Category Archives: rural doctor

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hope molting and growing new feathers

A friend away a friend some day
a friend can’t stay all the day
a friend won’t pray a friend can’t play
not today is what they say
a friend they say a friend always
a friend who may return some day

in a way you might say
hope molts and regrows feathers today

I think my inner four year old wrote today’s poem. I am thinking about the song my mother taught me, very young, for when I was frustrated.

My sister and I loved this song and others, Samuel Hall and “I don’t want to play in your back yard, I don’t like you any more. You’ll be sorry when you see me, sliding down my cellar door.”

I gave a young friend a book of rhymes. He looked at me with some horror. “These are nursery rhymes.” I grin at him. “Look again. It’s a book of insulting playground rhymes, suitable for all occasions.” He looked at the book again and held on to it.

The photograph is from the National Museum of Women in the Arts again. Another fabulous painting that seems to fit my theme.

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how to protect codgers

A friend calls me yesterday, complaining that the new Covid-19 vaccine doesn’t prevent infection nearly enough for him to want to get it. He is in his 70s and says darn it, he’d still have a 60% chance of getting infected.

I thought about it and wrote back this morning:

Re the new vaccine the POINT is NOT to prevent infection, though it lessens it in codgers like me and you.

The point is that the vaccinated younger people shed a s–tload less virus if they get it, because their immune system kills it fast. This reduces the amount of circulating virus so that the codgers stop dying like flies. Also the codgers get less sick if their immune system recognizes B4 and B5.

Got it? Get the vaccine.

I am waiting for the top ten causes of death for 2021 to come out. Over one million US people have died of Covid-19. In 2020, there were between 300-400,000 deaths from Covid. That means that we lost 600-700,000 in 2021. If we lost close to 700,000 people, then Covid-19 would beat out heart disease as the number one cause of death in the US. When did that last happen? During the 1918-1920 influenza, the “Spanish” flu that has been traced to a chicken farm in the US midwest.

Here is a provisional and not final list: https://www.cdc.gov/nchs/data/health_policy/provisional-leading-causes-of-death-for-2021.pdf. Hmmm. The numbers are not adding up unless a lot of US people died of Covid-19 in early 2022. And cancer is higher than it’s ever been and creeping up on heart disease. But these are not the final numbers, sigh.

Here is a fascinating chart: https://www.cdc.gov/nchs/data/dvs/lead1900_98.pdf. If you scroll to the end, the top two causes of death in 1900 were pneumonia first and tuberculosis. Heart was fourth. Heart rises to first in 1910 but then pneumonia is back at the top in 1918-1920. I think that the heart has been number one ever since, in the US. World top ten is not the same.

This is not the first pandemic and it won’t be the last. It is horrible. I think that everyone is doing the best they can, though some responses seem saner than others. Remember the old doctor joke about what to do in a code (when someone’s heart has stopped). First: check your own pulse. It’s a corollary that if the patient is dead, you can try to bring them back, but you can’t make them more dead. Also, my latest Advanced Cardiac Life Support class, on line, told me that sometimes I do not have to do cardiac life support. Their example was a decapitated patient. Really? Ouch, doctor humor. But truly, if you are freaking out or want to scream at someone or feel like the world is nuts and you have to do something, first check your own pulse. Slow it down. Breath in four and out four. I can drop my pulse from 101 to 71 in 20 seconds, just by slowing my breathing. You can learn to too.

My recommendation is that if you are due for the booster, get it. And thank you for protecting me and my friend and the other codgers.

No, it is not snowing here yet. But codger seems to be a word for an old GUY. Humph. Would a grumpy hummingbird be a grummer? What is a female codger? I am using codger for any gender, to heck with it.

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welcome home

home home welcome home
home is where you are, Beloved
and you are everywhere

not in churches, not for me
I run outdoors, long to be free
you are everywhere I see

the beauty in the world
love and grief and pearls
small child dance and twirl

I have crossed the boundary
over and over again
Beloved, let me stay, friend

I’ve searched for you so long
Beloved, you make us so strong
look everywhere that’s wrong

home home welcome home
home is where you are, Beloved
and you are everywhere

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August 31, 2022

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Sing from the sea

This is another poem where I did not know where it was going when I started it. I was thinking about the sea and sirens and singing. My poems go where my heart thinks I should go, but I don’t know where that is until the poem is done. And it’s clearly a song and next I need a tune. And chords. And more practice.

I sing from the sea, from the sea, from the beautiful sea
tied to the mast, you won’t come to me

unplug your ears, unblock your heart
before it breaks and truly stops
listen to my lonely heart
we’ll make music and never part

I sing from the sea, from the sea, from the beautiful sea
hear my voice, listen to me

our hearts melt together like stone
in the depths of my volcano home
you shut your heart down, run away
lava strings like glass, all the way

I sing from the deep, from the deep, from the beautiful deep
small child calling, she still weeps

volcano boiling from ocean floor
new island built as lava roars
small child with faith as adult caves to fear
small child holds your heart dear

I sing from the land, from the land, from the new born land
don’t be afraid, take my hand

hope has feathers, a poet said
in the darkest time, hope is not dead
I morph to dragon, to kite, to bird
your resistance is so absurd

I sing from the air, from the air, from the smoke filled air
vision dark, can’t see where

circle in flight, hope you too
listen to the small child hidden deep in you
a promise is a promise, you know it’s true
I do not give up on you

I sing in the wood, in the wood, in the beautiful wood
five elements sing as all things should

In the wood in the trees
on an island in the sea
in the heart of the volcano
my heart is free

I sing from the sea, from the sea, from the beautiful see
no matter what happens, my heart is free

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I took the photograph at the National Museum of Women in the Arts, a painting by Shinique Smith.

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Exercise mets

Mets could be metastases, a terrible word in cancer. But this is exercise mets. I am half way through my pulmonary rehabilitation for pneumonia and getting stronger. So what is a met? “One MET is approximately 3.5 milliliters of oxygen consumed per kilogram (kg) of body weight per minute.” (from https://www.healthline.com/health/what-are-mets#definition).

Ok, that doesn’t seem very useful. I find this way more useful, a chart of how many mets are used for certain activities:

https://www.healthline.com/health/what-are-mets#examples

The treadmill I am using at pulmonary rehab tells me how many mets I am using. However, last time I turned it on and didn’t enter my weight. It uses 155 pounds, which is more than I weigh. I think that then the mets are wrong. It isn’t exact anyhow. The important thing is that I am improving and off oxygen! I am now up to 5.3 mets, going at 3.3 mph, on a 4% grade, for 40 minutes. Pulmonary rehab is twelve weeks, twice a week, with a respiratory therapist and a physical therapist.

My respiratory therapist asks my goals. To bicycle distance, hike across the Olympics, and to ski again, off oxygen. That means altitude. Once we are above 5500 feet, the body really starts noticing the thinner air. I am not there yet but I am so pleased to be improving.

On the chart, I am in the moderate exercise range. To bicycle, I would have to be able to sustain 8 mets. Not yet, not yet.

Being off oxygen (except night, flute, sustained singing and heavy exercise) is GREAT! The intrinsic problem has not been fixed, thought. Fully twenty specialists since 2012 have not figured out why I get pneumonia easily and how to protect me, other than masking and not working in Family Medicine or anything people intensive. It’s annoying, my career has been blown up. I don’t have much hope of an overarching diagnosis at this point, but I’m willing to keep trying. We don’t know everything in medicine and really, I do not think we ever will. It’s endlessly complex and fascinating.

I think the mets chart should be shared with patients. I had one couple who insisted that the woman had PMS even though she was postmenopausal. I scratch my head and continue to watch her. After months something made me suspicious and I order an echocardiogram. She had congestive heart failure, seriously reduced heart output. I promptly called the cardiologist and said, “This is new, she is on NO MEDICINES.” He saw her within a week. Sometimes things do not present in a straight forward manner. She felt much better once we got her heart functioning better. If a person is losing their ability to perform moderate intensity mets, they should see their doctor. It could be spending too many hours in front of a screen (turn it off, get up, go outside, walk daily!) but it could also be something else. Heart is the number one killer still.

Stay healthy and keep those mets up!

Ha. I did use the word certain, didn’t I? And one of my favorite exercises is dancing. Listening to this right now:

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patriotic lobster

…because the pants alone aren’t loud enough.

Another in my Outfits Inappropriate For Work series. It is difficult to type wearing my claws. Also patients would get distracted if I wore something too weird. I can’t think why.

I got the claws at a church sale yesterday. I was told they went with a game, “You’ve Got Crabs!” Turns out they don’t, but maybe they should! I went looking vaguely for a CD case for my car and got two: however they came with CDs. Everything from Cake to Spongebob Favorites to Johnny Cash to Disney Favorites. I am SET.

So who wants to play “You’ve got crabs!”?

Do you have an Outfit Inappropriate For Work? Is a Silly Selfie a Silthie?

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flying dream

I dream I am Superman flying, but I am still me and female too. It is night and I fly over a beautiful bay, with a bridge at the opening of the bay. Cars are crossing. The people on the bridge call me down, calling β€œHelp!” I fly down. β€œThere are people in the water below the bridge! What are they going to do! Stop them!” I fly down to the water. β€œCome in,” say the people in the water. β€œThe water is warm!”

I join them in the water. It is warm and the bridge is beautiful. I say, β€œThe people on the bridge are scared of you.” The people in the water say, β€œWe just like the water. They are silly. They should join us. We won’t hurt them.” I thank them and fly back up.

I say, β€œThe people in the water just like the water. They say they won’t hurt you.” The people on the bridge say, β€œNo, no! They will hurt us. We don’t want them in the water! They might blow up the bridge!” I shrug. β€œWell, the water is fine. I am going back there.” I fly down and join the people in the water.

I wake up.

For the Ragtag Daily Prompt: cape.

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flight

Cormorant, I think.

About to take flight.

A good take off point.

It takes five years for bald eagles to fully mature. This one is close.

And a great blue heron in flight in the fog.

For the Ragtag Daily Prompt: flight.