Tag: observation

A World Upside Down

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Obscurely yet most surely called to praise,
As sometimes summer calls us all, I said
The hills are heavens full of branching ways
Where star-nosed moles fly overhead the dead;
I said the trees are mines in air, I said
See how the sparrow burrows in the sky!
And then I wondered why this mad instead
Perverts our praise to uncreation, why
Such savour’s in this wrenching things awry.
Does sense so stale that it must needs derange
The world to know it? To a praiseful eye
Should it not be enough of fresh and strange
That trees grow green, and moles can course
in clay,
And sparrows sweep the ceiling of our day?
~Richard Wilbur “Praise in Summer”

It is possible that God says every morning, “Do it again” to the sun; and every evening, “Do it again” to the moon. It may not be automatic necessity that makes all daisies alike; it may be that God makes every daisy separately, but has never got tired of making them. It may be that He has the eternal appetite of infancy; for we have sinned and grown old, and our Father is younger than we. 
~G.K.Chesterton from Orthodoxy

I need no help to imagine this world feels upside down much of the time. When I read the headlines, I have difficulty understanding how anything makes any sense anymore.

Creation inversed: the birds somehow soar through the earth beneath us and the moles and mushrooms are populating the clouds. Instead of stars in the sky, there are innumerable molehills gracing the hillside. We are all mixed up in our perspective, turning creation on its head.

Thank goodness and thank God that everything is put back where it belongs when we are in sore need of reorientation. When we forget our purpose in creation, He reminds us by restoring predictable order and rhythms. When we destroy, He heals and protects. When we get bored with how things are – desperate for innovation and excitement in our attempt to turn the world upside down – He demonstrates contentment with how things were created, and turns it back to right again.

There is enough to keep us busy in this world: crazy weather, global pandemics, volcanic eruptions and quaking ground. We don’t need to complicate an already complicated creation with our designed messes.

We’re meant to admire the birds’ soaring in the skies and appreciate that grubs and gophers course through the soil beneath us. We can praise the sun as it rises each morning and the moon’s varied journey at night – so predictable and reliable and meant to be that way from the very beginning.

Keep it going, God. Do it again.

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Hiding Nothing

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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 “in your hands” from Swan: Prose and Poems

When I take myself to the doctor, I trust I’m seeing someone who tries to know me thoroughly enough that he or she can help me move out of illness into better health.

This is how acceptance feels: trusting someone enough to come out of hiding, allowing them to see the parts of me I prefer to keep hidden.

As a physician myself, I am reminded by the amount of “noticing” I did in the course of my work. Each patient, and there were so many,  deserved my full attention for the few minutes we were together.  I started my clinical evaluation the minute I entered the room and I began taking in all the complex verbal and non-verbal clues offered up, sometimes unwittingly, by another human being.

During the COVID pandemic, my interactions with patients became all “virtual” so I didn’t have the ability to observe as thoroughly as I usually did. Instead, I needed them to tell me outright what was going on in their lives, their minds and their hearts in both spoken or written words. I couldn’t ‘see’ them, even on a screen, in the same way as face to face in the same room.

How can someone call out their worries to me when they are hidden behind a camera lens?

I can’t witness first hand the trembling hands, their sweatiness, their scars of self injury.  Still, I am their audience and a witness to their struggle; even more, I must understand their fears to best help them. My brain must rise to the occasion of taking in another person, accepting them for who they are, with every wart and blemish, offering them the gift of compassion and simply be there for them at that moment.

God isn’t blinded in His Holy work as I am 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 trying to stay hidden from Him.

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

Those of us who believe we can remain effectively hidden will never be invisible to God.

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The Grandest Spectacle

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There is one spectacle grander than the sea, that is the sky; there is one spectacle grander than the sky, that is the interior of the soul.
~Victor Hugo from Les Misérables

There is not one blade of grass, there is no color in this world that is not intended to make us rejoice.
~John Calvin quoted in John Calvin: A Sixteenth Century Portrait 

Already the end of August.
As another summer wraps up, I am blinded to the glory surrounding me in the seemingly commonplace.

I can’t remember the last time I celebrated a blade of grass, given how focused I am at mowing it into conformity.

I didn’t notice how the morning light was illuminating our walnut tree until I saw the perfect reflection of it in our koi pond — why had I marveled at a reflection instead of the real thing itself?

I mistook a spider’s overnight artwork in the grass: from a distance, it looked like a dew-soaked tissue draped like a tent over the green blades. When I went to go pick it up to throw it away in the trash, I realized I was staring at a small creature’s masterpiece.

I miss opportunities to rejoice innumerable times a day. It takes only a moment of recognition and appreciation to feel the joy, and in that moment time stands still. Life stretches a little longer when I stop to acknowledge the intention of creation as an endless reservoir of rejoicing. 

If the sea and the sky, a blade of grass, a leaf turning color, a chance reflection, a delicately woven web — if all this is made for joy, then maybe so am I.

Colorless, plain and commonplace me – created an image-bearer and intended reflector of Light?

Grandest of all is the spectacle of the interior of the soul;
yes then, so am I.

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Despite the Mess

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More than the fuchsia funnels breaking out
of the crabapple tree, more than the neighbor’s
almost obscene display of cherry limbs shoving
their cotton candy-colored blossoms to the slate
sky of Spring rains, it’s the greening of the trees
that really gets to me. When all the shock of white
and taffy, the world’s baubles and trinkets, leave
the pavement strewn with the confetti of aftermath,
the leaves come. Patient, plodding, a green skin
growing over whatever winter did to us, a return
to the strange idea of continuous living despite
the mess of us, the hurt, the empty. Fine then,
I’ll take it, the tree seems to say, a new slick leaf
unfurling like a fist to an open palm, I’ll take it all.
~Ada Limón “Instructions on Not Giving Up”

It wasn’t until I paused under the huge silver maple tree in front of our house that I began to notice not the blossoms, but the way the leaves were unfurling. How suddenly a tree transformed back into a tree, with all its good green leaves. It felt like a lesson in resilience. The tree wasn’t giving up. The tree was just going to keep doing its tree thing. Noticing those leaves felt like the first moment of breath I’d had all winter. Under that tree, the line “it’s the greening of the trees that really gets to me” came to me.
~Ada Limón writing about how “Instructions on Not Giving Up” came to her

I watch daily as our farm’s trees reawaken in the spring. Some, like the maples and chestnuts turn green in April. The walnuts stay naked well into May, quite bohemian compared to their glossy green neighbors.

New growth is always an encouragement to me, especially after a brutally cold winter when branches have broken off in the snows or a tree has toppled over in exhaustion from resisting the winter wind.

As leaves swell and begin to unwrap in the spring sun, trees are feeling what I feel: the need for fresh air and renewal, absorbing the warmth of the sun while new nutrients surge in my sap.

Most trees find it is easy being green, as that is who they are and that is who I am. Some are colorful show-offs, putting me to shame for my plainness. They bloom their hearts out with the joy of living yet another spring, exuberant and wild, and oh so messy.

The trees’ resilience captures my heart. Dogwood and crabapple petals follow us inside the house stuck to our shoes, left scattered here and there on the floor. Perhaps they think they can remain bright and beautiful inside a different wooden home. I sweep them up to put them back outside on the ground where they, like I will someday, become part of the soil once again.

Exuberant in my messy plainness.

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There is a tree beyond this world
In it’s ancient roots this song is curled
I am the fool whose life’s been spent
Between what’s said and what is meant
~Carrie Newcomer

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Letting It Go

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Sometimes they
go outside, maybe

move a rosebush
to the back yard or

clean a window.
Usually they

simply stand,
under a maple

or in a snowfall.
And this is often

when they see
a nuthatch on its

dizzy route down
a trunk, or

the quick flick
of a chickadee

across the yard
and onto a branch.

They don’t do
much. That’s for

others. They know
how to take things

for granted, know
what to miss.

Every morning
they make breakfast.

And when the sun
sets, they let it go.
~Jack Ridl “The Neighbors” from Practicing to Walk Like a Heron

We are surrounded by acres of farmland, blessed by neighbors hard at work cherishing the land and buildings and animals they own. They don’t take anything for granted and strive to preserve a heritage of good stewardship. Even so, they know when to sit back to appreciate the rhythms of the seasons.

There is joy in simply watching time pass by.

The land continues to teach us all, through the sweet springs, the sweaty summers, the colorful autumns and harsh winter winds. We need each other when the snow drifts high on our driveways, the power goes out, the well runs dry, or the garden produces far more than we can just use ourselves.

And when the sun sets — well, we watch it with awe.

Another day of letting it go, grateful for what our gentle neighbors share with us – those who are next door, those just down the road, and I’m daily reminded of the generosity of those of you who take the time to stop by to read these words and say howdy.

To live in this world

you must be able
to do three things:
to love what is mortal;
to hold it

against your bones knowing
your own life depends on it;
and, when the time comes to let it go,
to let it go.
~Mary Oliver, “In Blackwater Woods”

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Startled By the Sun, Not By the Eclipse

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We should always endeavour to wonder at the permanent thing, not at the mere exception. We should be startled by the sun, and not by the eclipse. We should wonder less at the earthquake, and wonder more about the earth.
~ G.K. Chesterton from ILLUSTRATED LONDON NEWS, October 21, 1905

As a physician, I was trained to perform physical examinations by learning first what was normal about the human body. As young, theoretically healthy, medical students, we practiced physical examinations on each other, and then had to demonstrate our skills in front of a professor for our class grade in physical assessments.

Since I went to medical school at a time when fewer than 1 in 5 students was a woman, each female student was placed in a physical exam group of three men, taught by a male physician, and then evaluated by a male professor. These were full examinations, including internal assessments, conducted in a typical open-backed hospital gown, in a classroom with long black lab tables to substitute for exam tables.

It was the ultimate feeling of vulnerability to be exposed to one’s classmates, supervisors and evaluators in such a way. Yet, it helped me understand the naked vulnerability of a patient undressing for a physician’s evaluation in the exam room.

After learning to assess and document what was normal in the physical exam, I was then trained to take note of the exceptions –
the human body equivalent of
an eclipse or an earthquake,
a wildfire or drought,
a hurricane or flood,
or merely an annoying pothole or molehill.

A physician’s attention is rarely focused on everything that is going well with the human body, but instead concentrating on what is aberrant, failing, or could be made better.

This is unfortunate; there is much beauty and amazing design to behold in every person I meet, especially those with chronic illness who feel nothing is as it should be — they feel despair and frustration at how their mind or body is aging, failing or faltering.

To counter this tendency to just find what’s wrong and needed fixing, I learned over the years to talk out loud as I was trained to do during those medical school physical assessments:
you have no concerning skin lesions,
your eardrums look clear,
your eyes react normally,
your tonsils are fine,
your thyroid feels smooth,
your lymph nodes are tiny,
your lungs auscultate clear,
your heart sounds are perfect,
your breasts reveal no palpable lumps,
your belly exam is reassuring,
your reflexes are symmetrical,
your prostate is smooth and normal,
your cervix, uterus and ovaries are healthy,
your emotional response to your stress level and
your tears are completely understandable.

I also wrote messages to patients meant to reassure:
your labs are in a typical range
or are getting better
or at least maintaining,
your xray shows no concerns,
or isn’t getting worse,
those medication side effects are to be expected and could go away.

I chose to acknowledge what was working well before attempting to intervene in what is not.

I’m not sure how much difference it made to my patient.
But it made a difference to me to wonder first at who this whole patient was before I focused in on what was broken and causing dis-ease.

I remain startled nearly 50 years later, and always astonished, by the sheer wonder that is our bodies – the Artist’s masterpiece.

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Ascending Together

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At the gate, I sit in a row of blue seats
with the possible company of my death,
this sprawling miscellany of people—
carry-on bags and paperbacks—

that could be gathered in a flash
into a band of pilgrims on the last open road.
Not that I think
if our plane crumpled into a mountain

we would all ascend together,
holding hands like a ring of skydivers,
into a sudden gasp of brightness,
or that there would be some common place

for us to reunite to jubilize the moment,
some spaceless, pillarless Greece
where we could, at the count of three,
toss our ashes into the sunny air.

It’s just that the way that man has his briefcase
so carefully arranged,
the way that girl is cooling her tea,
and the flow of the comb that woman

passes through her daughter’s hair . . .
and when you consider the altitude,
the secret parts of the engines,
and all the hard water and the deep canyons below . . .

well, I just think it would be good if one of us
maybe stood up and said a few words,
or, so as not to involve the police,
at least quietly wrote something down.
~Billy Collins “Passengers”

I don’t spend much time in airports these days, but I know many who must depend on airplanes to get them where they need to go to see the people they need to see.

Due to some recent horrifying airplane mishaps in the news, I know many say prayers as they sit in airports awaiting their flights and their fates.

Instead of dealing with airports and the sad necessity of leaving on jet planes, I walk on my own two feet out to our farm’s hilly fields, noticing many more jets passing overhead than I remember from past years. Most aren’t as low as I would expect for take offs and landings from Vancouver (B.C.) International Airport an hour north of us or descending for an approach to SeaTac International 100 miles to the south. They are in mid-flight mode, at least 35,000-45,000 feet above us, carrying their loads and passengers in almost guaranteed safety.

I have found a website that shows real-time location of flights all over the world. I can literally stand on our hill looking at a flight overhead while checking my phone to see where it has come from and where it is going. In some high tech way, I feel linked with those people so far above me in that plane, strangers though they be.

Most of these flights are from, or bound for Japan or Korea, to or from the east coast or midwest United States. Apparently these flights are taking a longer circuit over the Pacific Ocean to avoid going too close to Russian air space. They have a long flight ahead as they pass the coastline here in northwest Washington and over Vancouver Island. My husband and I have made that trek over the Pacific to Japan a half dozen times. I can easily imagine myself seated in the economy section, trying to keep my legs from stiffening up over 10+ hours, distracting myself watching movies on the inflight channels.

Instead of having leg cramps, I am here with my dogs and farm cat leaving a trail of footprints in a frosty winter field. Above me, a plane leaves a condensation trail which blurs, fades and disappears in the evening light.

I stand on a hillside at home, someone living out my days in this spot; those flying above are in transit, each with an individual story with joys and tribulations of their own. Though we are miles apart, the passengers in the plane above me connect with me for a brief few minutes.

It makes sense for me to pray these people fly safely to their destination. Someday, someone may look up at a plane I am belted into, and pray for my safety. Or maybe write something down to remember the moment.

We all find our way home eventually, leaving our transient and temporary trails behind us. Surely, that home will be breathtaking and beautiful – and just exactly where we belong.

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A Trace of Peace

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I don’t know where prayers go,
or what they do.
Do cats pray, while they sleep
half-asleep in the sun?
Does the opossum pray as it
crosses the street?
The sunflowers? The old black oak
growing older every year?
I know I can walk through the world,
along the shore or under the trees,
with my mind filled with things
of little importance, in full
self-attendance. A condition I can’t really
call being alive.
Is a prayer a gift, or a petition,
or does it matter?
The sunflowers blaze, maybe that’s their way.
Maybe the cats are sound asleep. Maybe not.

While I was thinking this I happened to be standing
just outside my door, with my notebook open,
which is the way I begin every morning.
Then a wren in the privet began to sing.
He was positively drenched in enthusiasm,
I don’t know why. And yet, why not.
I wouldn’t persuade you from whatever you believe
or whatever you don’t. That’s your business.
But I thought, of the wren’s singing, what could this be
if it isn’t a prayer?
So I just listened, my pen in the air.
~Mary Oliver “I Happened to be Standing” from A Thousand Mornings

For all
the pain

passed down
the genes

or latent
in the very grain

of being;
for the lordless

mornings,
the smear

of spirit
words intuit

and inter;
for all

the nightfall
neverness

inking
into me

even now,
my prayer

is that a mind
blurred

by anxiety
or despair

might find
here

a trace
of peace.

~Christian Wiman “Prayer” from Once in the West: Poems 

Each morning, I say a prayer that I might find something of value to share here.

Maybe what I offer is a bit of glue to help heal a broken heart, or a balm to soothe a worried mind, or it touches a place of pain so it might hurt less. 

Maybe a song becomes a poignant reminder, or an image might capture the eye.

What might the beauty in the world and in words be but a kind of prayer offered to our Creator? Why not listen, even for a moment, to the purring cat and the singing wren to hear a prayer of thanks and joy they offer in their own way?

Prayer is breath combined with need.

We are capable of just such a silent dialogue with God, breathed out in thanksgiving and breathed in deep during desperate times.

I too know about worry, and hurting, and the need for glue. Within prayer is a trace of peace. So I listen, waiting.

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Cloudy with Sun Breaks

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When it snows, he stands
at the back door or wanders
around the house to each
window in turn and
watches the weather
like a lover. O farm boy,
I waited years
for you to look at me
that way. Now we’re old
enough to stop waiting
for random looks or touches
or words, so I find myself
watching you watching
the weather, and we wait
together to discover
whatever the sky might bring.
~Patricia Traxler “Weather Man”

My farm boy does still look at me that way,
wondering if today will bring
frost,
a wind storm,
maybe fog or mist,
a scorcher,
or a deluge.

I reassure him as best I can,
because he knows me so well
in our many years together:

today, like most other days,
I predict I will be partly cloudy
with a chance of showers,
and as always, occasional sun breaks.

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Still Open for Business

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Astonishing material and revelation appear in our lives all the time. Let it be.
Unto us, so much is given.
We just have to be open for business.
~Anne Lamott from Help Thanks Wow: Three Essential Prayers

It was my privilege to work in a profession where astonishment and revelation awaited me behind each exam room door.

During an average clinic day, I opened those doors 36 times, then close them behind me and settle in for the ten or fifteen minutes allocated per patient. I needed to peel through the layers of a problem quickly to find the core of truth about why a patient was seeking help.

Sometimes what I was looking for was right on the surface: a bad cough, a swollen ankle, a bad laceration, but also easily were their tears, their pain, their fear. Most of the time, the reason was buried deep and I needed to wade through the rashes and sore throats and headaches to find it.

Once in a while, I could actually do something tangible to help right then and there — sew up the cut, lance the boil, splint the fracture, restore hearing by removing a plug of wax from an ear canal.

Often I simply gave permission to a patient to be sick — to allow themselves time to renew, rest and trust their bodies to know what is needed to heal well.

Sometimes, I was the coach pushing them to stop living “sick” — to stop self-medicating when life is challenging, to stretch even when it hurts, to strive to overcome the overwhelm.

Always I was looking for an opening to say something a patient may consider later — how they might make different choices, how they could be bolder and braver in their self care and care for others, how every day is a thread in the larger tapestry of their one precious life.

At night I took calls and each morning woke early to get online work done, trying to avoid feeling unprepared and inadequate to the volume of tasks heaped upon the day. I know I was frequently stretched beyond my capacity, stressed by administrative pressures and obstacles I faced in providing the best care.

I understood trials my patients were facing because I had faced them too. I shared their worry, their fears and vulnerabilities because I had lived through it too.

Even now, I try to simply let it be, especially through troubled times, when I have been gifted so much over the years. So my own experience is a gift I can still share here, even in retirement.

I’ll never forget: no matter who waited behind the exam room door, they never failed to be astonishing and revelatory to me, professionally and personally.

I’m so grateful I was open for business for 42 years.
I don’t see patients in an exam room any longer.
This Doctor is In, writing every day, with friendly advice.
Let it be so.

Peanuts comic by Charles Schulz

What is it You see
What do I possess
Oh how could it be
I should be so blessed

I am nothing much
Neither saint nor queen
I am just a girl
And You are everything

But if You ask
Let it be so
Let it be so
and if You will
Let it be so

I am so afraid
Of this great unknown
They may turn away
I may be all alone

My life is so small
so small a price to pay
to see my savior come
and take my sin away

I will bear their scorn
I will wear the shame
All things for the good
All things in Your name

Father be my strength
Shepherd hold my hand
Open wide my heart
to welcome who is there
~Sarah Hart

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