Category Archives: rural doctor

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S is for sloth

S is for sloth, the sixth of our seventh sins.

I took the photograph of my daughter a few weeks ago. She can’t be accused of sloth, though, because that was the day after a 12 mile mountain bike race. She came in first in the women’s 18-26 division. She also came in last, because she was the only one….

Dictionary.com at present:
1. habitual disinclination to exertion; indolence; laziness.
2. any of several slow-moving, arboreal, tropical American edentates of the family Bradypodidae, having a long, coarse, grayish-brown coat often of a greenish cast caused by algae, and long, hooklike claws used in gripping tree branches while hanging or moving along in a habitual upside-down position.
3. a pack or group of bears.

Webster 1913:
1. Slowness; tardiness.
These cardinals trifle with me; I abhor This dilatory sloth and tricks of Rome. Shak.
2. Disinclination to action or labor; sluggishness; laziness; idleness.
[They] change their course to pleasure, ease, and sloth. Milton.
Sloth, like rust, consumes faster than labor wears. Franklin.
3. Zool. Any one of several species of arboreal edentates constituting the family Bradypodidae, and the suborder Tardigrada. They have long exserted limbs and long prehensile claws. Both jaws are furnished with teeth (see Illust. of Edentata), and the ears and tail are rudimentary. They inhabit South and Central America and Mexico.

Just think of meeting a sloth of bears, eating blueberries, in the summer… I would not feel slothful then. And looking at the examples from Webster 1913, are we more slothful and sloppy with language than Franklin and Milton?

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Sloth is a sin… but my daughter earned her rest…. and we all need to relax and rest sometimes and change our course to pleasure, ease and sloth…..

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R is for ridiculous

Ridiculous. Silly. I can’t do S for silly because another of the 7 sins starts with S.

My sister and I could be so silly together. I bought the ridiculous Dr. Suess Christmas hat one year. On Christmas morning my sister wore it and then played with a Sesame Street style puppet. A monster puppet, where you could put different arms and eyebrows and eyes on for different moods. She and the puppet had a discussion about which arms the puppet would wear! And then she put all the velcro monster parts on her cashmere sweater! Ridiculous!

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The last photograph is my sister with her daughter, being goofy and ridiculous. My sister died in 2012 of cancer…. I hope she gets to continue to be goofy sometimes on the next plane of existence and I miss being ridiculous with her!

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Q is for querulous

Welcome back to 7 sins and friends…. Have you ever felt querulous?

1. full of complaints; complaining.

2. characterized by or uttered in complaint; peevish:

a querulous tone; constant querulous reminders of things to be done.
Querulous is like a sophisticated version of whiny.
I used it in an alphabet poem, for querulous quail. And the truth is that I thought of myself and my sister as the quail. Right before that was One old orangutan’s pompous pronouncements were being ignored by many merry meercats. My sister and I and our cousins again… and the orangutan was my father. My mother did the illustration…. and it does look like my father when he was in THAT mood….
Alphabeasts

ambulating antelopes
bellies bearing beer
carrying cantelopes
deride damp deer

elegant elephants
feeling fitly fat
give generous gifts
handing hippos hats

ignorant iguanas
jealously jeer
keen kindly kites
lilting laughing leers

many merry meerkats
nearly never notice
one old orangutan’s
pompous pronouncements

querulous quail
reject reports regarding
shimmering snow snakes
tearing through tunnels

undulating ungulates
veer vivaciously
wondering why whales
xerox xylophones

yellow yaks yell
zip zap zoo!

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fraud in medicine: cow thymus guinea pig

We are making a change in clinic. We ask all new patients to bring ALL the pills they take. Prescription, vitamin, supplement. Most of them don’t. So now we are telling patients that they need to bring all pills or they will be rescheduled.

I want to know what my patients are taking. My town is a delightful spectrum mix from very conservative to very liberal and some libertarians thrown in. But I look at the ingredients of the bottles.

With prescription medicines, people will say “I am on metoprolol.”

“What strength?” I say, “And is it the short acting, middle or long acting?”

Some patients: “Uh…. it’s blue. It’s a small blue round pill.”

Eye rolling would be unprofessional. I pick the lowest dose and type in “unsure dose”. “Bring it next time.”

I examine vitamin bottles. Some contain multiple herbs as well as vitamins. Most people don’t seem aware of this. Sometimes people have four different vitamins with vitamin A in them. “The fat soluble vitamins A, D, E and K can build up in your tissues and people have managed to kill themselves. I would recommend you take less then you are taking.” And then there are the high dose vitamins: one with 3999% of the recommended daily allowance of vitamin A. Hello. Why is this being sold? I guess people have the right to take things that can kill them. But I wish they wouldn’t.

Supplements. I read the ingredients. One ingredient is cow thymus. “This has cow thymus in it.” I say. Medicine seems a bit vague on what the thymus does, though it is involved with myasthenia gravis: http://www.mayoclinic.org/diseases-conditions/myasthenia-gravis/multimedia/thymus-gland/img-20007802

“Oh.” says my patient.

“I am very unenthusiastic about taking cow thymus.” I say. “Unless you are working with a naturopath who has prescribed it for a compelling reason. Who prescribed it?”

“Uh, it’s not prescribed. It’s made by a good company.”

Right. Like I trust corporations. Scamming thieves and liars. Sell anything that isn’t nailed down in pill form. Including cow thymus.

My medical philosophy is as few pills as possible. Prescription, vitamin or supplement. Eat food, exercise, make friends, work well, be kind to yourself and others and avoid pills unless necessary. We don’t know how cow thymus and metoprolol interact. The FDA considers supplements to be natural, like a carrot. A pill is not a carrot. It doesn’t grow on a tree or in the ground. It has to be made by people. The supplement companies do not have to do any testing for medical safety and efficacy and I frankly hate the pills with multiple herbs in them. They have to use ingredients that are “generally recognized as safe” which is pretty lukewarm: http://www.fda.gov/Food/IngredientsPackagingLabeling/GRAS/. Also, kidney failure is on the rise from too many pills. Everything is metabolized by either the kidneys or the liver and kidney failure is in the top ten causes of death in the US.

And I don’t want to be a guinea pig. I don’t want to be the personal home chemistry trial of cow thymus plus metoprolol. No way. And I will bet that you don’t want to be a personal home guinea pig either.

I took the photograph with a zoom lens looking down from the dock in Port Townsend Bay in 2014.

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P is for pride

Pride is the fifth of the seven sins, in our seven sins and friends.

Which of the following is a sin?

1. a high or inordinate opinion of one’s own dignity, importance, merit, or superiority, whether as cherished in the mind or as displayed in bearing, conduct, etc.
2. the state or feeling of being proud.
3. a becoming or dignified sense of what is due to oneself or one’s position or character; self-respect; self-esteem.
4. pleasure or satisfaction taken in something done by or belonging to oneself or believed to reflect credit upon oneself:civic pride.
5. something that causes a person or persons to be proud: His art collection was the pride of the family.
6. the best of a group, class, society, etc.: This bull is the pride of the herd.
7. the most flourishing state or period: in the pride of adulthood.

Two quotations come to my mind:
Pride goes before a fall.
Death be not proud.

Pride goes before a fall: Proverbs 16:18, King James Version, Pride goeth before destruction, and an haughty spirit before a fall.

Here is the whole chapter: http://www.christianity.com/bible/bible.php?q=Proverbs+16&ver=kjv

Proverbs 16:5 is also relevant. Every one that is proud in heart is an abomination to the Lord: though hand join in hand, he shall not be unpunished.

And then Death be not proud is from John Donne: http://www.poetryfoundation.org/poems-and-poets/poems/detail/44107

Death, be not proud, though some have called thee
Mighty and dreadful, for thou art not so;
For those whom thou think’st thou dost overthrow
Die not, poor Death, nor yet canst thou kill me.
From rest and sleep, which but thy pictures be,
Much pleasure; then from thee much more must flow,
And soonest our best men with thee do go,
Rest of their bones, and soul’s delivery.
Thou art slave to fate, chance, kings, and desperate men,
And dost with poison, war, and sickness dwell,
And poppy or charms can make us sleep as well
And better than thy stroke; why swell’st thou then?
One short sleep past, we wake eternally
And death shall be no more; Death, thou shalt die.

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I am ambivalent about pride. I have mixed feelings. I find it easier to be proud of my children than myself. I am aware of my faults. Also, when I am really proud of something, I am more liable to mess up! To say something arrogant, to not pay attention, to lose my keys, to hurt someone’s feelings not on purpose! An analyst wrote that in their household, whoever has the best week, the most accolades, has gotten a prize or had a really good week: that person is in charge of the cat litter box for the next week. I think that is so sensible, to keep everyone grounded and connected to the daily tasks and remind us that even if we do something brilliant, the cat litter box still needs attention and the bathroom still needs to be cleaned. It is hard to keep a swelled head while scrubbing the toilet. I am proud that my children both did chores every weekend and my son still pitches in when he is home from college!

And now… the cat is reminding me….

I took the photograph in 2012 and came across it yesterday. Sometimes we get lost in a fog of pride or fantasy or emotion……. service to others and basic tasks like cleaning ground us again…..

 

 

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sing for the girls

Sing for the girls who grow up in war zones.
Sing for the girls who grow up scared.
Sing for the girls who grow up abused.
Sing for the girls unprepared.

Sing for the girls who grow up with alcohol.
Sing for the girls who grow in broken homes.
Sing for the girls who don’t tell anyone.
Sing for the girls alone.

Sing for the girls who grow up beaten.
Sing for the girls who grow up raped.
Sing for the girls who care for siblings.
Sing for the girls who learn to hate.

Sing for the women who now look frozen.
Sing for the women who now look old.
Sing for the women who survived it anyway.
Sing for the women who told.

Sing for the girls who grow up broken.
Sing for the girls who break everything.
Sing for the girls who break the silence.
We are broken and breaking: sing.

I took the photograph at the US Synchronized Swimming Nationals in 2012.

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O is for open

O for open.

What does feeling open mean to you?

Dictionary.com lists 42 adjective meanings, including:
34. not constipated, as the bowels.

That one made me giggle, but I am thinking of open as in open to other people and open to discussion and open to change. Walking outside and seeing birds and deer and the spring here exploding in flowers and small new leaves opens me. I get tired in clinic and by the end I am grumpy and think: no more people. Ick, people. But I love clinic and miss it when I have been off and sick. I missed hugs from my patients!

With 42 different adjective meanings, think about how amazing it is that we think we know what someone means when they use the word open…..

 

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With all of the discussion generated by the US presidential election, I am also thinking about an open society. A friend said that we have to be open to discussion but we also have to listen to each other. And listen to feelings.

I think of Sweet Honey in the Rock singing “Would you harbor me?”

Would you harbor me?
Would I harbor you?
Would you harbor a Christian, a Muslim, a Jew
a heretic, convict or spy?
Would you harbor a run away woman, or child,
a poet, a prophet, a king?

The lyrics are here.

I took the photograph yesterday. I was trying to focus on my neighbor in the background, but I am open to seeing the grasses instead….

 

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N is for normal

N is for normal. How often do you feel normal? Are your feelings normal? Are mine?

I kept my books from when I was little and I have some of my mother’s too. Some we wore out. I am thinking of Nobody is Perfick, a book by Bernard Waber. The illustrations are fabulous as are the sentiments from a kid’s point of view. Peter Perfect is held up as a model to all the other children: he is polite, he says thank you, he says please, he doesn’t roll in the glorious mud….. but…. the ending is very satisfying.

Does normal mean average? No one is the perfect average. Does normal mean the cultural norm? Are animals normal? Maybe we are all normal all the time: if a sparrow is normal and a deer is normal and a cat is normal even when she is acting like there is a phantom in the house…. maybe we are all normal too….

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And since we’re on children’s books, I started playing with N words, inspired by another great children’s author….

Normal is nice, normal is nutty, normal is naughty and nasty and new. Maybe it’s nearly narcissistic to need to know that no one is not normal. It’s nasty to natter that Norman’s not normal. It’s naughty to name a normal nematode Abnormal Norma. Nodes newly known nearly never need normalcy. It’s not nice to knock nude nuts. Knight knapping is not as nice as night napping… nighty night!

Bernard Waber’s website: http://www.bernardwaber.com/

nematodes: http://entnemdept.ufl.edu/creatures/nematode/soil_nematode.htm

I took the photograph of my daughter and two friends at an October beach Hawaiian birthday party…Β  the coldest Hawaiian birthday party I’ve been to, so the girls were gathering wood for the fire.

 

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M is for mourn

M is for mourn. We mourn for losses. Mourning is part of being human and we have to give grief room and space. How can we love and feel intimacy without also feeling grief and mourning?

M

I wrote a poem the day my sister died. I had flown home four days before, after seeing her in hospice, 7 years of cancer. I flew home the day before her birthday. My birthday is three days after hers. She died the day after my birthday. It has now been four years.

An apology, a love note and a remembrance

I step outside into a fine mist rain.

I am enfolded in cloud.

The dog still wants to be walked.
The cats want their treats.
The bunny rattles her cage.
The fish will want feeding at the usual time.

My heart lies stunned in my chest.
The dog does not pull.
I walk measured.
He waits.

The rain comes harder.

I hope that where you are, is joy.

The crows harsh caws comfort me.
I answer.
They watch from the tree tops as we circle.

I am enshrouded in cloud.

We are back to the house.

I try to remember.
I have the birds.
I have the trees.

We go in.

first published on everything2.com with other poems for her here: http://everything2.com/title/An+apology%252C+a+love+note+and+a+remembrance

I don’t know who took the photograph. Probably my grandparents.