Category Archives: rural doctor

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Chronic pain #I forget

The CDC has a new set of recommendations for chronic pain.

I will write about them. I have to read them first. Hurts too much, right now, the election, and all the pandemic fighting. Stress people and you see what they are really like.

My church has melted down into a huge fight. I was in a chorus singing instead of being in a meeting. Apparently there is a group that says brown people have “taken over” the national organization of the church. Um. Hello. That is discrimination. Does the color of the skin matter if it is a good leader? Why are people insane? I filled out a county survey on drug use today. I know we have methamphetamines and heroin in our high schools because patients have told me. But then I get to the race question. What race am I? I checked OTHER and wrote HUMAN. The race bullcrap is NOT SCIENCE. I haven’t done any genetics testing. I DO NOT KNOW WHAT RACE I AM THOUGH I LOOK WHITE.

It is important for medicine in that there is proven discrimination with less screen health services offered to “brown” people, whatever the heck “brown” people means. I wish the heavens would turn us all the same color over night. Or perhaps blind us. That is not nice of me and I do not care.

I am glad that this horror came out in my church. Because now the discrimination is out in the open. And the committee has sent out a message saying NO. We WILL stay part of the national organization. We WILL not give in to this discrimination. AND I SAY HOORAY AND BLESSINGS ON THEM.

Here is the new CDC set of recommendations for chronic pain: https://www.cdc.gov/mmwr/volumes/71/rr/rr7103a1.htm . You can read them yourself.

I read to this sentence so far: “Approximately one in five U.S. adults had chronic pain in 2019 and approximately one in 14 adults experienced “high-impact” chronic pain, defined as having pain on most days or every day during the past 3 months that limited life or work activities (5).”

Part of me is horrified and part of me is calm. Because pain is a part of life. Pain, love, joy, fear, it’s all part of our emotional evolved systems to survive, right? If God is love, God is also pain and fear. It is not a split. It is both.

This song is a love song. But to me, it’s a love song from heroin to a woman. One lovely day, a place where there is no pain. There will be pain on the return, the withdrawal. I have patients say, “You need to get me pain free.” My reply was “I will not get you pain free. Pain free is dead. Or at least, they can no longer tell me if the next form hurts.” In this song, “she won’t let on, that the feelings have got so strong.” Addiction, opioid overuse.

I took the photograph of Elwha yesterday. He is my relaxation mentor.

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We want to believe

My cousin said to me once: “We want to believe what we want to believe.”

This was right before Mr. Trump was elected President.

After my cousin said that, I was unsurprised that Mr. Trump was elected. He was elected out of fear and anger and shame and grief. He was elected by people who are afraid that people rising out of discrimination will take things from them. Lower their standard of living. They are afraid that they will have to give things up.

A friend was working on my boat. He said that if I paid in cash, it would be less. Because, unspoken, he would not report the income. I thought about it. I said, “My medical practice is mostly medicare and state insurance. That is paid for out of our taxes: yours and mine. Therefore I am giving you a check and I don’t care if it costs more.”

There is a big culture here of not paying taxes. Cheat the government. Pay cash to each other, nod, nod, wink. It is tempting, takes a percentage off what I pay. But…. the people who I know are doing this are mostly conservative. They say drain the swamp. They say the government is cheating us. But THEY are cheating all of us.

I asked my cousin why he and my maternal family believed a story masterminded by my sister. That my father and my neice’s father and I were villains. One of the villainies was the our grandmother’s money had paid for MY graduate school but not my sister’s graduate school.

But that is not true. My grandmother paid four years of medical school tuition. 21K. I paid my own loans.

After my grandmother died, and then my mother died, my father used “my grandmother’s money” to pay off my sister’s graduate school loans. 36K. My parents also cosigned on a house, that my sister walked away from. They wrote 30K off thier taxes that year selling it. My father bailed her out of 7K on a work credit card. My father called me crying when she bullied him out of another 30K for another house. And that is when I said to her ENOUGH. I refused to visit for a year: until she went into hospice for her cancer. I visited three times while she was in hospice. We made peace. But she did not tell anyone else the truth.

I said to my cousin that I could send the bank statements showing that my father paid for my sister’s graduate school. That is when he said, “No. We want to believe what we want to believe.”

I thought really? So you want to believe my sister because she is dead. We will not speak ill of the dead, so you are ok with me and my father and my niece’s father being villainized and you will not even look at the lies.

VOTE and VOTE against FEAR, SHAME, DISCRIMINATION, ANGER AND GRIEF. We have to stand up. I loved my sister even when she was dishonest and bounced 1000$ worth of checks in my small town with people I knew. My father got threatening phone calls and he paid. That was the last straw for me.

So guess which politician stirs up fear and hate and discrimination and anger and grief? Well, honestly, both sides are guilty of that, but I stand against discrimination. We all shall rise up.

Love and Blessings and Peace you.

The photograph is on one of the last three visits to my sister. She died in March 2012.

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defiance

I am listening to the Offspring today. Because I have a friend who is not behaving like a friend.

It is what people do that matters, not what they say. They can say they are my friend all they want, but if they treat me badly, I will walk.

The Offspring are fabulous for defiance. Though I need to change the genders on this one.

And not only that: they are fighting opioid overdoses and death:

Bravo, Offspring. Blessings and peace you.

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gently

I try to be so gentle with you
trauma drama boy

I know just what it’s like
though mine is not the same as yours

you run away, though
again and again

saying that you would never try
to hurt me ever

that is a shut down
really

since you disavow all intention of hurting
you do whatever you want

your attitude is that if I am hurt or sad
it’s my own fault

you take no responsibility for failures
as a friend

trauma drama boy, you run away
once more

and this time
I’ve had enough

This time
I let you go

Beloved bless you and keep you
for the days you have left

sending love
goodbye

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Elephant

My daughter got the elephant in the mail yesterday.

She called me, very happy with it. “It has a TAIL! It matches the pillowcase. I love the fishy fabric.”

The back story is that when she was a baby, her father’s mother made her a pillow. It had two pockets. In the pockets were four small stuffed toys. Her older brother has one too. The toys were not exactly the same. Hers had an elephant.

When she got sick earlier this year, I start sending her care packages. I send the pillow with three of the stuffed toys. However, I don’t find the elephant.

She loves it but asks, “Where’s the elephant?”

“I’m still looking.” The elephant is pink, with fabric ears that are different from the body. I find it! She is coming here for a month, so I don’t mail it. She is very pleased with the elephant.

It goes AWOL before she flies back to work. “Check the tent, mom.” She stayed in the tent in the back yard with two of her friends. I take the tent apart. No elephant. I check the sleeping bags. I sweep under her bed and search the house. As my daughter says, my house has a lot of hiding places and the cats like the elephant too. No elephant.

So for her birthday I make one. I remember how it looks and I make it while watching some continuing medical education. It’s easier to hand stitch than to get out the machine. I have to buy a large bag of stuffing, because the store downtown only has one size. Never mind, maybe I will make more elephants.

I made her a pillowcase last year, with the whale/mermaid fabric and the fish. So the elephant matches.

And she likes it! Hooray!

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My daughter says I can’t make clothes for her, but pillowcases and elephants are great! A breakthrough!

For the Ragtag Daily Prompt: breakthrough.

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silence

You are silent.

I try a little more but I am tired. I am tired of drama, trauma drama. I dream and dream and dream. I dream that my ex touches a live bat. The bat changes in my dream, from a tiny brown nose bat to a huge fox bat with fur and stripes. It is unconscious.

“Don’t touch it! You touched it! Now we have to take it to the Health Department!” I am eyeing the bat and thinking of throwing something over it. A container. It’s huge.

My ex laughs. “No we don’t.”

“Yes we do! Rabies! It could have rabies! If we don’t take it in, you’ll need rabies shots!” Poor bat, I think, it will be killed to test for rabies.

My ex keeps laughing. “I’m not going to be tested, I won’t have shots, and the bat is fine!”

“WHAT!” I say, “No, you could die!”

I wake up. What was that dream about? Oh. It’s about you, refusing to test for Covid after being exposed. You said you would hike with me. “Not if you won’t test,” I say, “I can’t afford to get Covid again, I can’t be around you for 15 days if you won’t test.”

And you go silent.

And I try a little more and I let go. You will have to break the silence if you plan to keep your promises. Will you or won’t you? I am supposed to trust you. But people say trust me, and then sometimes they are drunk, and lying, and you can’t trust them. “I will never hurt you,” is a lie. Try this instead: “I will try not to hurt you and I will listen if you feel hurt.” And change, maybe?

Maybe.

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Dreams are funny. Fox bats ARE the largest bats in the world, but they do not have stripes: https://allthatsinteresting.com/giant-golden-crowned-flying-fox.