What Did I Know?

Sundays too my father got up early
and put his clothes on in the blueblack cold,
then with cracked hands that ached
from labor in the weekday weather made
banked fires blaze. No one ever thanked him.

I’d wake and hear the cold splintering, breaking.
When the rooms were warm, he’d call,
and slowly I would rise and dress,
fearing the chronic angers of that house,

Speaking indifferently to him,
who had driven out the cold
and polished my good shoes as well.
What did I know, what did I know
of love’s austere and lonely offices?
~Robert Hayden “Those Winter Sundays”

As a child growing up,
I was oblivious
to the sacrifices my parents made
to keep the house warm,
place food on the table,
teaching us the importance of being steadfast,
to crack the door of opportunity open,
so we could walk through
to a better life
and we did.

It was no small offering
to keep dry seasoned fire and stove wood always at the doorstep,
to milk the cows twice a day,
to grow and preserve fruits and vegetables months in advance,
to raise and care for livestock,
to read books together every night,
to sit with us over homework
and drive us to 4H, Cub Scouts and Camp Fire,
to music lessons and sports,
to sit together for meals,
and never miss a Sunday
to worship God.

This was their love,
so often invisible,
too often imperfect,
yet its encompassing warmth
splintered and broke
the grip of cold
that can overwhelm and freeze
a family’s heart and soul.

What did I know? What did I know?
Too little then,
so much more now
yet still – never enough.

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The Beginning Shall Remind us of the End: The Worst Our Kind Can Do

It’s when we face for a moment
the worst our kind can do, and shudder to know
the taint in our own selves, that awe
cracks the mind’s shell and enters the heart:
not to a flower, not to a dolphin,
to no innocent form
but to this creature vainly sure
it and no other is god-like, God
(out of compassion for our ugly
failure to evolve) entrusts,
as guest, as brother,
the Word.
~Denise Levertov “The Mystery of the Incarnation”

In the Christmas story, God … takes the risk of incarnation. The flesh God chooses is not that of a warrior but of a vulnerable baby, a claim that brought me tears of wonderment when I was young. But my adult knowledge of that infant’s fate — a fate shared by so many who have devoted their lives to love, truth, and justice — brings tears of anger and grief, along with a primal fear of what might happen if I followed suit.

…I know I’m called to share in the risk of incarnation. Amid the world’s dangers, I’m asked to embody my values and beliefs, my identity and integrity, to allow good words to take flesh in me. Constrained by fear, I often fall short — yet I still aspire to incarnate words of life, however imperfectly.

What good words wait to be born in us, and how can we love one another in ways that midwife their incarnation?
~Parker Palmer from “The Risk of Incarnation”

I, like you, am entrusted to care for the Word in its earthly incarnation: born into impoverished, humble, and homeless circumstances, He has no where to dwell except within me and within you.

And that is no small price for Him to pay, as my human heart can be inhospitable, hardened, cold and cracked. I am capable of the worst our kind can do.

So it is up to me to embody the Word in what I say and do, even if it means rejection as He suffered, even knowing that is the risk I must take. For me, it feels as vulnerable as if I were a bare tree standing naked in the chill winter wind. I’m fearful I might break or topple over.
Yet if I’m created to harbor the incarnated Word, I must reach my roots deep, stand tall and find others who will stand alongside me.

This Advent, Iet us midwife the Word here on earth, to deliver it straight to receptive, warm, and loving hearts.


Come, my Way, my Truth, my Life:
Such a Way, as gives us breath:
Such a Truth, as ends all strife:
Such a Life, as killeth death.

Come, My Light, my Feast, my Strength:
Such a Light, as shows a feast:
Such a Feast, as mends in length:
Such a Strength, as makes his guest.

Come, my Joy, my Love, my Heart:
Such a Joy, as none can move:
Such a Love, as none can part:
Such a Heart, as joys in love.
~George Herbert “The Call”

1.Let all mortal flesh keep silence,
And with fear and trembling stand;
Ponder nothing earthly-minded,
For with blessing in his hand,
Christ our God to earth descendeth,
Our full homage to demand.

2.King of kings, yet born of Mary,
As of old on earth he stood,
Lord of lords, in human vesture,
In the body and the blood;
He will give to all the faithful
His own self for heavenly food.

3.At his feet the six-winged seraph,
Cherubim, with sleepless eye,
Veil their faces to the presence,
As with ceaseless voice they cry:
Alleluia, Alleluia,
Alleluia, Lord Most High!

This year’s Barnstorming Advent theme “… the Beginning shall remind us of the End” is taken from the final lines in T.S. Eliot’s poem “The Cultivation of Christmas Trees”

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Born Broken

Man is born broken.
He lives by mending.
The grace of God is glue.
~Eugene O’Neill
from Act 4, Scene 1 – The Great God Brown

None of us can “mend” another person’s life, no matter how much the other may need it, no matter how much we may want to do it.

Mending is inner work that everyone must do for him or herself. When we fail to embrace that truth the result is heartbreak for all concerned.

What we can do is walk alongside the people we care about, offering simple companionship and compassion. And if we want to do that, we must save the only life we can save, our own.
~Parker Palmer writing about Mary Oliver’s poem “The Journey”

One day you finally knew
what you had to do, and began,
though the voices around you
kept shouting

their bad advice – – –
though the whole house
began to tremble
and you felt the old tug
at your ankles.
‘Mend my life!’
each voice cried.
But you didn’t stop.

You knew what you had to do,
though the wind pried
with its stiff fingers
at the very foundations – – –
though their melancholy
was terrible. It was already late
enough, and a wild night,
and the road full of fallen
branches and stones.

But little by little,
as you left their voices behind,
the stars began to burn
through the sheets of clouds,
and there was a new voice,
which you slowly
recognized as your own,
that kept you company
as you strode deeper and deeper
into the world,
determined to do
the only thing you could do – –

– determined to save
the only life you could save.
~Mary Oliver “The Journey”

We are born hollering and suddenly alone,
already aware of our emptiness
from the first breath,
each tiny air sac bursting
with the air of our fallen world~
air that is never enough.

The rest of our days are spent
filling up our empty spaces
whether alveoli
or stomach
or synapses starving for understanding,
still hollering in our loneliness
and heart
broken.

So we mend ourselves
through our walk with others
also broken,
we patch up our gaps
by knitting the scraggly fragments
of lives lived together.
We become the crucial glue
boiled from gifted Grace,
all our holes
somehow made holy.

A book of beauty in words and photography, available for order here:

The Safety of the Thicket

He loved to ask his mother questions. It was the pleasantest thing for him to ask a question and then to hear what answer his mother would give. Bambi was never surprised that question after question should come into his mind continually and without effort. 

Sometimes he felt very sure that his mother was not giving him a complete answer, was intentionally not telling him all she knew.  For then there would remain in him such a lively curiosity, such suspicion, mysteriously and joyously flashing through him, such anticipation, that he would become anxious and happy at the same time, and grow silent.
~Felix Salten from Bambi

A Wounded Deer—leaps highest—
I’ve heard the Hunter tell—
‘Tis but the Ecstasy of death—
And then the Brake is still!
~Emily Dickinson from “165″

My first time ever
seated next to my mother
in a movie theater, just
a skinny four year old girl
practically folded up in half
by a large padded chair
whose seat won’t stay down,
bursting with anticipation
to see Disney’s Bambi.

Enthralled with so much color,
motion,  music, songs and fun
characters, I am wholly lost
in a new world of animated
reality when suddenly
Bambi’s mother looks up,
alarmed,  from eating
a new clump of spring grass
growing in the snow.

My heart leaps
with worry.
She tells him
to run
for the thicket,
the safest place where
she has always
kept him warm
next to her.

She follows behind,
tells him to run faster,
not to look back,
don’t ever look back.

Then the gun shot
hits my belly too.

My stomach twists
as he cries out
for his mother,
pleading for her.
I know in my heart
she is lost forever,
sacrificed for his sake.

I sob as my mother
reaches out to me,
telling me not to look.
I bury my face
inside her hug,
knowing Bambi
is cold and alone
with no mother
at all.

My mama took me home
before the end.
I could not bear to watch
the rest of the movie 
for years.

Those cries
still echo
in my ears
every time someone hunts and shoots
to kill the innocent.

Now, my own children are grown,
they have babies of their own,
my mom is gone from this earth,
I can even keep the seat from folding
me up in a movie theater.

I am in my seventh decade, and
there are still places in this world where
mothers and fathers
sons and daughters
grandmothers and grandfathers
sisters and brothers
and babies are hunted down
despite the supposed safety of the thicket~
of the sanctuary, the school, the grocery store, the home,
where we believe we are shielded from violence.

There is innocence no longer,
if there ever was.

A book of beauty in words and photography, available to order here:

In His Keeping

God keep my jewel this day from danger;
From tinker and pooka and bad-hearted stranger.
From harm of the water, from hurt of the fire.
From the horns of the cows going home to the byre.
From the sight of the fairies that maybe might change her.
From teasing the ass when he’s tied to the manger.
From stones that would bruise her, from thorns of the briar.
From evil red berries that wake her desire.
From hunting the gander and vexing the goat.
From the depths o’ sea water by Danny’s old boat.
From cut and from tumble, from sickness and weeping;
May God have my jewel this day in his keeping.
~Winifred Lett (1882-1973) Prayer for a Child

photo by Anna Blake

This prayer has hung in our home for almost three decades, purchased when I was pregnant with our first child.  When I first saw it with its drawing of the praying mother watching her toddler leave the safety of the home to explore the wide world, I knew it addressed most of my worries as a new mother, in language that helped me smile at my often irrational fears.  I would glance at it dozens of time a day, and it would remind me of God’s care for our children through every scary thing, real or imagined.

And I continue to pray for our grown children, their spouses, and now for four precious grandchildren who live too far away from us. I do this because I can’t not do it, and because I’m helpless without the care and compassion of our sovereign God.

May I be changed by my prayers.


I pray because I can’t help myself. I pray because I’m helpless. I pray because the need flows out of me all the time, waking and sleeping. It doesn’t change God. It changes me.
~C.S. Lewis

Sleep child upon my bosom,
It is cosy and warm;
Mother’s arms are tight around you,
A mother’s love is in my breast;
Nothing shall disturb your slumber,
Nobody will do you harm;
Sleep in peace, dear child,
Sleep quietly on your mother’s breast.

Sleep peacefully tonight, sleep;
Gently sleep, my lovely;
Why are you now smiling,
Smiling gently in your sleep?
Are angels above smiling on you,
As you smile cheerfully,
Smiling back and sleeping,
Sleeping quietly on my breast?

Do not fear, it is nothing but a leaf
Beating, beating on the door;
Do not fear, only a small wave
Murmurs, murmurs on the seashore;
Sleep child, there’s nothing here
Nothing to give you fright;
Smile quietly in my bosom,
On the blessed angels yonder.

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Unanswerable Questions

Under the harvest moon,
When the soft silver
Drips shimmering over the garden nights,
Death, the gray mocker,
Comes and whispers to you
As a beautiful friend
Who remembers.

Under the summer roses
When the flagrant crimson
Lurks in the dusk
Of the wild red leaves,
Love, with little hands,
Comes and touches you
With a thousand memories,
And asks you
Beautiful, unanswerable questions.
~Carl Sandburg, “Under the Harvest Moon”

As we enter the season
of all that is lush and lovely
which starts to wither and decay before our eyes,
we know the flowers and trees aren’t alone.
Death, whispering within its gray night’s cloak,
has been stealing the young and old since time began,
but never as boldly as during a pandemic.
Millions of family members are left
with nothing but bittersweet memories
of their loved ones now buried deep.

The harvest moon – not nearly bright enough,
as a poor reflection of the sun –
mocks us who covet light
during a rampage of contagious illness and death.

As we endure the searing beauty of yet another dying season,
let us treasure those we protect through our care and concern.
Let us cherish the memories of those we’ve lost.
There can be only one answer to the unanswerable questions:
Love itself died to become Salvation,
an ever-sufficient Light that leads us home.

A book of beauty in words and photos is available to order here:


	

Into a Commonwealth of Joy

The meaning of marriage begins in the giving of words. We cannot join ourselves to one another without giving our word. And this must be an unconditional giving, for in joining ourselves to one another we join ourselves to the unknown.
~Wendell Berry from “Poetry and Marriage” in Standing By Words

Our vows to one another forty years ago today:

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.”

(our wedding vows for our September 19, 1981 wedding at First Seattle Christian Reformed Church — the last line adapted from Thomas Hardy’s  “Far From the Madding Crowd”)

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.

We enter, willing to die,
into the commonwealth of its joy.
~Wendell Berry from “A Country of Marriage”

…Marriage… joins two living souls as closely as, in this world, they can be joined. This joining of two who know, love, and trust one another brings them in the same breath into the freedom of sexual consent and into the fullest earthly realization of the image of God.  From their joining, other living souls come into being, and with them great responsibilities that are unending, fearful, and joyful. The marriage of two lovers joins them to one another, to forebears, to descendants, to the community, to heaven and earth. It is the fundamental connection without which nothing holds, and trust is its necessity.
~Wendell Berry from Sex, Economy, Freedom and Community

We married in our Seattle church with our pastor officiating, with a small group of family and friends as witnesses.

It was a wedding created by two frugal people with little to spend – I sewed my dress and Dan’s shirt from muslin, we grew our own flowers, our families helped potluck the lunch afterward and our tiered carrot cake was made by a friend.

Yet our vows to one another were not frugal and held nothing back.
They were extravagant and comprehensive, coming from our hearts and spirits. The music we asked our amazing organist to play (versions below) inspired us by its simplicity and complexity – very much like the families that raised us and the God we worship.

Our vows have taken us from the city to the countryside, to the raising and rejoicing in three amazing children (each of whom wrote movingly to us today) and now four grandchildren. We served more than forty years as a public-employed attorney and physician, have laid down those responsibilities, and picked up the tools of farm and garden along with church and community service for as long as we are able.

We treasure each day of living together in faithfulness, respect, compassion and hope – knowing that how we love and find joy in one another mirrors how God loves and revels in His people.

We are praying for many more days to fill us with what endures.

A pot of red lentils
simmers on the kitchen stove.
All afternoon dense kernels
surrender to the fertile
juices, their tender bellies
swelling with delight.

In the yard we plant
rhubarb, cauliflower, and artichokes,
cupping wet earth over tubers,
our labor the germ
of later sustenance and renewal.

Across the field the sound of a baby crying
as we carry in the last carrots,
whorls of butter lettuce,
a basket of red potatoes.

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”

Here are versions of the organ music we selected for prelude, processional, recessional and postlude

The Beauty of a Fogbow

We don’t need to understand why a rainbow or fogbow is formed in order to appreciate its beauty, of course, but understanding the physics of rainbows does give us a new set of eyes. I call this the beauty of knowledge.
~Walter Lewin from For the Love of Physics

Ghaist o a gaw that few hae seen
paintit on fog lyk a fugue o thi scheme
Noah supposit thi Lord tae mean
     when aa were drooned,
ither hauf o yin o His een
     thon runic roond.

Rope o smoke lyk a loop on a cable,
Grisaille Cain tae thi rainbow’s Abel,
ultra-blank tae infra-sable,
     auld noose o tow;
Yin that’s strang whaur Yang is faible:
     faur are ye now?
~WN Herbert “The Fogbow” from Omnesia

(this is my best guess of the meaning of Herbert’s inventive English/Gaelic/Scottish)

Ghost of a rainbow bruise that few have seen
painted on fog like a fugue of this scheme
Noah supposed the Lord to mean
when all were drowned
the other half of the dark cold earth is
a mysterious rune ruined.

A rope of smoke like a loop on a cable
a gray pallid Cain to the rainbow’s Abel,
outer-white to inner-black
old noose in tow;
the cold and dark is strong where warmth and light is feeble:
where are you now?

Look at a rainbow.
While it lasts, it is or appears to be,
a great arc of many colours occupying a position out there in space….
And now, before it fades, recollect all you have ever been told about the rainbow and its causes, and ask yourself the question,
Is it really there?
You know from memory that if you walked to the place where the rainbow ends, or seems to end, it would certainly not be ‘there’. In a word, reflection will assure you that the rainbow is the outcome of the sun, the raindrops and your own vision.
~Owen Barfield writing about “The Rainbow”

We saw our first “fogbow” or “ghost rainbow” early yesterday on our morning walk. It happened as we were heading east toward the sun, with the fog thickening, filling in behind us. We had just turned around to check the road to be sure no cars were coming before we crossed to the other side and there was this spectral image of foggy columns curving upward over the road to barely touch one another at the top. As we moved away from it, it vanished, as they say, “into thin air.”

This is an unusual phenomenon where the light and moisture in the air needs to be just right – reading about the physics of the fogbow helps to explain it and to render it even more beautiful. But the knowledge of how it happens isn’t nearly as impactful as the fact it was there at all for us to witness. Without our vision, it wasn’t really “there.”

The “bruised” rainbow color in the sky is God’s Old Testament promise to Noah to never destroy the world by flood again, establishing an everlasting covenant with His people while giving us the capacity to witness His promise. Perhaps the fogbow is ghostly reminder of those who have perished, whose blood, like Abel’s, cried out to God from the earth.

But where are we now? Do we seek to understand, believing the promises God made to us? Or do we walk right past God and His miraculous physics of creation, oblivious to what would not even exist without our ability to see it?

Somewhere, over the fogbow, way up high…

If you enjoy these posts, this book from Barnstorming may be of interest for yourself or as a gift to someone who loves beautiful photography and words of wisdom (from Lois Edstrom) – available to order here:

Wonder in Their Eyes

Serene the silver fishes glide,
Stern-lipped, and pale, and wonder-eyed!
As through the aged deeps of ocean,    
They glide with wan and wavy motion.   
They have no pathway where they go,
They flow like water to and fro,    
They watch with never-winking eyes,
They watch with staring, cold surprise,    
The level people in the air,  
The people peering, peering there:
Who wander also to and fro, 
And know not why or where they go,    
Yet have a wonder in their eyes,  
Sometimes a pale and cold surprise.

~ Max Eastman, “At the Aquarium”  Max Eastman: A Life

The fish are drifting calmly in their tank
between the green reeds, lit by a white glow
that passes for the sun. Blindly, the blank
glass that holds them in displays their slow
progress from end to end, familiar rocks
set into the gravel, murmuring rows
of filters, a universe the flying fox
and glass cats, Congo tetras, bristle-nose
pleocostemus all take for granted. Yet
the platys, gold and red, persist in leaping
occasionally, as if they can’t quite let
alone a possibility—of wings,
maybe, once they reach the air? They die
on the rug. We find them there, eyes open in surprise.
~Kim Addonizio “Aquarium,” from The Philosopher’s Club

Our shadows bring them from the shadows:
a yolk-yellow one with a navy pattern
like a Japanese woodblock print of fish scales.
A fat 18-karat one splashed with gaudy purple
and a patch of gray. One with a gold head,

a body skim-milk-white, trailing ventral fins
like half-folded fans of lace.
A poppy-red, faintly disheveled one,
and one, compact, all indigo in faint green water.
They wear comical whiskers and gather beneath us
as we lean on the cement railing
in indecisive late-December light,
and because we do not feed them, they pass,
then they loop and circle back. Loop and circle. Loop.
“Look,” you say, “beneath them.” Beneath them,
like a subplot or a motive, is a school
of uniformly dark ones, smaller, unadorned,
perhaps another species, living in the shadow
of the gold, purple, yellow, indigo, and white,
seeking the mired roots and dusky grasses,
unliveried, the quieter beneath the quiet.
~Susan Kolodny “Koi Pond, Oakland Museum”

The water going dark only
makes the orange seem brighter,
as you race, and kiss, and spar
for food, pretending not
to notice me. For this gift
of your indifference, I am
grateful. I will sit until
the pond goes black, the last
orange spark extinguished.
~Robert Peake from “Koi Pond”

the kingdom of heaven is like a net that was let down into the lake and caught all kinds of fish. When it was full, the fishermen pulled it up on the shore. Then they sat down and collected the good fish in baskets, but threw the bad away. 
Matthew 13: 47-48

I caught a tremendous fish
and held him beside the boat
half out of water, with my hook
fast in a corner of his mouth.
He didn’t fight.
He hadn’t fought at all.
He hung a grunting weight,
battered and venerable
and homely. 
I looked into his eyes
which were far larger than mine
but shallower, and yellowed,
the irises backed and packed
with tarnished tinfoil
seen through the lenses
of old scratched isinglass.
They shifted a little, but not
to return my stare.
– It was more like the tipping
of an object toward the light.
I admired his sullen face,
the mechanism of his jaw,
and then I saw
that from his lower lip
– if you could call it a lip
grim, wet, and weaponlike,
hung five old pieces of fish-line,
or four and a wire leader
with the swivel still attached,
with all their five big hooks
grown firmly in his mouth.
Like medals with their ribbons
frayed and wavering,
a five-haired beard of wisdom
trailing from his aching jaw.
I stared and stared
and victory filled up
the little rented boat,
from the pool of bilge
where oil had spread a rainbow
around the rusted engine
to the bailer rusted orange,
the sun-cracked thwarts,
the oarlocks on their strings,
the gunnels- until everything
was rainbow, rainbow, rainbow! 
And I let the fish go. 
~Elizabeth Bishop  from “The Fish”

All my life, I’ve taken care of a variety of fish in tanks and ponds.  As a child, I would watch, mesmerized, as our tropical fish glided around, happily exploring their little ten gallon world.  I willingly cleaned away the algae, rinsed the gravel and changed the filter. As a teenager, I boasted at least three different tanks aerating away in my bedroom, my own little aqua-cultural world of bubbles and fins.

During college and medical school, I chose to share my room with goldfish and bettas, thriving on their apparent contentment within a clear glass bowl.  I didn’t think of them as emotional support animals, but there was a joy obvious in their albeit limited existence: they still thrived when I was away, not missing me, but were always thrilled when I fed them, and tolerated my messing with their home maintenance.

My current thirty gallon aquarium is decades old and boasts over two dozen fish and plenty of furry algae and plants. Some of my watery friends have lived ten years or more and when they pass, I miss them.  Even the dozen koi and goldfish in our farm pond have expressive faces and individual personalities that I’ve gotten to know well as they come when I call.

I know the heart of compassion I feel for any creature I’m responsible for, as I know and have experienced the compassion of our Creator.

I would hope when the time comes that I end up in His net, that He’ll look me in the eye, see the wonder there as I gape at Him. He’ll count my blemishes and wounds and the number of hooks in my mouth from the times I’ve been caught and escaped, and if He’s not yet ready to take me home, or deems me not yet ready to leave this world, He’ll throw me back rather than throw me away to keep trying to get it right.

He has promised us that.

Rainbows, rainbows, rainbows indeed…

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The Fly in the Currant Cake

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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