Ox outside the box

X in Ox for the Blogging from A to Z.

I am still thinking about my dream about refusing to pick a box or stay in a box. They weren’t comfortable and I did not fit. So this morning I thought about the Chinese year of the Ox, my birth year. I am a Metal Ox, or Ox in the Sea. I knew that there is an Ox outside the Gate, and that brought up Ox outside the box, so I read on line about the different Ox years.There are 60 years of cycles and so five of each Chinese animal year. My daughter is also an Ox, but she is a Fire Ox, Ox on the Way. Each of the 60 has different characteristics and different patterns.

I am surprised to be Metal, but I like to be in the sea. I love the water and I dream of water. My daughter has spent more time in the water, as a synchronized swimmer and swim team member, but I love the sea. I love living near the Salish Sea and the coast as well.

The photograph is from the National Junior Synchronized Swimming competition in 2009 in Federal Way, Washington. This team is practicing a beautiful lift. They are wearing caps and goggles, so this is a practice, not the competition itself. In the competition they will have make up, some sort of sequinned head piece and no goggles….


W for water in the Blogging from A to Z.

Water, water, water. After my mother died of ovarian cancer in 2000, I went to therapy in 2002. I dreamed of water, over and over again.

The photograph is from the 2009 National Junior Synchronized Swimming Competition, in Federal Way, Washington. Cameras with removable zoom lenses were not allowed. There was a professional photographer. I had an electronic camera given to me by my father, with a formidable built in zoom. Synchro is difficult to photograph because they are in the middle of the pool and they are under water at least half the time. I had been practicing taking pictures of my daughter’s intermediate level team and would time the electronic delay to try to catch lifts.

We were at the Junior Nationals volunteering to help. This earned our team points for the northwest district and it takes many volunteers to run the contests.

This is an eight person Junior team at Nationals and six of them are under water. They are not allowed to push off from the bottom. They all have to be in position to do the lift and the person lifted has to be strong and balanced and ready. Two people are being lifted here: the woman below supporting the woman above and in turn, being supported and lifted by the rest of the team. I chose this photo because of the strength, athleticism, balance and teamwork. The team members swim so closely together that they kick and scratch each other. Or fall on each other in a lift. I want all humanity to have this kind of teamwork and lift each other.


V for veracity in the Blogging from A to Z challenge.

I am thinking about veracity and my father. Veracity is truth, faithfulness, accuracy, correctness.

I was frustrated about how someone was reacting to something and asked my father about it.

My father said, “Most people don’t want reality.”

“What do you mean?” I said.

“Most people work hard to avoid reality. They have a set of ideas and a world view and they get upset if something does not fit in it or if it is questioned.”

I have been thinking about a song that I learned as a kid. It falls into one of the “Dead Girl” songs, as my sister called them. I think of them as teaching songs. I am taking guitar lessons and my teacher says that he won’t sing those songs.

I will. I like the dark songs. And I am very ambivalent about this song:

There was a wee cooper wha lived in Fife,
Nickety, nackety, noo, noo, noo;
And he had married a gentle wife,
Hey, willy, wallacky, ho John Dougle
Alane, quo rushity roo, roo, roo.

She would na bake nor would she brew,
For spilin’ o’ her comely hue.

she would na caird nor would she spin,
For shamin’ o’ her gentle kin.

The cooper has gone to his wool pack,
And he’s laid a sheep’s skin on his wife’s back.

“I’ll no be shamin’ your gentle kin,
But I will skelp my ain sheepskin.”

“O I will bake and I will brew,
And think nae mair o’ my comely hue.”

“O I will wash and I will spin,
And think nae mair o’ my gentle kin.”

A’ ye what hae gotten a gentle wife,
Send ye for the wee cooper o’ Fife.

This is Child Ballad number 277 and has been recorded by Burl Ives and others.

Ambivalence. It’s a song about wife beating, I don’t approve. But it’s also a song about surviving. A cooper builds barrels. The job division was that the wife would bake and brew, card wool and spin. However, this wife is “gentle” as in gentleman, of “good birth” and rejects the work as beneath her. Does she expect to be served? In the stories of happily ever after, we are happy when the poor underdog poor person wins the love and admiration of the other person, but we don’t see what happens when they go home. In Disney movies, the girls are poor and win a prince. Or Aladdin becomes a prince.

Skelp is defined as “hit, beat, slap”. The song doesn’t say whether the cooper does beat the sheepskin tied to his wife’s back or only threatens to do so.

I love word play so I like the “alane, quo rushity roo, roo, roo.” Nonsense words delight me aside from the topic of the song and I like the tune.

I think that our culture has years of men dominating women and expecting women to obey. I dislike that intensely. At the same time, I don’t like it when people won’t contribute and when they avoid work, so I also have some sympathy for the wee cooper. And our culture spends too much time thinking “happily ever after”, trying to find just the right person. We do not enough time actually asking each other what “happily ever after” would look like. And anyhow, it doesn’t exist. For richer, for poorer, in sickness and health: that is the veracity. We all will have challenges and everyone will have illness and hopefully good times too.

I am thinking of the many people lost in the recent earthquake. Lost: killed suddenly. Enjoy each day and be kind to yourself and others. We never know when grief will strike.

Under covers

U is for under covers in the Blogging from A to Z Challenge.

Under covers I had this dream:

I am in a large space, no walls. No grass or sky or sun either. There are boxes everywhere.

A male voice is telling me to get in a box.

“Which one?” I say.

“You may pick.” says the voice.

I look at the boxes. They are all next to each other, all different shapes. Square, octagonal, pentagon. They are made of wood and carved or inlaid. There are many beautiful designs, all different. I step from box to box.

“They are too small.” I say.

“If you sit down and tilt your head to the side, you fit.”

“That isn’t comfortable.” I say, after trying to sit. “It’s too small.”

“Pick a box.” the voice insists.

No, I think. I won’t. They are too small.

“Why do I need to be in a box?” I ask.

I wake up.


S is for Shadow in the Blogging from A to Z Challenge.

I wrote this poem in April of 2014 after hearing a sermon based on the bible passage that if you cast one devil out, it will return with 7 more.

Mathew 12:45 “Then goeth he, and taketh with himself seven other spirits more wicked than himself, and they enter in and dwell there: and the last state of that man is worse than the first.”

My minister was talking about how feeling virtuous can make us behave worse than ever, and that we don’t acknowledge our own bad thoughts even to ourselves. I thought about how hard it must be to be an unloved shadow or feeling who is cast out or denied.



I am happy today
Because I let the shadows alone

I see them
I did not name them

They aren’t mine
Unless I name them
Then I add to them
They stick to me
Their owners disavow them
Their owners recoil in horror
from me, a huge talking shadow

Their owners disavow them

Poor shadows
They are so lonely

But it doesn’t serve if I name them
Their owners think they are mine
Their owners think they are gone
Evil named and cast out

Once I am alone, the shadows roil
They cry for home
They cry for their people
They are fearful
They gather into gangs
To face the terrible journey home
To their owners

When the shadow is offered
I don’t reject it
I don’t name it
I wait

It is in the room
Between us

And mostly the owner
Speaks of something

And the shadow sinks

I hear the shadows weeping
To be loved


I hear the shadows weeping
To be loved

I thought if I named the shadows
They would be visible

I was wrong

I am so sorry, shadows
I am so sorry, owners

I was wrong

I send you all my love
and tears

I hear the shadows weeping
to be loved.



R for roar and rant and rats in the Blogging from A to Z Challenge

We have to buy new computers for the clinic because of ICD10. ICD-10 is the list of diagnosis codes. The list will increase from 17,000 diagnosis codes to codes to 42,000 and is a major pain in the butt. All new, all different, so hypertension is no longer 401.1. My five year old computers “work” but don’t have enough memory for the Amazing Charts Electronic Medical Record update. I need to go ahead and buy new computers because medicare is supposed to be accepting the new codes now (in theory. I haven’t checked if our local medicare provider Noridian really is accepting them.) I need to practice with the stupid new codes until they go full on live in October.

Will this make medicine more precise and give us better data? Well, no. From what I have seen, providers really care about patients and do not care about strings of numbers and letters attached to the diagnosis. At Madigan Army Hospital, the faculty said that they didn’t care about the codes and were not teaching them to the residents. However, medical policy gets based in part on the coding and insurance companies refuse to pay tons of bills because they are “coded wrong”.  I think we will lose even more of the solo providers and small medical practice and medicine in the United States will be even more controlled by big corporations. Why do you care? (That is, if you are from the US. If you are from a civilized country you are laughing at us.) Well, for example. In 2012 I was in my local hospital emergency room. I am a physician who worked for our local hospital district from 2000-2009. The emergency room doctor did a CT scan of my neck. I thought, this is the wrong test, he should be doing a lateral neck film, but hey, I was septic. Maybe I was confused. He put in his notes that he’d ordered a lateral neck film and the CT scan was an error.

They charged me and the insurance company anyhow. I went through my records and wrote to them this year. They paid me back the 900.00$. They say it’s “too late” to pay back the insurance company. If I can figure out which stupid insurance company I had in 2012, I will notify them to bill the hospital.

So read every single note in the clinic and the emergency room if you are a patient in the United States. And ask for the itemized bill. And complain to the patient advocate. Just check out how much they charge for the stupid little socks they “give” you. Fight back.

I wish I lived in a country with civilized healthcare not corporate healthcare.

The medicare website has a countdown clock to the initiation of ICD 10. The main advice to doctors is to have “3-6 months” of overhead money stashed, since they expect it to be a mess and we won’t get paid for 3-6 months. Right. Do the work anyhow and cross your fingers and pray. It’s a bit of a challenge for me, since I was out sick for 10 months. Used up that 3-6 month reserve.

Bet half or more of the doctors/hospitals/clinics in the country have to buy new computers. Watch your bill climb…..

A UK writer asks about ICD-10 international. No, that’s not what the stupid US is going to use. ICD-10 international has 14,000 codes that can be stretched to 17,000. No, we are going to use our own stupider version of ICD-10 with 42,000 codes so that more insurance companies can refuse to pay for more visits. Meanwhile, ICD-11i will be released in 2017.

The stupid US has multiple electronic medical records that don’t talk to each other, so yes, I can sort of code with my computer electronic medical record except I have to look things up in the paper coding book, like “bruise”, aka contusion, and any stupid “cut”, aka laceration, because the search sucks. I was trying to find prehypertension the other day. The electronic medical record lists it as “elevated blood pressure without diagnosis of hypertension”. Great. I have a coding book in each exam room. By October, I will have a massive pile of  coding books in each exam room.

The photo is my father and my wonderful office manager, at the clinic opening party in 2010. My father died in early June 2013. The clinic is due for our five year anniversary…..

Want some taters

T for taters in the Blogging from A to Z challenge and for Ronovan writes weekly Haiku challenge: this week’s words are want and tatters. I suppose I have cheated by changing the tense. Tatters brought up taters and I am hungry and a bit insomniac. I am back at work, have less time to write, but apparently writing eventually trumps sleep…. want to write, too.

want some taters not
too tattered on a platter
save me gravy do

I made the most delicious potato salad the other day. Potatoes from a local farm: they have a 24 hour walk in buy vegetables, on the honor system. They have the best potatoes ever: Colinwood Farm.

Cut potatoes into 1 cm approximate chunks
Steam the potatoes until just tender
Sprinkle with the vinegar of your choice while hot
and a little hot chili oil.
Wait 10 minutes. (I failed on that.)
Add mayonnaise, not sweet.
A chopped dill pickle.
Salt and pepper.
Whatever else you want, but that is all I added.
Eat while warm…. I couldn’t wait for my daughter to get home….

The photo is from Thanksgiving at my cousins’ in 2013.


Q is for Quimper in the Blogging from A to Z Challange.

I live on the Quimper Peninsula in Jefferson County, Washington, USA. The Quimper Peninsula is a small peninsula jutting up from the northeastern corner of the Olympic Peninsula. So, a peninsula attached to a bigger peninsula.

We are surrounded by water. When I first moved here I was confused. I am from the east coast of the US. So, the ocean was to the east. Here on the west coast it is west: except that where I live, the Salish Sea is north and east and south. The Quimper Peninsula runs southwest to northeast and ends at a lighthouse. I can stand on the beach at the lighthouse and look over the Salish Sea and see mountains. It took me a while to get oriented, because I can see the Olympic Mountains looking over the water or the Cascades: Mount Baker, Glacier, Tahoma.

The Quimper Peninsula is named after Manuel Quimper, a Peruvian born Spanish explorer and cartographer. He contributed to the charting of the Strait of Juan de Fuca in the late 1700s. Until I wrote this post, I had not read about him.

Our thin rural phone book for Port Townsend and Port Ludlow lists five Quimper named businesses:

The Quimper Inn, a bed and breakfast. Our town had a boom in the 1860s-1880s and the architecture is still here. There are wonderful old houses and downtown.

Quimper Mercantile, a community started and owned store.

Quimper Sound, a quite fabulous local music store, albums and CDs.

Quimper Unitarian Universalist Fellowship, a church.

And lastly: Quimper Family Medicine, my family practice clinic!

Phoenix Rising

P for Phoenix, for the Blogging from A to Z Challenge. This post is for Amanuensis Sobriquet-Reverie. Her poem today “Burn the witch” brings up present and past difficult memories. Here is the poem I wrote about it in 2003.

Phoenix Rising

Set a torch to me
Why don’t you?

It’s not the tearing sound of fabric
A small rip
And now a tear
That I feel

It’s the torch

I’ve been here before
A job where the idealistic came
As moths to the flame
Because they had ideals

I watched and burned and rose

It’s the torch
The flames that rise
As the witch is burned
Tilts back her head
In ecstasy and knowledge
Eager to learn what she can
From these burning brands

In the burning we learn
In pain we learn
If we can remain open
Ashes fall to the ground
Buckets of water
Wash any remains to grey mud
Gone, punished
Relief for the frightened
An example has been set

No but what stirs at night
Moon or none
What rises from the mud
The ashes
Takes form
Takes flight

Set a torch to me
Why don’t you?
And see what is created

a local bookstore
previously published on everything2.com


O for open: open water and open heart, for the Blogging from A to Z Challenge.

I kept thinking O for ocean, but the photos that I want to use are not of the ocean but of a lake. My daughter and I were there in 2012. She was a synchronized swimmer for seven years and then joined swim team in eighth grade. We went to the lake and she practiced distance swimming. She is used to a 1950s 20 yard pool. She started at the lake by swimming to a little island we call Kidnap Island. I canoed while she swam, and my cousin’s daughter came along on the first trip. They left the lake soon after that. My daughter swam farther and farther every day, with me in a canoe to ensure that no power boat would run her over.

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We were on our way to the parking lot one day, when a power boat slowed. “Long way out, aren’t you? All alone?” said one of the men. I was in a small one person canoe that only weighs 18 pounds and is really tippy. I wouldn’t take it out in any sort of nasty weather.

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“No, I am with my daughter.” I pointed to the water.

“She’s swimming? Where did you start?” he said.

I pointed back to our cabin. Far enough that he couldn’t see it.

“Really? She swam that far?” He and his friend watched my daughter power along.

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“Yes. Swim team.”

“Is she swimming to the parking lot?” The cars were still really distant.

“Yes and probably back, too.”

“Wow. I thought it was a long way for a canoe!”  They drove on, shaking their heads.

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Open water and open heart. It takes practice to swim that far. I swim about two days a week, about a mile in the pool. My daughter shakes her head: the swim team swims three to five miles at each practice, and she swims six days a week in the season. She considers me a wuss. I consider her a calorie burning machine.

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It takes practice to keep an open heart. That is what I need in my rural family medicine clinic. An open heart allows space and expansion and time for people to open up. To say things that are bothering them or frightening them or grieving them. I am back at work now for two weeks, but by the end of the day yesterday, I was tired, tired, tired, as if I had swum across that lake. I need to rest sometimes…..