I only dress like this part time.
A friend took this with my camera at my request. Thank you, friend!
For the Ragtag Daily Prompt part time.
I only dress like this part time.
A friend took this with my camera at my request. Thank you, friend!
For the Ragtag Daily Prompt part time.
I keep reading bits about despair and about how a generation of children is being “ruined” by the pandemic.
Not so, I say. There is hope. We need to support each other to survive and then to thrive.
This generation WILL have a higher than average ACE score. If the Adverse Childhood Experience scale is from zero to eight, children in this time period will have at least one higher point than average and many will have three or four or more. Loss of a parent, a sibling, beloved grandparents during covid. Increases in domestic violence, child abuse and addiction. These are all part of the ACE score.
What does this do to children? They have survival brain wiring. They will do their best to survive what is happening. A friend and I both have high ACE scores, 5 or more, and we are both oppositional defiant. We showed this in different ways. He grew up in the same community. He escaped from home and knew all the neighbors. He walked to the local church and attended at age 3 or 4. He has lived in this community all his life.
His oppositional defiance showed up at home, where he consistently refused to obey. And in school, where he confounded and disobeyed teachers and passed anyhow.
My family moved every 1-5 years. I hated moving. I wouldn’t talk to kids in a new school for a year. It was very difficult. So my oppositional defiance was very very internal. I hid in books and in my head. In 6th grade I got in trouble for hiding novels inside the school book I’d already read. I also would just not listen and my respect for the teacher got even lower when she would be angry that I knew the answer to the question once she’d repeated it. I wasn’t listening because I was bored. She was the first teacher that I thought, well, she is not very bright. The next year they stuck me in the honors class and I stopped being bored, though I still questioned practically every opinion every teacher had. I wanted evidence and I did not believe it just because the teacher said it.
I am not saying that oppositional defiance is in every high ACE score. I don’t know that. Why oppositional defiance? Imagine you are a small child and you are beaten. There isn’t rhyme or reason. You can’t predict when the adult will be out of control. Why would you behave “well” if it makes no difference? You might as well do what you want, because nothing you do will change the adult. Or imagine you are a small child who is with one person, passed to another, then to another. You may not exactly trust adults after two or three repetitions. And you want to survive.
There is an increase in addictions, behavioral health diagnoses, and chronic illness in adults with a high ACE score. A researcher when I first heard a lecture about it said, “We think perhaps that addiction is a form of self medication.” I thought, oh, my gosh, how are we ever going to treat THIS? Well, we have to figure that out now, and we’ve had 30 years to work on it.
I was very comfortable with the oppositional defiant patients in clinic. I got very good at not arguing with them and not taking their behavior personally. They might show up all spiky and hostile and I might be a little spiky and gruff back: sometimes that was enough. I think the high ACE score people often recognize each other at some level, though not always a conscious one. With some people I might bring up ACE scores and ask about their childhood. Sometimes they wanted to discuss it. Sometimes they didn’t. Either was ok.
One thing we should NOT do is insist that everyone be “nice”. We had a temporary doctor who told us her story. Her family escaped Southeast Asia in a boat. They had run out of water and were going to die when they were found by pirates. The pirates gave them water. They made it to land and were in a refugee camp for eight years or so. She eventually made it to the US. She was deemed too “undiplomatic” for our rural hospital. I wondered if people would have said that if they knew her history and what she had been through. It’s not exactly a Leave it to Beaver childhood, is it? When she was telling us about nearly dying of thirst in the boat, my daughter left her chair and climbed on my lap. She was under ten and understood that this was a true and very frightening story.
We can support this generation of children. This has been and is still being Adverse Experiences for adults as well. Family deaths, job loss, failure of jobs to support people, inflation. Remember the 1920s, after World War I and the last pandemic, of influenza. “On October 28, 1919, Congress passed the National Prohibition Act, also known as the Volstead Act, which provided enabling legislation to implement the 18th Amendment.” (wikipedia). There were forces trying to legislate behavior, as there are now. The result in 1920s of making alcohol illegal was speakeasies, illegal alcohol, and violence. Some people acted wild after WWI and the influenza pandemic and some people tried to lock down control, by controlling other peoples’ behavior. It did not work then and it will not work now. The wildness is out of control grief, I think, grief dysfunctional and drinking and shooting and doing anything and everything, legal or not. We remember how the 1920s ended too. Let us not repeat that. Let us mourn and grieve and support each other and support each other’s decisions and autonomy.
I wrote this in 2017, about influenza. However, I think covid-19 can do the same thing. Part of long covid is letting the lungs really heal, which means infuriating amounts of rest and learning to watch your own pulse. Watching the pulse is easier then messing around with a pulse oximeter. The very basics of pulse is that normal beats per minute is 60 to 100. If your pulse is 70 in bed and 120 after you do the dishes, you need to go back to bed or the couch and REST.
From 2017: Influenza is different from a cold virus and different from bacterial pneumonia, because it can cause lung tissue swelling.
Think of the lungs as having a certain amount of air space. Now, think of the walls between the air spaces getting swollen and inflamed: the air space can be cut in half. What is the result?
When the air space is cut down, in half or more, the heart has to work harder. The person may be ok when they are sitting at rest, but when they get up to walk, they cannot take a deeper breath. Their heart rate will rise to make up the difference, to try to get enough oxygen from the decreased lung space to give to the active muscles.
For example, I saw a person last week who had been sick for 5 days. No fever. Her heart rate at rest was 111. Normal is 60 to 100. Her oxygen level was fine at rest. Her oxygen level would start dropping as soon as she stood up. She had also dropped 9 pounds since I had seen her last and she couldn’t afford that. I sent her to the emergency room and she was admitted, with influenza A.
I have seen more people since and taken two off work. Why? Their heart rate, the number of beats in one minute, was under 100 and their oxygen level was fine. But when I had them walk up and down a short hall three times, their heart rates jumped: to 110, 120. Tachycardia. I put them off from work, to return in a week. If they rest, the lung swelling will have a chance to go down. If they return to work and activity, it’s like running a marathon all day, heart rate of 120. The lungs won’t heal and they are liable to get a bacterial infection or another viral infection and be hospitalized or die.
I had influenza in the early 2000s. My resting heart rate went from the 60s to 100. When I returned to clinic after a week, I felt like I was dying. I put the pulse ox on my finger. My heart rate standing was 130! I had seen my physician in the hospital that morning and he’d gotten a prescription pad and wrote: GO TO BED! He said I was too sick to work and he was right. I went home. It took two months for the swelling to go down and I worried for a while that it never would. I dropped 10 pounds the first week I was sick and it stayed down for six months.
Since the problem in influenza is tissue swelling, albuterol doesn’t work. Albuterol relaxes bronchospasm, lung muscle tightness. Cough medicine doesn’t work very well either: there is not fluid to cough up. The lungs are like road rash, bruised, swollen, air spaces smaller. Steroids and prednisone don’t work. Antiviral flu medicine helps if you get it within the first 72 hours!
You can check your pulse at home. Count the number of beats in one minute. That is your heart rate. Then get up and walk until you are a little short of breath (or a lot) or your heart is going fast. Then count the rate again. If your heart rate is jumping 20-30 beats faster per minute or if it’s over 100, you need to rest until it is better. Hopefully it will only be a week, and not two months like me!
Feel free to take this to your doctor. I was not taught this: I learned it on the job.
I took the photograph, a stealthie, in June 2021, when I was still on oxygen continuously.
The latest issue of Family Practice Medicine has an article on patient satisfaction scores.
I remember my first patient satisfaction score VIVIDLY.
I am in my first family medicine job in Alamosa, Colorado. I receive a 21 page handout with multiple graphs about my patient satisfaction scores. I am horrified because I score 30% overall. I am more horrified by the score than the information that I will not receive the bonus.
I go to my PA (physician’s assistant). He too has scored 30%. We are clearly complete failures as medical providers.
Then I go to my partner who has been there for over 20 years.
She snorts. “Look at the number of patients.”
“What?” I say. I look.
My score is based on interviews with three patients. Yes, you read that correctly. THREE PEOPLE.
And I have 21 pages of graphs in color based on three people.
I am annoyed and creative. I talk to the Physicians Assistant and we plan. I call the CFO.
“My PA and I think we should resign.”
“We scored 30% on the patient satisfaction. We have never scored that low on anything in our lives before. We are failures as medical people. We are going to go work for the post office.”
“NO! It’s not that important! It is only three patients! You are not failures!”
“Three patients?” I ask.
“Yes, just three.”
“And you based a bonus on three patients? And sent me 21 pages of colored graphs based on three patients?”
“I think we should discuss the bonus further….”
I did not get the bonus. It was a total set up and I am not sure that ANYONE got that bonus. Much of the maximum “earning potential” advertised was impossible for any one person to get. You would have to work around the clock. They got out of paying us by having multiple bonuses that each required a lot of extra work…. They were experts in cheating the employed physicians. That became pretty clear and I was 5th senior physician out of 15 in two years, because ten physicians got right out of there. I lasted three years, barely. I knew I would not last when an excellent partner refused her second year of $50,000 in federal rural underserved loan repayment to quit AND stayed in the Valley working in the emergency room. I called the CEO: “Doesn’t this get your attention?”
“She just didn’t fit in.”
“Yes, well, I don’t think anyone will.” I asked my senior partner how she stayed. “You pick your turf and you guard it!” said my partner. I thought, you know, I hope that medicine is not that grim everywhere.
Unfortunately I think that it IS that grim and getting grimmer. Remember that in the end, it is we the people who vote who control the US medical system. If we vote to privatize Medicare, we will destroy it. Right now 1 in 5 doctors and 1 in 4 nurses want to leave medicine. Covid-19 has accelerated the destruction of the US medical non-system, as my fellow Mad as Hell Doctor calls it. We need Medicare for all, a shut down of US health insurance companies, and to have money going to healthcare rather than to paying employees $100,000 or more per year to try to get prior authorizations from over 500 different insurance companies all with different rules, multiple insurance plans and different computer websites. Right now I have specialists in four different local systems. The only person who has read everyone’s clinic notes is ME because it is nearly impossible to get them to communicate with each other. Two of them use the EPIC electronic medical record but consider the patient information “proprietary” and I have to call to get them to release the notes to each other. Is this something that we think helps people’s health? I don’t think so. I have trouble with the system in spite of being a physician and I HATE going to my local healthcare organization. Vote the system down and tell your congresspeople that you too want Medicare For All and single payer.
Physicians for a National Healthcare Program: https://pnhp.org/
Healthcare Now: https://www.healthcare-now.org/
I have had people say, but think of all the people out of work when we shut down insurance companies. Yes AND think of the freedom to start small businesses if we no longer have to fear the huge cost of insurance: Medicare for all!
I am blogging A to Z about artists, particularly women artists and mostly about my mother, Helen Burling Ottaway.
I find two copies of her resume. One is from 1991 and one from 1993. I will add the 1993 information, but it’s a LOT. My mother was prolific! She complained about getting ready for shows and I did not realize how very many she did! I am so proud of her. She died of ovarian cancer in 2000 and I do miss her still.
Helen Burling Ottaway
Del Ray Atelier
105 E. Monroe Ave
Alexandria, VA 22301
SELECTED SOLO SHOWS
1991 Nov Will have solo show at Bird-in-Hand Gallery, Washington, DC
1989 Sept “Cascades: Watercolors of Washington State”, Bird-in-Hand Gallery, Washington, DC
1988 Nov “Fantasy Etchings”, National Orthopedic Hospital, Arlington, VA
1987 Oct “Spirits to Enforce, Art to Enchant”, Fantasy Art, River Road Uniterian Church, Bethesda, MD
1986 Mar “Prints and Poems”, Poetry by Katy Ottaway, Martin Luther King Library, Washington, DC
1984 Nov “Forests, Flower, and Fantasies”, Sola Gallery, Ithaca, NY
Apr “Birdland and other Lullabies”, Pastels, Gallery West, Alexandria, VA
1981 May “Fantastical Bestiary”, Etchings and Drawings, Gallery West, Alexandria, VA
Mar “The Way of the Brush”, Watercolors, Gallery One, Alexandria, VA
TWO PERSON SHOWS
1986 Nov Two Person Show, “An Occasional Pair of Claws”, Fantasy Art with Omar Dasent, Gallery West, Alexandria, VA
1985 Apr Two person Show, “Figures and Foliage”, Pastels, Capital Centre Gallery, Landover, MD
1982 Nov Two Person Show, “The Four Seasons”, Gallery West, Alexandria, VA
SELECTED GROUP SHOWS
1990 Feb “Visions 1990” Westbeth Gallery, New York, NY
1989 Feb “Year in—Year out”, Studio Gallery, Washington, DC
1988 Mar “independent Visions III”, Metro Gallery, Arlington, VA
May Juried Show, Sculpture, The Art League, Alexandria, VA, Juror: Bertold Schmutzart
1987 Dec Juried Show: “The Best of 1987”, Martin Luther King Library, Washington, DC, Jurors: Dr.
Jacqueline Serwer, Sandra Wested, Robert Stewart
1987 Apr “Independent Visions, Fifteen Women Artists”, Metro Gallery, Arlington, VA
Feb “Portraits 1987”, The Art Barn, Washington, DC
1986 Oct “Juried Show, “Printmakers VIII”, The New Art Center, Washington, DC
Jan “Independent Visions”, Metro Gallery, Arlington, VA
1985 Dec Invitational, “Highlights of the Year”, Martin Luther King Library, Washington, DC. Jurors:
Linda Hartigan and Monroe Fabian
Nov Invitational, “The Macadam Nueve-Splintergreen Conspiracy Show”, Gallerie Inti,
Washington, DC. Curated by Omar Dasent and Ann Stein
Oct Juried show, “Printmakers VII”, WWAC, Washington, DC. Juror: Jane Farmer
Mar Invitational, “Mama, Don’t Let Your Babies Grow up to be Artists”, The Splintergreen
Conspiracy, Martin Luther King Library, Washington, DC. Curated by Omar Dasent
Mar “Shakespearean Images”, Hofstra University, Hempstead, NY
1984 Nov Juried Show, “Printmakers VI”, WWAC, Washington, DC. Juror: Carol Pulin
July Juried Show, “Printmakers VI”, WWAC, Washington, DC. Juror: Jo Anna Olshonsky
Oct Four Person Show, “Just Four”, Galerie Triangle, Washington, DC
“The First Great American Camel Show”, Gallery West, Alexandria, VA
1983 Mar Juried Show, “Printmakers V”, WWAC, Washington, DC. Juror: Barbara Fiedler
Feb Juried Show, “Artists – Art Historians: A Retrospective 1972-1982”, National Conference, The Women’s Caucus for Art,m Bryce Gallery, Moore College, Philadelphia, PA
1982 May Juried Show, “Woman as Myth and Archetype”, WWAC, Wshington, DC. Juror: Mary Beth Edelson
Feb Invitational, “Art is where the Heart is”, Gallery 805, Fredricksberg, VA
Feb “The Printmakers of the WWAC, The Torpedo Factory, Alexandria, VA
Jan Juried Show, “The Eye of Eleanor Monroe”, WWAC, Washington, DC Juror: Eleanor Monroe
1981 Oct. Juried Show, “Collage and Drawing”, WWAC, Washington, DC Juror: Jan Root
Numerous juried shows, the Art League, Alexandria, VA
Numerous group shows, Gallery West, Alexandria, VA
1967 B.F.A Cornell University, Ithaca, NW
1992-currently Teach Drawing and Watercolor, Capital Hill Arts Workshop, Washington, DC
Teach Art Class for Seniors, Recreation Department, Alexandria, VA
Teach etching workshops and watercolors at the Delray Atelier, Alexandria, VA
1987-1990 Graphic Artist, Al Porter Graphics, Washington, DC
1985 Fall Co-Director of Gallery West, Alexandria, VA
1982 Director of Exhibitions, WWAC, Washington, DC
1982 Director of Gallery West, Alexandria, VA
1981 Chair of Exhibitions Committee of Gallery West, Alexandia, VA
Taught watercolor classes at Washington Women’s Art Center, Washington, DC
Taught children’s art classes for the Arlington Recreation Department
1967-1970 Assistant Curator at the Ithaca College Museum of Art, Ithaca, NY
ATOZBLOGGINGCHALLENGE2022 #art #Women artists #Helen Burling Ottaway #ATOZCHALLENGE #Christine Robbins Ottaway #APRILATOZ
For more information about the #AtoZChallenge, check out this link.
I think doctoring makes one cynical. Or at least messes up the scale of normal.
Maybe there are Marcus Welby docs out there, but I don’t know any. Doctoring messes up one’s scale. A wound is compared to black horrifying gangrene to the knee, pain is compared to screaming delirium tremens or full thickness burns or heroin withdrawal, one in four adults can be diagnosed with a psychiatric disorder at some time in their life…. so then, what is normal?
What is normal for relationships? How many deeply happy marriages do you know? If half end in divorce, what are the odds?
Where is the line in love? Where is the line between loving the other person no matter what and wait, that is domestic violence. Where is the line for abuse? Do people agree on it?
No. They do not. What I think is behavior that is frightening may be normal behavior to my partner. Is it ok to drink until one is drunk? I don’t want to be around it. I saw enough of that shit at work. I deal with addiction daily. If someone wants to get drunk, they can choose to do that. But not around me. And no, I don’t want to date them. And if they are working themselves to death, is that ok? Well, I might be a tad hypersensitive to that, since I nearly managed that myself. So I don’t want to be around that either. That might be viewed as noble self-sacrifice. But at work, I see the caregiver die before the recipient of the care, all too often. Especially in older couples, where neither one wants to let anyone in the house to help….
….but then, some people do hear me. A woman thanked me last year for saying she should quit covering for her husband. She was afraid, but backed off. He is able to do more than she expected and he also is more respectful and kind to her. She thanked me and I got all shy and tongue-tied.
My definition of love is listening. Someone who listens and hears and lets me listen and hear. When each person can say what they are thinking and feeling and wanting and worried about…. because if only one person is speaking, if only one person is determining what the relationship is, it is not a relationship.
You could be a cat
A bit snotty
Refusing to share your thoughts
Keeping your secrets
Enjoying refusing to answer questions
Macavity the mystery cat
when something happens
He’s never there
You could be an elk
Guarding the herd
While the elder ladies
Lead it through the woods
At certain times of year
And want them
And they/we/I mew
And you find me
And we both enjoy it
I am a cat too
I will travel alone
If you won’t travel with me
I will find other music
If you won’t play with me
I enjoy it when you come round
I keep my claws sharp
Just in case I need them
If I long for cuddles and purring
That is my problem
I am a lady elk
Confident in the woods
I let you do the guarding and bugling
While I lead the herd
Up and over the ridges
The spine of the mountain
The spines of the dragons
Elwha and Sol Duc
I know them well
I hear you bugle
And think about whether this time
I will mew
I have found new forage
And the loggers are changing the forest
You bugle anyhow
Even if I am distracted
I like to work
But I like to mew too
Maybe we will come together
Now and then
My father read me T. S. Eliot’s Old Possum’s Book of Practical Cats when I was little. He loved Macavity the mystery cat, called the Hidden Paw. And my goodness, the cat outfits in this show are quite something!
This is a beautiful living cedar.
Unfortunately, the trunk, twenty feet high, had split in half in high winds. So now it was a very dangerous very tall living cedar that is going to come down and is right next to a house.
An expert was consulted. He said the tree could not be taken down intact. Each of the four tall trunks would have to come down individually. This is terribly dangerous, because felling trees is dangerous enough, but when you are up IN the tree, it is worse.
There are four men and me. I am there with a camera. I do not help at all, I just try to stay well out of the way.
When the last trunk fell, it swung towards me and they shouted “Run!” It had slipped of the trunk and can’t be controlled as well even though there was a cable and a machine pulling in the desired direction. I ran and I am still here, thankfully.
For the Ragtag Daily Prompt: WAR. I wish we were all just working and there was no war.
No names or faces, because you know, those loggers are shy and wild, right?
Written in 2009.
Set a torch to me
Why don’t you?
It’s not the tearing sound of fabric
A small rip
And now a tear
That I feel
It’s the torch
I’ve been here before
A job where the idealistic came
As moths to the flame
Because they had ideals
I watched and burned and rose
It’s the torch
The flames that rise
As the witch is burned
Tilts back her head
In ecstasy and knowledge
Eager to learn what she can
From these burning brands
In the burning we learn
In pain we learn
If we can remain open
Ashes fall to the ground
Buckets of water
Wash any remains to grey mud
Relief for the frightened
An example has been set
No but what stirs at night
Moon or none
What rises from the mud
Set a torch to me
Why don’t you?
And see what is created
I think I finally understand what I have been doing in clinic all these years. And not just in clinic. As a theory it explains both why patients, nurses, hospital staff and specialists really really like me and my fellow Family Practice doctors, particularly the males, and the administrators, really really do NOT like me.
I am on a plane flying to Michigan a few weeks ago. Double masked. N95 with another mask over it. Sigh.
A friend keeps saying that he can see into me. He can, but he can see thoughts. Not feelings. I am wondering if I see feelings. But I see the stuffed feelings particularly, the ones that people keep hidden. They are like clouds.
And then I think, oh.
I automatically scan any new person for their small child. The inner small child, who is often damaged and hidden. The small child is hidden under those stuffed feelings, which I think of as monsters. In Ride Forth, I am writing about pulling every monster feeling that I can find stuffed out and letting myself feel them. And that people do not like seeing me like that. Their monsters attack me!
Except that the monsters don’t attack. The monsters come to me and say, “Please, please, help me. I want out. The small child needs to heal.” The monsters lie their monstrous heads in my lap and weep.
Now WHY would I develop this skill? That is weird.
I develop it because my parents both drink. The myth in the family is that it was my father. But my mother’s diaries and also her stories make it clear that she drank heavily too. I think they were both alcoholics. And she told two stories about me trying to get someone to get out of bed to give me food as a toddler. As jokes. But it is not a joke. I have food insecurity. At every meal, I think of the next one and whether there is food available. My daughter has it too….. epigenetics.
I think that the only way I could love my parents was to have compassion for them. Once you see another person’s damaged small child, then how can you not feel compassion for them?
With patients I learned to be very very delicate and gentle about asking about the cloud. Just gently. Sometimes people open up on the first visit. Sometimes they shut tight like a clam and I back off. Sometimes they return the next visit or the 3rd or the 8th or after a couple years… and say, “You asked me about this.”
It’s nonverbal communication. The reason why I take the WHOLE history MYSELF at the first visit is for the nonverbal communication. When the person doesn’t want to answer a question, veers away from a topic, switches subjects: there is my cloud. That is where the hurt is. That is where the pain is.
The first cracks in the United States medical system collapse are appearing. Not doctors quitting, not nurses, but medical assistants. Here is an article about how clinics all over can’t hire medical assistants. Because there are tons of jobs, employers are offering more money, why would you do a job where you may well be exposed to covid-19 if you can do something else? And make as much money or more….
The cracks will widen. Ironically doctors are doing what I have done for the last ten years: “rooming” the patients themselves. Ha, ha, good may come out of it, after the disaster. Which is getting worse fast. If people don’t put their masks on and don’t social distance and don’t get vaccinated, I predict more deaths in the US this winter then last winter. Sigh. And in the US we will run out of medical assistants, doctors and nurses.
It is ok to gently ask a patient about that cloud. It is not polite to “see” it in a Family Medicine colleague or and administrator. I can’t “not see” it. I can’t turn it off. However, on the plane my behavior changed even before I could put all of this into words. The words are that I have to be as gentle with everyone as I am with patients.
And the trip felt so odd. I was putting this into effect before I had words. That is how my intuition works. But everyone, absolutely everyone, was kind to me on the trip. A Chicago policeman helped me in the train station and was super kind. It was weird, weird, weird, with bells on. It took me a few more days to be able to put it into words.
Problem intuited, after 60 years of study. Implementation of solution proceeds immediately. Logical brain struggling to catch up, but results satisfactory long before logical brain gets a handle on it.
Pretty weird, eh? I think so. My doctor said that an episode of Big Bang Theory could be written just by following me around for a day. I think it was both saying that I am smart AND that I have no social skills. But I have implemented the social skills program already. She’s just upset that I gave her justifiable hell two visits ago and also…. I do hide my brain. Because sometimes colleagues are jealous.
But maybe they should not be jealous. Maybe they can learn it too. Maybe I can teach. Maybe….
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