down

I’ve let myself come down again

it’s not really quiet down here
whales
the earth shuddering
new mountains being born
the ebb and flow
as the earth makes love to the moon
and small bubbles

I am quiet
when I let myself
go all the way down

the ocean is not quiet, but it is dark
dark as a dungeon
damper than dew
I keep sinking

and my eyes slowly adjust
my lungs adjust too
it hurts like knives at first
but I adjust faster than i used to
like the sea lions
I can go down and get back up
no bends
I have learned from them
I hold the oxygen
and let the nitrogen out slowly
through my gut

my eyes adjust
and then they come
the glowing ones, slow and fast
like ghosts swimming towards me
maybe they are my dead
someday I will join them

I expect to return this time
maybe
or not
I don’t know if I will find pearls
or a leviathan
who will swallow me whole
and barely notice

this time I walked in
myself
I don’t blame you
or family or past or circumstances
it is time for me to go down
I go
down and down and down
deep

___________

Practicing Conflict II

Practicing conflict II

In Practicing conflict, I wrote about practicing conflict by arguing different sides of a topic inside my head. I wrote that I don’t fear conflict and have learned to enjoy arguing with myself. I am a physician and physicians argue all the time.

What? No they don’t. Well, the doctor persona does not argue with the patient much. Some doctors give orders to patients, others try to negotiate, some try to convince. But behind the scenes, doctors are more like the Whacky Racer Car with the Cave Guys, running with their feet and hitting each other with clubs.

In residency in Family Practice at OHSU in Portland, Oregon, I start on General Surgery during internship. This is in the early 1990s and there was not much in the way of “disruptive physician” rules. I have to cover Trauma and Plastic Surgery and General Surgery at night on call. The resident is present but I get paged first for patients on the floor. I learn that I should go to all Trauma pages in the emergency room. If I know what is happening with the new Trauma patient, it’s a lot easier to handle the phone calls for more drugs and so forth. Also, the resident is less mean to me.

We attend the Trauma “Grand Rounds”. These are unreassuring to a new intern. A resident presents a trauma patient, giving the history in the accepted formal order. The Faculty Trauma Surgeons interrupt, disagree with management of the patient and yell. They yell at the resident and at each other. The upper level residents yell too, being well trained. The Trauma Surgeons do not agree with each other. They are inflammatory and rude. I am shocked initially: medicine is not a cookbook, is not simple and it appears that it is a controversial mess. It turns out that medicine IS a controversial mess.

There is not as much yelling on the next rotation. At that time Trauma Surgeons yelled more than any other set of doctors that I ran across. They yelled in the ER, at each other, at the staff, at the nurses, at the residents. The culture has changed, I suspect, but that’s how it was then.

I take Advanced Trauma Life Support as a third year resident. The Trauma Surgeons at OHSU helped write the course. They don’t agree with it. On some questions the teaching Surgeon says, “The answer to this question is (c), “ followed by muttering loudly, “though I totally don’t agree with that and I would do (b).” Another Trauma resident or surgeon then might start arguing with him, but they moved on pretty quickly, to teach the current agreed best practices in the book. Which change every few years. Great.

Years later (2009) I join the Mad as Hell Doctors, to go across the US talking about single payer. They are a group from Oregon. Physicians for a National Healthcare Program are a bit cautious with us the first year: we might be whackos. We have an RV with our logo and we have a small fleet of cars and what do you think we do in the cars? We argue. Or discuss. Or whatever you want to call it. We spend the driving dissecting issues and how to present things best and tearing apart the last presentation and rebuilding our ideas. The group does 36 presentations in 24 days. Each presentation takes an hour to set up, two hours to do and another hour to break down and debrief. We get more and more exhausted and cranky and um, well, argumentative, as the trip proceeds. Even though I think of the Whacky Racer Cave Guys running with their feet and bonking each other with clubs, this is the most wonderful group of doctors I have ever been with. A common goal that we all want to get to, discussing and disagreeing on strategy all the way! I feel closer to those physicians in a week then I feel to any of the physicians that I’ve worked with for the last 9 years in my small town. Conflict with a common goal.

Doctors are TRAINED to argue, even with themselves, to document every decision in the chart with reasons why they have reached that decision. And that they have thought about all of the reasons for say, a low potassium, thought of every possible cause and worked their way through testing. The testing always has two strands. One strand is rule out the things that could kill the person NOW, even if rare. The other strand is what is common? You have to think about both at the same time, always. And argue with yourself about which tests should be done, in what order, what is most important, how do you treat the person while awaiting results, and have I missed anything? And if we aren’t sure, we call another doctor, run it by them, wait for them to shoot holes in our logic or to say, no, I can’t think of anything else.

We can deal with conflict. We must deal with conflict. The world is too small not to deal with conflict, with disagreements, with different viewpoints and positions and ideas. If doctors can do it every single day at work, then everyone else can too. Trying to see all the positions and possible diagnoses saves lives in medicine. We need to extrapolate that to everything else. Try to see other positions, try to understand them, to respect them. We can and we must.

Blessings.

Here are the Whacky Racers:

And Madashell Doctors blog: http://madashelldoctors.com/category/uncategorized/page/3/

For the Ragtag Daily Prompt: discuss.

The photograph is from my clinic once we had stopped seeing patients and were selling everything. Mordechai was our clinic skeleton, made of plastic, from China. This was in January 2021.

caged rose

WHY is this poor rose caged, you ask? I removed the top bit of cage to take the photograph. This is the only bloom this summer, because the rose keeps growing out of the cage. It’s in my backyard and the deer chomp down to the wires. I think they need vitamin C.

I tested this the other day. I trimmed a rose in the fenced front yard. I took the trimmings and spread them under the apple tree. This is not a great picture but I was happy to see this young visitor eating roses and fallen apples.

For Cee’s Flower of the Day.

begonia

The friend that I visited the last two weeks has a green thumb and a beautiful garden. This was on her porch.

For Cee’s Flower of the Day.

I am watching the service for Queen Elizabeth II. I wish every family who has lost someone recently or years ago, finds their way through stages of grief to a stage of peace. I fall out of it every so often and miss my mother, my father, my sister. Blessings all.

Lit

My friend Maline Robinson is an artist, paintings and silk screens. This one fits today’s “luminous” prompt, pale lit color and layers and texture.

Meanwhile my brain starts playing one of our choral pieces: Luminous night of the soul. It builds and builds, layers of sound and complexity. Here is another group doing the piece:

For today’s Ragtag Daily Prompt: luminous.

Agatize

A long time ago, at least by a child’s time, he starts turning. He blocks things out. He locks his heart. He decides to be happy and do what he wants. His heart slowly turns to stone.

The blood roars through, pushed by each beat, how can a stone heart beat? Not normally, that is for sure. His brain controls it, cold, logical, no emotion, except happiness, that is what he says. He says it over and over, I am happy all the time, until he thinks he believes it. And then he believes it and his heart is stone.

But the blood flows and the body feels and emotions come anyhow. He refuse them, all but happiness, and blood lays down a wall of emotion inside his heart. Chalcedony, lining the chambers, coating the valves, coating the arteries that feed the heart. The heart doesn’t need the arteries open because it is not beating. It is stone. His brain is beating. Beating the emotions away, away, away, refusing the body and the heart.

The heart is hollow. Slowly it is lined with clear agate. At last his heart is full: no more chamber. Agatized, all the way through. When he is cracked open, far in the future, a chalcedony nodule will show the perfect interior of a stone heart.

And where does the blood go now? we wonder. Laying down the lining of agate, clear, colored lines of emotions rejected, all the colors of the rainbow, what he thinks of as impurities. That is how he thinks of his emotions: impurities, to be rejected.

What will be agatized next? His liver? His lungs? He says strokes are the end for his family. He calls it then, his brain is agatized. The part that controls the pumping, overriding his heart over and over, when that part turns to agate, he will be correct. A stroke. How long will it take, we wonder? One year, five years, ten? He says he won’t go past 80. That will be 13 years. How apropos.

Can nothing stop this? Chalcedony is hard, not hard as diamonds, but very very hard. Agates are common and we search for the clear ones, the lit ones on the beach. Almost nothing can wear them down: high pressure would kill him, high heat would kill him, what is left? Water. Water wears down rock.

Enter the sea. The sea of love, the sea of dreams, the sea of the unconscious. Seek help, before you turn yourself to full stone. Agatized and dead.

Maybe there are other treatments, I don’t know.

A stone shaped heart is rare, I hope. See how it catches the light. Beautiful and sad.

August 30, 2022

mansion of the sky

My mansion is the outdoors. What could be more beautiful than the sky and the sea and the outdoors? Not only does my mansion have more rooms than I can ever explore, all over the world, but it has every mood imaginable too.

For the Ragtag Daily Prompt: mansion.

Sing from the sea

This is another poem where I did not know where it was going when I started it. I was thinking about the sea and sirens and singing. My poems go where my heart thinks I should go, but I don’t know where that is until the poem is done. And it’s clearly a song and next I need a tune. And chords. And more practice.

I sing from the sea, from the sea, from the beautiful sea
tied to the mast, you won’t come to me

unplug your ears, unblock your heart
before it breaks and truly stops
listen to my lonely heart
we’ll make music and never part

I sing from the sea, from the sea, from the beautiful sea
hear my voice, listen to me

our hearts melt together like stone
in the depths of my volcano home
you shut your heart down, run away
lava strings like glass, all the way

I sing from the deep, from the deep, from the beautiful deep
small child calling, she still weeps

volcano boiling from ocean floor
new island built as lava roars
small child with faith as adult caves to fear
small child holds your heart dear

I sing from the land, from the land, from the new born land
don’t be afraid, take my hand

hope has feathers, a poet said
in the darkest time, hope is not dead
I morph to dragon, to kite, to bird
your resistance is so absurd

I sing from the air, from the air, from the smoke filled air
vision dark, can’t see where

circle in flight, hope you too
listen to the small child hidden deep in you
a promise is a promise, you know it’s true
I do not give up on you

I sing in the wood, in the wood, in the beautiful wood
five elements sing as all things should

In the wood in the trees
on an island in the sea
in the heart of the volcano
my heart is free

I sing from the sea, from the sea, from the beautiful see
no matter what happens, my heart is free

_____________________________________________

I took the photograph at the National Museum of Women in the Arts, a painting by Shinique Smith.

flying dream

I dream I am Superman flying, but I am still me and female too. It is night and I fly over a beautiful bay, with a bridge at the opening of the bay. Cars are crossing. The people on the bridge call me down, calling “Help!” I fly down. “There are people in the water below the bridge! What are they going to do! Stop them!” I fly down to the water. “Come in,” say the people in the water. “The water is warm!”

I join them in the water. It is warm and the bridge is beautiful. I say, “The people on the bridge are scared of you.” The people in the water say, “We just like the water. They are silly. They should join us. We won’t hurt them.” I thank them and fly back up.

I say, “The people in the water just like the water. They say they won’t hurt you.” The people on the bridge say, “No, no! They will hurt us. We don’t want them in the water! They might blow up the bridge!” I shrug. “Well, the water is fine. I am going back there.” I fly down and join the people in the water.

I wake up.

For the Ragtag Daily Prompt: cape.