Fuzzy Poet Doctor and the small child

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….

Yard Art

There is a fabulous garden in Portland, Oregon decorated with bowling balls.

i have decided to decorate with oxygen tanks.

if anyone has any oxygen paraphernalia, I want it, please.

This art installation is titled “Tethered”. Or possibly “Chained.”

broken

I wrote this poem in 2014. Sometimes you know things without knowing them. Or you know them before you are ready to know them and so…. you forget.

broken

I think you said
“Break her.”

And you told them how.

You told them my weaknesses
and my strengths.

You told them that I twisted your words.

You said, “You twist my words.”
K said, “You twist my words.”
S said, “You twist my words.”
Ko said, “You twist my words.”

and on everything2
they, too, twist my words.

Twist
twisted
fisted.

When the outer is charming and perfect
the damage is inside.

I wear my spikes on the outside.


No one, to date, has been allowed more then
visitation rights
inside.

No one except
you
and my children
and all children.

Only they are allowed inside.

Twist
twisted
fisted.

I am broken.

But I was always broken and knew it.

I hope that no one cut their hands
when they tried to smash me.

Pretty on the outside
deadly on the inside.

Yet I think a spark in you said,
“Break her.”

What you didn’t tell them
is that I don’t bother to lie
because no one listens anyhow
no one ever listened
and so I can always tell the truth
until they stop listening.

because they don’t believe me

but you knew

I tell the truth

And I was already broken.

8/22/14

And this should connect to this: https://drkottaway.com/2014/11/

the virtue of the disconnect

the virtue of the disconnect
learnt early
as a child

they say we are broken
wired wrong
enduring horror

he wakes at night
sleeps lightly

what was your childhood like?
how did you sleep?

it was not safe
we had to get up
leave in the night
gunshots

you survived your childhood

yes, I did

sleeping lightly saved you

yes, it did

you could rewire that
it takes a lot of time
to change the childhood wiring

or you could just
be ok

with sleeping lightly

The chances of a poet reaching us are slim

I wrote this after working at Madigan Army Hospital in 2009 for three months as a temporary doctor. I am posting it here because Shoreacres sent me this link about poetry and medicine.

____________________

I would pray if I could. It seems ludicrous to pray for a poet, but there it is.

It started with two soldiers. The Army was embedding a behavioral health specialists (the new politically correct term for mental health specialists) in units starting before 2010. Soldiers were trained in suicide prevention, instructed to stay with a buddy if they made any comments about suicide. A soldier was to walk his or her buddy directly to the behavioral health specialist or to to higher rank. As soldiers went on their fourth and fifth tours, post traumatic stress disorder, depression and traumatic brain injuries were rampant. Unfortunately, psychologists basically felt like they were putting Power Ranger band-aids on hemorrhaging brain arteries. It wasn’t working.

A soldier was accompanying a convoy in Iraq when an IED went off. Right through the bottom of a convoy truck. The driver died screaming from an arterial groin bleed. Two of the eight soldiers were killed. The truck was abandoned and the rest of the convoy got back to the safe (mostly) zone. That soldier had the glassed ghost look in her eyes and got quiet. The usual response was to avoid someone’s eyes and hope for the best, but another soldier wouldn’t let her alone. She kept asking, “Tell me. What happened?”

The first soldier finally snarled out part of the story.

The second soldier pinned a poem to her pillow, describing the event. Our first soldier came in screaming and threw the crumpled ball of paper at her chest. “That’s not what happened! That’s not how I felt! Not even close!”

“Well, what DID happen!” The rest of the unit tried to hide in plain sight or disappeared to the bathroom or got really interested in books or watching the same video over and over, but the two of them stood face to face and went at it. Words, not fists. The crumpled paper was retrieved, the poem rewritten. It took two weeks before soldier one suddenly said, “That’s it. That’s pretty good. For a poem.” But she was back, her gruff foul mouthed efficient self.

Of course it wouldn’t have gone anywhere if the behavioral health specialist hadn’t joked about it to his superiors. The Army was really desperate. In spite of all the work, the suicide rate was still challenging the combat death rate, and there just weren’t enough people to deploy.

The Army went looking for poets. Four were promptly deployed into units. Two of them turned out to be pretty useless, but the other two: the units thrived. Word started getting around. The poets were swamped with people from other units.

The recruiting campaign: “We want you, yes we do, poet show your heart so true!” was painful, but the Army did not care. And poets stepped forward from within the ranks! Don’t ask, don’t tell turned on it’s head. In spite of the medical community’s cries for waiting until more scientific studies were done, and the press and cartoonists drawing pictures recruiters welcoming wimpy pale asthenic writers with open arms, the Army embedded a poet in every unit, right beside the behavioral health specialist. Oh, of course they tried prose too. The academics had a field day fighting about why prose didn’t work. But it didn’t.

It’s the height of irony that we’re cut off with everything we need, except a poet. A water source, food, ammunition. We’re holding our position. Our back up poet is dead ten days ago, but our main poet got an IED blast. Traumatic brain injury, two weeks ago. We can’t get him out, of course. You would think someone would bleed if they were that bad, but he just can’t hold on to any memory. The soldiers tell him their stories, he struggles and tries, but he can barely hold on to one line. Can’t read, though he can write. Can’t see very well either.

The whole unit is starting to look glass-eyed and haunted. Smith asked to go in the jail yesterday and for the door to be closed. He promptly started screaming. It got quiet after a while so they went in. He was sitting on bunk. “Ok.” he said. “I might come back tomorrow.” Some soldiers are writing their own limericks or free verse. It’s ironic that it hurts morale so much, knowing there’s help available. Knowing the chances of a poet reaching us in time are very slim.

________________________

I will use this for the Ragtag Daily Prompt: comeback.

loyal

For the Daily Prompt: loyal.

I am thinking of the men working with the Weinstiens and the Cosbys. They might have heard a rumor, but they ignored it? Women are free to speak up if there is a problem?

No, gentlemen, actually women are only “free” to speak up if they are rich and in massive groups.

Otherwise, we are dismissed, silenced, disbelieved and ignored.

For me, it was at age 7. Are you going to say I was dressed wrong? I was too sexy? I should not have been alone with him? It’s my fault?

The water is beautiful and reflects the sky. What do you think is there beneath the surface in the depths?

 

damage

This is not about one patient. It is about many. I have permission from the person I gave a copy to: one of many.

what do you say
to the person
with the terrible childhood
with addiction and chaos
and suicide attempts and hospitals
and that was the parents
that they ran away from

and then numbed themselves
in addiction for years
multidrug and chaos
and now stable
working their 12 steps

and grieving
their lost years
and their behavior
unforgiven, it takes time
to build trust after
thirty years of damage

and grieving
the next generation
following the same
path and feeling helpless
to stop them
and guilt for their
contribution

it is not a matter
of a pill
of a diagnosis

the simplicity of stopping
of getting clean
joy and pride
yes

and then the hard work
of grieving
begins

 

____________________________________________________________________________________________

I took the photograph at the Renwick Gallery.

Through storm and fear

This is for photrablogger’s Mundane Monday #34.

I was downtown in the early morning for coffee and a walk. I walked out to Port Hudson. The wind was blowing very hard and the rigging was singing that eerie whistle wail. There are giant cleats out as both seats and advertising. I put one of my earrings on the cleat and took the picture. The earrings were my mother’s. After she died I looked at her jewelry. She loved little boxes and I was trying to understand the organization of the earrings. It was not by value, since plastic and gold were all mixed together. She was an artist and organized the earrings by color. These little plastic eiffel towers were in the box with red and pink earrings of all sorts. They are probably at least 30 years old. The tower looks so small against the black cleat with the rainwater. I hope that we can all care for each other through storms and fear.