In the warm

In the warm

I am here in the warm.
The thumper.
Sometimes it is fast.

I am in the warm.
The thumper.
The loud swish thing.
I kick it.
Loud place, I kick.
I am running out of room.
I push.

I push.
Thumper wild.
Thumper fast.
I have no room and now it is squeezing!
Stop squeezing! Pushing me! I want room! Room!

Ahhh! Bright!
Noisy! No warm! Cold!
Things touch me! Room! But no warm!

I am warm but not wet.
Bright. Wrapped.
Here is thumper.
I cough. No wet, something else. Air.
I want. Oh, thumper. Oh, mouth on warm, milk.

Here is room.
Thumper and others.
I know others. They are fast.
They are noisy.
That one is the one that held the swish thing. I kick.
Thumper and those are big.
These two are small, I am smaller.
Noisy! I like them.
I am getting used to light and dark.
More room. Milk. Air.

I know names. I have hands like others.
I can chew my hand.
My hands don’t work like theirs.
My noise doesn’t work either.
Not like brothers. Thumper is mom.
Other big is father.
Other bigs come and go.
I want my noise and hands to work!
I keep practicing.

I keep practicing
More!

I took the photograph of my daughter in 1998. This is scanned. I may try with another scanner….

Β 

March for people

My daughter and I marched yesterday.

She decided to come home from college for the weekend, planning to leave Saturday night. I decided not to go to the Seattle Womxn’s march, but do the Port Townsend one and asked her to join me.

We went out to breakfast and then to our small downtown. I no longer have television and look at news sites daily though a bit erratically, so neither of us had a pink hat. I wore my Mad As Hell Doctors t-shirt, my lab coat from working at the National Institutes of Health with the National Cancer Institute Patch, my Rotary name badge and pins gathered from going across the country trying to get medicare for all, single payer health care, from 2009 until now.

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Four bus loads went from our county to the Seattle march. We heard that the Bainbridge ferry was FULL. That is, they couldn’t not take any more walk on people. Another thirty people or more flew to the Washington DC march. And in Port Townsend, my guess is that we still had 200-300 people, women, men and children, people in wheelchairs, babies, gay, lesbian, straight, bi, trans, that marched from a small park downtown to the Haller Fountain. Galetea, naked statue at the fountain, sported a pussy hat.

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Our local organizer spoke and our House Representative, Derek Kilmer.

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Older women spoke about demonstrating over and over in their lives. A friend of mine called me up to help her sing Holly Near’s Singing for Our Lives, making up new verses on the fly. They invited people to speak.

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I spoke: “I am one of your local doctors. I want to be able to treat anyone who comes to my clinic. We are one nation: health care for all. No discrimination: medicare for all.”

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Home then, and tired. My daughter has decided she wants to learn guitar, to play while people sing. I taught her basic chords and basic strumming. We sang Jamaica Farewell. She picks it up immediately, after all of those years of viola. And she will take one of my father’s guitars back to college.

And this is amazing: https://www.nytimes.com/interactive/2017/01/21/world/womens-march-pictures.html?smid=fb-share

Blessings all around.

Physicians for a National Health Care Program: http://www.pnhp.org/

https://dailypost.wordpress.com/prompts/successful/

Watercolor

This is for the Daily Post Prompt: retreat.

I have been changing the art in my clinic with the seasons. This is by my mother, Helen Burling Ottaway, and is currently up in the clinic. This is her largest watercolor, of the Olympic Mountains, painted in the last few years of her life.

A retreat into beauty….

Thanks

The photograph is from Thanksgiving in 2007, a friend using my camera. That is me and my daughter dancing. She was good at that lift! It’s mostly timing, rather than body weight. She jumps at the same time as I lift — and I’m jumping too!

My daughter called last night, stranded in New York City, the bus company she had set up with turning out to be very fly by night. But her brother got her a train ticket and she ran for Penn Station and now is with family! Hooray! I am thankful!

On death and feelings

When my mother was dying of cancer, she did not want us to cry.

So we didn’t. We had her at home in hospice for nearly six weeks and we did not cry. Almost.

My sister called me. “I started crying today, at the kitchen table.” My mother was in another room in the hospital bed. “Everyone left. No one stayed with me. Everyone left.”

I didn’t cry but when people called to say how were things, I couldn’t speak. I sat there with the phone, silent. Because what I wanted to say was my truth and I knew very well that that was not what they were calling to hear. So I did not speak.

After my mother died, time passed. I felt…. many things, but the strongest one was “I wish my mother had let me cry.” We did what she wanted. But I wanted to cry.

My sister got cancer and fought it ferociously. She refused hospice until the last week. I flew down three times in the last two months.

Six days before she died, her friend and I were helping her. “I’m sad!” said my sister.

“Don’t be sad.” said the friend.

“It’s ok to be sad.” I said. “What are you sad about?”

My sister started crying: “I won’t be at my daughter’s high school graduation! I won’t see her get ready for prom! I don’t want to leave her!”

“You won’t leave her.” I said. “You will be there. Not in this form.” I meant it absolutely.

“I want to stay!” she said.

“I know.” I said. “I am so sorry.”

With my sister, I did not do what she wanted. I thought of my mother and that I wished she had let me cry. With my sister, I tried to listen to what she wanted and listen to what I wanted. I tried to be honest with her. She even got mad!

But… I watched her go in the cancer bubble. Where fewer and fewer people were being honest. They were afraid. They did what she wanted. They wanted her to be happy. And she tried so hard….

When I had arrived for the last visit with my sister, she was sitting with my cousin. I hugged her. She was not speaking much. I asked if she would like me to sing something and she nodded. I started singing “I gave my love a cherry”, a sweet lullaby. My sister shook her head, angry and fierce. I studied her. “How about Samuel Hall?” I said. My sister smiled and nodded. I started singing “My name is Samuel Hall.” It is about a man who is going to the gallows for killing someone and he is entirely unrepentant and angry. My cousin looked at me, startled. “I haven’t thought of that song in years,” he said. We both sang it to my sister. “To the gallows I must go, with my friends all down below, damn your eyes, damn your eyes.” That was the right song, angry, resisting, raging. “Hope to see you all in hell, hope to hell you sizzle well, damn your eyes, damn your eyes.”

I flew back to work three days before my sister died. I am told that she was scared when she died. “I said, don’t be scared.” said a friend.

Why not? I thought. Why can’t the dying be scared, be anxious, be angry? Why are we afraid to let them? I would have said, Why are you scared? And I would have said, I am scared too. And sad. And angry.

I told my counselor once that my husband was on the couch, angry, and I had to leave the room.

“Why?” she said.

“I am afraid.” I said.

“Why?” she said.

“I am afraid he’s angry at me.” I said.

“So what?” she said.

I thought, so what? “I want to fix him. I want him to not be angry.” Even if it isn’t at me.

“Why can’t you stay in the room?” she said.

I practiced. I stayed in the room. He was angry, grumpy, acting out. It’s not my anger. I don’t have to fix it. It may be just or unjust. Does it really matter? It is his anger not mine. I can stay present.

A friend said that his friend was dying leaving small children. “He was so angry that almost all his friends stopped visiting.”

A man and his sister are not speaking four years after their father died because they disagreed so strongly about how his lung cancer should be treated.

An elderly woman in the hospital agrees to go home for care with her son when he is present and with her daughter when she is present. When neither is present she will not make a decision.

A woman says to me that she is angry that hospice didn’t tell her which drug to give at the end to keep her friend from being anxious.

I hope that we learn to stay present for the dying and for the living. For all of the “negative” emotions. I see most of my hospice patients want LESS medicine rather than more. As their kidneys fail, the medicines last longer. They do not want to be asleep. They may cry. They may be angry. They may be unreasonable. Why should they be reasonable or nice or peaceful?

We want most to be loved entirely. Even when we are sad or whiney or angry or anxious. Who wants to be left alone when they are afraid? I hope we all learn to stay present.

And when we were alone, in that last three days, my sister said “I’m bad!” I said, “You are not bad. You’ve done some really bad things.” She said, “I’m sorry.” I said, “I love you anyway.” And she lit up like a buddhist monk, like an angel. And we both cried and I am so glad I was there.

small child

my small child was locked under rock for years

she came out shy reluctant distrustful

you are special, the first adult in whom
she recognized another small child
locked in and called you
out to play

and we played hard

now she stomps her foot at me
“He does not play fair! He won’t come to my house!
He makes all the rules! He doesn’t listen!”

yes, bear, I know

time to go home, small child
you have had your first playmate
since you were locked away
but he is still locked in a dungeon
of monsters and zombies
you unlocked him for a little while
just a tiny bit

but he has decided not to play
he is locked down

come, small child

she is in my arms, head on my shoulder
sucking her thumb, crying
until she is too tired
and falls asleep

she will always love you, you know

anything, to have someone to play with
she let you make all the rules
for a long time

but now she wants
someone who will play fair
and share the rules
and love her back

 

12/2015

death in childbirth

When I was in residency, one of the obstetrics-gynecology faculty asked us, “Women died in childbirth. What did they die of?”

We were silent. Stumped. Infection? Well, when there was no infection control and the male physicians went from room to room with no hand washing, yes… but….

Preeclampsia? No. Not that common. Eclampsia? Ditto.

“What if a woman is in labor and the baby is stuck? What do they die of?”

Ick. “Bleeding?”

“The uterus contracts until it ruptures. It contracts until it is thinner and thinner. If there is fetal malposition or a hand presentation or transverse or certain breech positions, the uterus ruptures and both bleed to death.”

We were all silent.

When I hear people bemoaning caesarean section and too much surgery and too many interventions…. I remember what women died of. All the stepmother stories. In the 1797 diary I am reading, the “lady” dies of a fever. She is 24 years old. There is no surprise, just sorrow. The author writing is the same age and grew up with her and grieves, but goes on.

We would like to think this is in the past, but it isn’t. It still is going on, right now, inΒ  poverty stricken areas and war zones where the hospitals have been destroyed, the medical people have left, there are no services…

When I was still delivering babies, I would tell patients: my ideal labor plan is the baby comes out and I hand it to you. And the placenta comes out and the baby nurses and I don’t seem to be doing much. But that is not always what happens. I do not have control nor do you. I will only intervene if I think it is your life or the babies life or both….

http://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/1471-2393-14-43

http://www.msf.org/en/article/perils-childbirth-democratic-republic-congo

http://www.who.int/maternal_child_adolescent/documents/childbirth/en/

http://www.who.int/mediacentre/factsheets/fs348/en/

Donate:Β  http://www.doctorswithoutborders.org/

The picture is me on my maternal grandfather’s lap. I was one very lucky baby. My mother had tubuculosis through the pregnancy. She coughed blood in her 8th month. If there had not been medical care and a Tuberculosis Sanitorium to be born in, I would not be here.

 

Art at Quimper Family Medicine

I change the art at clinic, these for the summer. We had four reproductions up before, of alchemy paintings from the 1400-1600s. I thought they were creepy but also interesting and beautiful.

The painting on the left is by my mother, Helen Burling Ottaway, of my sister, Christine Robbins Ottaway. On the right is an oil by an artist that I don’t know. It looks like my father. I inherited art, but I keep finding beautiful pieces. At least I can display a little and rotate them with the seasons…

 

 

 

Black lives matter

My family moved from upstate New York to Alexandria, Virginia when I started high school. My mother, Helen Burling Ottaway, took life drawing classes at the community college to meet other artists and because she would have a model. More than one.

She met Michal Platt and took classes with him. He pushed her. My mother did tiny etchings and fantasy drawings and big drawings and watercolors. Micheal wanted her to do powerful drawings. So she did. When he had to be gone for a day from the class, he would have my mother fill in teaching.

I have this picture hanging in my clinic. The title is “One fist of iron”.

The stages of grief for the recent deaths include denial, anger, bargaining, grief and acceptance. It is not a series one goes through. We do them over and over, going from one to another, like a spiral, a whirlpool, a tornado. Black lives matter, police lives matter, I wish my mother were still alive.