Tag Archives: home

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excrescence evolution

I’ve shown a photograph of these fungi from my yard a few weeks ago. They are changing. They still look like mushroom flowers but more mature. The fungal network still has not dragged me or the cats underground. Hopefully the network will be patient during winter break.

For Cee’s Flower of the Day.

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No mosquitoes

Do they really have toes? I don’t know. Probably, tiny insect toes to hold on.

I still have a daisy blooming outside in spite of weather dropping below freezing off and on for a week. We had snow flurries, but further out in the county, they got inches of snow. Port Townsend is in on the Quimper Peninsula, sticking out from the Olympic Peninsula, so all that water gives us a different microclimate.

This is the second year for my “Christmas stick”. I put it up last year because I had these two kittens tearing things apart.

First I need to get the stick to stand. I had a bare stick, with the angel on top, for a week.

Then I cut four branches from the huge tree in my yard and added them to the stick.

The cats wondered, but this year they are not knocking it over so far. I put up lights and decorations yesterday. Not the glass ones: paper and soft ones. Because I’m not sure about the cats.

The cats still aren’t sure about it. We tend not to have a lot of mosquitoes even in summer, partly because the wind often howls up my street. The mosquitoes are blown inland. Too cold right now.

Happy Christmas stick!

For the Ragtag Daily Prompt: mosquito.

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Thaw

This is Tiktok. In 2019 he overwintered at my house. We had snow and it got very cold at night and I worried. But every morning, he’d appear near the feeder when it got light. Then he would throw a mild conniption at me when I went outside with a hot towel to try to thaw the feeder. “Hurry up, hurry up, I am hungry!” He certainly figured out that I was the person who dealt with the feeder. He would buzz me if the feeder was empty, too. He makes a ticking sound, so that’s where the name is from. One of those old things called clocks, with hands, that ticked.

Right now I have two feeders up. I am seeing a female Anna’s hummingbird in the front, chasing others away, and a male at the kitchen feeder. It may be Tiktok still! I have named the female Emerald. I have seen them together in the top of the plum tree, but this is after Emerald chased Tiktok away from her feeder. It’s a bit unclear if they are friends or not.

Meanwhile, Elwha has the opposite of a conniption.

For the Ragtag Daily Prompt: conniption.

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Yammer

You’ve joined my silent dead: doesn’t matter
whether you speak or not. You’d like this song
and be jealous of the skills. I yammer
to my dead, the number rising strong.
At sixty I declare that I am middle aged
Mom dies at sixty-one which feels unfair.
My sister dies at forty-nine, cancer rage.
I watched them both as chemo takes their hair.
You too are dead no words across the breach.
I yammer to you daily in my head.
Agates gleam, treasure on the beach.
You refuse to look, I mourn that you act dead.
You sit stubborn in a rocking chair alone.
You don’t believe your dead will call you home.

For the Ragtag Daily Prompt: yammer.

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rest day

I have been writing daily for a long time but pushed from the start of Novemeber and completed Nanowrimo, 50,000 words and a very rough novel. My shoulders hurt! They have been stiff and sore for days! It is time for a rest day!

Hooray for rest and may you have a rest day too.

One time we were visiting very dear friends in California. We were up late with a dinner. In the morning people got up and floated around quietly in bathrobes. Eventually we decided that it was a bathrobe day and we would lounge around lazily for the entire day. It was very relaxed and felt mildly wicked and we all enjoyed it.

Have a wonderful Sunday.

Oh, for the Ragtag Daily Prompt: rest.

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Roots

Roots of the earth running through the rock. The more I learn about rocks, the more amazed I am. Rocks are formed by volcanic action, melting and hardening, or by sediment, layers over years, or by pressure on one of the other two.

And there are these roots on the beach as well:

An enormous tree will be there one day and gone the next. Or it will stay in position for years and then disappear.

Here are roots from the sea:

I thought it looks like a mermaid or merman, tossed ashore.

More gifts from the sea.

For the Ragtag Daily Prompt: roots.

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Integrated behavioral health

The buzzwords now in Family Medicine. Integrated behavioral health in primary care. I am finding it a bit annoying.

Integrated does not mean race in this context. It just means the clinic should have a behavioral health person.

I suppose that is a good idea maybe, or might seem like one. But what do they think I have been doing for thirty years? Ignoring behavioral health?

Really, primary care is half or more behavioral health, if a primary care doctor gives people time and pays attention. People have an average of 8 colds a year. Why do they come in for cold number 4 if it is no worse than all the others? Because the cold in not really why they are coming in. The cold is the excuse. Notice that the person is there, that they are not that sick, that they do not care that you are not going to prescribe antibiotics.

I have my hand reaching for the door when an older patient says, “May I ask you something?” She came in for something that she didn’t seem to care about, so I am not surprised. I turn back. “Yes.”

“I have friends, in another state. They had a baby. The baby is very disabled.”

I sit down. This is more than 15 years ago, so I do not remember what the baby had. Hydrocephalus. Cerebral palsy. Something that requires multiple doctors and physical therapy and the parents are grieving.

“What bothers me most is that they have to struggle so much for services. There is very little support and very little money set aside. One of the parents has quit their job. It is a full time job taking care of this child and they are frightened about the future. Is this really what it’s like?”

And that is the real reason for the visit. “Yes,” I say. “It can be very difficult to access services, you have to track down the best people in your area, some physicians won’t pay much attention and others are wonderful. And the same with physical therapists and everyone else. Tell them to find some of the other parents of these children. Get them to recommend people. And the parents have to be sure to take care of themselves and each other.”

She frowns. “It’s a nightmare. Their life completely changed from what they thought. First baby. And it is overwhelming.”

“I am sorry. You are welcome to come back and ask me questions or just talk.”

“Thank you. I might.”

“Do you need a counselor?”

“No, I’m fine. I am just worried about them and feel helpless.”

“It sounds like staying in touch is the best thing you can do.”

“Ok.”

The true reason for the visit is often something entirely different from what the schedule says. Sometimes people are there without even knowing why they came in. “Can I ask a question?” That is key. Saying to see people for one thing is criminal and terrible medicine and makes behavioral health worse. There is so much we can do in primary care just by listening for these questions and making time for them.

I have nothing against adding a behavioral health person to the clinic. They talked about “embedding” a behavioral health person in each group of soldiers back in 2010, when I worked at Madigan Army Hospital for three months. I always pictured digging a hole in my clinic floor, capturing a counselor, and then cementing them in the hole. I would have to feed them, though. I always thought that was sort of a barrier. One more mouth to feed. I found it more useful to contact counselors, ask what they wanted to work with, learn who knew addiction medicine, learn who was good with children or families or trauma. And ask patients to tell me who they liked and why. I integrated behavioral health in my community, not just in my clinic, because there is no one counselor who is right for everyone.