small cruse

The Ragtag Daily Prompt is cruse, which I had to look up. I thought, I don’t have any earthenware. Then I thought, yes I do, but can I find it? I did.

My sister and my maternal cousins and I had elaborate doll houses with china dolls. I think the adults were trying to stave off Barbie. We collected whatever we could find for the doll house, for 8 inch dolls that were the “kids”. The adult doll was 12 inches.

The three earthenware pieces in the back are from the late 1960s or early 1970s. I am guessing SE US or Mexican. The three in front are Native American and from after 2000, at least, we got them after 2000. Possibly at a garage or thrift sale.

I think my grandmother made that dress, because of the button detail down the front and the short sleeves. I did do lots of sewing, small quilts, dresses, mattresses for the beds we made.

Here are the live cats, wondering what I am doing.

Dinosaur dreams

Dinosaur Dreams

The problem
With Intelligent Design
Is those old bones
Those dinosaurs

Also that of 10,000 dreams of creation
One would be right
And the followers of all the others
Consigned to hell
If so, I go gladly, clutching
Dinosaur bones to my chest
And will enjoy the diversity
Not the narrow heaven with a narrow
Small-minded deity

But is evolution right?

Well, I think it’s on the right track

But wholly done and all correct?

After all, think how often
Medicine has been wrong
Think of tobacco and vioxx
Think of Galen, over 2000 years ago
Thinking that evil humors built up in the uterus
Causing hysteria
External pelvic massage was the cure
For over 2000 years
For old maids, widows and nuns
Who had no male to cleave unto
Massage was a treatment into the early 1900s
And now we wonder about prozac too

Evolution is an evolving science

I think of when my son was four
And he watched “Jurassic Park”
Against my wishes
Because I thought it was too violent
He studied it carefully many times

One day he asked me, anxiously,
“Mom, is DNA real?”
To check that it wasn’t another of those Santa stories
I was able to reassure him
Yes, I think DNA is real
He was pleased

A few days later he announced
That when he grows up
He wants to be a plant and animal scientist
Extract DNA from amber
And grow those dinosaurs

A laudable ambition
For any four year old

If God left the dinosaur bones
Around to fool us
And they never lived
She has a nasty sense of humor
And my son and I will not forgive

I believe in evolution
And dream of dinosaurs

written in 2009

adult doll house

When mom leaves in the car with the kids, dad gets trashed on beer and destroys the living room. Yes, there is an enormous black panther in the background. Will it eat dad? Maybe it will wait until some of the alcohol wears off. He won’t taste as good drunk.

_______________________________

For the Ragtag Daily Prompt: Tiger.

Adverse Childhood Experiences 13: unsense

As a child in an alcoholic/addict household where you can not trust adults, who do you trust?

You either trust yourself or you buy in the alcohol story.

If you buy in, you have a high probability of either becoming an addict or marrying one, depending if you prefer the enabler or the enablee role.

If you trust yourself, you develop certain senses. You pay attention to people’s emotions. You pay attention to what people FEEL, what people DO and not what people SAY. You do not care what they say: what matters is what they do. My sister said she used to walk my parent’s house during high school and try to feel the mood. Did she need to hide?

The enabler role is trying to control the other person. There are amazing variations on this. I cared for a person whose sister would not take care of herself. Every time the sister is hospitalized, the person goes and cleans tons of garbage and rotted food from the apartment.

“Stop doing that,” I say, “You are enabling her. Call Adult Protective Services to go look at it instead.”

It can be very difficult to stop and can take years. People can change.

I have noticed that the enabler role is lethal. The enablers seem to die before the enablee. Certainly in my immediate family and with many patients too.

Enablee is the person controlled. Alcohol, drugs, gambling, anger, emotions. It is very very interesting to watch. I have read parts of my mother’s diaries. She was the enabler, with my father as the enablee. However, the diaries document them fighting in the middle of the night when he is drunk. And I remember high school, putting the pillow over my ears, because they were screaming at each other.

But wait. Why would she argue with her drunk husband? Why would anyone argue with a drunk person? You have to wait until they are sober.

And slowly I realize that my mother too was an alcoholic. I remember her drinking. Best cover for an alcoholic is a worse alcoholic, right? It’s fairly horrid. But it explains some stories and my food insecurity. They would not get up in the morning to feed me. My mother told stories of me trying to feed myself: cheerios and laundry soap. If my father was hung over, ok, but, why wouldn’t my mother get up? I think they were both hung over. That or else she really did not want a child. Especially a nine month old with opinions while she was trying to get over tuberculosis. She never got to hold me after birth until 9 months. And then I did not want her. I wanted her mother.

Trusting yourself, life can be a bit complicated. You sense the emotions others are hiding. Being a physician allows me to ask about the hidden things, very gently. Sometimes they come out right away. Sometimes it takes months. Sometimes years and sometimes never. My sister and I discussed going to parties and thinking, oh, that person is the child of an addict/alcoholic. This person is in pain. This person is quite happy but hiding stuff.

I told a counselor I do not know how to turn it off. She replies, “Why do you think I am a counselor?”

I don’t see auras. I feel things: like a cloud. Like a tiger, like a bear, like a whale, singing.

I think I will go with the whale.

small child

You work at healing
For years

You dive in the swamp
Of your psyche
Turn over the mud
Tunnel through it
Breath it
See lilies arise
From the muck

The Beloved is a deer
Dainty hooves
In the swamp

At last you come
To bedrock

So you rest
Bedrock
You think

Until you notice
A chink in the rock
You look away
You avoid it

At last you look
It isn’t going away

The Beloved is a bittern
In the reeds

Fluid leaks
From the chink

Foul black bilious
Acidic
Burning holes in the slanted rock
Again you look away
But not for long

You step forward
Touch the rock

I am present you say
Who is there?

The stream of foul black
Increases
Pours from a widening crack

Beloved is a tiger
Paw against the rock

You see the acid burning
Her paw
But she does not run
She stands guard

Who are you?
You whisper

The rock crumbles

There is a child

Go away” says the child
Ancient

No you say
Beloved and I
Stay present

The black is swirling around you
It’s hard to keep your footing
Beloved, an orca
Steadies you, swimming

No one stays says the child

We stay present you say

I was born I loved I was abandoned When I was afraid

We are present now you say
Swimming by the Beloved
Hand on black fin

I was abandoned When I grieved

We are here now you say

I was abandoned In my despair

We are here you say

You say
You fought
Out of love
You argued
Out of love
You gave
Out of love
Please child
Let us cradle you

The child is silent

The tide is slowing
The rock has crumbled away
A trickle of clear water bubbles

You will stay? says the child

We stay you say

Beloved is a whale
Singing in space
Singing to the stars

Am I lovable? says the child

You and Beloved
Earth and sky
Wind and trees
Moon and stars
Answer yes

Am I loved?

Yes
Yes

8/27/2007

Ode to defiance

Is oppositional defiance running YOUR life?

I am oppositional defiant. I have been for as long as I can remember. I ALWAYS want to argue when someone tells me to do something or gives me advice. BUT, I have learned to work with it.

I work with it by arguing with myself.

Give me a topic. Or advice. I will promptly argue the opposite, internally or externally. Then I will argue the original side. Then my demon fights my angel until they are both tired and decide to go have a beer. Somewhere along the way I will make a decision and also I will laugh, because it’s funny.

B has figured this out. “You argue with EVERYTHING.” he says.

“Yes, and if there is no one around, I argue with myself. All the time.”

However, he is also oppositional defiant. He is smart too, and doing some self examination.

“I am thinking about my life. I think ALL of my important decisions were oppositional defiant ones.”

“Someone told you you couldn’t do that?

“Yes.”

He’s chewing on that. Heh. He accuses ME of overthinking. I replied that I am making up for his underthinking, heh. He suggests that I STOP overthinking and I say, “You want to DESTROY the SOURCE of my poetry?” Double heh.

The point is, some of us are oppositional defiant, but really, we don’t want that to run our lives EITHER. We don’t want ANYTHING or ANYONE to tell us what to do.

B says, “I think that everyone refusing the vaccine is oppositional defiant.” He has a lot of friends, both liberal and conservative.

“That is interesting.” I say. And I wonder if it is worth dying for, to be oppositional defiant. Not if it’s running your life, right? I don’t want ANYTHING to run my life except ME.

So then I spend a bunch of time arguing with myself about the causes of refusing the vaccine. And I have not reached a conclusion. Yet.

I took the photograph at the Bellevue Mall on Monday. A three story waterfall. Really? Isn’t there enough rain in Seattle? We should have a three story sun instead.

Why care for addicts?

I posted this in November, 2015. I am reposting it.

_________________

Why care for addicts?

Children. If we do addiction medicine and help and treat addicts, we are helping children and their parents and our elderly patients’ children. We are helping families, and that is why I chose Family Practice as my specialty.

Stop thinking of addiction as the evil person who chooses to buy drugs instead of paying their bills. Instead, think of it as a disease where the drug takes over. Essentially, we have trouble with addicts because they lie about using drugs. But I think of it as the drug takes over: when the addict is out of control, the drug has control. The drug is not just lying to the doctor, the spouse, the parents, the family, the police: the drug is lying to the patient too.

The drug says: just a little. You feel so sick. You will feel so much better. Just a tiny bit and you can stop then. No one will know. You are smart. You can do it. You have control. You can just use a tiny bit, just today and then you can stop. They say they are helping you, but they aren’t. Look how horrible you feel! And you need to get the shopping done and you can’t because you are so sick…. just a little. I won’t hurt you. I am your best friend.

I think of drug and alcohol addiction as a loss of boundaries and a loss of control. I treat opiate overuse patients and I explain: you are here to be treated because you have lost your boundaries with this drug. Therefore it is my job to help you rebuild those boundaries. We both know that if the drug takes control, it will lie. So I have to do urine drug tests and hold you to your appointments and refuse to alter MY boundaries to help keep you safe. If the drug is taking over, I will have you come for more frequent visits. You have to keep your part of the contract: going to AA, to NA, to your treatment group, giving urine specimens. These things rebuild your internal boundaries. Meanwhile you and I and drug treatment are the external boundaries. If that fails, I will offer to help you go to inpatient treatment. Some people refuse and go back to the drug. I feel sad but I hope that they will have another chance. Some people die from the drug and are lost.

Addiction is a family illness. The loved one is controlled by the drug and lies. The family WANTS to believe their loved one and often the family “enables” by helping the loved one cover up the illness. Telling the boss that the loved one is sick, procuring them alcohol or giving them their pills, telling the children and the grandparents that everything is ok. Everything is NOT ok and the children are frightened. One parent behaves horribly when they are high or drunk and the other parent is anxious, distracted, stressed and denies the problem. Or BOTH are using and imagine if you are a child in that. Terror and confusion.

Children from addiction homes are more likely to be addicts themselves or marry addicts. They have grown up in confusing lonely dysfunction and exactly how are they supposed to learn to act “normally” or to heal themselves? The parents may have covered well enough that the community tells them how wonderful their father was or how charming their mother was at the funeral. What does the adult child say to that, if they have memories of terror and horror? The children learn to numb the feelings in order to survive the household and they learn to keep their mouths shut: it’s safer. It is very hard to unlearn as an adult.

I have people with opiate overuse syndrome who come to see me with their children. I have drawings by children that have a doctor and a nurse and the words “heroes” underneath and “thank you”. I  have had a young pregnant patient thank me for doing a urine drug screen as routine early in pregnancy. “My friend used meth the whole pregnancy and they never checked,” she said, “Now her baby is messed up.”

Addiction medicine is complicated because we think people should tell the truth. But it is a disease precisely because it’s the loss of control and loss of boundaries that cause the lying. We should be angry at the drug, not the person: love the person and help them change their behavior. We need to stop stigmatizing and demeaning addiction and help people. For them, for their families, for their children and for ourselves.

ring

I dream a night sky thick with stars

all the stars start falling

I think “That isn’t good.”
sore afraid

all the stars are angels falling

I think “That isn’t good.”
sore afraid

an angel falls close past me
in space
face at perfect peace

I think “Why do they fall?”
sore afraid

I am falling in space
head down
no earth beneath me
with the angels

crying, imperfect acceptance
sore afraid

I wake
I put the dream away

it comes back
in a decade

I write about wings
sore afraid

I try to understand
sore afraid

I am asked what my small self
my child self
wants

wings

I say yes
no longer
sore afraid

did you hear the bell?

yes

Covid-19: Emotional weather

I do not think of emotions as bad or good. None of them are bad or good. They are information, controlled by electrical impulses and hormones, evolved over millions of years (or endowed by our creator, for those who swing that way).

I don’t dismiss emotions. I listen to them.

I think of myself as an ocean. There is all sorts of stuff happening in the depths that I don’t understand. Probiotics, for example. I don’t take them. If not for penicillin, I’d be dead many times over, from strep A pneumonia twice and other infections. I don’t think we understand probiotics yet. We don’t understand the brain, either.

The emotions are the weather in my life. I don’t really control them but they don’t control my ocean, either. Some days are sunny and gorgeous and then a storm may blow up. I am afraid of hurricanes, one destroyed my grandparents’ house in North Carolina, on the outer banks. I think all the cousins still mourn that house. And I miss my grandparents too, all of them. And my parents and my one sister.

See? The weather got “bad” there for a moment, but it isn’t bad. Storms have their own beauty though we hope to batten the hatches and that not too much damage is done. Maybe there is rain, scattered showers, sun breaks, a lenticular cloud. In the Pacific Northwest on the coast, the weather can change very quickly and we have microclimates. My father lived 17 miles away, but inland from me and in a valley. It was warmer in the summer and colder in the winter.

My goal with my weather emotions is to pay attention to them, let the storms blow in and out, and try not to harm anyone else because of my weather. When my sister was in hospice, we had a sign up in my small clinic. It said that my sister was in hospice with cancer and that clinic would be cancelled at some point with little warning. Patients were kind and gentle with me. And then it was cancelled, when she died. I got cards from people. They were so kind, thank you, thank you, and I could barely take it in. My maternal family then dealt with grief by having lawsuits. I don’t think that is a good way to deal with grief, but we just see things differently. Maybe it’s the right way for them. I don’t know.

Whenever I was having internal emotional weather that stirred me up, I would tell my nurse or office manager. Because they will sense my weather and need to know what is up. I had enormous support from them during a divorce, while my partners treated me horribly. My nurses and office manager knew me and my partners didn’t. My partners distanced me as if a divorce were catching. Whatever. Their loss.

Sometimes patients sensed that I was upset. I could tell by their faces. If they didn’t ask, I would. Bring the emotions out. Reassure them that I AM grumpy but not at them. Stuff in my own life. No worries.

Sometimes clinic is about a patient’s weather. They ask if they can tell me something. Often it is prefaced by “Maybe I need an antidepressant.” or “I feel really bad.” When they tell the story, usually I would say, “I think it is perfectly reasonable and normal that you feel angry/hurt/shocked/horrified/grieved/upset.” And then I would ask about an antidepressant or a counselor and most of the time, the person would say, “Well, I don’t think I need it right now.” What they needed was to know that their weather was NORMAL and REASONABLE.

I am seeing things on Facebutt and on media saying that mental health problems and behavioral health problems are on the rise. Maybe we should reframe that. Maybe we could say, “The weather is really bad right now for everyone and it’s very frightening and it is NORMAL and REASONABLE to feel frightened/appalled/angry/in denial/horrified/confused/agitated/anxious or WHATEVER you feel.” This weather is unprecedented in my lifetime, but as a physician who had very bad influenza pneumonia in 2003 and then read about the 1918-19 influenza, I have been expecting this. Expecting a pandemic. Expecting bad weather. This will pass eventually, we will learn to cope, be gentle with yourself and be gentle with others. Everyone is frightened, grieving, angry, in denial or in acceptance. The stages of grief are normal.

Hugs and prayers for all of us to endure this rough weather and help each other and ourselves..

I took the photograph in color. My program made a black and white version. It looks like the back of a stegosaurus to me, a dinosaur now living as a mountain.

For the Ragtag Daily Prompt: rainbow. Because sometimes the rain and sun combine to make a rainbow.

Makeup

Poem: Makeup

For a fellow blogger and for the Ragtag Daily Prompt: Still. I am thinking of both stillness and of still photography. A photograph. For a still, I think that it is usually posed. I like taking portraits when people are not posed.