Mnemosyne

I am reading The Female Trickster: The mask that reveals, by Ricki Stefamie Tannen.

Regarding Mnemosyne, she writes: “The power of memory was recognized in Ancient Greece by the goddess Mnemosyne who ruled over the Elysian Fields. The nine daughters of Mnemosyne and Zeus are the muses, with Thalia, the muse of comedy imaged with a Trickster’s mask as she playfully composed comedy and ironic poetry. The muses were women unto themselves. According to the myth, upon death a person makes a choice to either drink from the river Lethe or the spring of memory. If you drink from Lethe you forget your pain and all the lessons of your life and are reborn again on earth. Those who choose to drink from the spring of memory go to the Elysian Fields, where there is no strife or pain. The myth tells us that the path to psychological integration comes from a willingness to value and interact with memory. Those that repress memory are doomed to repeat it, over and over again.” (pp72-73)

This seems apropos both to my personal and professional life and also to US culture. Our President speaks like my stage IV substance abuse patients. He says things that are obviously lies, obviously not true, obviously refutable and yet to all appearances he believes his own lies entirely, even when he contradicts himself. He manufactures his own reality and just laughs when someone else disagrees. But my substance abuse patients crash: they eventually find that they are isolated with their own lies when they become so fantastic and bizarre that no one believes them any more. We are watching that play out.

Re my personal life, I think of my maternal aunt’s memorial. I wrote two memories for the memory book. One was about my father saying that she had perfect pitch. I did not know what perfect pitch was when I was little, but I knew from my father’s voice, the respect, that it was special and important. That he was envious. That he admired it. The second was about my aunt and uncle’s divorce, that I had seen them as a unit and liked both of them better when they turned into individuals.

My cousins wanted to use the first memory but not the second. They said that family wouldn’t like it. I thought about their request and finally said no. Use both or neither. They chose neither. And this pretty much illustrates why I have very little contact from a large part of my family. I want to remember the whole person, light and dark, love them all. And that is not what that part of my family wants. An old family friend has not spoken to me about my sister since my sister died 6 years ago. I asked her directly about it a few months ago. She wants to talk to me “only about happy memories of your mother, father and sister.” I respond, “Why don’t you ask me what sort of relationship I want?”

She was and is silent. So I am too.

It’s not a lack of love but it’s a difference in philosophy. I think it is crazy to whitewash the dead: how will our children understand their own dark feelings and impulses and mistakes if they think that their ancestors, grandparents, parents are angels? Why aren’t we honest as a culture? How can we expect our children to be honest with us when we lie to them? The curated lives on Facebook are an abomination, false, lies and look what we have in the White House.

I like the dark as well as the light. If we truly love everything in the universe, how can we not love the dark as well as the light? If each of us owned our dark sides, our dark impulses, the myth says that we will not enact them over and over each generation. Owning the dark, acknowledging our own dark does not mean that we have to act it out in the world and then lie to ourselves and others.

And now I want coal for my stocking: just a small piece, to remind me that I have not always, or will I ever, only be good.

Mundane Monday #176: bones

For Mundane Monday #176: bones.

This is from the National Mississippi River Museum and Aquarium, in the Port of Debuque, Iowa. We had eight people in two vans, age range from 8 to 75, and drove there from Wisconsin. It was really excellent and something for everyone. A DiVinci exhibition, live alligators, this alligator snapping turtle skeleton, river boats and history.

What bones inspire you? The snapper was about four feet long, beak to tail, and the jaws and beak is very impressive. I’ve seen a pair of live ones in the wild on the outer banks of Virginia.

Link or message your Mundane Monday bone contribution and I will list them next week.

From Mundane Monday 175: line up:

KL Allendorfer finds lines in nature and …. frogs.

 

 

 

 

Long notes and unhappy patients.

A patient of mine saw a cardiologist recently.

His previous cardiologist has retired. The patient had a cardiac bypass in the past, he has a stent, he has known coronary heart disease and he’s in the young half of my practice. That is, under 60.

He had not seen a cardiologist for 2-3 years because he had a work injury, worked with Labor and Industries, the case was closed, he couldn’t go back to work, he found a lawyer. He lost his regular health insurance along with the job, so couldn’t see the cardiologist.

The L & I case is reopened. A physiatrist recommended specific treatment that was not done, and that allowed the case to reopen.

The specific treatment center then notes that he has heart disease and that he needs clearance from a cardiologist. I set him up with a new cardiologist.

“How was the visit?” I ask.

He shrugs. “The staff was nice.”

“I have the note.”

“The cardiologist spent under ten minutes with me. It was clear that she was rushed. She did not seem very interested. It was difficult to get my questions answered.”

“Her note is six pages.”

He snorts. “Great that she could get a six page note out of that visit.”

“Do you want a copy?”

“No.”

He is cleared for the specific treatment.

I have no doubt that the cardiologist spent more than 6-8 minutes on his visit and his note. But not in the room. Other people are entering the information filled out in the waiting room, medicines, allergies, past medical history, family history. Hopefully the cardiologist is reading my note and letter. But the problem is, doctors aren’t doing it in the room. So the impression left with the patient is that we spend 6-8 minutes on their visit, we are late, we are rushed. Doctors are looking at data. They are not listening to patients.

Medical Economics, a journal that arrives without me asking for it, says over and over that we need more physician “extenders”, that we need to have people doing the data entry, people doing the patient teaching, more people and machines….No. They are wrong. We need LESS barriers between us and the patients, not MORE. We need more time with patients. Every single extender we add burns physicians out more, because the salary has to be paid AND more patients seen faster to do that AND we are still ultimately responsible for knowing and reading and absorbing every single piece of information that is placed in that patient’s chart. An extender is NOT an extension of my brain and an extender is another person I have to communicate with and train.

Just. Say. No. to the managers who pile MORE barriers between the physician and the patient. NO.


It just makes me so mad that he lost his health insurance BECAUSE he got injured at work and so then his heart disease goes untreated as well… can’t afford medicines…if he then has a heart attack while uninsured we lifeflight him to Seattle, it costs a fortune, he loses his house and property and then is on medicaid and may end up on permanent disability, and what are the chances he returns to work? The US medical corporate money grubbing is insane. Single payer, medicare for all, make the US great again.

Work place

Mostly I post photographs from outdoors, but this is clinic Friday afternoon. Mordecai took off her feather boa, wig and headdress and came into the exam room to add to a visual discussion about the sacroiliac joints. Mordecai is a plastic skeleton and her sacroiliac joints are attached incorrectly but conveniently for the sellers. After all, her bones don’t have the weight of a real skeleton nor does she have tendons or muscles or skin to connect everything. She is sitting beside my Netter Atlas of Human Anatomy, which I use in clinic every day. To show the knee ligaments and menisci, to show the back muscles, to show the connections of the psoas muscle….

Many thanks to Dr. Netter’s brilliant paintings and also to Mordecai for their help!