Live germ

This is for Ronovan’s Weekly Haiku Challenge #72, prompt words life and give.

They say they protect
life given by taking a
life, germ live alone

I am thinking of more than one definition of germ: an ovum and a sperm are germ cells, that could develop into an organism. When there is fighting and death over abortion I remember that the egg and the sperm are alive too separately. They can’t all live: we don’t have room or food, do we? And I was playing with more than one meaning and pronunciation of live.

Full Definition of GERM

1a :  a small mass of living substance capable of developing into an organism or one of its parts
b :  the embryo with the scutellum of a cereal grain that is usually separated from the starchy endosperm during milling

2:  something that initiates development or serves as an origin :  rudiments, beginning

3:  microorganism; especially :  a microorganism causing disease

I took the photo at our home swim meet.

at the end of the massage

at the end of the massage
I was dreamy and he put a warm towel over me
and said that I was not to get up until
my body had absorbed all of the heat from the towel
and he left the room

and I thought dreamily that it was so nice
to have my armor removed and muscles unlocked
and to just be assigned to let warmth seep in to me
until I held it all

and I thought dreamily that if all of the archetypes
are in each of us and I am learning to love all of mine
and even and especially the most horrific ones the ones
we all want to reject, not mine, the monsters, oh, poor monsters
that howl in the wilderness that howl in the dark that howl
to be loved

and I thought dreamily that if I love all of the archetypes
inside me then they aren’t a group that is around a table
in my mind, when they are all loved they come together and I
am one and everything is one

and I thought dreamily that how surprising that I felt one
quite suddenly and with no warning and with warming and oh
Beloved all connected

and I thought dreamily that was I really feeling healed as if
all of the splits and breaks and damaged are healed just by
love and I can add to the love in the world loving the inside
terrible parts of myself oh and the monsters long to be loved so
their weeping is terrible

and I thought dreamily blessings monsters blessings Beloved and
love to all and I lay there until I had absorbed all of the warmth
from the towel

and I got up slowly

and returned to the world

Cindy gets real and skips the ball

We had a lovely dinner with family and friends. I look at the tablecloths and napkins that I have inherited and I am glad that I live in a time where I can work as a female physician and am not embroidering elaborate tablecloths and napkins. Some of the ones that I have WERE done by female relatives. Amazing and work that is currently not very valued.

So my centerpiece was an acknowledgement of the changes: Cindy is not going to ride in the coach. She has a canoe and paddles and a backpack, sleeping bag, stove, water bottle and GPS. She is going to find her own way and paddle her own canoe.

Through storm and fear

This is for photrablogger’s Mundane Monday #34.

I was downtown in the early morning for coffee and a walk. I walked out to Port Hudson. The wind was blowing very hard and the rigging was singing that eerie whistle wail. There are giant cleats out as both seats and advertising. I put one of my earrings on the cleat and took the picture. The earrings were my mother’s. After she died I looked at her jewelry. She loved little boxes and I was trying to understand the organization of the earrings. It was not by value, since plastic and gold were all mixed together. She was an artist and organized the earrings by color. These little plastic eiffel towers were in the box with red and pink earrings of all sorts. They are probably at least 30 years old. The tower looks so small against the black cleat with the rainwater. I hope that we can all care for each other through storms and fear.

Fraud in medicine: mail order pharmacies

My clinic refuses to fax to mail order pharmacies. Instead, I give the prescription to the patient and tell them to mail it.

I started this policy over a year ago, when five different patients called in the same week, about two mail order pharmacies.

Patient: “I called my mail order. They say that they don’t have the prescription and the doctor just needs to cal.”

I check. Each of the prescriptions had been faxed. I called the two companies a total of five times that week. Each time they would ask for my identifying information, the patient’s identifying information, transfer me and then say, “Oh, yes, we have the prescription.”

Ah. This is a nice example of triangulation. The patient calls for their refill. The mail order company faxes me a request. I check the chart, see if the person is due for labs or a visit, and fax the prescription. Then the company sits on it. The patient calls them and the company says they don’t have it. They delay. Finally the patient calls me to call the company and then the company admits, oh, yes, actually we do have it.

So we refuse to fax to these companies.

Last week I saw a patient who had mailed her prescriptions. She did not get her medicine.

“I called the company five times. They told me they didn’t have it. They said to call you to send a “hard copy”. I said, “I mailed it to you myself on this date.” Then they said, “Oh, yes, we have it.” However she was out of her medicine for three weeks.

I said, “They saved the cost of three weeks of medicine. That is fraud.” I explained the scam.

Comprehension dawned on her face. “They do it on purpose?”

I shrug. “Five in one week seems like a business operation to me. I recommend that you write to the state insurance commissioner.

She said, “Next time I will mail it certified. And yes, I will call the insurance commissioner if they do it again.

The patient main insurance sends information that getting the prescriptions mail order will be cheaper, and so people want to use the mail order: but the mail order pharmacies in our area are saving costs by ripping people off and delaying prescribed medicine. I do hope they end up in jail: if we can’t jail the corporation, let’s at least jail the CEO and the top 4 officers.

I took the picture yesterday at sunrise.

 

Dream state

I am in the soft dream state
longing for my love and mate
my heart won’t stop or hesitate

I cross the border into dreams
nothing quite is what it seems
I stop and play in bubbling streams

I wander in the tall green grass
years since the mower’s pass
unsullied by the smell of gas

I lean against a tree
I feel quiet happy free
I feel accepted just as me

my childhood was a frightened place
the woods were the safest space
if I spoke my heart would race

my work is with adults in pain
scars deep as canyons bleeding strain
my tears fall as gentle rain

my youngest child has reached eighteen
she’s bright and smart and kind not mean
I wonder what her eyes have seen

my adult work is nearly done
it’s time for me to have some fun
beneath the tree in moon or sun

I wander as a child
heart gentle meek and mild
connected to the world so wild

Fallen

I took this photograph outside the Weyerhouser King County Aquatic Center, where my daughter was one of the many WA state high school swimmers. It rained driving all the way there, rained the entire time we were there and then rained on my entire drive back…

This is for Photrablogger’s Mundane Monday Challenge #33. Water again, but now the beauty of water and leaves and asphalt….

Safe harbor

For Ronovanwrites haiku challenge #70, prompt words cover and color.

cover, shelter all
colors, would you harbor me
should be a cover

Sweet Honey in the Rock: Would you harbor me? https://www.youtube.com/watch?v=i0XBXJjoXJ4

I thought about cover meaning shelter and meaning the song, and the refugees needing shelter, harbor and cover. We are frightened and seek cover, shelter, harbor. Who do we have to harbor us but each other?

The photo is a synchronized swimmer in 2012.

Adverse Childhood Experiences 8: Social cues

I am thinking about social cues for people with high Adverse Childhood Experience scores. With crisis brain wiring the response to social cues may be very different than what is considered the acceptable “norm”.

I always miss the cue when someone says “see you later”. I think “When?” Then I realize it’s a social comment and they do not in fact plan to see me later. I have a moment of disappointment. I do the same thing when someone says, “Let’s get together for dinner.” or “Let’s have coffee some time!” or “I will call you back!” or “Why don’t you come to our cabin some day?” Yes, I think, when?

And then I think “Liar.”

So I fail social cues….. or do I? Maybe I am not responding to the “correct” or “conventional” or “nice” social cues.

My father drank too much and especially while I was in high school and college. And my mother would enable and cover up and pretend nothing was happening. Children in this situation, which is way too common, develop special skills.

My sister was three years younger. As adults we discussed the stages of drinking and which one we hated most. We would both walk in the house from school with trepidation. In the door and almost feeling the air: what is happening? Am I safe? Do I need to hide? How dangerous is it? How much will it hurt?

I walked in once during high school and missed the cue. I was thinking about something. I thought my father was asleep in the kitchen. I went in to get something. I was very quiet so as not to wake him. I made a cup of tea.

He was not asleep, or else he woke up. And it was the worst stage, or the one I hated most.
Not physical violence. But he started talking. One of things he said was “You can tell me anything.” Now, he meant it. But he was crying by then and I knew I did not want to tell him anything and all I wanted was desperately to leave the room. And neither my sister or my mother was home. Finally I was crying too, because I said “I just want to go read my book.” and he was more crushed and maudlin and emotional and crying. And I tore out of the room and up to my room, as my mother walked in.

I did not cry much. Ever.

I refused to talk to my mother about it.

The next day she said to me, “Your father told me that you were talking about Lamont.” Lamont Cranston was a very beloved cat, The Shadow, who was missing now. Dead, we thought.

I said nothing. Because we had not talked about Lamont. So either my father was lying or else he’d had a blackout, didn’t remember and was making shit up. And if I told my mother the truth, she would back him and deny what I said or make it into a joke.

The stages my sister and I identified were:
1. sober
2. a little bit
3. goofy/silly/makes no sense
4. crying
5. asleep

We were ok with 2 and 5. I don’t think we saw 1 for years. We disliked 3 intensely, especially in public and especially when our mother was doing a cover up dance. And 4 we hated.
And yet I loved my parents and mostly miss them now that they are gone. Except when I remember things like this.

So, what is the point?

I miss “social cues” because that is NOT what the crisis brain, the ACE score brain, pays attention to. I am paying attention to far more intuitive things: body language. Whether what the person is saying matches what I know about them and what they have done in the past. I am looking for whether this person is telling me the truth.

I don’t trust instantly. Why would I?

I said to a counselor once that reading the “cloud” around the person was terribly useful in medicine but made me a social misfit. “I don’t know how to turn it off.” I said. She grimaced and said, “Why do you think I went into counseling?” She said, “I can’t turn it off either but I have learned to ignore it during social situations.” I was in my forties before I realized that there are people who don’t sense this cloud, who trust people until the person is dishonest, who understand that it is just fine to say “Let’s get together.” and not mean it.

Because actually, when someone says “I’ll see you later.” and they don’t mean it, they are saying an untruth. They are not planning to see me later. They don’t mean it. And my brain automatically files that under evidence that this person is not trustworthy. To them it is a social cue that is polite. To some of us, it is clearly something that is not actually true. I pick up on a cloud of social cues, but not the ones that are acceptable or conventional. And I am not the only one.

my sister on the left and me on the right, in the 1960s