We Couldn’t Do Anything


Yesterday our children, playing
in a tree, watched as the tiniest bird
fell from above them,
where it belonged,
to land below them,
where it did not.
The dog, animal and eager,
stepped on the bird, then
lowered his head. Our daughter
screamed, hauled him back,
then cupped her trembling hands
around the trembling bird,
Its one wing stretched and bent.
Our son ran inside, obedient
to our daughter’s instructions.
I was in the shower, useless.
You found a shoebox, sheltered the bird,
helped our children find leaves and twigs,
perched the box in the tree. At supper,
we prayed for the bird while its mother
visited the shoebox,
her beak full. She fretted
and fluttered. She couldn’t do anything,
and we couldn’t do anything,
and after supper, we found the trowel.
Dust to dust,
I said.
O how I longed to gather you,
you said, as a mother hen gathers
her young beneath her wings.
Our son pushed a stick into the soft earth.
Our daughter told him not to push too far.

~Shea Tuttle “After reading our daughter’s poem” from Image Journal

Hope is the thing with feathers
That perches in the soul,
And sings the tune without the words,
And never stops at all,

And sweetest in the gale is heard;
And sore must be the storm
That could abash the little bird
That kept so many warm.

I’ve heard it in the chillest land,
And on the strangest sea;
Yet, never, in extremity,
It asked a crumb of me.

~Emily Dickinson

I have known the helplessness of watching life ebb away from a living creature and not be able to do a thing to change what is happening.

As a teenage nurse aide in a rest home for the elderly, I saw much of dying over those years before going to medical school – some deaths were anticipated and some unexpected. What was most apparent to me in that setting is that my primary role was to be a caring witness and comforter. I could not change what was happening but I could be there, not leaving my patients to die alone. I hoped that I was useful in some way.

Later, when I worked as a physician in a hospital, there were certainly things we would do to respond to a sudden cardiac event, and it was very dramatic to see someone’s pulse restored and stabilized due to our intervention. But more often than not, what we could do wouldn’t change the reality – dying still happened and we were gathered to witness the end. We often left the bedside feeling useless.

Now I have grandchildren who are learning about death through observing the natural cycles of animals living and dying on our farm. They discover a dead bird or vole on the ground; they were aware one of our elderly horses recently died. They are aware our beloved farm dogs are aging and so are grandma and grandpa.

Children naturally ask “why?” and we do our best to explain there is always hope and comfort, even when physical bodies are dust in the ground, marked by a stick or stone or only a memory.

It is “Hope” that sings alive within us, even when we’re naked and featherless, even if we fall far from the nest we were born to. We are caught and safe under our Savior’s wings for the rest of eternity, never to be “just dust” again.

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Naming Your Hopelessness

Instead of depression,
try calling it hibernation.
Imagine the darkness is a cave
in which you will be nurtured
by doing absolutely nothing.
Hibernating animals don’t even dream.
It’s okay if you can’t imagine
Spring. Sleep through the alarm
of the world. Name your hopelessness
a quiet hollow, a place you go
to heal, a den you dug,
Sweetheart, instead
of a grave.
~Andrea Gibson “Instead of Depression” from You Better Be Lightning

We didn’t say fireflies
but lightning bugs.
We didn’t say carousel
but merry-go-round.
Not seesaw,
teeter-totter
not lollipop,
sucker.
We didn’t say pasta, but
spaghetti, macaroni, noodles:
the three kinds.
We didn’t get angry:
we got mad.
And we never felt depressed
dismayed, disappointed
disheartened, discouraged
disillusioned or anything,
even unhappy:
just sad.
~Sally Fisher “Where I Come From”  from Good Question.

…if you could distinguish finer meanings within “Awesome” (happy, content, thrilled, relaxed, joyful, hopeful, inspired, prideful, adoring, grateful, blissful.. .), and fifty shades of “Crappy” (angry, aggravated, alarmed, spiteful, grumpy, remorseful, gloomy, mortified, uneasy, dread-ridden, resentful, afraid, envious, woeful, melancholy.. .), your brain would have many more options for predicting, categorizing, and perceiving emotion, providing you with the tools for more flexible and functional responses.
~Lisa Feldman Barrett from How Emotions Are Made: The Secret Life of the Brain

Our own experience with loneliness, depression, and fear can become a gift for others, especially when we have received good care. As long as our wounds are open and bleeding, we scare others away. But after someone has carefully tended to our wounds, they no longer frighten us or others….
We have to trust that our own bandaged wounds will allow us to listen to others with our whole being. That is healing.
— Henri Nouwen from Bread for the Journey

If there is anything I came to understand over the decades I served as a primary care physician, it is that every person experiences painful emotions that make them miserable, making it even more difficult to share with others. Sometimes those feelings build up such pressure that they leak out of our cells as physical symptoms: headaches, muscle tightness, stomach upset, hypertension. Other times they are so overwhelming we can no longer function in a day to day way – described clinically as rage, panic, mood disorder, depression, self-destructive, suicidal.

Somehow we’ve lost permission to be sad.
Just sad. Sometimes unbearably, hopelessly sad.
 
Sadness happens to us all, some longer than others, some worse than others, some deeper than others. What makes sadness more real and more manageable is if we can say it out loud — whatever ‘sad’ means to us on a given day and if we describe our feelings in detail, explaining to others who can understand because they’ve been there too, then they can listen and help.

Painful emotions don’t always need a “fix” in the short term, particularly chemical, but that is why I was usually consulted. Alcohol, marijuana and other self-administered drugs tend to be the temporary anesthesia that people seek to stop feeling anything at all but it can erupt even stronger later.

Sometimes an overwhelming feeling just needs an outlet so it no longer is locked up, unspoken and silent, threatening to leak out in ways that tear us up and pull us apart.

Sometimes we need a healing respite/hibernation, with permission to sleep through the world’s alarms for a time. At times, medical management with antidepressants can be incredibly helpful along with talk therapy.

It helps to find words to express how things felt before this sadness, where you are now in the midst of it and where you wish you could be rather than being swallowed by sorrow. Healing takes time and like anything else that is broken, it hurts as it repairs. Armed with that self-knowledge and some gentle compassion, tomorrow and the next day and the next might feel a little less hopeless and overwhelming.

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When the Lines Went Flat

I was still a kid
interning at State
he reminisces late in the meal—
It was a young red-headed woman
looked like my sister
when the lines went flat
I fell apart
shook
like a car with a broken axle
Went to the head surgeon
a fatherly man
Boy, he said, you got to fill a graveyard
before you know this business
and you just did row one, plot one.
~Alicia Suskin Ostriker, “The Surgeon” from The Book of Seventy

As a physician-in-training in the late 1970’s, I rotated among a variety of inner city public hospitals, learning clinical skills on patients who were grateful to have someone, anyone, care enough to take care of them. There were plenty of homeless street people who needed to be deloused before the “real” doctors would touch them, and there were the alcoholic diabetics whose gangrenous toes would self-amputate as I removed stinking socks. There were people with gun shot wounds and stabbings who had police officers posted at their doors and rape victims who were beaten and poisoned into submission and silence. Someone needed to touch them with compassion when their need was greatest.

As a 25 year old idealistic and naive student, I truly believed I could make a difference in the 6 weeks I spent in any particular hospital rotation. That proved far too grandiose and unrealistic, yet there were times I did make a difference, sometimes not so positive, in the few minutes I spent with a patient. As part of the training process, mistakes were inevitable. Lungs collapsed when putting in central lines, medications administered caused anaphylactic shock, pain and bleeding caused by spinal taps–each error creates a memory that never will allow such a mistake to occur again. It is the price of training a new doctor and the patient always–always– pays the price.

I was finishing my last on-call night on my obstetrical rotation at a large military hospital that served an army base. The hospital, built during WWII was a series of far flung one story bunker buildings connected by miles of hallways–if one part were bombed, the rest of the hospital could still function. The wing that contained the delivery rooms was factory medicine at its finest: a large ward of 20 beds for laboring and 5 delivery rooms which were often busy all at once, at all hours.  Some laboring mothers were married girls in their mid-teens whose husbands were stationed in the northwest, transplanting their young wives thousands of miles from their families and support systems. Their bittersweet labors haunted me: children delivering babies they had no idea how to begin to parent.

I had delivered 99 babies during my 6 week rotation. My supervising residents and the nurses on shift had kept me busy on that last day trying to get me to the *100th* delivery as a point of pride and bragging rights; I had already followed and delivered 4 women that night and had fallen exhausted into bed in the on call-room at 3 AM with no women currently in labor, hoping for two hours of sleep before getting up for morning rounds. Whether I reached the elusive *100* was immaterial to me at that moment.

I was shaken awake at 4:30 AM by a nurse saying I was needed right away. An 18 year old woman had arrived in labor only 30 minutes before and though it was her first baby, she was already pushing and ready to deliver. My 100th had arrived. The delivery room lights were blinding; I was barely coherent when I greeted this almost-mother and father as she pushed, with the baby’s head crowning. The nurses were bustling about doing all the preparation for the delivery:  setting up the heat lamps over the bassinet, getting the specimen pan for the placenta, readying suture materials for the episiotomy.

I noticed there were no actual doctors in the room so asked where the resident on call was.

What? Still in bed? Time to get him up! Delivery was imminent.

I knew the drill. Gown up, gloves on, sit between her propped up legs, stretch the vulva around the crowning head, thinning and stretching it with massaging fingers to try to avoid tears. I injected anesthetic into the perineum and with scissors cut the episiotomy to allow more room, a truly unnecessary but, at the time, standard procedure in all too many deliveries. Amniotic fluid and blood dribbled out then splashed on my shoes and the sweet salty smell permeated everything. I was concentrating so hard on doing every step correctly, I didn’t think to notice whether the baby’s heart beat had been monitored with the doppler, or whether a resident had come into the room yet or not. The head crowned, and as I sucked out the baby’s mouth, I thought its face color looked dusky, so checked quickly for a cord around the neck, thinking it may be tight and compromising. No cord found, so the next push brought the baby out into my lap. Bluish purple, floppy, and not responding. I quickly clamped and cut the cord and rubbed the baby vigorously with a towel.

Nothing, no response, no movement, no breath. Nothing.  I rubbed harder.

A nurse swept in and grabbed the baby and ran over to the pediatric heat lamp and bed and started resuscitation.

Chaos ensued. The mother and father began to panic and cry, the pediatric and obstetrical residents came running, hair askew, eyes still sleepy, but suddenly shocked awake with the sight of a blue floppy baby.

I sat stunned, immobilized by what had just happened in the previous five minutes. I tried to review in my foggy mind what had gone wrong and realized at no time had I heard this baby’s heart beat from the time I entered the room. The nurses started answering questions fired at me by the residents, and no one could remember listening to the baby after the first check when they had arrived in active pushing labor some 30 minutes earlier. The heart beat was fine then, and because things happened so quickly, it had not been checked again. It was not an excuse, and it was not acceptable. It was a terrible terrible error. This baby had died sometime in the previous half hour. It was not apparent why until the placenta delivered in a rush of blood and it was obvious it had partially abrupted–prematurely separated from the uterine wall so the circulation to the baby had been compromised. Potentially, with continuous fetal monitoring, this would have been detected and the baby delivered in an emergency C section in time. Or perhaps not. The pediatric resident worked for another 20 minutes on the little lifeless baby.

The parents held each other, sobbing, while I sewed up the episiotomy. I had no idea what to say,  mortified and helpless as a witness and perpetrator of such agony. I tried saying I was so sorry, so sad they lost their baby, felt so badly we had not known sooner. There was nothing that could possibly comfort them or relieve their horrible loss or the freshness of their raw grief.

And of course, there were no words of comfort for my own anguish.

Later, in another room, my supervising resident made me practice intubating the limp little body so I’d know how to do it on something other than a mannequin. I couldn’t see the vocal cords through my tears but did what I was told, as I always did.

I cried in the bathroom, a sad exhausted selfish weeping. Instead of achieving that “perfect” 100, I learned something far more important: without constant vigilance, and even with it,  tragedy intervenes in life unexpectedly without regard to age or status or wishes or desires. I went on as a family physician to deliver a few hundred babies during my career,  never forgetting the baby that might have had a chance, if only born at a hospital with adequately trained well rested staff without a med student trying to reach a meaningless goal.

This baby would now be in his 40’s, likely with children of his own, his parents now proud and loving grandparents.

I wonder if I’ll meet him again — this little soul only a few minutes away from a full life — if I’m ever forgiven enough to share a piece of heaven with humanity’s millions of unborn babies who, through intention or negligence, never had opportunity to draw a breath.

Then, just maybe then, forgiveness will feel real and grace will flood the terrible void where, not for the first time nor the last, my guilt overwhelmed what innocence I had left.

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Moving from Loneliness to Love

It’s the immemorial feelings
I like the best: hunger, thirst,
their satisfaction; work-weariness,
earned rest; the falling again
from loneliness to love;
the green growth the mind takes
from the pastures in March;
the gayety in the stride 
of a good team of Belgian mares
that seems to shudder from me
through all my ancestry.
~Wendell Berry “Goods”

photo by Joel De Waard
photo by Joel De Waard

It seems unlikely anyone would say
I didn’t work hard enough all those years.
After all, I come from a long line of human work-horses
and I know it takes sweat and tears, and sometimes bleeding.

Even so, I know I could have done more all those years.

I could have thrown myself more fully into the pull on the tugs,
could have shouldered the yoke with more enthusiasm,
could have bent down low with unbroken determination.

You might say somewhere I lost the gayety in my stride,
and you would be right — I ended up trudging through my day,
bruised from running into too many submerged rocks,
bumping into immoveable tree stumps and tripping on hidden roots,
falling into deep furrows of long and lonely post-midnight hours.

You might even say eventually the knowledge of a job well-done
seemed to lay deeper than my plow could ever reach.

When it came time for me to shrug out of the yoke
and shake off the harness,
I knew others die in their harness,
never to rest easy on this earth.

I am unsure what to do next with the seasons I have left.
Even so, I love the wondering and wandering,
almost as much as I love the feel of the sun on my unyoked withers.


photo by Joel De Waard
photo by Joel De Waard
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Taking a Moment to Thank the Light

Now a red, sleepy sun above the rim
Of twilight stares along the quiet weald,
And the kind, simple country shines revealed
In solitudes of peace, no longer dim.
The old horse lifts his face and thanks the light,
Then stretches down his head to crop the green.
All things that he has loved are in his sight;
The places where his happiness has been
Are in his eyes, his heart, and they are good.
~Siegfried Sassoon from “Break of Day”

We grow older along with our horses – as we near seventy, our oldest mare is thirty years old. None of us, horses or humans, have to climb in the harness to pull the heavy loads of our former work lives.

During these October days, as the horses feel the morning sun on their withers and the green blades under their feet, they scan the pasture for the sweetest tender patch to munch in the fields they know and love so well. They nap more now than in their younger years, taking breaks to let their heads hang relaxed and nodding, their tails slowly swishing at flies.

To be honest, I nap and nod more now as well.

They remind me to borrow the calm of the pasture to balance the noise and misery always present in the morning headlines. Carrying that calm to my decades of work as a physician was an essential survival skill. I remembered how peace and light intentionally descended to a troubled earth in sore need of healing.

A new day’s sunlight breaks fresh each morning and sinks gently and quietly beneath the horizon each evening. All things I love are within my sight; happiness and contentment do grow, like the grass beneath my feet, thanks to the Light.

And I am glad, so very glad that it is good.

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The Fog is Rising

I must go in; the fog is rising…
~Emily Dickinson, her last words

I have watched the dying
in their last hours:
often through the fog of waning breaths,
they see what I cannot,
they listen to what I do not hear,
stretching their arms overhead
as their fingers extend and grasp
to touch what is, as yet,
far beyond my reach.

I watch and wonder how it is
to reverse the journey that brought me here
from the fog of my amnion.

The mist of living lifts.

I will enter a place
unsurpassed in brilliance and clarity;
the mystery of what lies beyond solved
only by going in to it,
welcomed back to where I started.

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Whispering Words of Wisdom: Let It Be

Aspire to decency. Practice civility toward one another. Admire and emulate ethical behavior wherever you find it. Apply a rigid standard of morality to your lives; and if, periodically, you fail ­as you surely will, adjust your lives, not the standards.
Ted Koppel

Ten years ago during this week in August, my clinical work was routine and ordinary but took a quick turn when I got a message from the media director at my university that a 14 month old medical opinion article I’d written for the student newspaper and then posted as a regular contributor on www.kevinmd.com was suddenly being quoted on the Huffington Post, Salon.com and other websites.  

Within hours, over a dozen media websites were citing “A War on Pubic Hair”

The original article was written as one in a series of opinion pieces on medical issues pertinent to college students requested by the student newspaper. I wrote it in spring 2011 after draining my umpteenth staph bacteria genital abscess due to the increasingly common practice of cosmetic removal of pubic hair. I felt the students needed to understand the hazards of what they were doing and hoped I could spare the next patient from experiencing an infection so painful and potentially serious.

So it went viral, over a year after it was written, all in a matter of hours. I was being quoted as if I had just been interviewed by these news agencies, which I had not, and they began feeding wrong information to each other: I was identified as “a leading British physician” since the first media report originated in the U.K.  One British site actually asked permission to reprint the original article, which I appreciated so that my words could not be taken out of context, but they attached a photo of me to the article lifted from my family picture on my personal blog.

Soon my personal cell phone started to ring in the middle of the night and my email in-box filled up. Messages from Europe, South America and all over the U.S. came in with requests for interviews, wanting me to elaborate in more detail on my very “provocative” point of view. I said no to every one of them even though some were respectable agencies, like the BBC, because I’d said all I had to say on this particular subject. I did not want my long career to be reduced to my defense of pubic hair or my life motto to read “Leave it alone!” Indeed I can hold my head up and be proud to tell my grandchildren someday that I actually turned down the Playboy Channel.

The online comments on the articles rapidly reproduced themselves, numbering in the thousands, with many hostile to my perspective and saying so in the most mean and inflammatory ways possible, citing my age, my looks and obvious lack of sex appeal as showing I lacked credibility in this subject. I dared to question the point of a multi-billion dollar cosmetic industry spawned by the even bigger multi-billion dollar porn industry, and no one was going to let me get away with it unscathed.

Civility has become even more endangered on the internet in the intervening ten years so I believe I actually got off easy at the time. Human beings lack accountability for their words and actions while hiding behind anonymous comments on media websites and blogs. It is easy to attack, lie, threaten, and bully when it is only words on a screen directed at someone you don’t know and will never meet. Decency and civility are lost forever when the standards for moral and ethical behavior disappear in a fog of pixels and bytes.

It has taken some time and distance for me to consider whether I did the right thing writing about a medical issue no one else would touch at the time. The “bare” trend has definitely waned over the last decade yet plenty of people still engage in the practice, although the recent sexual spread of the monkey pox virus is making some think twice about it.

If I managed to convince someone to put away the razor, stop the waxing, and respect their body as nature intended it to be, maybe I did the right thing after all.

After all – I shared whispered words of wisdom:
Let it be…

Cartoon by Clay Bennett
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To Keep From Being Forgotten

I like to stroll the graveyard in the middle of town
With my friend Anne, though we seldom agree
On what an epitaph we happen to read implies.
I’m inclined to find the one-line gravestone,
Dr. Noah Vedder, M.D., as sadly comic.
If we can’t take our money into the dark,
I read it as saying, at least we can take our titles.
But Anne, whose sympathies are aroused
More quickly than mine, reads it more darkly
As confessional. Here is the man’s admission
That he saw himself as a better doctor
Than he was a friend, or father, or husband,
A better listener in his office than at home.

If his kin were responsible for the inscription,
Its terseness, I say, may suggest they were moved
More by duty than they were by love.
But for her, its terseness seems to imply
Their painful acknowledgment that no praise
Inscribed on the stone would keep their friend
From being forgotten soon after they would be.
And behind this truth she hears a protest:
If the world were fair, he wouldn’t be sentenced
To endless retirement but allowed to practice,
In a life beyond this one, the profession he loved.

What use would a doctor be, I ask, in a realm
Where bodies are laid aside? But for her the point is
That those who knew him were certain that if
Such a realm existed and a doctor were called for there,
He’d volunteer, glad to hold office hours
And glad after hours to visit patients
Too sick to leave home,
However modest the streets they lived on,
However winding and poorly lit.

~Carl Dennis “At the Graveyard with Anne”

Since my people are crushed, I am crushed;
    I mourn, and horror grips me.
 Is there no balm in Gilead?
    Is there no physician there?
Why then is there no healing
    for the wound of my people?

Jeremiah 8:21-22

We physicians can be an arrogant lot in our devotion to our profession above all else in our lives – I’ve known a few who wear their M.D. title full-time like a banner and shield to prove their expertise.

The only time the label M.D. is relevant is on a name tag in a clinical setting and often it doesn’t even make a difference there. We do what we can with what knowledge we possess from our training, as limited as it is. There is so much that we don’t know and don’t understand.

Even so, there are many altruistic physicians who give of themselves 24 hours a day for their lifetime. Some would gladly continue their healing efforts long after they have become dust, yet those skills are no longer needed. In heaven, all are already healed.

Our healing comes from beyond our expertise, from a balm that can never be prescribed. We have a Great Physician who never forgets us, even when we are crushed and mourning, when all seems hopeless with our wounds so incredibly deep.

We are not forgotten.

Every face is in you, every voice,
Every sorrow in you.
Every pity, every love,
Every memory, woven into fire.
Every breath is in you, every cry,
Every longing in you.

Every singing, every hope,
Every healing, woven into fire.
Every heart is in you,
Every tongue, every trembling in you,
Every blessing, every soul,
Every shining, woven into fire.
~Michael Dennis Browne

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When Mortal Life Shall Cease

(Fourteen years ago this week, a healthy young college student came to our university health clinic ill with seasonal influenza complicated by pneumonia. His family gave permission for his story to be told. I share this again to honor the patients, young and old, who have fallen victim to the even more devastating COVID-19 pandemic over the past two years, as well as their families who have not had the same privilege of being at their bedside as they die. And honoring the health care workers who have witnessed so many preventable deaths over and over and will never truly recover from that experience.)

Nothing was helping.  Everything had been tried for a week of the most intensive critical care possible.  A twenty year old man – completely healthy only two weeks previously – was dying and nothing could stop it.

The battle against a sudden MRSA (Methicillin Resistant Staph Aureus) pneumonia precipitated by a routine seasonal influenza infection had been lost. Despite aggressive hemodynamic, antibiotic, antiviral and ventilator management, he was becoming more hypoxic and his renal function was deteriorating.  He was no longer responsive to stimuli.

The intensivist looked weary and defeated. The nurses were staring at their laps, unable to look up, their eyes tearing. The hospital chaplain reached out to hold this young man’s mother’s shaking hands.

After a week of heroic effort and treatment, there was now clarity about the next step.

Two hours later, a group gathered in the waiting room outside the ICU doors. The average age was about 21; they assisted each other in tying on the gowns over their clothing, distributed gloves and masks. Together, holding each other up, they waited for the signal to gather in his room after the ventilator had been removed and he was breathing without assistance. They entered and gathered around his bed.

He was ravaged by this sudden illness, his strong body beaten and giving up. His breathing was now ragged and irregular, sedation preventing response but not necessarily preventing awareness. He was surrounded by silence as each individual who had known and loved him struggled with the knowledge that this was the final goodbye.

His father approached the head of the bed and put his hands on his boy’s forehead and cheek.  He held this young man’s face tenderly, bowing in silent prayer and then murmuring words of comfort:

It is okay to let go. It is okay to leave us now.
We will see you again. We’ll meet again.
We’ll know where you will be.

His mother stood alongside, rubbing her son’s arms, gazing into his face as he slowly slowly slipped away. His father began humming, indistinguishable notes initially, just low sounds coming from a deep well of anguish and loss.

As the son’s breaths spaced farther apart, his dad’s hummed song became recognizable as the hymn of praise by John Newton, Amazing Grace.  The words started to form around the notes. At first his dad was singing alone, giving this gift to his son as he passed, and then his mom joined in as well. His sisters wept. His friends didn’t know all the words but tried to sing through their tears. The chaplain helped when we stumbled, not knowing if we were getting it right, not ever having done anything like this before.

Amazing Grace, how sweet the sound,
That saved a wretch like me.
I once was lost but now am found,
Was blind, but now I see.

Through many dangers, toils and snares
I have already come;
‘Tis Grace that brought me safe thus far
and Grace will lead me home.

Yea, when this flesh and heart shall fail,
And mortal life shall cease,
I shall possess within the veil,
A life of joy and peace.

When we’ve been here ten thousand years
Bright shining as the sun.
We’ve no less days to sing God’s praise
Than when we’ve first begun.

And he left us.

His mom hugged each sobbing person there–the young friends, the nurses, the doctors humbled by powerful pathogens. She thanked each one for being present for his death, for their vigil kept through the week in the hospital as his flesh and heart had failed.

This young man, now lost to this mortal life, had profoundly touched people in a way he could not have ever predicted or expected. His parents’ grief, so gracious and giving to the young people who had never confronted death before, remains unforgettable.

This was their sacred gift to their son so Grace could lead him home.

The Impeded Stream

It may be that when we no longer know what to do we have come to our real work and that when we no longer know which way to go we have begun our real journey. The mind that is not baffled is not employed. The impeded stream is the one that sings.The world, the truth, is more abounding, more delightful, more demanding than we thought. What appeared for a time perhaps to be mere dutifulness … suddenly breaks open in sweetness — and we are not where we thought we were, nowhere that we could have expected to be.
~Wendell Berry from “Poetry and Marriage: The Use of Old Forms,” in Standing By Words

Who among us knows with certainty each morning
what we are meant to do that day
or where we are to go?

Or do we make our best guess by
putting one foot ahead of the other as we were taught
until the day is done and it is time to rest?

For me, over four decades,
I woke baffled each day
that I was allowed
to eavesdrop on heartbeats,
touch tender bellies,
sew up broken skin,
set fractured bones,
listen to and through tears.

I woke humbled with commitment and duty
to keep going even when too tired,
to offer care even when rejected.
to keep striving even if impeded.

Doing that work, I learned that
obstacles will slow but cannot stop
the cascade of love and hope over the rocks of life.

My days overflow with the uncertainty
of what comes next:
finding my real work
is to wade in deep,
tumbling over the barriers
and still keep singing.

Simply keep singing.

photo by Josh Scholten

Find more beautiful words and photography in this Barnstorming book available for order here: