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 There is a whole lot that I need to un-learn because it is now proven that it is no longer valid as it originally was over four decades of medical practice.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.

Let Your Heart Go Forth

sunset102215

sunset81115

westsky

sunset8101516

The season of sunset as it draws a veil over the day,
befits that repose of the soul
when earthborn cares yield to the joys of heavenly communion.
The glory of the setting sun excites our wonder,
and the solemnity of approaching night awakens our awe.
If the business of this day will permit it, it will be well, dear reader,
if you can spare an hour to walk in the field at eventide,
but if not,
the Lord is in the town too,
and will meet with you in your chamber or in the crowded street.
Let your heart go forth to meet Him.

~Charles Spurgeon from his Morning and Evening Devotionals

 

Many of the young adults I see in my practice struggle to sleep at night. Their minds are racing, they can’t stop worrying, their bodies are tight with tension.
Their hope is I might prescribe a pill since they’ve tried marijuana and several shots of vodka, and that isn’t helping.

I would like to prescribe an hour with God at sunset but that is not permissible at a public institution.

Instead, I’m allowed to speak of emotional support animals, or yoga, or an evening stroll, or “meditation” or even a labyrinth walk, but never letting one’s heart go forth to meet God.

Spurgeon, out of his own anxiety and depression, knows the healing of a walk with God at sunset.
It is throwing the cares of the heart out to Him and knowing He will catch and hold them tight.

octobermoon

sunset910152

sunset810158

sunset811153

My Dripping Sleep

rainyclothesline3

rainygrass

 

I went to bed and woke in the middle of the night thinking I heard someone cry,
thinking I myself was weeping, and I felt my face and it was dry.
Then I looked at the window and thought:
Why, yes, it’s just the rain, the rain, always the rain,
and turned over, sadder still, and fumbled about for my dripping sleep and tried to slip it back on.
~Ray Bradbury

rainyclover

rainyweeds

rainyweeds3

Good Medicine

photo by Josh Scholten
photo by Josh Scholten

A good night sleep, or a ten minute bawl, or a pint of chocolate ice cream, or all three together, is good medicine.
~Ray Bradbury

If there is anything I’ve learned in 35 years of my medical career, it’s that I still must “practice” my art every day.  As much as we physicians emphasize the science of what we do, utilizing “evidence based” decisions, there are still days when a fair amount of educated guessing and a gut feeling is based on my past experience, along with my best hunch.  Many patients don’t arrive with classic cook book symptoms that fit the standardized diagnostic and treatment algorithms so the nuances of their stories require interpretation, discernment and flexibility.    I appreciate a surprise once in awhile that makes me look at a patient in a new or unexpected way and teaches me something I didn’t know before.   It keeps me coming back for more, to figure out the mystery and dig a little deeper.

I’ve also learned that not all medicine comes in pills or injections.  This isn’t really news to anyone, but our modern society is determined to seek better living through chemistry, the more expensive and newer the better, whether prescribed or not.  Chemicals have their place, but they also can cause havoc.  It is startling to see medication lists topping a dozen different daily pills.  Some are life-saving.  Many are just plain unnecessary.

How many sleep without the aid of pill or weed or alcohol?  Fewer and fewer.  Poor sleep is one of the sad consequences of our modern age of too much artificial light, too much entertainment keeping us up late, and not enough physical work to exhaust our bodies enough to match our frazzled and fatigued brains.

How many of us allow ourselves a good cry when we feel it welling up?  It could be a sentimental moment–a song that brings back bittersweet memories, a commercial that touches just the right chord of feeling and connection.  It may be a moment of frustration and anger when nothing seems to go right.  It could be the pain of physical illness or injury or the stress of emotional turmoil.  Or just maybe there is weeping when everything is absolutely perfect and there cannot be another moment just like it, so it is tough to let it go unchristened by tears of joy.

And without a doubt, the healing qualities of chocolate are unquestioned by this doctor, however it may be consumed.  It can fix most everything that ails a person. at least for an hour or two.

It doesn’t take an M.D. degree to know the best medicine.  It just takes a degree of common sense.
Time for bed and time to turn off the light.  A good bawl and chocolate will wait for another night.