Tag Archives: happy things

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Happy no

Name, noun, nut, gnome, know, no…

I have a nutty streak, a silly streak and love silly things. It helps me to balance clinic. Sometimes things are hard there, I hope to be able to do something for many people that I see. Half my patients are over 65, one is now 100, and no one lives forever even if I recommend the right things and they live a medically perfect life. I am always mourning for someone.

So my nutty streak comes out with listing words for the letter N and adding gnome and know. Are they N words or not? I think they are.

And my happy thing today is the word NO. How, you say, can NO be a happy thing?

This weekend I wanted to do too much. I wanted to attend a retreat about change that went from 9:30 to 3:00 but I also was already tired. It would be with a  group of people that I don’t know well, so my introvert side would be on guard. My son was coming into town and I needed to make choices and save energy and say no to myself. I went to the retreat, but only for two hours. I wanted to stay longer but did not. And that protected my energy for the next day and this busy week.

Do you argue with yourself and want to do too much or something your shouldn’t or spend too long on something that you didn’t plan to? Look, I thought this would be a very short post to catch up….

N

There were three great blue herons on the beach the other night, and then an eagle in the surf. The herons were fishing but also watching the nearby eagle, the people on the beach, loose dogs going by, and each other. Their feathers were windblown and they made me think of teens at a dance, looking at each other with interest, but pretending they were more interested in fishing.

Happy Blogging from A to Z!

 

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Love, labor, laughter

Blogging from A to Z, my theme is happy things. Love, labor, laughter, I love my labor, my work (except when it is driving me nuts, of course). I love my family, including my cat, my friends, taking photographs, writing and blogging, the list goes on and on. I have a very silly streak and love to laugh.

I love being in my local Rotary. I get to work on real world problems, local and international, meet exchange students, and work with a diverse group of people in my town.

The photograph is of Patrick, in Hawaii, with my “stealthie” shadow, up at 9600 feet.

And we found a Rotary meeting in Waemea and showed up and were welcomed. We had a delicious lunch. This photograph is of the club banners brought to their club from all over the world! I didn’t think to bring a banner from our club, but will take one on the next trip.

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I’m still a day late, but hooray for the letter L.

L

 

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I for intent

My Blogging from A to Z theme is happy things. Three happy things with intent!

We took a beach walk two nights ago and the beach was full of birds. Three great blue herons, three oyster catchers, an eagle landed in the surf, crows, gulls and the flock of brant. There were various dogs being walked, who were not chasing any of the birds, hooray for that!

I love this great blue heron: so intent on fishing. What are you intent on? Intent, intention, attention, retention. So many tents….

I was intent in clinic yesterday. We had a packed schedule and I started thirty minutes early to add an extra patient and I had good intentions to run on time. I didn’t. By the last person I was running 20 minutes late, and three people were grumpy. No, four people were grumpy because I have to add myself to that. I had good intentions, but I can’t control what problems people bring to clinic and they don’t always fit in the time allotted!

Here is the eagle, also intent on dinner. I don’t think of bald eagles as surf birds, but this one had caught something and landed. We did not get close, not wanting to disturb things.

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The photographs are taken at the Port Townsend Bay beach below Chetzemoka Park. Happy blogging. 

I

 

 

 

 

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hipaa, health insurance, and health information

Blogging from A to Z, my theme is happy things. Letter H is for HIPAA and health insurance and health information.

H is for hipaa: the Health Information Portability and Accountability Act, from 1996. I’ve been thinking about HIPAA and I have a question: if the patient handouts are supposed to be written at the fifth grade reading level for patients, why doesn’t Congress have to write laws at the fifth grade reading level?

Ignorance of the law is no excuse, right? Everyone in the US is supposed to follow the laws. Have you read them? I am supposed to follow HIPAA, right? I am supposed to follow the Affordable Care Act, (also nicknamed ObamaCare). It is 3600 pages long. It is written by Congress and attorneys.

What about health insurance? Have you read your health insurance policy? It’s a contract. If multiple US citizens have difficulty reading, why isn’t health insurance written at a fifth grade level?

CMS too and triwest and medicaid. I do not have time as a physician to learn the language of their websites.  I run my own small practice. It is infuriating to try to read, understand and follow medicare, medicaid and Veterans Choice rules and they change every year. We ask why health care costs so much, and then there are over 800 different insurance companies, each with multiple insurance plans, and more and more people are hired to try to navigate and understand the rules. It’s ridiculous. We need a single payer system so there is ONE set of rules. Everybody in, nobody out.

At the UW Telepain telemedicine, I said that I show chronic pain patients the link to the Washington State Law about opioids and pain medicine.

One of the faculty said, “Patients can’t understand that.”

I said, “Well, I’m supposed to follow that law and I am not an attorney. ”

My patients are all smart in something. Some of them can’t read well. I have had two recently that I recognized a reading issue in the clinic room when I gave them a survey tool to fill out. I promptly said, “Let’s do this together.” I read them the questions and the answers. They are not stupid, but I am not sure that their reading skills were up to the form.

I am not using the American Academy of Family Practice patient handouts much because I think they are too dumb. I use the Mayo Clinic much more. I direct patients to the CDC, to NIH, to the Mayo Clinic website. Sometimes my patients may not be able to read at that level, but I think everyone appreciates being treated with respect. I am also happy to go over and explain more about a topic. I also warn them that there are loads of crappy medical sites and pseudo scientific sites and misinformation on the internet. If they want to look something up, I want them on a decent site.

Now how are these happy things to think about? It makes me happy to question my own behavior and my own assumptions. It makes me wonder how our country can insist that medical information has to be at a fifth grade level but lets Congress write laws that I find nearly unreadable.

Now I am warning my patients that a federal law may go into effect in January 2019, about opioids, and that it will be different and override the state law. Change will keep coming.

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The photograph is from the beach last night: brant. What would the flock think about our health insurance? 

 

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feeling, farm, friends

My theme is happy things: feeling, farm and friend.

Feelings: I find our culture a bit bipolar about feelings. Love and friendship and joy are celebrated and other feelings are labelled “negative”. Grief, fear, anger, basic  grumpiness. I see posts about staying away from “toxic” people and away from people that are “downers”. But we all experience all of these feelings. Feelings are as important as thoughts. Feelings are quicker that thought, hormonal and electrical information in brain and body: we pull the finger out of the candle lightning fast, we jump out of the way of the swerving car, we feel the cascade of fear if someone is following us at night. The feeling is not always correct — we may feel threat from someone who is not threatening us.

In high school my daughter said that most of the arguments she noticed were someone saying something not well thought out or offhand as they left. It is misinterpreted, stewed over, discussed with other people and then  the person who felt that it was “at” or “about” them will react. The first person is shocked and doesn’t even remember or understand the trigger. Misunderstandings all the way.  We have to step back from feelings and have the courage to be vulnerable and ask, “What did you mean when you said that?” We all get grown up and over that after high school… well, I try.

Farm: I got my first local CSA box on Wednesday, lovely vegetables straight from the farm and tulips! I get an email each week and often with recipes.  I love my CSA box. I eat more vegetables too, because I don’t like to throw them out.

Friends: My  friends give me  such joy! I have an email this morning from friends in Berlin, Germany! I have not seen them for more that a decade but they are coming to visit this summer! What absolute joy!

And may your day be joyous too!

F

Another photograph from Hawaii, my friend Patrick and one of the lovely green turtles. For scale….  

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Eeeeeee

My theme is happy things, though sometimes they are things where I am trying to find the perspective to love what is happening.

When my son was little, I had Dr. Suess’s ABCs memorized: Ear, egg, elephant, E, e, e!

My words today are everybody, embody and evening.

E for Everybody. Everybody in, nobody out! This is one of the calls for Healthcare for all, and I am still a Mad as Hell Doctor, working for single payer.

Our state representative was here a year ago and said that there is not a mandate for healthcare for all. I said, “I politely disagree. We already have a law in place that emergency rooms cannot turn anyone away. They cannot refuse to treat a person. This is a mandate for care. Unfortunately, the emergency room is the most expensive and inefficient care, unless you are about to die. The emergency room cannot do chronic care: it cannot help people stop smoking, help lower blood pressure, help people with chronic illness such as diabetes, do preventative care like pap smears and checking kidney function to stave off renal failure. We have the mandate: now we need the political will to change to a single payer system that gives good care. A patient can see me in my family practice clinic a dozen times for the cost of one emergency room visit.” S o, everybody in, nobody out. The law that insurance companies can ONLY keep 20 cents of every dollar does not comfort me: I want my dollar to go to health care for everyone and not 1/5 to profit!

Embody: what do I embody? What do you embody? Do you treat your body well? Do you thank it? What is it carrying?

I see people so fixed on success and progress and getting goals, that sometimes we don’t pay any attention to our bodies. We treat the body like a tool, like a hammer or a wrench, use and abuse it, try to make it conform to some idea of external beauty, get angry when it breaks down. Fix me back to where I was three years ago, when I could work 12 hours a day and never ever paid attention to my body. Bad food, tobacco, alcohol, marijuana, gallons of caffeine, energy drinks, sugar, illegal drugs, no exercise… and then we are surprised when it breaks down? Even exercise is seen as an inconvenient and necessary job, like buying new tires for the car. When people say get me back to where I was, I ask, “Back to working the 12 hours a day that caused this damage? Do you think that is a good idea?

And I include myself in that! I have had pneumonia with sepsis symptoms twice. The second time I thought, how dumb I am! My father died and I did not take any time off. I just kept working and added executor to my jobs and cried daily. Is it any surprise that after a year of that I became ill? Now my goal is to not do medicine for more than forty hours a week and to listen to my body and to take breaks!

Evening: the sunset. I am so grateful for the day, for the night, for the light changing and the world turning, for the stars and the moon and the sun and the glorious, gorgeous, generous world.

E

This is an evening photograph from Mauna Loa last week.

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Big D, little d, what begins with D?

Happy things starting with D:

Discrimination, death, delight.

I am happy that slowly, slowly, it feels as if there is change in the world and a decrease in discrimination. It is NOT gone by any means, but I think it is slowly being eroded.

My parents had a party when I was two and they were both in college. The party was raided in Knoxville, Tennessee in 1963 and my father was taken to jail. My mother and I were left alone and she was afraid we would be lynched by the neighbors. The next morning the paper wrote about a MIXED RACE COLLEGE STUDENT PARTY possibly with orgies. My parents were both suspended from the University of Tennessee.

They were both reinstated after a hearing, because there were no drugs, no underage drinkers, and it was not illegal to have a mixed race party. My parents never touched marijuana ever and I think it was because of that party. I don’t remember it, but I still feel cautious at parties and in crowds. My mother refused to return to the U. of TN and eventually finished her undergraduate degree at Cornell. My parents were so notorious that we left Knoxville as soon as my father graduated.

I grew up learning protest songs and work songs and joke songs. My mother joked about the party and it was years before I found out how terrifying it was. My mother joked that they sat at the one liberal table at the University of Tennessee. I hate discrimination and I do not understand it.

Death: is death a happy thing? Death is as much a mystery as life, and we cannot have one without the other. How could we value life if it were eternal? And we’d also get awfully crowded. I have the privilege of caring for all ages in clinic, all genders, any race that comes in the door, age newborn to 104, what joy! I get to be present when someone is dying and try to help the person and the family. There is no single idea about death or about how to “do it right” and often families struggle with multiple opinions and ideas and feelings. Death is as intense as birth and I have had the privilege to attend both.

Delight: there are many things that I find difficult and depressing, but I find delight too! The latest morbidity and mortality report from the CDC on overdose deaths, up from 52K in the US in 2015 to 62K in the US in 2016: Overdose deaths involving opioids, cocaine and psychostimulents — United States, 2015-2016. We have to work harder to prevent addiction, why do we choose addictive substances, why do people think it won’t happen to THEM?

And yet, I still find delight, taking photographs of bird, seeing patients that I know well in clinic, we laugh often, finding joy walking outside, my family and friends.

D

The photograph is from Mauna Loa last week. It is not a giant dinosaur nest, it’s a cinder cone. At least, that’s what a geologist claims….

 

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birds, beauty, brains

Three happy things today: Birds!

Not a great photograph, right? I like it, partly because it was such a challenge. Still on the big island of Hawaii, we spot two very small birds building a nest. I am zoomed all the way in and holding the camera up to catch a glimpse when one flies in. They are very quick and there is lots of greenery in the way!

I am happy about brains. No, I am not a zombie, I don’t eat them, I just like that my work engages my mind. I learn new things daily from patients, from specialists, from looking up engaging questions! Medicine is changing continuously and I am grateful to be part of it.  (Ok, I am not grateful that insurance companies are increasing prior authorization exponentially.)

I am happy about beauty. Here is another glimpse of our small nest builders and we think we’ve identified them.

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I think that this is a common waxbill, also not a native bird. Either that or a black-rumped waxbill but neither of us got a good shot of the back. Hooray for spring and nests.

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admire

Three happy things for the letter A:

I am thinking of the women I admire, whose names start with A. Anne, Amelia, Azula, Artemis, Adele.

They run businesses, work at the post office, make gorgeous hats, teach dogs and their owners, work in healing.

I am so happy I have so many women, whose names start with A, who I admire!

That is two happy things: the third is the abstract photograph and abstract art, that encourages me to dream.

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Happy things

This is for the Blogging from A to Z theme reveal:

I choose my theme today: Happy things.

When we first moved to Port Townsend, my mother had recurrent of ovarian cancer. My husband was very unhappy and my son had to switch schools in January, leaving a teacher that he loved in Colorado and all his friends. I was working and finding learning all the new phone numbers, specialists, acronyms and patients difficult.

After a while, I instituted Happy Things. At bedtime I told my son that we each had to say three happy things.

“But mom,” said my son. “I am not happy.”

“Well,” I said, “They don’t have to be very happy.”

“What do you mean?” he said.

“Just a little happy. Like, only three patients cried today and not four. No one died today in my clinic. I didn’t forget my lunch like yesterday.”

He thought about it. “We didn’t have the awful pizza at lunch today.”

“Good job! What else?”

“I only got yelled at by the teacher twice.”

“Great! How about the other kids?”

“I only got hit on the playground once.”

“Good job. Yeah, stuff like that. A meteor didn’t hit the school and destroy everyone.”

“I’d get out of school then.”

“If you survived.”

So we did happy things every night and sometimes they were very dark and gradually they got better. I will do happy things from A to Z and some days they may only be a little happy….

The rat is for my son. He has pet rats. This rat is loose on Hawaii, which is not a happy thing for the native birds, but I think the rat may be happy. It came down the tree and was then holding very still, trying to convince us that we couldn’t see it. Be careful, rat, because we saw a mongoose there too.

For the Daily Prompt: toxic. Is the rat toxic? An immigrant? I would immigrate if I had to, so how can I scorn others who do?

It is a small picture, because I had my phone zoomed all the way in. Hello, rat. We see you.