and still does —
wondering if today will bring
a hard frost,
a chilly northeaster,
a scorcher,
or a deluge,
and I reassure him as best I can,
because he knows me so well
in our many years together:
today, like every other day,
will always be partly sunny
with some inevitable cloud cover
and always a possibility of rain.

The Daylights

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When I wake up earlier than you and you
are turned to face me, face
on the pillow and hair spread around,
I take a chance and stare at you,
amazed in love and afraid
that you might open your eyes and have
the daylights scared out of you.
But maybe with the daylights gone
you’d see how much my chest and head
implode for you, their voices trapped
inside like unborn children fearing
they will never see the light of day.
The opening in the wall now dimly glows
its rainy blue and gray. I tie my shoes
and go downstairs to put the coffee on.
~Ron Padgett, “Glow” from Collected Poems.

It is my morning routine to wake early
and I take a moment to look at you still asleep,
your slow even breaths and peaceful face-
I’m thankful for every day I get to spend with you.

I know you know this~
we remind each other each day
in many ways, to never forget.

What blessing comes from a love
openly expressed and never hidden~
thriving in the dark of night,
yet never shining brighter
than in the delights and daylights
of each new morning together.

Returning Home

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In the quiet misty morning
When the moon has gone to bed,
When the sparrows stop their singing
And the sky is clear and red,
When the summer’s ceased its gleaming
When the corn is past its prime,
When adventure’s lost its meaning –
I’ll be homeward bound in time

Bind me not to the pasture
Chain me not to the plow
Set me free to find my calling
And I’ll return to you somehow

If you find it’s me you’re missing
If you’re hoping I’ll return,
To your thoughts I’ll soon be listening,
And in the road I’ll stop and turn
Then the wind will set me racing
As my journey nears its end
And the path I’ll be retracing
When I’m homeward bound again

Bind me not to the pasture
Chain me not to the plow
Set me free to find my calling
And I’ll return to you somehow

In the quiet misty morning
When the moon has gone to bed,
When the sparrows stop their singing
I’ll be homeward bound again.
~Marta Keen “Homeward Bound”

Seventy eight years ago, my parents married on Christmas Eve. It was not a conventional wedding day but a date of necessity, only because a justice of the peace was available to marry a score of war-time couples in Quantico, Virginia, shortly before the newly trained Marine officers were shipped out to the South Pacific to fight in WWII.

When I look at my parents’ young faces – ages 22 and just turned 21 — in their only wedding portrait, I see a hint of the impulsive decision that led to that wedding just a week before my father left for 30 months. They had known each other at college for over a year, had talked about a future together, but with my mother starting a teaching job in a rural Eastern Washington town, and the war potentially impacting all young men’s lives very directly, they had not set a date.

My father put his college education on hold to enlist, knowing that would give him some options he wouldn’t have if drafted, so they went their separate ways as he headed east to Virginia for his Marine officer training, and Mom started her high school teaching career as a speech and drama teacher. One day in early December of 1942, he called her and said, “If we’re going to get married, it’ll need to be before the end of the year. I’m shipping out the first week in January.” Mom went to her high school principal, asked for a two week leave of absence which was granted, told her astonished parents, bought a dress, and headed east on the train with a friend who had received a similar call from her boyfriend.

This was a completely uncharacteristic thing for my overly cautious mother to do, so… it must have been love.

They were married in a brief civil ceremony with another couple as the witnesses. They stayed in Virginia only a couple days and took the train back to San Diego, and my father was shipped out. Just like that. Mom returned to her teaching position and the first three years of their married life was composed of letter correspondence only, with gaps of up to a month during certain island battles when no mail could be delivered or posted.

As I sorted through my mother’s things following her death over a decade ago, I found their war-time letters to each other, stacked neatly and tied together in a box.

In my father’s nearly daily letters home to my mother during WWII, month after month after month, he would say, over and over, while apologizing for the repetition:

“I will come home to you, I will return, I will not let this change me, we will be joined again…”

This was his way of convincing himself even as he carried the dead and dying after island battles: men he knew well and the enemy he did not know. He knew they were never returning to the home they died protecting and to those who loved them.

He shared little of battle in his letters as each letter was reviewed and signed off by a censor before being sealed and sent. This story, however, made it through:

“You mentioned a story of Navy landing craft taking the Marines into Tarawa.  It reminded me of something which impressed me a great deal and something I’m sure I’ll never forget. 

So you’ll understand what I mean I’ll try to start with an explanation.  In training – close order drill- etc.  there is a command that is given always when the men form in the morning – various times during the day– after firing– and always before a formation is dismissed.  The command is INSPECTION – ARMS.  On the command of EXECUTION- ARMS each man opens the bolt of his rifle.  It is supposed to be done in unison so you hear just one sound as the bolts are opened.  Usually it is pretty good and sounds O.K.

Just to show you how the morale of the men going to the beach was – and how much it impressed me — we were on our way in – I was forward, watching the beach thru a little slit in the ramp – the men were crouched in the bottom of the boat, just waiting.  You see- we enter the landing boats with unloaded rifles and wait till it’s advisable before loading.  When we got about to the right distance in my estimation I turned around and said – LOAD and LOCK – I didn’t realize it, but every man had been crouching with his hand on the operating handle and when I said that — SLAM! — every bolt was open at once – I’ve never heard it done better – and those men meant business when they loaded those rifles. 

A man couldn’t be afraid with men like that behind him.”

My father did return home to my mother after nearly three years of separation. He finished his college education to become an agriculture teacher to teach others how to farm the land while he himself became bound to the pasture and chained to the plow.

He never forgot those who died, making it possible for him to return home. I won’t forget either.

My mother and father could not have foretold the struggles that lay ahead for them. The War itself seemed struggle enough for the millions of couples who endured the separation, the losses and grieving, as well as the eventual injuries–both physical and psychological.  It did not seem possible that beyond those harsh and horrible realities, things could go sour after reuniting.

The hope and expectation of happiness and bliss must have been overwhelming, and real life doesn’t often deliver.  After raising three children, their 35 year marriage fell apart with traumatic finality.  When my father returned home (again) over a decade later, asking for forgiveness, they remarried and had five more years together before my father died in 1995.

Christmas is a time of joy, a celebration of new beginnings and new life when God became man, humble, vulnerable and tender. But it also gives us a foretaste for the profound sacrifice made in giving up this earthly life, not always so gently.

As I peer at my father’s and mother’s faces in their wedding photo, I remember those eyes, then so trusting and unaware of what was to come.  I find peace in knowing they returned home to behold the Light, the Salvation and the Glory~~the ultimate Christmas~~in His presence.

In the quiet misty morning
When the moon has gone to bed,
When the sparrows stop their singing
And the sky is clear and red,
When the summer’s ceased its gleaming
When the corn is past its prime,
When adventure’s lost its meaning –
I’ll be homeward bound in time

Bind me not to the pasture
Chain me not to the plow
Set me free to find my calling
And I’ll return to you somehow

If you find it’s me you’re missing
If you’re hoping I’ll return,
To your thoughts I’ll soon be listening,
And in the road I’ll stop and turn
Then the wind will set me racing
As my journey nears its end
And the path I’ll be retracing
When I’m homeward bound again

Bind me not to the pasture
Chain me not to the plow
Set me free to find my calling
And I’ll return to you somehow

In the quiet misty morning
When the moon has gone to bed,
When the sparrows stop their singing
I’ll be homeward bound again.
~Marta Keen “Homeward Bound”

What Lasts and What Does Not

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I save my love for what is close,
for the dog’s eyes, the depths of brown
when I take a wet cloth to them
to wash his face. I save my love
for the smell of coffee at The Mill,
the roasted near-burn of it, especially
the remnant that stays later
in the fibers of my coat. I save my love
for what stays. The white puff
my breath makes when I stand
at night on my doorstep.
That mist doesn’t last, evaporates
like your car turning the corner,
you at the wheel, waving.
Your hand a quick tremble in a
brief illumination. Palm and fingers.
Your face toward me. You had
turned on the over-head light so I would
see you for an instant, see you waving,
see you gone.
~Marjorie Saiser “I Save My Love,” from Learning to Swim

Mist is ephemeral~
evaporates as the light comes out,
unable to bear the heat.

Not so you.

I am grateful
you have been beside me
all these months of stay-at-home,
never wavering
nor wishing to be somewhere else.

So we now have confirmation:
love that lasts
stays close
when all else dissipates.

Thirty Nine Years Ago Today

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Sometimes our life reminds me
of a forest in which there is a graceful clearing
and in that opening a house,
an orchard and garden,
comfortable shades, and flowers
red and yellow in the sun, a pattern
made in the light for the light to return to.
The forest is mostly dark, its ways
to be made anew day after day, the dark
richer than the light and more blessed,
provided we stay brave
enough to keep on going in.
~Wendell Berry from “The Country of Marriage”

I want to remember us this way—
late September sun streaming through
the window, bread loaves and golden
bunches of grapes on the table,
spoonfuls of hot soup rising
to our lips, filling us
with what endures.
~Peter Pereira from “A Pot of Red Lentils”

Lovers must not live for themselves alone. 
They must finally turn their gaze at one another
back toward the community. 
If they had only themselves to consider,
lovers would not need to marry,
but they must think of others and of other things. 
They say their vows to the community as much as to one another,
and the community gathers around them
to hear and to wish them well, on their behalf and on its own. 

It gathers around them because it understands how necessary,
how joyful, and how fearful this joining is. 
These lovers, pledging themselves to one another “until death,”
are giving themselves away… 
Lovers, then, “die” into their union with one another
as a soul “dies” into its union with God. 

And so, here, at the very heart of community life,
we find … this momentous giving. 
If the community cannot protect this giving,
it can protect nothing—and our time is proving that this is so.
~Wendell Berry from Sex, Economy, Freedom & Community

Before God and this gathering, I vow from my heart and spirit that I will be your wife/husband for as long as we both shall live.

I will love you with faithfulness, knowing its importance in sustaining us through good times and bad.

I will love you with respect, serving your greatest good and supporting your continued growth.

I will love you with compassion, knowing the strength and power of forgiveness.

I will love you with hope, remembering our shared belief in the grace of God and His guidance of our marriage.

“And at home, by the fire, whenever you look up, there I shall be–and whenever I look up, there will be you.”

(wedding vows written during a lunch break on the roof of Group Health on Capitol Hill, Seattle Washington in July 1981 before our September 19, 1981 wedding at First Seattle Christian Reformed Church)

*the last line is adapted from Thomas Hardy’s  “Far From the Madding Crowd”

Acres of Opinions

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Now we are here at home, in the little nation
of our marriage, swearing allegiance to the table
we set for lunch or the windchime on the porch,

its easy dissonance. Even in our shared country,
the afternoon allots its golden lines
so that we’re seated, both in shadow, on opposite

ends of a couch and two gray dogs between us.
There are acres of opinions in this house.
I make two cups of tea, two bowls of soup,

divide an apple equally. If I were a patriot,
I would call the blanket we spread across our bed
the only flag—some nights we’ve burned it

with our anger at each other. Some nights
we’ve welcomed the weight, a woolen scratch
on both our skins. My love, I am pledging

to this republic, for however long we stand,
I’ll watch with you the rain’s arrival in our yard.
We’ll lift our faces, together, toward the glistening.
~Jehanne Dubrow from “Pledge”

photo by Bette Vander Haak

Whether it is a beloved country, or a devoted marriage, there is need for loyalty to last through the difficult times and the imperfections.

We pledge allegiance to the republic of one another among acres of opinions: our differences in how we see the world contrast with our shared goals and dreams. Our stubborn persistence to stay intact is threatened by our fragile weaknesses that can easily break us asunder.

So we stand united, no matter the dissonance and the disagreements, drenched with the responsibility and accountability to make this union work, no matter what, for as long as we shall live, and much much beyond.

May we glisten with the pledge of allegiance:
we can only accomplish this together.

Why Another?

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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 “Evening”

Even on a Monday,
despite so much of the world
suffering,
there is work
that must be done;
I’ve been allowed
this day
to do my best
and maybe as this day dies
there will come, just as miraculous,
another.