Alive and Ticking

Had I not been awake I would have missed it,
A wind that rose and whirled until the roof
Pattered with quick leaves off the sycamore

And got me up, the whole of me a-patter,
Alive and ticking like an electric fence:
Had I not been awake I would have missed it

It came and went too unexpectedly
And almost it seemed dangerously,
Hurtling like an animal at the house,

A courier blast that there and then
Lapsed ordinary. But not ever
Afterwards. And not now.
~Seamus Heaney  “Had I Not Been Awake”

It is very still in the world now –
Thronged only with Music
like the Decks of Birds
and the Seasons take their hushed places
like figures in a Dream –

~Emily Dickinson from an envelope poem fragment

My dreams have been exceptionally vivid recently, not scary but seemingly real. I’ll awake suddenly, surfacing out of deepest sleep to take a breath of reality and remind my brain that I’m still in bed, in a dark hushed room, my husband solid and warm beside me. All is well. I lie awake, reorienting myself from dream world to my world and ponder the hazy neuro-pathways in-between.

If I had not been awake after my dreams, I would have missed the night sounds of coyotes howling in the fields around the farmhouse, the chorus of peepers in the wetlands, the trickling waterfall in our koi pond, the clicking of the owls flying overhead, the sudden gust of wind that shakes the windows, the pelting of heavy rain.

So much still happens when I am asleep to the world, numb and inattentive. Even so, when dreams wake me, I find myself alive and listening, electrified by the awareness of everything around me.

Suddenly, nothing is ordinary because everything is. I am the most unordinary ordinary of all.

Forevermore.

Absorbing the Shock

There are three kinds of men.
The ones that learn by reading.
The few who learn by observation. 
The rest of them have to pee on the electric fence for themselves.
~Will Rogers

Learning is a universal human experience from the moment we take our first breath.  It is never finished until the last breath is given up.  With a lifetime of learning, one would think eventually we should get it right.

But we don’t.  We tend to learn the hard way especially when it comes to matters having to do with our (or others’) health.

As physicians in training, we “see one, do one, teach one.”   That kind of approach doesn’t always go so well for the patient.   As patients, we like to eat, drink, and live how we wish, demanding what interventions we want only when we want them – this also doesn’t go so well for the patient.  You’d think we’d know better, but as fallible human beings, we may impulsively make decisions about our health without actually using our heads (is it evidence-based or simply an anecdotal story about what “worked” for someone else?).

The cows and horses on our farm need to touch an electric fence only once when reaching for greener grass on the other side.  That moment provides a sufficient learning curve for them to make an important decision.  They won’t try testing it again no matter how alluring the world appears on the other side.   Humans are smarter sentient beings who should learn as quickly as animals but unfortunately don’t.  I know all too well what a shock feels like and I want to avoid repeating that experience.  Even so, in unguarded careless moments of feeling invulnerable (it can’t happen to me!), and yearning to have what I don’t necessarily need,  I may find myself reaching for the greener grass (or another cookie) even though I know better.   I suspect I’m not alone in my surprise when I’m jolted back to reality when I continually indulge myself and climb on the scale to see the results.

Many great minds have worked out various theories of effective learning, but, great mind or not, Will Rogers confirms a common sense suspicion: an adverse experience, like a “bolt out of the blue,” can be a powerful teacher.  As clinicians, we call it “a teachable moment.”  None of us want to experience a teachable moment — none of us, and we resent it when someone points it out to us.

When physicians and patients learn the hard way, we need to come along aside one another rather than work at cross-purposes.

It just might help absorb the shock.