Evening light on the beach again…. maybe I have the blues….The hint of the moon behind the clouds…
This boulder was over my head and out of the water and there are the limpets. Holding on and along a small canyon in the rock that must give them some shelter. Does it protect them from the waves when they return or the birds when the water is low? Hold on, limpets.
What is wellness and what is illness?
Many of the people that I see in clinic want healing. But healing is complicated. Many people define healing as “I want to be the way I was six years ago when I felt good.”
I delve into the time when they felt good. Sometimes when I start asking about it, they were very busy. Often very stressed. Often not paying attention to their own care, caring for someone else, a parent, a child, a partner. Or overworking with great intensity. “But I could do it!” they say, “I didn’t feel bad!”
…Maybe not. But the self care was deferred. The body struggled on as best it could, absorbing trauma after trauma, being ignored until a tipping point was reached. Then the switch was thrown and the system crashed…
When my sister died of cancer at 49, the family fought. Lawsuits. I promptly crashed and was out sick for two months. I nearly died too, of sepsis. I thought, I’m not going to be that stupid again. Well, except I was. My father died fourteen months after my sister and I was executor, dealing with a 1979 will. I was sure that I would be sued. I did not cut back work and I didn’t rest. I worked on the estate and cried, evenings and weekends.
After a year, I crashed again. Sepsis, again. I did not die, but this time I was out for ten months and then had to work half time for ten months. And I thought, oh, am I stupid or what? I didn’t take time off when my father died. I just pulled my boots up and kept working, two jobs. Executor and physician.
I made the rounds of specialists. I coughed for six months. Pulmonary. My lungs were slowly improving, very slowly. My muscles were lagging: neurology said they would get better. “When?” I said. “We don’t know,” said the neurologist, grinning. “I hate doctors,” I said. He laughed. On to Ear, nose and throat, then Asthma/Allergy, then Infectious Disease. “We don’t know how to keep you from getting it again.” says the Infectious Disease specialist cheerfully. “No idea.”
Back to work. Half time for ten months. And now my new “full time”. My goal is not to work more than forty hours a week. I spend 4.5-5 hours seeing patients and 3 hours reading and making decisions about labs, specialist notes, ER notes, inpatient notes, pharmacy notes, garbage from insurance companies, medicare’s new and improved impossible rules, continuing medical education, pathology reports, notes from patients and phone calls. And then I go home.
I would have qualified for a diagnosis of chronic fatigue six months into the illness. I didn’t seek it because I didn’t care. I was quite certain that I would get better, though I didn’t know how long it would take. I was quite certain that I would have to behave differently or I would crash again. If I get it again, I don’t think I will be able to do medicine and I like doing medicine. Also, if I get it again, there is a 28-50% mortality rate. Not good odds. So I need to pay attention, rest when the stress reaches the level of stupid, and take care of myself.
It is now thirty months since I got sick. I do actually feel like my muscles are back to normal. My lungs aren’t quite. I can tell when I play the flute that there is some scarring, after three bad pneumonias. But I can play and sing and I am slowly getting back to shape.
But note: I am NOT going back to where I was. I am paying attention. I am changing my job and my life so that I stay healthier. I am not returning to unhealthy levels of work and stress. And if stress in my personal life flips to high, I take time off from work. I have to, to stay healthy.
When I meet a new patient, the ones that are hardest to help are the ones who want to turn back the clock. They want the exact same life back that crashed them. The life that they got sick in. Think of a veteran getting blown up: we don’t expect them to be the same. Think of my 90 year old patient who went through both brain and heart surgery. He was better. He was able to hunt again which was his goal. But he said, “You have not made me feel that I am 20 again.” I laughed and said “And I am not going to. Talk to your higher power.” He was teasing me, but he was also acknowledging that his body and his endurance and his health at 90 was different than at age 20.
We need a new paradigm of wellness. Wellness is not staying the same for one’s entire life. You will not be 20 for 70 years. Wellness is changing as your life changes and paying attention to what you and others need. Wellness is accepting illness and deciding how our life needs to be changed to be well.
I took the photograph of Mount St Helen’s five years ago. The mountain changed too, as we all do.
Back to Fort Worden in the evening at the end of a beach walk. Fading light and everything turning blue and beautiful and mysterious.
Hiking last Saturday, we both heard and alerted to a bird call. Here: song.
However, there were two, and not an alarm call.
We spotted both and then on the hike back, here they are, perched in the snag. A pair of adult bald eagles. I think it was flirting calls that we heard, or a pair talking about this year’s nest.
I am so glad that bald eagles are back in numbers…. and that we are protecting them.
Our rock sitter is not a seal: an otter. We see at least 5 otters in groups of one and two while we are hiking. These are river otters even though they are on Puget Sound. They can make a terrible mess in a boat, but they swim with such joy.
According to the Cape George website, it’s 6.5 miles from Port Townsend. However, that may be by map or road or as the crow flies. My phone claims that I walked for 5 hours and 47 minutes. I had the location turned off, so it does not include distance.
This clay boulder is about 3 feet by 3 feet by one foot. This slide from the cliff is recent enough that the clay has split and the layers are unmarred. It is all too easy to imagine standing there when the cliff comes down. We stepped carefully between the boulders, trying to stay on gravel, because the clay is way too slippery. Clay is aluminum silicates with small particles and a sheetlike structure. It can contain iron, as the brown streaks in here show. The sheetlike structure is very clear.
This is for photrablogger’s Mundane Monday # 97.
My friend J is here for the weekend. He used to live here. High tide was around 9 yesterday and he invited me on a long beach hike. From North Beach to Cape George and back. J says that this is 10-12 miles round trip.
We park at North Beach and start the hike. The tide was still going out. The beach curves along bluffs that get quite high. These bluffs are a mix of clay and sand and sections collapse. I was walking along North Beach once when it was raining after a dry spell. I hear little trickles of sand and there are small collapses that I can see…. I turned back.
This is a photo of the bluff after a fairly recent big collapse. The chunks of clay and rock and trees go all the way out to the water line. J. has seen a big collapse when hiking and said it was terrifying.
The chunks of clay are a dark grey, a lighter gray and an orange color and there they are in the cliff face. We both wish that we had more geology training.
The hike was beautiful. My feet complained at me for the last half mile coming back. J. said that he has invited more than 20 people to go with him over the years, and I am the only one who has. I am glad that I didn’t whine. Today I am limping a bit and sore, but it will get better.
A beautiful hike….