Vital signs II

For the Ragtag Daily Prompt: vital. For me, vital brings up vital signs. I wrote this poem in 2006. Pain was made the fifth vital sign in 1996. I have written about it here. In June of 2016, the American Medical Association recommended dropping pain as a vital sign. The idea that we should be “free” of pain has not died yet and the latest CDC report says that the overdose death rate for women has risen a horrifying 240% from 1999 to 2017. That report is here: Drug Overdose Deaths Among Women Aged 30–64 Years — United States, 1999–2017. My poem is still relevant and we still have to change our ideas about pain.

Vital signs II

Pain
Is now a vital sign
On a scale of 1:10
What is your pain?
The nurses document
Every shift

Why isn’t joy
a vital sign?

In the hospital
we do see joy

and pain

I want feeling cared for
to be a vital sign

My initial thought
is that it isn’t
because we can’t treat it

But that isn’t true

I have been brainwashed

We can’t treat it
with drugs

We measure pain
and are told to treat it
helpful pamphlets
sponsored by the pharmaceutical companies
have articles
from experts

Pain is under treated
by primary care
in the hospital
and there are all
these helpful medicines

I find
in my practice
that much of the pain
I see
cannot be treated
with narcotics
and responds better
to my ear

To have someone
really listen
and be curious
and be present
when the person
speaks

If feeling cared for
were a vital sign
imagine

Some people
I think
have almost never felt cared for
in their lives

They might say
I feel cared for 2 on a scale of 10

And what could the nurses do?

No pills to fix the problem

But perhaps
if that question
were followed by another

Is there anything we can do
to make you feel more cared for?

I wonder
if asking the question
is all we need

I took the photograph yesterday with my cell phone. It was so gloriously sunny that the water really was turquoise and I did no photoshop changes.

Mnemosyne

I am reading The Female Trickster: The mask that reveals, by Ricki Stefamie Tannen.

Regarding Mnemosyne, she writes: “The power of memory was recognized in Ancient Greece by the goddess Mnemosyne who ruled over the Elysian Fields. The nine daughters of Mnemosyne and Zeus are the muses, with Thalia, the muse of comedy imaged with a Trickster’s mask as she playfully composed comedy and ironic poetry. The muses were women unto themselves. According to the myth, upon death a person makes a choice to either drink from the river Lethe or the spring of memory. If you drink from Lethe you forget your pain and all the lessons of your life and are reborn again on earth. Those who choose to drink from the spring of memory go to the Elysian Fields, where there is no strife or pain. The myth tells us that the path to psychological integration comes from a willingness to value and interact with memory. Those that repress memory are doomed to repeat it, over and over again.” (pp72-73)

This seems apropos both to my personal and professional life and also to US culture. Our President speaks like my stage IV substance abuse patients. He says things that are obviously lies, obviously not true, obviously refutable and yet to all appearances he believes his own lies entirely, even when he contradicts himself. He manufactures his own reality and just laughs when someone else disagrees. But my substance abuse patients crash: they eventually find that they are isolated with their own lies when they become so fantastic and bizarre that no one believes them any more. We are watching that play out.

Re my personal life, I think of my maternal aunt’s memorial. I wrote two memories for the memory book. One was about my father saying that she had perfect pitch. I did not know what perfect pitch was when I was little, but I knew from my father’s voice, the respect, that it was special and important. That he was envious. That he admired it. The second was about my aunt and uncle’s divorce, that I had seen them as a unit and liked both of them better when they turned into individuals.

My cousins wanted to use the first memory but not the second. They said that family wouldn’t like it. I thought about their request and finally said no. Use both or neither. They chose neither. And this pretty much illustrates why I have very little contact from a large part of my family. I want to remember the whole person, light and dark, love them all. And that is not what that part of my family wants. An old family friend has not spoken to me about my sister since my sister died 6 years ago. I asked her directly about it a few months ago. She wants to talk to me “only about happy memories of your mother, father and sister.” I respond, “Why don’t you ask me what sort of relationship I want?”

She was and is silent. So I am too.

It’s not a lack of love but it’s a difference in philosophy. I think it is crazy to whitewash the dead: how will our children understand their own dark feelings and impulses and mistakes if they think that their ancestors, grandparents, parents are angels? Why aren’t we honest as a culture? How can we expect our children to be honest with us when we lie to them? The curated lives on Facebook are an abomination, false, lies and look what we have in the White House.

I like the dark as well as the light. If we truly love everything in the universe, how can we not love the dark as well as the light? If each of us owned our dark sides, our dark impulses, the myth says that we will not enact them over and over each generation. Owning the dark, acknowledging our own dark does not mean that we have to act it out in the world and then lie to ourselves and others.

And now I want coal for my stocking: just a small piece, to remind me that I have not always, or will I ever, only be good.

brown water

For Wordless Wednesday. (But sort of wordy!)

We hiked part of the Chesapeake and Ohio Canal yesterday. It has rained tons in the last week, so the Potomac River is really really high and fast. The Billy Goat Trail is blocked off by the park service, partly flooded and not safe. My daughter pointed out how different the color of the fast river is than our Salish Sound.

It was a gorgeous day, sun, not very warm, birds, tow path and wild rushing river.

family escape

For the Ragtag Daily Prompt: family.

My daughter and I are out visiting my son and his girlfriend on the east coast. My son wanted ideas for Christmas, since he and my daughter know I have enough stuff. I suggested tickets to something: a play, music, something in the DC area.

They took us to Georgetown on Sunday and we did an escape room! We were in the prehistoric one and solved it before the one hour timer. Lots of clues and math and letters! It was great fun! We escaped being eaten by solving all of the clues and leaving the escape rooms, hooray!