phoenix rising

Written in 2009.

Set a torch to me
Why don’t you?

It’s not the tearing sound of fabric
A small rip
And now a tear
That I feel

It’s the torch

I’ve been here before
A job where the idealistic came
As moths to the flame
Self-immolation
Because they had ideals

I watched and burned and rose

It’s the torch
The flames that rise
As the witch is burned
Tilts back her head
In ecstasy and knowledge
Eager to learn what she can
From these burning brands

In the burning we learn
In pain we learn
If we can remain open
Ashes fall to the ground
Buckets of water
Wash any remains to grey mud
Gone, punished
Relief for the frightened
An example has been set

No but what stirs at night
Moon or none
What rises from the mud
The ashes
Takes form
Takes flight
Laughing

Set a torch to me
Why don’t you?
And see what is created

Adverse Childhood Experiences 12: welcome to the dark

Welcome to the dark, everyone.

When you think about it, all the children in the world are adding at least one Adverse Childhood Experience score and possibly more, because of Covid-19. Some will add more than one: domestic violence is up with stress, addiction is up, behavioral health problems are up, some parents get sick and die, and then some children are starving.

From the CDC Ace website:

“Overview:Adverse Childhood Experiences (ACEs) are potentially traumatic events that occur in childhood. ACEs can include violence, abuse, and growing
up in a family with mental health or substance use problems. Toxic stress from ACEs can change brain development and affect how the body responds to
stress. ACEs are linked to chronic health problems, mental illness, and substance misuse in adulthood. However, ACEs can be prevented.”

Well, can they be prevented? Could Covid-19 be prevented? I question that one.

I have a slightly different viewpoint. I have an ACE Score of 5 and am not dead and don’t have heart disease. I spent quite a bit of time thinking about ACE scores and that it’s framed as kids’ brains are damaged.

I would argue that this is survival wiring. When I have a patient where I suspect a high ACE score, I bring it up, show them the CDC web site and say that I think of it as “crisis wiring” not “damaged”. I say, “You survived your childhood. Good job! The low ACE score people do not understand us and I may be able to help you let go of some of the automatic survival reactions and fit in with the people who had a nice childhood more easily.”

It doesn’t seem useful to me to say “We have to prevent ACE scores.” Um. Tsunamis, hurricanes, Covid-19, wars… it seems to me that the ACE score wiring is adaptive. If your country is at war and you are a kid and your family sets out to sea to escape, well, you need to survive. If that means you are guarded, untrusting, suspicious and wary of everyone, yeah, ok. You need to survive. One of my high ACE Score veterans said that the military loved him because he could go from zero to 60 in one minute. Yeah, me too. I’ve worked on my temper since I was a child. Now it appears that my initial ACE insult was my mother having tuberculosis, so in the womb. Attacked by antibodies, while the tuberculosis bacillus cannot cross the placenta, luckily for me. And luckily for me she coughed blood at 8 months pregnant and then thought she had lung cancer and was going to die at age 22. Hmmm, think of what those hormones did to my wiring.

So if we can’t prevent all ACE Scores, what do we do? We change the focus. We need to understand crisis wiring, support it and help people to let go of the hair trigger that got them through whatever horrid things they grew up with. 16% of Americans have a score of 4 or more BEFORE Covid-19. We now have a 20 or 25 year cohort that will have higher scores. Let’s not label them doomed or damaged. Let’s talk about it and help people to understand.

I read a definition of misery memoirs today. I don’t scorn them. I don’t like the fake ones. I don’t read them, though I did read Angela’s Ashes. What I thought was amazing about Angela’s Ashes is that for me he captures the child attitude of accepting what is happening: when his sibling is dying and they see a dog get killed and he associates the two. And when he writes about moving and how their father would not carry anything, because it was shameful for a man to do that. He takes it all for granted when he is little because that is what he knows. One book that I know of that makes a really difficult childhood quite amazing is Precious Bane, by Mary Webb. Here is a visible disability that marks her negatively and yet she thrives.

A friend met at a conference is working with traumatic brain injury folks. They were starting a study to measure ACE scores and watch them heal, because they were noticing the high ACE score people seem to recover faster. I can see that: I would just say, another miserable thing and how am I going to work through it. Meanwhile a friend tells me on the phone that it’s “not fair” that her son’s senior year of college is spoiled by Covid-19. I think to myself, uh, yes but he’s not in a war zone nor starving nor hit by a tsunami and everyone is affected by this and he’s been vaccinated. I think he is very lucky. What percentage of the world has gotten vaccinated? He isn’t on a ventilator. Right now, that falls under doing well and also lucky in my book. And maybe that is what the high ACE score people have to teach the low ACE score people: really, things could be a lot worse. No, I don’t trust easily and I am no longer feeling sorry about it. I have had a successful career in spite of my ACE score, I ran a clinic in the way that felt ethical to me, I have friends who stick with me even through PANDAS and my children are doing well. And I am not addicted to anything except I’d get a caffeine headache for a day if I had none.

For the people with the good childhood, the traumatic brain injury could be their first terrible experience. They go through the stages of grief. The high ACE score people do too, but we’ve done it before, we are familiar with it, it’s old territory, yeah ok jungle again, get the machete out and move on. As the world gets through Covid-19, with me still thinking that this winter looks pretty dark, maybe we can all learn about ACE scores and support each other and try to be kind, even to the scary looking veteran.

Take care.

covid 19 two

From November 20th, 2020:

My ex called Saturday. Early, which unusual. I thought he was calling to say his mother died.

Nope.

He is an RN at a nursing home. “We’ve gone from one Covid 19 patient to 55 in the nursing home in one week. And they installed a new computer program on Tuesday that makes everything take twice as long. I quit.”

Actually he gave two weeks notice.

He called our kids yesterday. He has Covid 19. However, they are so short of staff that he is working. On the Covid 19 ward of the nursing home.

____________________

In my clinic, we are struggling with watching people travel for Thanksgiving. We have decided. If someone travels or has Thanksgiving with other households, we will offer a zoom visit or a reschedule in two weeks. We do not want them to expose others in clinic. And if we get it or are exposed, we are closed for a minimum of two weeks.

____________________

He called me. Today 60 out of the 70 nursing home patients have it. All of the staff have it. The staff are working anyhow because there is no one else.

Free fall

I feel safest with the fallen

Everyone falls
No one is good

I am afraid
Of the people who
pretend to be good

the fallen
don’t pretend

We fell down down down
like an eternity
like it would never end

We were bad
depressed drunk addicted
liars cowards thieves

We held our arms out
There was nothing to stop us
Free fall

All we could do
was pray

We prayed
As best we could
With all our hearts
If we had no words

Falling angels
Caught us

Helped us
Claw our way back

Some people fall
Are still falling
Fall forever

Are they crazy
Or do they choose
To stay with the angels?

The people who say
They are good

We look at them

We know they haven’t fallen

They are lying to us
They are lying to themselves
They are lying to the Beloved
They want to be good
They want what they say to be true

But it isn’t

I meet the eyes of another fallen
Knowledge

I can see the memory
Of infinite free fall
In their eyes.

Yard Art

There is a fabulous garden in Portland, Oregon decorated with bowling balls.

i have decided to decorate with oxygen tanks.

if anyone has any oxygen paraphernalia, I want it, please.

This art installation is titled “Tethered”. Or possibly “Chained.”

Game ball

Warning: this post contains some time out words.

How do I process the game you played?

I am the subject of the game.

Or the victim.

Or no, I refuse. It is your game. I was not playing. I am the honey badger, metabolism so fast that I have to run from one meal to the next or else I will starve. I eat whatever I can find: cobras, bees, anything. I eat or I die.

You have tethered a honey badger to oxygen by playing a game.

I am the football and you have been kicking me, throwing me, catching me, slamming me to the ground as hard as you can in the end zone.

And now that I am worn and damaged and torn, you’ll toss me away, not even notice me, and find a new ball.

You will need a new football. To play with.

I don’t envy that person.

The truth is, it will be one of you. The group will rest on their laurels, oh, we nearly killed her, wasn’t it great? We showed her. She is so stupid, took her what, 21 years to fucking figure it out? And she thinks she’s so smart.

I was looking for food because I am always hungry. The food insecurity goes back to infancy. Maybe to the womb: my mother says she was not to gain weight and spent the entire pregnancy longing for a gigantic ice cream Sunday. Think of being in a womb, attacked by antibodies to tuberculosis, and starving all the time. Might be a little bit worried when birth happens. Fuck, I am going through a tunnel, what horrors await me here? But maybe there will be more food.

Maybe someone will love me. Maybe there will be someone for me to love. And feed. We can give each other food.

My advice to you is don’t be the ball. I was the ball for 21 years. I was so hungry the whole time, for food and for love, that I kind of noticed but dismissed it as unimportant. Food and love were more important. Work and my patients were more important. You don’t matter and your games are trivial.

It will be the weakest one who will be the ball. You worry that you are the one. You should worry. You had better look strong right away. Post some horror. Write something really tough. Don’t show anyone any niggling doubts. Um, the ball is wearing oxygen. I am feeling a little bad about this. Are you feeling bad about this? The ball isn’t just crazy, it’s hurt. Actually crazy is an illness too: I know that you discriminate and think that cancer is a legitimate illness and that mania isn’t, but you are assholes. No, you’re too small and pathetic to be an asshole. You are a one celled animal that is clinging to a hair on an asshole and you get shat on daily. And you know, deep deep in your tiny shrunken heart, that you deserve it.

I am so glad I am not you.

I am tethered to oxygen. But I am healing. I don’t think you can. You are locked in your small sick pathetic triangulation competition and pretending that it’s a game that it’s ok that you are just playing.

Ick.

Meanwhile, the oxygen is portable.

I have food and I have love and I have work to do that lifts me on wings. I will go too near the sun and light on fire and fall burning, but that’s ok. I’ve done it before. The ocean heals me, always. It is so much fun to fly!

This is in memory of my mother, my father and my sister. I miss all three and I love them and they love me. Today is the day my mother died. The longer we live, the more days are days when someone that we love died. But they are still here. They are in the rocks and the sky and the trees and the coffee cup. They are not in sugary donuts or foods that cause heart attacks. But they are all around us, cradle us, still love us. Joy to you and the memories of your loved ones who have gone on. Blessings.

Thoughts on Ramadan

I have been thinking about Ramadan.

Those religions. Judaism, where you don’t eat pork or shellfish. We do know the reasons: trichanosis and food poisoning. And possibly that paralytic shellfish disease: that would be bad, right? People die fast. So pork and shellfish are forbidden.

But Ramadan. I have thought about it for a long time. I think I will do it next year, the diet part. Because I think I have been doing it: in 2012 and 2014 and now. I change my diet to help kill whatever bacteria I have. I go ketotic and the bacteria that require sugar or glucose or fructose can’t grow. It kills them. Quite effectively, since I was sent home after 24 hours of hospital observation when I had strep A pneumonia and sepsis in 2012, after drinking only 4 liters of fluid and putting out ten liters of urine. This is not a good thing. If it goes on, my circulation would collapse, which happens to be the defining symptom of sepsis. Since I did not want my circulation to collapse, I drank 6 liters of water when I got home. With electrolytes and MgS04 because I had a very low potassium and magnesium when I hit the ER. The hosptialist just said that I was bananas in her discharge summary, but she failed to explain the potassium and magnesium and she didn’t even LOOK at the nurses record of the oral intake and urine output. This is not my standard of care. I think one should ALWAYS look at the test results. The usual urine output is up to 2 liters. Ten liters should have stopped her dead in her tracks. Unfortunately I think she had me labeled. Bananas or not, a crazy person can ALSO get pneumonia and sepsis. Really.

She did give me a penicillin shot. Unfortunately it was the dose for strep throat. Not very much penicillin. After I failed to improve from the antibiotics for a couple of days, I thought OH. THERE ARE TONS MORE BACTERIA WHEN IT IS A SYSTEMIC INFECTION. INADEQUATE ANTIBIOTICS. I pulled my sanford guide. For strep A sepsis you are supposed to treat with:

penicillin G 5 million units iv every 6 hours

and clindamycin 3 million units iv every 6 hours. At least, that was the treatment in 2012.

Damn, I thought. Bit hard to do that at home on my own, isn’t it? Now what?

So I called a local pharmacy. I ordered penicillin V 500mg one four times a day and clindamycin 300mg four times a day and then I hunkered down and ate NO CARBOHYDRATES for two weeks.

Penicillin tablets are horse pills and bitter. Yet the first one I put in my mouth, it tasted delicious. Super weird. But my body must have been saying THANK YOU THANK PENICILLIN and released a crazy high dose of dopamine in my brain.

After two weeks I hoped the damn strep would be dead. I took myself out to dinner, feeling like shit, and ordered food. It tasted like heaven, but…..sepsis symptoms once my blood sugar went up. Third spacing fluid. It feels like sand running out of an hourglass as the fluid leaves your arteries and veins. It also causes an instant and terrifying panic attack as your body tries to tell you YOU ARE ABOUT TO DIE GET FLUID HELP HELP HELP.

Which is why sepsis can get misdiagnosed as a panic attack or mania or what the fungk ever. It is by miles one of the most terrifying things I have ever been through.

Survived it. At home. While my fellow docs in my small town whispered about how I was bipolar. A physician’s assistant told me that the internist told her at a party that I am bipolar. Ok, I cried again. He sucks. How the hell does he know? He’s not my doctor.

Another woman doctor said, “I heard about you in a meeting. After all we aren’t really friends.” I didn’t say much. Afterwards I stared at the phone. I thought we were friends. Guess not. And ok, speaking of HIPAA, what the fungk did they say about me in a hospital meeting? Fungk them. Over and over and over, please. Spank them with a HIPAA paddle.

Next I read about strep A sepsis. Gosh, once you get it you are more likely to get it again. Damn. Power of suggestion. I got it again one year to the day from when I found my father dead in his house. Stress, you see. He’d left an out of date will, my sister was dead of cancer, it was written when I was nineteen. I knew what my father wanted. He’d said that I was the only person he know who could handle my sister, so I was the person he wanted to watch over her daughter. But the damn will didn’t SAY that.

So I did what any sensible human would do. I took the stupid will to an attorney and did what he said. So then the interfering family sued the executor (me) on my niece’s behalf. Stupid interfering mean and actually not very bright family. After three rounds, I said give it to her.

Half the estate? said my attorney.

Yes.

But… how do you feel about that?

It’s good for me. I will be done with her and that part of the family. It’s not what my father wanted but my niece clearly doesn’t want me to watch over her. Ok, fine. Give her the money. Never mind that her mother extracted at least 1/3 of the estate before my father died and made him cry. I was pretty pissed at my sister for making our father cry. That is when my father and I started comparing notes on what my sister was doing. It was grim. Anyhow, let the dead lie. Sometimes they do when they are alive, too.

It’s not good for the niece. Handing her that stack of money is thoroughly dangerous. And she’s over 18, so, well. It is on my cousins’ heads, whatever happens.

Long silence. My attorney says: you are a really nice person.

Well? I said. Have you known any cases like this.

Yes, he said reluctantly. A 19 year old. He got half a million dollars. He was dead in five years.

Mmmm hmmm. I said. Well, I wish her the best.

Anyhow, second round of strep A sepsis/pneumonia. And third round of pneumonia. With the hospital physicians for the most part still insisting that I was a liar. I mostly handled it at home though I confess that when I started bleeding from my gums, I got scared and went in. The kale water, vitamin K source, kicked in and it stopped by the time I got there. The ER doctor said that he wouldn’t believe me unless the disseminated intravascular coagulopathy labs were high. They were only a little high, but he broke his word, told me I was nuts and sent me home. He also told me I was dehydrated, which was comic because I’d asked the nurses for a “hat” and urinated 4 liters while I was in the emergency room. I was keeping track. I WOULD have been dehydrated except that I was drinking fluid when he was not looking. My daughter brought in a water bottle and quietly went to fill it. I didn’t trust that moron ER doctor to take care of me if my blood pressure tanked. Stupid man.

Home again home again.

This time they don’t believe me again. This time I think it’s funny. Also I caught it early enough so that I don’t have sepsis, praise to (your deity of choice)! I have been here for 21 years, doing medicine in this town. I was one of the two doctors who took the lead in the opioid overuse crisis. The hospital didn’t break down and train its doctors until 8 years after I started. You’d think they might say, wait, she has weird ideas….. but you know, sometimes they are really GOOD weird ideas.

Back to Ramadan. I think spending a month being ketotic and only drinking water during the day has a purpose. I think that it kills bacteria that require sugar, and also yeast and fungi, and possibly some viruses, too. What is the mechanism for the virus killing? Well, the cells slow their metabolism in ketosis, because the lizard brain thinks that the person is starving. Some systems get shut down, like chronic pain. Acute pain is still on line because WE HAVE TO FIND FOOD. In ketosis, the body burns fat and protein to make just enough glucose to keep the brain alive, and the side product is ketones. If it is the body’s store of fat and protein, well, that is starving, right? The lizard brain can’t tell if it’s an outside source. FIND FOOD so vision is sharper, hearing is more acute. Fast twitch muscles burn too many calories, so they are decreased. The slow twitch are ON so that we can go for miles and miles if need, cross continents… and where did I learn all this? Not from medical school or residency. There was a brilliant article in the Atlantic Monthly, about fasting for over a month to lose weight. He wrote about the history of fasting and fear of it and about… ketosis. Thank you, Atlantic Monthly, your article helped save my life when my doctors would not listen and sent me home to die.

Maybe viruses can’t get into the cell as easily when the cells slow their metabolism. Or, better hypothesis, the cells are slower so they don’t make viruses very well. They are slow. They ought to ride the short bus.

Ramadan 2022 starts April 1, 2022 and ends May 1, 2022.

I think I will start three days early, on March 29. Because I want to end early. Because… something big is happening at the end of that April in 2022.

Blessings.

alternative medicine

Ok, I got this picture off Facebutt. I CONFESS. But I really want a doctor kit like this: so I can practice alternative medicine. I am disabled from Family Practice and I have to apply for disability payments (miles of paperwork) and I hear that even as a contractee I can apply for unemployment (miles more paperwork) and I see my hospital bill on line for the ER visit where I had chest pain and shortness of breath and the ER doc didn’t even give me an aspirin, so I want to know why I should pay them $900 and I am going to apply for reduced payments because last year I made 42 K, less then the nurses at Jefferson Healthcare (EVEN MORE PAPERWORK FOR THE REDUCED PAYMENTS) and really, it all sounds rather exhausting and I’d rather let the paranoia rise and hide under the bed. Where the OCD and ADHD will make me arrange the dust bunnies and dust elephants by size.

So this looks like a great doctor kit. If the patient sees me and doesn’t do a darn thing that I say, I shoot them with the gun in the forehead. If they do a little but not really very much, I set up the bowling pins and shoot them with the gun while I talk about how irritating it is to have patients use MY TAX DOLLARS though MEDICARE MEDICAID ACTIVE MILITARY DUTY AND THE VETERANS ADMINISTRATION NOT TO MENTION SOCIAL SECURITY DISABILITY to get advice and not follow it.

If they are merely disrespectful and tell me what Dr. Google says, I say “Duck.” and throw one at them. If they say, “I don’t take any farmasuiticals.” and bring a bag with the 12 supplement and vitamin pills they take daily, I give them the plastic pills to replace all their stupid supplements. “Here, take this. If it doesn’t work, I have suppositories, but they are four times this size so some people complain that they are uncomfortable.”

I am not sure WHAT the thing in the lower right corner is. A hair dryer? A fentenyl lollipop? Part of an old fashioned telephone?

Anyhow, someone find me one of these kits and send it to me. Pretty please. I am not allowed to do Family Medicine any more and really want to get started on Alternative Medicine.

chronic fatigue

I am realizing that I have had chronic fatigue since 2014. Or possibly 2012.

We know that chronic fatigue can be kicked off by infection. One in ten people with a severe infection is diagnosed with chronic fatigue. Severe stress can also kick it into gear or a combination of stress or grief or attack or assault and infection can kick it in to gear.

We don’t really understand it, though I am finding experience to be a very great teacher.

As far back as medical school and residency, I was curious about it. I love the edges of things: it is the things that we don’t understand that I study. I pick up bits of information like a crow or magpie. I add it to the pile of things related to it in my brain. Sometimes I will add just one more small piece and the entire pile of puzzle pieces with suddenly, in just a blink, rearrange itself into a picture.

The pieces won’t arrange themselves until I have a complete picture. Or, well, until something in my brain is satisfied that it is complete enough. Since nothing is every complete or completely understood, is it? Nothing fixed and we make up all the words.

Anyhow, chronic fatigue would explain why running my own clinic, I did not see more than ten patients a day. Also I do have some OCD, hidden under a messy packrat gene. You would NOT look at my house two months ago and think that I have some OCD. Messy and chaotic. But I am a precision demon about patient charts and I am always thorough. In 2009 our local hospital let me know that my reputation was of a brilliant diagnostician. Ironically, this was right before they fired me for arguing about the patient quota of 18 per day. I ran late because I could not stop being thorough. I cut my work from 4 days a week to 3.5 but that was still two hours of dictating and paperwork for every day of clinic. So clinic was 28 hours plus the dictating and paperwork and calling specialists and calling insurance and a one hour meeting at lunch with the administration EVERY DAY FOR MONTHS, so really clinic was 8 hours of patient contact plus the one hour lunch meeting. Redo the math: 28 hours plus 4 one hour lunch meetings plus 7 hours of the generated deal with stuff AND do not forget about call nights. 39 hours plus call. At least one call night a week, 6 pm to 8 am, so that is 51 hours or more. I felt that I was working flat out as fast as I could every single day in clinic and I still was not keeping up.

I also really really resented the one hour lunch meetings because I was only allowed 20 minutes for a patient and was to see them “for one thing”. Seeing people “for one thing” is unethical and dangerous because for example: a diabetic with a toe infection. That is already two things. But you’d better calculate the third: kidney function, because you have to dose the antibiotic for the toe based on the kidney function, and diabetes is the number one cause of adult kidney failure in the US. Oh, and you’d better check on the diabetes too, because if their blood sugar is whomping out of control, the toe won’t heal and that’s how they got infected in the first place. So I might have ranted a bit about seeing people “for one thing” because I think it is an UNETHICAL DANGEROUS LOAD OF CRAP. DO NOT PUT UP WITH IT, DOCTORS AND PATIENTS OF THE UNITED STATES. It is corporate trying to maximize profit and they can frankly go to hell and stay there. Single payer. ‘Nuf said.

Even more ironically is that two years after they fired me for vocally disagreeing with the quota (I would add that I was not diplomatic and I was vociferous), the hospital dropped the quota down. To what I had asked for, 16 patients a day. I actually had kept track through my career and knew that I averaged 16 patients a day. One partner usually saw 20 or 21, but the problem was that he kept the chart in his head. When I would get one of his patients, I’d have to say, “Um, you have some heart disease, right? You’ve had a heart attack or a bypass? What year was the bypass? How many vessels?” I’d be guessing from the medicines and clues… but the past history was not entered into the chart. So, yeah, I only saw 16 patients a day but my charts were solid and thorough and the charts on his patients were a lot more comprehensible every time I saw one of his patients and did the chart for him. He owes me. Pay up.

Anyhow, I have worked really hard for the last seven years, in spite of some chronic fatigue and fibromyalgia. Which I rather refused to admit to myself. I thought I was “well”. I felt bad that I didn’t clean up my chaotic house.

Now I forgive myself for the house. Because the truth is I couldn’t clean up the house. Not after 7-10 patients and running my own clinic, CEO, chief cook and bottle washer, dealing with the covid changes, trying to figure out medicare’s arcane language, fielding malpractice insurance, business insurance, insurance insurance and phone company scam calls.

I have been sick at home for 6 weeks. I have been on oxygen for 4 days? 5 days? I would have felt a lot better and been able to think better if I had been on oxygen the whole time. Meanwhile, turns out I CAN clean up and organize in spite of being hypoxic. My house is now a very different place and the garden has changed enormously very quickly.

I am sending more money to India, via https://www.pratham.org/ . I can hardly bear to think about the people who cannot get oxygen. It feels terrible and terrifying to not be able to breathe. My chest hurt and lungs and heart when I even sat up, much less walked. If I walked slowly enough, it was bearable, just barely. I walked anyhow. Those edges, I am always there.

It is very weird being on oxygen. I have told people in the past when I had pneumonia. I’ve almost died from it four times. Heart rate of 135 holding oxygen level, but it doesn’t feel good. I am confident that I do not have coronary artery disease, because if I did, I would have had a heart attack the first week. A heart rate of 135 is running a marathon. It is exhausting. Right now on oxygen, my heart rate is 86 and oxygen at 98%. My normal heart rate is more like low 70s. Normal is 60-100, you knew that, right?

It is very weird being on oxygen. Because now I have a visible signal that I have been/am sick. Somehow this is making people more kind, more concerned. I keep thinking, but I told you I was ill before. Why does being on oxygen make people kinder?

I think that is the difference between having an illness where there is not much comprehension and one that we think we understand. So chronic fatigue and fibromyalgia are dismissed, disrespected and discriminated against, while cancer and sepsis and covid-19 and massive trauma in the military are supported. People send gifts.

In the past, tuberculosis was thought to be an illness of sensitive poets. Then the tuberculosis bacillius was discovered and it morphed into a disease of the poor dirty overcrowded low scum of humanity. My mother had tuberculosis, but luckily it was when we’d moved on to sanitoriums, because it is airborne, so stop the spread and take care of people. There was also medicine. My mother had to take 36 pills a day. At one point in the hospital, someone brought her a medicine.

“What is it?” asked my mother.

“Don’t worry about it.” said the nurse.

“No,” said my mother. “I want to know what it is.”

The nurse got the doctor. He came in and said, “Take the pill.”

“What is it?” said my mother. She was 22, 8 months pregnant, very poor, and a student at the University of Tennessee.

“Don’t worry about it.” said the doctor.

My mother threw it at his head. Because not only was she 22, 8 months pregnant, very poor and a student at the University of Tennessee, but she was also the daughter of F. Temple Burling MD, a psychiatrist, physician and professor at Cornell University.

And he had told her, don’t take anything unless you know what it is…..


________________________________________________________________

The picture is of my mother, Helen Burling Ottaway, in 1945. Helen Temple Burling II at the time of the picture.

________________________________________________________________

I think the final straw that made the hospital fire me was me singing “The 18 Patient Blues” which I’d made up, to the tune of 16 Tons, into the Chief Financial Officer’s voicemail and at the open mike at the Upstage, here in town. I admit, it was not diplomatic.

broken

I wrote this poem in 2014. Sometimes you know things without knowing them. Or you know them before you are ready to know them and so…. you forget.

broken

I think you said
“Break her.”

And you told them how.

You told them my weaknesses
and my strengths.

You told them that I twisted your words.

You said, “You twist my words.”
K said, “You twist my words.”
S said, “You twist my words.”
Ko said, “You twist my words.”

and on everything2
they, too, twist my words.

Twist
twisted
fisted.

When the outer is charming and perfect
the damage is inside.

I wear my spikes on the outside.


No one, to date, has been allowed more then
visitation rights
inside.

No one except
you
and my children
and all children.

Only they are allowed inside.

Twist
twisted
fisted.

I am broken.

But I was always broken and knew it.

I hope that no one cut their hands
when they tried to smash me.

Pretty on the outside
deadly on the inside.

Yet I think a spark in you said,
“Break her.”

What you didn’t tell them
is that I don’t bother to lie
because no one listens anyhow
no one ever listened
and so I can always tell the truth
until they stop listening.

because they don’t believe me

but you knew

I tell the truth

And I was already broken.

8/22/14

And this should connect to this: https://drkottaway.com/2014/11/