sing

For the Ragtag Daily Prompt: dead.

I took this in church two weeks ago. What does this have to do with death? I am thinking of one of the rounds we learned to sing when I was small:

all things shall perish from under the sky
music alone shall live
music alone shall live
music alone shall live
never to die

We sing for birth and death and loss and joy and work and to comfort each other and for harmony. May all the world dissolve in music.

 

deep

today goes deep

I let it

when someone says “You are too emotional.”

it means “I am not comfortable with your emotions.”

it is them not me
I could care less
what they think
what they feel
whether they are comfortable with my emotions
they will be on my shit list
until they learn

I am comfortable with my emotions

today goes deep

I let all the darkness rise
grief
anger
disillusionment
humiliation

and my small child

is wild
with joy

this day is yours
small child

I am with you today
all day
you I the Beloved

no shoulds today
no list
nothing that you do not want to do

food
music
warmth
church
beach walk

I will not clean
I will not pay bills
I will not sit with fools
who say I am too emotional

we can laugh
or cry
or rage

would you like to smash a plate?

no
says small child

food
warmth
outdoors
birds
deer
music of the spheres

here
dear one

we go deep

early

Driving to work yesterday, I pulled over and took this photograph. It was so beautiful in the early morning.

Yesterday evening I walked downtown after work. Our local Kiwanis is working on a memorial for all those lost at sea. I started thinking and wondering if we have a memorial for those lost to drug addiction, lost to domestic violence, for lost innocence.

This photograph is for all those losses.

 

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.

Speaking up

For yesterday’s Ragtag Daily Prompt: justice.

I keep hearing “Why didn’t she speak up sooner?”

I spoke up. I was 7. The abuser was a neighbor. Nothing was done. I thought it was my fault, that I was not a virgin, and that at age 7 I was pregnant. I did not understand puberty. I spoke up to my mother, who dismissed it.

So I did the only thing I could: I tried to protect myself and my four year old sister. I told her never ever to go near that neighbor. And I never went near him again.

I was taken for a well child check a month or two later. I didn’t say anything but I thought that surely the doctor would have noticed if I was pregnant, so I must not be.

I grieved on the school bus, thinking that I was the only girl who was not a virgin. I was wrong about the not a virgin, but I also was probably wrong about being the only girl.

I didn’t even realize that hello, I was seven, it was not my fault, I didn’t even understand what was happening. I didn’t understand until I was in college and heard a radio program about how women who are raped feel guilty. Here is a poem about that realization: The bacon burning.

So do you think I spoke up after that? Why would I? No one helped me and I was silenced. I learned this lesson: no one will help and I am on my own. I did speak up in medical school: Make a difference.

Where is justice? And do you really want us ALL to speak up now? About ALL of it?

When I was in my early teens, a friend of my parents french kissed me. He said, “I wanted to be your first french kiss.” Hello, I avoided him after that and did I want a french kiss from an old friend of my parents? He had a PhD but no boundaries, no emotional intelligence and poor ethics.

Shall I go on? In college I worked in two labs: both fruit fly labs. In one the graduate student was professional, courteous and quickly gave me a raise. In the other, I never saw the professor again and I was ignored. I went to resign from the second. The PhD professor said, “What do you plan to do after college?”

“What do you mean?” I asked.

“Do you plan to get married and become some man’s cow?”

Oh, really? Do you Mr. PhD professor refer to all married women as men’s cows? Would you have the same conversation with a male student? I quit. I don’t like you or your lab and that sort of comment reinforces my dislike.

In medical school we had two female physicians on the faculty. One was married but no children. Residents joked about her, that she had the balls in the family, because they were both physicians. The other was not married, an OB-gyn. We asked her to speak to our Women in Medicine group about children and career.

“If you want to be taken seriously as a physician, you should not have children.” she said.

I asked, “What if we have a house husband?”

“No man’s ego could stand up to that,” she replied.

I have children and a career.

I had worked in a clinic for a year and another provider talked to me. “Do you know that they are paying the other physician (male) twice what they are paying you?”

Oh, really? I set up a meeting with the administration.

“Oh, the male physician is the clinic director, that’s why we pay him more.”

This was a lie. I had been in the clinic for a year and there had never been one word that he was clinic director. The next year they standardized paying us by RVUs: his salary went down and mine went up. And so justice was done, right? No, the male physicians are given jobs such as head of hospice or medical director and extra money. Do they work harder? The jobs are not offered to the women physicians.

A male physician at the hospital was made chief of staff. He asks me in the hall, “Do women physicians just quit because they want to stay at home with children?”

“Do you want a serious answer?” I said. He looked surprised. We went to an office and I discussed that almost all the hospital staff were women at that time and that they have a different relationship with female physicians than male physicians. Most of the administrators were male, white males.

So really, do you want all the women in the US to speak up? Maybe we all should. The above is not anywhere near an exhaustive list, it is a start. This is just from thinking about it for two days. I can fill pages…..

 

 

 

 

stay or go?

For the Ragtag Daily Prompt: migration.

I took this on a beach walk with my aunt and uncle on Sunday. They were visiting from Virginia. They’ve flown back now.

This is taken with the zoom all the way out. I recognized the great blue heron, but in the first picture I can’t tell what the geese are. With a face in profile in this second photograph it’s clear that they are Canada geese.

The geese are migrating but the great blue heron stays and winters over. Most of our hummingbirds migrate, but the Anna’s can winter over. And I have been asked: stay or go? My landlord asks if I will renew my lease for my clinic in February.

I reply that I am waiting on the US Congress. My clinic is more than half medicare patients. 48% are over age 65. Congress is discussing paying a flat fee for medicare visits: about $43.00 dollars. At the moment I do not see how I could keep my small solo clinic open if that goes through. Stay or go? It is stressful. I want to stay. But I may have to migrate like the geese….

I think a frightening number of physicians would either migrate or stop taking medicare patients, opt out of medicare, if Congress passes this bill. The AAFP is fighting it. I contact Congress too, but I am tired of fighting for single payer, medicare for all. Patients spend more on their dogs’ health than their own. How can I do good care and feel valued for $43.00 per clinic visit?

I thought the thing most likely to close my clinic is the cost of my own health insurance. But Congress may close me down by dropping my payments from 48% of what I bill, to less than 25%. Yet they say they want good care for our country….

Message me if you contact Congress to say do not do this. And thank you so much if you do.

The proposal for medicare changes is 1472 pages. So I am supposed to find time to read that and comment on it in addition to taking care of my patients? What sort of insanity is this?

admit deny

For mindlovemisery’s prompt: opposing forces. The prompts are admit/deny and presence/absence.

The pairs bring up my current sadness right away. I am struggling with the realization that we have a pervasive legal substance that works at the opiate receptor, is all over the US, and I have to send out urine tests for ALL of my chronic pain and opiate overuse and anyone on any controlled substance. You say, “but it’s legal”. I say, “Overdose and death risk. I can’t ignore it.” Here is the resulting poem.

admit deny

admit to yourself you deny your addiction
the presence of the drug means the absence of the one I love