Category Archives: rural doctor

by

Stone heart

My mind is done and unsurprised. My heart a stubborn rock.
My heart does not give up: loves where it loves. It doesn’t care
about reality or whether it is derided or mocked.
My mind moves on and kicks my heart, wondering where
this tenacity stems from. My heart is done with tears.
It agrees to new friends and joys in dance.
When my mind says forget, my heart jumps and steers
my body into a warrior fighting stance.
My mind is cynical and laughs and derides my heart.
I let them fight back and forth every day.
I cannot reach an end unless I start
to honor my feelings, the heart must hold sway.
My mind moves on, ignoring what you do.
Yet my stubborn heart remains a friend, strong and true.

by

The New Old Time Chautauqua

Funny how our brains work. I think of going to the other computer and then think I will look in this one for a moment. I have photographs from years past of the New Old Time Chautauqua. I open the file of Nikon photographs. There are 28 subfiles. I go to July 2018. At the end of the file, here is this motley parade. The New Old Time Chautauqua with our local Unexpected Brass Band and Other Friends.

I didn’t “know” that these photographs were even on this laptop. At least, not consciously. These are taken at the fairgrounds, August 11, 2018, in Port Townsend, Washington.

The New Old Time Chautauqua is the last one on the road. They are fundraising to go work and play with the Blackfoot Confederacy in Canada and the US. There are too many people dying from fentanyl, so the Chautauqua is part of the healing process. They are fundraising as they hit the road. I wish all of them the best.

And here is the Unexpected Brass Band at THING last year. You can hear them even if you can’t see them!

To donate to the New Old Time Chautauqua, go here. No, I mean back there. Right.

For the Ragtag Daily Prompt: Chautauqua.

by

Frame

What is the tree and where is it?

I am still thinking about the Inflammatory Brain Disorder Conference.

The researchers and physicians are talking about the immune system as if it is broken in Long Covid and ME/CFS and the other illnesses, but I am not sure I agree. Maybe the immune system knows what it is doing. Maybe Covid-19 is a really really nasty infection and the immune system sends out antibodies to make us stay down, stay in bed, rest and keep from catching something else. Maybe an antibody that suddenly makes you weird will make you isolate and hide and not interact with the other potentially infectious humans.

Ok, the inflammatory brain disorders that destroy the brain, those are not adaptive. However, I’ve thought that MC/CFS was a “repair mode” since residency.

When I had my third pneumonia in 2014, I refused to admit to myself that I had chronic fatigue. It was sort of obvious. I went back to work six months after I got sick and seeing just four or five patients left me exhausted. I would come home and sleep on the couch. I also skipped breakfast, because I would go to sleep as soon as I ate. My blood sugar was fine and it was not a food allergy. It felt as if my body wanted to do repair work and wanted me to sleep while it was doing the repairs. I would sleep after lunch. For the next six months of work, I slept twelve hours a day and hoped that I would not have more than five patients. Also that I would not get sick.

We had everyone who had upper respiratory symptoms or a cough wear a mask and I wore one too, hoping to not get another pneumonia. That worked. I only got sick when I went to work in another hospital clinic system. I kept walking into rooms with patients with their masks off. I got Covid-19 in a mere five weeks there, after going a year at my clinic without getting it.

I spoke to a friend yesterday. She was talking about her damaged immune system. I said I didn’t think of it as damaged. With enough stress and infection, I think the immune system gets primed. And then it is as if it has PTSD: the immune system says, “Enough already! We are not going to LET you overdo and get sick again! We are putting you DOWN to sleep if you overdo!” It is an extreme version of “listen to your body”, as if the body is shouting. The immune system is hyperalert and goes all out if there is any threat or suspected threat.

Maybe we need to be more gentle with ourselves and each other. The US culture is so oriented to production and work and money as success. But is that really success, if we work 20 hours a day and drive our immune system to desperate measures?

Maybe we need to learn to relax. To take time off. To breathe.

And the talk about Mast Cell Activation Disorder said exactly that. We need to teach how to go from the sympathetic fight or flight crazy to the quiet, relaxed, parasympathetic state. That quiets the immune system down very nicely.

It won’t fix everything, I am not saying that. But it is something everyone can learn. Slow breathe, in five and out five. Practice.

Breathe.

______________________________

The tree is a Redwood and it’s in the Chimacum Woods Rhododendron Nursery. Not just rhodys and on the Olympic Peninsula.

by

BRAINS

On Thursday and Friday I spent six hours daily glued to zoom, for the Inflammatory Brain Disorders Conference. Speakers, both physicians and scientists and physician-scientists, from all over the world, spoke. The research is intensive and ongoing. They spoke about Long Covid, both the immune response and “brain fog”. They spoke about anti-NMDA antibody disorder (the book Brain on Fire) and now there have been over 500 people identified with that disorder and a whole bunch more antibody-to-brain disorders! They talked about PANS and PANDAS and chronic fatigue and Mast Cell Activation Disorder and about the immune system over and over. The new information is amazing and I need to reread all my notes. Psychiatry and Neurology and Immunology are all overlapping in research, along with Rheumatology, since these disorders overlap all four.

It is a medical revolution in the making.

Best news was that 96% of Long Covid patients are better by 2 years from getting sick. That is tremendously reassuring, though the number may change. And the definition of Long Covid is still being sorted out and we do not know if people relapse.

I felt that MY brain was MELTED by the end, but I managed to enjoy the Rhododendron Parade on Saturday and just puttered around the house on Sunday.

by

Fine fettle

Our giant salmon is in fine fettle
Stuffed with rhodys and not with nettles!

_________________

Taken at the Rhododendron Parade in Port Townsend, Washington, on Saturday, May 20, 2023.

For the Ragtag Daily Prompt: nettle. Gosh, telepathy or prescience or something. I took the picture two days before the prompt and those are the only photographs I took of the fabulous parade!