Category Archives: rural doctor

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Cloudy with a chance of hope

This is for the Daily Prompts: hopeful and year.

I took this from the beach with my zoom lens: fog, clouds, lowering, indistinct. My daughter left for college in September and is home now…. well, sort of, except she is off with friends all over the place, including right now.

It’s been a cloudy and hopeful period, since September. It is the first time in 24 years that I have not had children or teens at home, and the first time in 28 years that I have lived nearly alone…just the cat. The cat is not happy with then young adults leaving. She blames me.

I am worried about the US Medical system, the corporate takeover where more and more physicians are employed and then have no connection to how their patients are billed. They also take no responsibility for people going bankrupt over medical bills. We physicians are as responsible for the mess of US Health Care as the patients are, as Congress is, for letting 1300 insurance companies use 500 billion dollars on administrative costs….And people say I don’t trust government healthcare….but don’t take away my mother’s medicare, the VA benefits, medicaid for the disabled and very poor or the healthcare for our active duty. And yet I see for profit companies like triwest: the government contracts my local VA care to them and I fought Triwest for a year to get them to pay me for my Veterans Choice patients. And they won’t pay me for the time we spent fighting to get paid, nor the interest for waiting on a payment for an entire year. Guess who got that money? The For Profit Contractor Corporation: Triwest. And Noridian, the local medicare contractor, held my payments for 6 months. They said my paperwork was wrong….turned out it had been wrong for six years but they frankly didn’t care until they were getting audited. So who paid the price? I did and you did. In rising costs and confusion and physicians quitting. Again, I did not see a penny for the time on the phone, for the time spent trying to ask Noridian why, after 6 years of payments, they were refusing my renewal…..and meanwhile I saw my patients and went further into debt. And do you think the bank corporation wrote off their profits? No, you laugh at that…..

But, you say, where is the hope? The hope is that I think we are at the point where enough physicians are quitting outright, enough Veterans Choice patients are calling their Congress People, the patients refuse to be patient any longer….and I am seeing more people fight for a single payer system, for a system where the money does not go to profit and administration while people die waiting for prior authorization and insurance corporations change the rules every week and refuse and refuse and refuse care…..I think people: patients and physicians: will wake up and change the system.

And that, Mr. Trump, is what I would do to make the US great again….

 

 

 

 

 

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Under the surface

For the Daily Prompt: mope.

Mope. We think we should not mope. Go down, be down, downer, don’t go there… but sometimes we have to let ourselves feel, and feel deeply, even if it’s not the popular feelings.

I was grumpy four days ago driving with my daughter for a skiing vacation. She gently told me not to grump at her. By the next morning it was clear why I was grumpy: an awful cold had come to visit and I was not going to ski. And I probably got it from her, but maybe not, and it doesn’t matter. I moped a little, but was mostly proud that I rested for two days and did not try to push through it, power through it, feel the burn…. I’ve done that too many times and then gotten really sick. I rested for two days and slept for twelve hours daily and moped a little. And yesterday I did ski for part of a day. Then we drove home, my daughter driving most of it, and I hurt all over by the time we got home….

If every feeling is a gift, a visitor, sent from the Beloved, as Rumi writes… welcome them all. This body is a guesthouse, says Rumi. Welcome moping and treat it gently and with kindness and understanding, as we all long to be treated….

The Guesthouse.

 

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The dead are with me

I am at the lake. There are younger people with me. We go to the graveyard. The earth is soft and loose. There are no markers or stones. We do not need them.

“I can feel the people in the earth.” says one of the younger people.

“Me too!” says another.

“Of course.” I say. I name the people under the earth and introduce them. The young people are amazed. I am surprised that they have never felt the dead. I think the cities and concrete and phones and television and computers: all of these must block the signals. But we never allowed electricity here. The phones don’t work. Candles, aladdin lamps, propane stoves and heat with wood in old cabins. Thin shacks where we hear the wind and water, and tents, lying in the embrace of the earth.

We leave but when we come back, the young start to reach down into the soft earth, arms length. “Did they die young?” one asks. “We want to know more.”

“You must be patient.” I say. “Don’t push the dead.”

Later I return a third time to sit quietly alone with the dead. Dark falls, moonless, overcast, no stars. I stand to return to the cabins and my flashlight dies. I know the paths well, but not the path to the graveyard. I tie up my long skirt and kneel. I feel the ground gently. Yes, I can feel the path. I start to crawl slowly, stopping to feel the packed worn earth. I think of wolves and cougars but none have been here for years. It is not cold enough for exposure. It is just dark and slow. The dead are with me and approve.

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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….

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birth

Reading about drugs

LSD
and that people re-experience the terrible trauma of birth

but wait: terrible trauma…

I had the grace and delight and sometimes terror
of catching babies, new and slippery and surprised
for nineteen years

they do not arrive traumatized

an older obstetrician
always gentle
when I would ask for help
deep calm and sometimes
he would wait for the newborn
and not rush us to the operating room

and if the child emerged
he would say “girl ears”
or “boy ears”
he always guessed
frequently wrong
his small tickle of humor
and the mother too busy at that moment
to notice at all
except that his voice was calm

I think of the one forming
in the womb
the sounds of mother’s heart and guts
dark and sounds
of father brother sister other

the first time I see
the new baby in clinic
I imitate the sound of the doppler
swish swish swish
and the newborn alerts, and knows my voice too

I think of the one forming
in the womb
and my daughter
who tried to come early
confining me to bed for three months
and adrenaline-like terbutaline
continuously
my hands tremble
my heart rate at one hundred
I knit to channel the figdets
six sweaters
and my daughter is worth it

I think of the one forming
in the womb
out of room
the space is too tight
can no longer stretch or kick
head down
ready

I think of the one forming
in the womb
saying now
I need more room
now and the cascade starts

we don’t know what starts labor
the baby or the mother
or both

now
I need more room
and the infant pushes towards the door
towards more room

and I have had
the grace and delight and sometimes terror
of catching them
slick and messy and bloody
as they emerge
into the light

open their eyes
and breathe
startled
at light and room and air