Tag Archives: Beloved

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Heart call

I am lying in bed and missing my heart.

I prayed to the Beloved to fall in love and I do. I happen to be terribly sick because the Beloved is teaching me to take time off and not just work harder and longer to avoid grieving. This is the second lesson. Or the fifth, depending on how I count it. The previous one was two months, this will be ten.

But early on, before I realize that death is standing in my doorway, I am at a picnic. A sports picnic with parents and teens and some younger children. I see a man who has been flirting with me be nice to a tween girl. My heart falls out of my chest and attaches itself to him. It follows him home.

He is quite spectacularly wrong for me. I know it but my heart doesn’t care. And he is a liar, manipulator and a slut. Familiar ground, just like my family. I go to his place and try to catch my heart, but it is stubborn and skitters away from me. It is covered with sawdust, cat hair and motor oil. Also rabbit fur. He raises bunnies for meat and kills them. I cuddle the babies and then he does too.

My heart is brutally stubborn. I tell it it is stupid, it will get hurt, he doesn’t want it, all the usual stuff. I think the Beloved is laughing at me. By January I revise my prayers. Ok, Beloved, you win AGAIN, I am STUPID, now I want NOT ONLY to fall in love but to fall in love with someone who loves me back. I am so stupid I can’t believe it.

The Beloved ignores me, since my heart is already gone. Damn it.

The man tells me a dream. He dreams that his son is stuffed inside a giant teddy bear to keep him safe. He is fighting a war alone, being shot at and shooting a multitude of enemies. He tells me that his son is trained. If he needs to come out of the bear, he will be angry and he is trained to kill. Another dream is of zombies coming up from the shop and attacking the door. He and a teen or two are trying to hold them off.

There are no women in his dreams. At least the ones he tells me.

Uh, Beloved? Shit. I dream of angels, as many angels as there are stars. I meet with my minister to challenge his ideas. “The people in dreams are aspects of ourselves, ok, but not angels right? I can’t have that many angels. I was raised atheist, damn it.”

“The angels are aspects of yourself.”

And zombies…well, we’re well matched on a psychic level, right? I have enough angels to handle any number of zombies and more.

I connect with his small child self, because our small child selves are so alike. Abandoned at the same age and afraid and with desperate courage.

His pattern is obvious from the start. Mapped out like a constellation. I tell my heart, but it scurries up ladders, into boats, down the metal stands, under cars. It plays among the tools. I tell it to be careful of the saws and tools and it ignores me.

He lies and ignores emails and lies again and avoids me when he’s done something that will hurt me and like, obvious, duh. I get angry, but my angels map a new path to his small child each time. Boundary after boundary after boundary.

And now I am in contact only by text. Only by distant virtual message. He is showing up again, of course, because that’s the pattern. He has tried so hard to make me angry and make me abandon him in rage. I don’t really care. He fixes the leak on my boat that I asked him about over a year ago. He texts about installing the bilge pump. He offers to bag up the cushions and put them in his loft.

No, I reply. I have room in my house.

The only things left at his shop are a broken outboard, pipe clamps that I inherited from my father and my heart. I will go to get them.

I lie in bed, thinking of getting the motor and clamps. I think of asking for my heart too. But he has never noticed that he had it. I didn’t tell him. It was obvious. And he didn’t want it. So why would I tell him now?

And then I think, I can just call my heart. I don’t need to go in person.

I call my heart. Come home, I say. He never noticed you. You could stay, but we have done everything we can. He is still fighting the zombies, he doesn’t know he is fighting himself. He is fighting his own feelings. Come home.

My heart comes home.

It is in my chest. Filthy, sawdust, bruised, motor oil, banged up, with old tears that I mended with ribbon and dental floss and sewing thread and artificial cat gut.

Welcome home, my heart. Welcome home.

This is for the Music Prompt #63: Daniel Powter Bad Day. I took the photograph on the train from Chicago, in the evening in a storm. Prayers for those hit by the hurricane and other disasters.

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Fraud in Medicine: Heartwood

Here in my neck of the woods, people are continuing to quit medicine. Two  managers who have worked in the clinics eaten by the hospital are leaving on the same day, after 30 years. And another woman doctor, around my age, is retiring from medicine. She is NOT medicare age.

Meanwhile, the Mayo Clinic is publishing articles about how to turn older physicians into “heartwood”.

http://www.mayoclinicproceedings.org/article/S0025-6196(15)00469-3/fulltext

“As trees age, the older cells at the core of the trunk lose some of their ability to conduct water. The tree allows these innermost cells to retire…. This stiffened heartwood core…continues to help structurally support the tree…. Here a tree honors its elderly cells by letting them rest but still giving them something meaningful to do. We non-trees could take a lesson from that.” Spike Carlsen

Oh, wow, let’s honor the elderly. Even elderly physicians. Instead of what, killing them? Currently we dishonor them, right?

But what is the core of the issue? Skim down to “Decreased patient contact”:

“Already, many physicians are choosing to decrease their work to less than full-time, with resultant decreased patient encounters and decreased institutional revenue. Prorating compensation to match full-time equivalent worked will aid in financial balance, but the continued cost of benefits will remain. However, when that benefit expense is compared with the expense of recruiting a new physician (estimated by some to approach $250,000 per physician), the cost of supporting part-time practicing physicians becomes more attractive.”

Ok, so the core of the matter. “Decreased institutional revenue” and the employer still has to pay BENEFITS. NOTHING ABOUT THE QUALITY OF CARE FOR PATIENTS.

Again, the problem is still that you can’t really “do” a patient in twenty minutes, and that full time is really 60 or more hours a week. To be thorough, I  have to absorb the clinical picture for each patient: chief complaint, history of present illness, past medical history, allergies, family history, social history (this includes tobacco, drugs and alcohol), vital signs, review of systems and physical exam. And old records, x-rays, pathology reports, surgical reports, laboratory reports. I fought with my administration about the 18 patient a day quota. I said: ok, I have a patient every twenty minutes for 4 hours in the morning, a meeting scheduled at lunch, four hours in the afternoon. When am I supposed to call a specialist, do refills, read the lab results, look at xray results, call a patient at home to be sure they are ok? The administration replied that I should only spend 8 minutes with the patient and then I would have 12 minutes between patients to do paperwork. I replied that they’d picked the Electronic Medical Record telling us that we could do the note in the room. I could, after three years of practice. But it nearly always took me twenty-five minutes. I would hit send and our referral person had so much experience that she could have the referral approved before my patient made it to the front desk. BUT I felt like I was running as fast as I possibly could all day on a treadmill. Also, the hour lunch meetings pissed me off. I get 20 minutes with a patient and they get an hour meeting? Hell, no! I set my pager for a 20 minute alarm every time I went into a meeting and I walked out when it buzzed. I needed to REST!

After a few weeks of treadmill, I dropped a half clinic day. But of course that didn’t go into effect for another month and I was tired and ran late daily. And every 9 hour clinic day generated two hours of paperwork minimum: nights, weekends, 5 am when I would not get interrupted and could THINK. Do you really want a doctor to review your lab work when they are really tired and have worked for 11 hours or 24 hours? Might they miss something? It might have been best if I had been quiet and just cancelled two people a day, since the front desk knew I was not coming out of any room until I was done, but I argued instead.

The point is, you would like to see a doctor who listens and is thorough. You do not actually want a medical system where there all these other people who read your patient history forms and enter them in to the computer and your doctor tries to find the time to read it, like drinking from a fire hose. If we want doctors and patients to be happy, then doctors need time with patients and we need to off the insurance companies who add more and more and more complicated requirements for the most minimal care. One system, one set of rules, we’ll fight over the details, medicare for all.

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Red rock

Two days ago I went on a bike ride near the C & O Canal and we walked to this old stone cutting mill. Rocks were cut at the Seneca Quarry and and down the canal, which ends in Georgetown, and used for many buildings and monuments. Seneca Red Sandstone is used for the Smithsonian Castle. Beautiful.

This is for photrablogger’s Mundane Monday #75. He has sand and this is sandstone.

 

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I will marry only he who defeats me in battle

he
I am not really that attached to gender.
I’ve always thought that love is love
and who cares what birth sex or chromosome arrangement
people have
since nature’s diversity
is beyond insane

marry
I am not sure I would marry again
there is so much attached to the archetype
of a married couple
and no two are alike
in their conscious
much less unconscious
and then project the unconscious expectation
it makes me tired just thinking of it

battle
I agree that we are all fighting a battle
but I think it is always with ourselves
avoid avoid avoid
things that we fear
when we should go towards them
and embrace them
for our fears are the demons
we’ve chained in our unconscious

defeat
what is defeat?
loss of money?
loss of power?
the only defeat I have
is when I try to avoid myself
my true self
my dark self and my light self
there is no defeat
except my own failure
to admit my true self

I love who I love

whether they love me back

or not

 

I took the title from here: http://everything2.com/title/I+will+marry+only+he+who+defeats+me+in+battle and published there as well

 

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End of Life Plan

My End of Life Plan and Wishes are as follows:

1. My plan is that my life should end after a half day of skiing for free at age 125 or 126.
2. My wish is to ski quite brilliantly, smoothly and gracefully, though not as aggressively as at age 110 and below.
3. My plan is that other skiers will ask who that brilliant skier is and that all the lift operators will know.
4. My plan is that I will have a delicious lunch, with a glass of champagne, in a condo overlooking the slopes.
5. I plan to have a hot tub and then a massage from one of the many handsome men who flirt with me.
6. My plan is that I will sit in a comfortable leather armchair with my feet on a foot stool, while three of my male friends vie to be the one to bring me the second glass of champagne.
7. My wish is that I will not need any cosmetic surgery or false eyes or ears or teeth or joints or heart valves and will retain my spleen, teeth, gall bladder, appendix and brain in full operating order.
8. My plan is that I will not be on prescriptions, medicines, vitamins, supplements, medical foods, or nutraceuticals nor under the care of any quacks of any sort.
9. My wish is that my male flirts will all think that I am not a day over 75.
10. My wish is that I will be listening to live music, a woodwind quartet or string quartet, just dropped in to say hello, along with three of my great grandchildren, showing off their olympic ski medals, summa cum laude graduation documents, or Nobel prizes.
11. My plan is that after the quartet leaves, I will fall asleep….
12. ….and not wake up, and that though my attendants are sad, none of them throws themselves off the balcony over the cliff and are all surprised at my true age and at the bountiful gifts I have left to each of them with proof that a long life and compounded interest have excellent results. My children, grandchildren and great grandchildren will live long and prosper as well.

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death in childbirth

When I was in residency, one of the obstetrics-gynecology faculty asked us, “Women died in childbirth. What did they die of?”

We were silent. Stumped. Infection? Well, when there was no infection control and the male physicians went from room to room with no hand washing, yes… but….

Preeclampsia? No. Not that common. Eclampsia? Ditto.

“What if a woman is in labor and the baby is stuck? What do they die of?”

Ick. “Bleeding?”

“The uterus contracts until it ruptures. It contracts until it is thinner and thinner. If there is fetal malposition or a hand presentation or transverse or certain breech positions, the uterus ruptures and both bleed to death.”

We were all silent.

When I hear people bemoaning caesarean section and too much surgery and too many interventions…. I remember what women died of. All the stepmother stories. In the 1797 diary I am reading, the “lady” dies of a fever. She is 24 years old. There is no surprise, just sorrow. The author writing is the same age and grew up with her and grieves, but goes on.

We would like to think this is in the past, but it isn’t. It still is going on, right now, in  poverty stricken areas and war zones where the hospitals have been destroyed, the medical people have left, there are no services…

When I was still delivering babies, I would tell patients: my ideal labor plan is the baby comes out and I hand it to you. And the placenta comes out and the baby nurses and I don’t seem to be doing much. But that is not always what happens. I do not have control nor do you. I will only intervene if I think it is your life or the babies life or both….

http://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/1471-2393-14-43

http://www.msf.org/en/article/perils-childbirth-democratic-republic-congo

http://www.who.int/maternal_child_adolescent/documents/childbirth/en/

http://www.who.int/mediacentre/factsheets/fs348/en/

Donate:  http://www.doctorswithoutborders.org/

The picture is me on my maternal grandfather’s lap. I was one very lucky baby. My mother had tubuculosis through the pregnancy. She coughed blood in her 8th month. If there had not been medical care and a Tuberculosis Sanitorium to be born in, I would not be here.