Because You Matter to Me…

If I can stop one heart from breaking,
I shall not live in vain;
If I can ease one life the aching,
Or cool one pain,
Or help one fainting robin
Unto his nest again,
I shall not live in vain.
~Emily Dickinson

So if there is any encouragement in Christ,
any comfort from love,

any participation in the Spirit,
any affection and sympathy,
complete my joy by being of the same mind,
having the same love,
being in full accord and of one mind.
…. in humility count others more significant than yourselves.
Let each of you look not only to his own interests,
but also to the interests of others.
~Philippians 2: 1-4

Walk in a manner worthy of the calling
to which you have been called,
with all humility and gentleness,
with patience,
bearing with one another in love,
eager to maintain the unity of the Spirit in the bond of peace.
Ephesians 4: 1-3

By wearing a mask…

If I can stop one person from infection,
I shall not live in vain;
If I can ease another’s worry,
Though masking goes against the grain,
Or help a divided country be
Restored to health again,
I shall not live in vain.

I wear a mask because you matter to me…

How You Made Them Feel

I’ve learned that even
when I have pains, I don’t have to be one …
I’ve learned that people will forget what you said,
people will forget what you did,
but people will never forget how you made them feel.
~Maya Angelou
on her 70th birthday, citing a quote from Carl Buehner

I learned from my mother how to love
the living, to have plenty of vases on hand
in case you have to rush to the hospital
with peonies cut from the lawn, black ants
still stuck to the buds. I learned to save jars
large enough to hold fruit salad for a whole
grieving household, to cube home-canned pears
and peaches, to slice through maroon grape skins
and flick out the sexual seeds with a knife point.
I learned to attend viewings even if I didn’t know

the deceased, to press the moist hands

of the living, to look in their eyes and offer
sympathy, as though I understood loss even then.
I learned that whatever we say means nothing,

what anyone will remember is that we came.
I learned to believe I had the power to ease
awful pains materially like an angel.
Like a doctor, I learned to create

from another’s suffering my own usefulness, and once
you know how to do this, you can never refuse.
To every house you enter, you must offer

healing: a chocolate cake you baked yourself,
the blessing of your voice, your chaste touch.
~Julie Kasdorf– “What I Learned from my Mother”

Usually a mom knows best about these things — how to love others when and how they need it and how to ease pain, not become one.  We don’t always get it right though, and dads can do it better.

Showing up with food is always a good thing but it is the showing up part that is the real food;  bringing along a cake is simply the icing.

This is a good reminder that as a doctor,
my usefulness has tended to depend on another’s suffering.
No illness, no misery, no symptoms and I’m out of a job.
I can only hope that someday that might be the case.
What a world it would be, especially as now suffering is universal.

And then I can still be a mom and grandmom
even if there is no more doctor work to be done:
….if I’d known it could help, I’d have baked a cake and shown up with it…

You Never Know

What shall I say, because talk I must?
That I have found a cure
for the sick?
I have found no cure
for the sick

but this crooked flower
which only to look upon
all men
are cured. This
is that flower
for which all men
sing secretly their hymns
of praise! This
is that sacred
flower!
~William Carlos Williams from “The Yellow Flower”

The nail of each big toe was the horn of a goat.  Thick as a thumb and curved, it projected down over the tip of the toe to the underside.  With each step, the nail would scrape painfully against the ground and be pressed into his flesh.  There was dried blood on each big toe. 

It took an hour to do each big toe.  The nails were too thick even for my nail cutters.  They had to be chewed away little by little, then flattened out with the rasp, washed each toe, dried him off, and put his shoes and socks back on.  He stood up and took a few steps, like someone who is testing the fit of a new pair of shoes. 

“How is it?”

“It don’t hurt,” he said, and gave me a smile that I shall keep in my safety deposit box at the bank until the day I die.

I never go to the library on Wednesday afternoon without my nail clippers in my briefcase.
You just never know.

~Richard Selzer from “Toenails” from Letters to a Young Doctor

I know for a while again
the health of self-forgetfulness,
looking out at the sky through
a notch in the valleyside,
the black woods wintry on
the hills, small clouds at sunset
passing across. And I know
that this is one of the thresholds
between Earth and Heaven,
from which even I may step
forth and be free.
– Wendell Berry from “Sabbath Poems”

Whenever I lose perspective about what I’m trained to do
and who I am meant to serve,
when I wallow in the mud of self-importance
rather than in the health of self-forgetfulness~

I wash out a plug of wax from a deaf ear
and restore hearing
or remove a painful thorn in a thumb
or clip someone’s crippling toenails
so they can step forth in freedom
or I simply sit still as someone
cries out their heart’s pain.

I cling to the crooked flower
of healing and forgiveness I was handed
over forty years ago in order to share
its sacred sweetness.

I’ve been given these tools for a reason
so need to continue to use them.

You just never know.

Giving Life or Draining It

In every encounter we either give life or drain it. There is no neutral exchange. We enhance human dignity or we diminish it. The success or failure of a given day is measured by the quality of our interest and compassion toward those around us.
~Brennan Manning
from Abba’s Child: The Cry of the Heart for Intimate Belonging

Forty years ago this week I graduated with an M.D. degree from the University of Washington and began a lifetime of trying to be life-giving rather than life-draining to others.

There have been times when I’ve failed miserably, my interest waning and my compassion fatigued.

But like tracing the path of a spiral from inside to outside, I continue to try to reach farther and encompass more with each step I take in the time I have left, remembering the dignity of each person I meet and being worthy of their time and trust.

May this young woman who embarked so enthusiastically on the physician journey so many decades ago never forget, after so much seasoning, what it took to get there and what it means to continue to be worthy.

Known and Unknown

As a fond mother, when the day is o’er,
   Leads by the hand her little child to bed,
   Half willing, half reluctant to be led,
   And leave his broken playthings on the floor,
Still gazing at them through the open door,
   Nor wholly reassured and comforted
   By promises of others in their stead,
   Which, though more splendid, may not please him more;
So Nature deals with us, and takes away
   Our playthings one by one, and by the hand
   Leads us to rest so gently, that we go
Scarce knowing if we wish to go or stay,
   Being too full of sleep to understand
   How far the unknown transcends the what we know.
~Henry Wadsworth Longfellow “Nature”

I remember being reluctant to go to bed as a child; I could miss something important that the adults waited to do until after I was asleep, or I wasn’t sure that I wanted to turn myself over to my dreams.

I had a period of time when I was in third grade (during the Cuban missile crisis) when I really was terrified to go to sleep, and ended up reading comic books during the night hours, trying to keep myself distracted from whatever fears I harbored. My mother, frantic for sleep herself during this worrisome time, consulted my pediatrician who prescribed orange juice with a tablespoon of brandy – for me, not for her. She was outraged at the thought, being a teetotaler, so bought no brandy for me (or for herself). I eventually got over my sleep issues, but not my worried heart.

The unknown is always more frightening than the known, and the older I got, the more I learned during 24 years of formal education and training, the more I realized I didn’t know. There would be no end to it. Even though I still spend several hours a week reading for required and non-required continuing medical education, I don’t crack the surface of everything that is news in my profession. There is a whole lot that I need to un-learn because it is now proven that it is no longer valid as it originally was over four decades of medical practice.

During the last three months of COVID-19, it is like drinking from several firehoses at once, as data on this previously unknown virus comes piecemeal from countless sources: the studies are rushed and sample sizes are small, conclusions are tentative, often barely peer-reviewed and sometimes disproven the next week by another study. What was considered “fact” a month ago may no longer be so.

So I know I must settle into the reality that there will always be plenty of unknowns, particularly as I reluctantly let go of life’s playthings one by one.

The unknown will always transcend the known on this side of the veil so I appreciate that I am gently led, in faith, to that long-awaited sleep that was so elusive before.

Flat Affect

I used to think the land
had something to say to us,
back when wildflowers
would come right up to your hand
as if they were tame.

Sooner or later, I thought,
the wind would begin to make sense
if I listened hard
and took notes religiously.
That was spring.

Now I’m not so sure:
the cloudless sky has a flat affect
and the fields plowed down after harvest
seem so expressionless,
keeping their own counsel.

This afternoon, nut tree leaves
blow across them
as if autumn had written us a long letter,
changed its mind,
and tore it into little scraps.
~Don Thompson October

photo by Nate Gibson
photo by Nate Gibson

We’re in a time of seasonal abundance but our emotions are spent from containment through lock-down, shelter-in, social distancing, zoom-in and zoom-out.

As I meet with my patients via a televisit, I try to read their faces and find that along with the flatness of our screens, our emotions are flat too. My usual gentle humor to lighten things up becomes pointless – it is hard to elicit smiles these days. On the other hand, there no longer is a need for abundant tissues for tearful conversations because no one will weep on screen. There may be a hint of emotion in a catch in a voice, but I have yet to see anyone actually cry in two months of telehealth conversations. That would be too vulnerable – somehow being on camera suggests we need to put the actor-mask on, be expression-less, strong and invulnerable. And somehow my patient knows I can’t reach out as I would in an exam room, literally and verbally, to reassure them I’m present and listening. I’m not really present on a screen even though I’m listening.

And while out in society, we must literally hide ourselves behind a mask that conceals our smiles as well as our grim-faced frowns.

So our social and clinical interactions are as flat as the screens they play out on.

We need some unchecked tears about now, as well as endless belly laughs. Perhaps there will be a reawakening to the range of emotions we have taken for granted before finding ourselves in this time of restraint and restriction.

As we reintegrate and reunite, slowly, carefully and compassionately, let us re-experience in 3-D what we have been missing in our virtual meetings: tears that accompany joyous reunion as well as the lament of all we’re lost during this time.

Please pass the tissues.

So Much Better

How much better it is
to carry wood to the fire
than to moan about your life.
How much better
to throw the garbage
onto the compost, or to pin the clean
sheet on the line,
With a gray-brown wooden clothes pin.
~Jane Kenyon “The Clothespin”

I get easily overwhelmed with everything that needs to get done:
a full day of telehealth computer visits with patients from home but all the usual household and farm tasks waiting for me –grass to mow, flower beds to weed, garden to plant, fences to fix, manure to haul, animals to brush out — the list is endless and there are never enough hours in the day.  

So of course, I moan and whine and write about it.

Or I can set to work, tackling one thing at a time.  A simple task is accomplished, and then another, like hanging clothes on the line: this one is done, and now this one, pinned and hanging to freshen, renewed, in the spring breezes.

At the end of the day, I pull them down, bury my face in them and breathe deeply, knowing how much better I am than before I began.

So much better.

Using Both Hands

In the Pasture–Julien Dupre`

This is the grip, like this:
both hands. You can close
your eyes if you like. When I say,
“Now,” it’s time. Don’t wait
or it’s all over. But not
too soon, either—just right.
Don’t worry. Let’s go.
Both hands.

~William Stafford, “Survival Course” from Even in Quiet Places. 

I know well the feeling of pulling against a momentum determined to break free of the strength I can muster to keep it under control. This is how my life, personally and professionally has often felt over the decades. It seems I am barely hanging on, at times losing my grip, my feet braced but slipping beneath me.

The full-uddered cow in the painting is compelled to join her herd in a pastoral scene just across the creek, but the milk maid must resist the cow’s escape. For the cow’s benefit and comfort, she must be milked. The cow has another agenda. She has snapped her rope tie, almost pulled up the stake, and in a show of strength and determination, the maid braces to pull a much larger animal around to retie her and restore things to how they were.

The action suggests the maid may succeed, but the cow’s attention is directed far afield. She doesn’t even feel the tug on her halter. We’re not fully convinced the cow won’t suddenly pull loose and break away from the maid’s grip, leaping the stream, tail raised straight in the air like a flag of freedom.

Right now, as spring advances rapidly with grass growing thick in the pastures, our horses smell that richness in the air. Sometimes this tug of war takes place when my plan is different than the horse’s. The fields are too wet for them to be out full time yet, so they must wait for the appropriate time to be released to freedom. The grass calls to them like a siren song as I feed them their portion of last summer’s uninviting hay. They can pull my shoulders almost out of joint when they are determined enough, they break through fences in their pursuit of green, they push through stall doors and lift gates off hinges. Right now I’m barely an adequate counterbalance to the pursuit of their desires and I struggle to remind them I’m on the other end of their lead rope.

Each day I find I try too hard to restore order in my life, on the farm, in the house, in my work, with my family. I want to pull that cow back around, get her tied up and relieved of her burden of milk so that it can nurture and replenish others. Sometimes I hang on, only to be pulled roughly along on the ground, scraped and yelling in the process.

Sometimes I just let go and have to try to catch that cow all over again.

Once in awhile I successfully get the cow turned around and actually milked without a spill.

I’ve held on with both hands. I’m clasping them together in prayer and petition that I won’t get pulled into the mud. I’ve got a grip.
And maybe, just maybe, I will make cheese….

portrait of Dan’s mom, Emma Gibson, praying, by granddaughter Sara Larsen

But By His Grace: We Are Not Alone

God makes us happy as only children can be happy.
God wants to always be with us, wherever we may be –
in our sin, in our suffering and death.
We are no longer alone;
God is with us.
We are no longer homeless;
a bit of the eternal home itself has moved unto us. 
~Dietrich Bonhoeffer

It’s the season of scars and of wounds in the heart
Of feeling the full weight of our burdens
It’s the season of bowing our heads in the wind
And knowing we are not alone in fear
Not alone in the dark

Don’t forget
Don’t forget I love
I love
I love you
~Vienna Teng “The Atheist Christmas Carol”

Over the years I have found I don’t do alone well.  Never have.  I’ve always preferred plenty of activity around me, planning gatherings and communal meals, and filling up my days to the brim with all manner of socializing. 

Typically I don’t prefer my own company.  There is no glossing over my flaws nor distracting myself from where I fall short.  Alone is an unforgiving mirror reflecting back what I have kept myself too overly busy to see.

I’ve never even lived alone except for short times when Dan is traveling.
I didn’t like that either.

We have had a taste of quiet aloneness together during the last two weeks of social isolation on the farm, with more time alone to come.  I continue to work, able to do my behavioral health medical consultations “virtually” as I am now in an age category that would not do well if exposed to COVID19 in the clinic. These days have had a slower pace and cadence, blessed with a gained hour by not commuting to the clinic. There is more time to take walks, often in silence together, bowing our heads to the wind, taking cover from chilling spring rains.

Despite our isolation, we know we are not alone in our fear of the darkness happening in the world around us. The headlines buzz on our phones; there is no ignoring the suffering happening to so many around us. I hear the fear of uncertainty in my patient’s voices as we talk.

Yet I remind myself of the certainty that I know is the truth:

We need not be afraid.
We are not alone in the dark.
We are loved.
And don’t forget,
don’t forget:
God is with us
even through this.

This year’s Lenten theme for Barnstorming:

God sees us as we are,
loves us as we are,
and accepts us as we are.
But by His grace,
He does not leave us where we are.
~Tim Keller

We are not alone. We are not alone.
We are not alone. God is with us.
We are not alone. We are not alone.
We are not alone. God is with us.

We are never alone (We are not alone 3x)
For (God is with us)
We (We are not alone 3x)
We are never alone
For (God is with us)

Now (We are not alone)
Through all our days(We are never alone)
(We are not alone. We are never alone)
Always (God is with us 2x)
For(ever and ever)
We are never alone

Are not alone. We are not alone.
We are not alone. God is with us.
We are not alone. We are not alone.
We are not alone. God is with us.

He Accepts Us As We Are: Hiding Nothing

You can hide nothing from God.
The mask you wear before men will do you no good before Him.
He wants to see you as you are,
He wants to be gracious to you.
You do not have to go on lying to yourself and your brothers,
as if you were without sin;
you can dare to be a sinner.

~Dietrich Bonhoeffer from Life Together


In your hands

The dog, the donkey, surely they know
They are alive.
Who would argue otherwise?


But now, after years of consideration,
I am getting beyond that.
What about the sunflowers? What about
The tulips, and the pines?


Listen, all you have to do is start and
There’ll be no stopping.
What about mountains? What about water
Slipping over rocks?


And speaking of stones, what about
The little ones you can
Hold in your hands, their heartbeats
So secret, so hidden it may take years


Before, finally, you hear them?
~Mary Oliver from
Swan: Prose and Poems

When I myself go to the doctor, I am to trust I’m seeing someone who is meant to know me thoroughly enough that he or she will help me move out of illness into better health. This is how acceptance feels: trusting someone enough to come out of hiding.

As a physician myself, I am reminded by the amount of “noticing” I need to do in the course of my work.  Each patient, and there are so many,  deserves my full attention for the few minutes we are together.  I start my clinical evaluation the minute we sit down together and I begin taking in all the complex verbal and non-verbal clues offered up, sometimes unwittingly, by another human being.

Now, during the COVID19 pandemic, my interactions with patients are all “virtual” so I don’t have the ability to observe as I usually do, so I need them to tell me outright what is going on in their lives, their minds and their hearts in spoken or written words. I can’t ‘see’ them, even on a screen, in the same way.

How might someone call out to me when their faces are hidden?

I can’t witness first hand the trembling hands, their sweatiness, the scars of self injury.  Still, I am their audience and a witness to their struggle; even more, I must understand it in order to best assist them.  My brain must rise to the occasion of taking in another person, accepting them for who they are, offering them the gift of compassion and simply be there for them, just them, right now.

God doesn’t struggle in His Holy work as I do in my clinical duties. He knows us thoroughly because He made us; He knows our thoughts before we put them into words. There is no point in staying hidden from Him.

He holds us, little pebbles that we are, in His Hand, and He discerns our secret heartbeats.

We, the hidden, are His.

This year’s Lenten theme for Barnstorming:

God sees us as we are,
loves us as we are,
and accepts us as we are.
But by His grace,
He does not leave us where we are.
~Tim Keller

I will search in the silence for your hiding place.
In the quiet, Lord, I seek your face.
Where can I discover the wellsprings of your love?
Is my search and seeking in vain?
How can I recover the beauty of your word?
In the silence I call out your name.
Where can I find shelter to shield me from the storm?
To find comfort, though dark be the night?
For I know that my welfare is ever in your sight.
In the shadows I long for your light.
Lead me in your footsteps along your ancient way.
Let me walk in the love of the Lord.
Your wisdom is my heart’s wealth, a blessing all our days.
In the silence I long for Your world.
~Liam Lawton